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

We have a culture that actually has ignored women in the research field. You have this great line, which is, "Women are not small men." What the hell does that mean?

But we're told that we just need to do what the men are doing, but we're still not getting the same gains that the men are. Almost all the stuff you know with exercise and nutrition has been based on male data and generalized to women.

What are the nutrition mistakes that women are making mostly now?

They're listening to all the fad diets and they're listening to the rhetoric that's on social media. And they're not really paying attention to, okay, who am I? How do I respond? When am I hungry? You're not going crazy, you're just being compared against the wrong baseline. We need to stop the rhetoric of old is frail.

What you're basically saying is that by lifting heavy weights for women, it slows down Alzheimer's risk.

The very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with themselves. For longevity, you have your genetic code, but it doesn't have to dictate what's happening.

Dr. Stacy Sims is a leading exercise physiologist and nutrition scientist whose research focuses on sex differences in training, nutrition, and health, particularly for women. If you've been dealing with anxiety, low energy, or trouble focusing and still feel like you're missing something, you're not alone. That's why I created the Brain Shaping Academy, a new program that looks in places most people never think to check, like nutrient deficiencies, the health of your gut, metabolism, your immune system, and lots more. So join the waitlist and get special pricing at drhyman.com/brainshaping.

Stacy, welcome to the podcast.

Thanks. Great to be here.

All the way from New Zealand.

Yeah, but I'm home from New Zealand to home.

You know, your work is really unique because you're not a doctor, but you're an exercise physiologist. You're a scientist and you double down on things that are health, not disease.

Correct.

So most medicine, most doctors are focused on disease, not health. They don't even know about health. In fact, I, my joke is, you know, we never took a class in medical school creating Health 101, right? So we have no clue what health is. We just think it's the absence of disease, which it's not. And we don't know how to advise people on how to navigate the phases of their life to induce, create health. And your work is so great because You know, men have had a lot of focus. We have a misogynistic culture. We have a patriarchal culture. We have a culture that actually has ignored women in the research field predominantly. And there are studies, but they're kind of like, kind of mostly in the, in the margins. And, and what your work has done is really focused on how, how do we think about advising women to take care of themselves through the life cycles? You know, premenopause, perimenopause, premenopause, all the, all the different phases that are important. And, you know, I, I, worked for almost a decade at Canyon Ranch where most of my patients were, you know, 35 to 60-year-old women. And so I kind of had an immersion course in all the things that women were experiencing. And it was just so clear to me how woefully inadequate it was to just sort of deal with them. And you, you really taken this on really setting a different conversation for how to think about women's health and fitness. And you have this great line, which is women are not small men.

Right.

Okay.

Yeah. Yeah.

What the hell does that mean?

I know.

Other than the obvious thing, which is they're different.

I find it funny that that's become like the resonating mantra and tagline because it— or the origins were when I was at Stanford doing my postdoc, I was also doing some undergrad teaching. And in the afternoons, everyone's sleepy. And I would talk about training principles and practices and trying to go through all the systems that were sex differences. So I would open it up, "Women are not small men." And that was the subtitle of the class that I was teaching. And you'd say that and people are like, what are you on about? What does this mean? And then I'd say, well, you know, the cardiovascular system, there are inherent differences. We know from Jennifer Trimmel's work that a heart attack comes on differently for women versus men.

Right.

Why? So I'd get into all the nuances and, and hopefully enlightening all the students.

Yeah.

And then when I started a sport nutrition company, I was like one of the very first people that ever was like, we need different sport nutrition for women than men. So we had a men's line and a women's line. And the tagline for the women's line was women are not small men, but it was way too early. So we got a lot of pushback.

Yeah.

But still kept trying to pursue it.

Yeah.

And then I kept that tagline cuz people resonated with it so much. And basically it's like almost all the stuff, you know, with exercise and nutrition has been based on male data and generalized to women. And I don't find that appropriate, especially if I'm a woman and I wanna optimize my health in my life.

Mm-hmm.

And so I'm like, okay, I'm running with that. And that's how it kind of got out there.

And you, you've been one of the few people who's really like taken on the, the task of researching women. Yeah, specifically because most research has been on men, and that's come at a great cost to women, unfortunately, right? Because we can't apply the same principles of health and nutrition and exercise to women as we do to men.

So can you kind of talk about that a little bit, how I fell into that? Yeah, I'm a little bit bullheaded because— maybe, maybe not. Um, I grew up in a military family, and I mean, that's kind of how we wanted to be a Navy SEAL. I did want to be a Navy SEAL. I mean, it happened just about a mile from where we are. Saw my house this And yeah, growing up in a military household.

I think you would've been a good Navy SEAL actually.

Maybe, but it wasn't allowable, right? I was—

I mean, I shook your hand. I was like, oh wow, okay. I can't wrestle this girl. She's like, she'll knock me down.

Yeah. And so when you're used to not having any confines on you and you just, your friends are boys, your friends are girls, you do this, you do that. I was running cross country, my like teammates and I would all go for a run, we're all men and women. And then you get divided into the two groups to run the girls' race or the boys' race. And your times aren't that different. Difference. You're like, yeah, okay, whatever, it's just the way things are. But when someone tells you that you can't do something as an occupation because you are not the right sex or the right gender, it really throws you for a curveball and you're like, what? So that sat with me. And then when I got to university and I'm in exercise physiology and all the PDFs and the journal articles and textbooks represented he or they, and the only time they talked about women was in a pathophysiological standpoint. Where they're like, they're anemic, they don't get their periods, they break their bones, they get stress fractures, they get overtrained. And I was like, this is not representative of me. Like, I am on the crew team and we're training hard, but I'm not getting anemic, I'm not breaking my bones. Like, how do I train to prevent that? And no one could answer that question. And I was like, this is not right. Like, why do we put as much work into all the things that we're doing, but we're told that we just need to do what the men are doing, but we're still not getting the same gains that the men are. And so that was kind of the undercurrent, which kind of pushed the trajectory forward of doing research to answer these questions for me as an athlete.

Mm-hmm.

And then my friends who were athletes and then who became coaches and et cetera, going on through the years of their careers too.

Amazing. Okay, well let's, let's get into it. Yeah, let's get into it. Cuz, cuz if women are not small men, what's happening to them, eh, you know, metabolically, hormonally, as they kind of move through their 20s, 30s, 40s, and, and beyond that?

Yeah. So I like to tell people. It really does start in utero when we're looking at sex differences versus hormonal differences. And then when we get to puberty, we really start to see the effects of hormones because we see boys typically get stronger, faster, more aggressive. Girls, their center of gravity changes, their biomechanics change, they put body fat on, and then, oh, here's your period, right? And they drop outta sport and activity. They start to feel very self-conscious, and then that carries forward. Then when we get into our reproductive years, you have either— there's no such thing as a 28-day menstrual cycle. There's all sorts of variation within length, right? And then we have hormonal contraception. What are you on? What's the formulation? What's the generation of the progestin? All of those things have a hormonal effect. Or are you using an IUD or not? So there's so many different things in there. Do you have endometriosis or PCOS? All those affect you as well. And then we get into perimenopause and all the wide variations that happen with hormones and the undercurrent of aging, which also is another factor. And then we get to postmenopause and then we think about the data that accompanies that, it's all male data who is in a more of a linear fashion.

Yeah.

So when we start unpicking it and we see all of these things where women think that they're going crazy, it's like, you're not going crazy, you're just being compared against the wrong baseline.

Yeah.

And yeah, so when we get asked those questions, like, how do you differentiate what is endometriosis versus PCOS? I was like, actually in 2026, we don't have a definitive test. We know that you have symptomology and you can go for an invasive test to find out, but there isn't anything simple to tell you. What are our symptoms? These are our symptoms. Do I really have it or not? You have to go to your physician to find out.

Yeah, that's true.

And, and, and there's a lot of changes, you know, I think, you know, my, my experience, you know, working at Canyon Ranch, you know, taught me that there's this kind of chaotic period of, of, of shift in hormones that happens in women in their late thirties, forties, early fifties. And it's, I, I, It's like the four horsemen. It's like insulin, which is all about blood sugar regulation, and that leads to increasing, you know, belly fat, which women tend to get, but it's not inevitable.

No, it's not.

And a lot of women think, oh, this just happens and they don't have to get that little belly. Two, the stress levels go up because they're kind of in this generation of high stress work. Their grand— their parents are getting older. Their kids are teenagers. It's and their marriages are stressed. It's like a pressure cooker.

Yep.

And so that cortisol's going crazy and then they get thyroid, which also tends to go kind of sideways a lot of the times. And that can be caused by stress, environmental toxins, and that's a big factor, affects 1 in 5 women. And then you got the sex hormones that are all over the place.

Right.

And they, and they're affected by everything, especially lifestyle. What we eat, how we move, sleep, how we navigate stress, relationships, all those things have massive impacts on hormones and affect how women feel and what they can do, what they can't do, and also on their, on their overall level of metabolic and physical health. So that's kind of the soup that they're in. And the real question I have for you is, is how do women properly navigate this in terms of diet? And in terms of exercise. And you know, there's a lot of sort of kind of trendy things like intermittent fasting or, you know, like protein or this. I want to get into kind of all the nitty-gritty of it with you. So like, let's sort of start with the big picture and then kind of go into some of these two subtopics.

Okay. That sounds good. I'll unpack it all for you. Because I think the biggest thing is, is women think it's happening to them. And if you were born with the uterus, you're going to go through this, but if it's happening to you, it doesn't have to be negative. It means that you're gonna go through this, but you can actually take control and see how you can improve and empower your body as it's going through this natural transition. And I think that's one of the biggest things that women don't understand. They just think that they're going to become like an unfit, really unhealthy person, even if they've been active. So if we look at what's happening, we know that in the early 30s, you're, you're fine. And then your mid-30s, you're like, whoa, whoa, wait a second, something's happening here. The training that I'm usually doing isn't quite working. Maybe I'm not training hard enough. So they start to really question what they're doing and try to find different plans to help them lean up or, you know, get a little bit stronger. And then we really see a definitive switch in the 40s. And this is because we start to see a fluctuation of our hormones. We start to see a decrease in ovulatory cycles, so we don't have as much progesterone. We also see a shift in our gut microbiome. Because when you start having a change in your sex hormones, you start having a decrease in your gut microbiome diversity. And unfortunately, with that and the stress, we start to see a drive to increase the obesogenic phyla of the gut microbiome.

And in English, that means bacteria that make you fat.

Exactly.

In your gut, right?

It like makes you crave—

so I gotta translate something.

Yeah, no, no, that's good. Makes you crave simple carbs. Yeah. You know, it extracts more energy from the food.

Yeah.

And a lot of the times in this mentality.

Wait, just, just what you said there, I just wanna double-click on that.

Yeah.

'Cause you, you just don't think people are gonna gloss over your bacteria can control your appetite. Absolutely. And if you have bad bugs in there, you gotta figure out how to reset your gut in order to regulate your hormones and your appetite and your metabolism. Yeah. There's actually a whole thing called metabolic endotoxemia, which means you get basically insulin resistance and diabetes from bad bugs in your gut.

Exactly. And it changes your neurotransmitters as we know, like serotonin, melatonin, even dopamine take a hit when you have more of obesogenic phyla going around. So then that confounds all the variables that are causing anxiety and stress and depression. So when someone starts coming to me and saying, what's going on? I'm like, well, these are all the things we're having. Sex differences, of course, with aging. And we see that when we have the aging conversation that's happening right now, we know there's a definitive difference between the way men's muscle and bone age versus the way women's muscle and bone age. For example, if I start to get a little bit geeky, I'll try to explain. We have two contractile proteins, so two proteins that grab to each other to make the muscle fiber tighten to give you a contraction. One of them is myosin, the other is actin, right? So myosin and actin, they bond. We have different, what we call isoforms of myosin, and we start to have dysfunction.

That means different subtypes of the muscle contracting fibers called myosin.

Yeah. So the main one that really bonds with actin to create a strong contraction starts to become dysfunctional. Then when you also have a change in estrogen, it further exacerbates or, or causes that change. So women's first complaint is they don't feel powerful, they don't have strength. Or runners go, I don't know what happened, my pace dropped from a 7-minute mile to a 9:30, and I just don't know what's going on. Mm-hmm. It's because we're having this dysfunction in our fast-twitch fibers.

Ah, wow. So when we start going, so the quality and the function of the muscle changes related to the hormonal changes, right?

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So we start to see that happens first, and then you have cell death or loss of muscle mass. But for men, they don't have that. They lose muscle mass, so they maintain their fast-twitch fiber function and their strength capacity. Yes, you have to work on it as you get older because you're losing muscle mass.

It works. It takes hard work. I'm 66. I can tell you.

Yeah, it takes hard work.

I gotta work a little harder.

Yeah, it does. But when we start talking about strength training and the conversation out there about strength training, it's not just about lifting weights to failure. To optimize women, we really have to get them to understand that neuromuscular connection. Like, we want to work on the heavier end. But not only that, one of the other sex differences that's really apparent is dementia and Alzheimer's and cognitive decline. And that is exacerbated during perimenopause, partially because of the receptor changes with estrogen dropping. But also we see, uh, like neuron connectivity, or the way that the brain is wired, starts to change when we're getting older, as well as having hormone shift, which causes anxiety and depression. But we see in some of the research that came out even last month that if you're doing heavier load lifting, which is that power range where you're doing heavy loads, 80% of what you think you can do, 5 or 6 reps, then it stimulates neural conductivity improvement in the prefrontal cortex, which is, you know, primarily driving cognition. And then you have other changes in other parts of the brain that help, but all of this helps attenuate or slow dementia and Alzheimer's risks. So if we're looking—

Slow down. So, so you, you just, I want everybody to hear what you just said. What you're basically saying is that by lifting heavy weights for women, it slows down Alzheimer's risk.

Yes.

Okay.

And the reason for that is—

I might stop you occasionally, cuz like you're used to like an encyclopedia and I wanna make sure people understand what you're saying.

It's cuz I'm so excited about it.

I wanna, I wanna know. If you don't mind, I'll just kind of like pause occasionally.

No, that's good.

Until gotta translate.

Yeah, because I'm like, part of the problem is we have brain metabolism change. So we know that glucose is not as effective as a brain fuel. As you know, insulin resistance comes up, glucose isn't as available for other systems of the body. And we want to increase neuroplasticity. So that means how our neurons are forming and firing and talking to each other. And if we create a new motor pattern or we need a stimulus to recruit more muscle fibers, that's that neuro connectivity. And that's what you get at the very low end and heavy strength training. It's a neural connectivity. And that's the important factor in the resistance training concept. I'm not telling people who've never done resistance training to immediately start on that end. Any resistance training is great. You have to—

You don't wanna start with 100-pound weights.

No.

No.

Start with body weight. Work your way up with the eye in 2 or 3 years of getting down to the heavy weights.

Okay.

But this is honestly, I, I feel like I know a lot of stuff, but I, I never heard this before.

Oh my gosh.

I never heard that you, by, by lifting heavy weights, you're increasing your brain connectivity. I know exercise is good for your brain in general, but this particular piece is new to me. So I'm sure it's new to everybody out there listening.

Yeah. It was a randomized controlled trial that came out, out of 100,000 people that was just published from the UK last month. I'll forward it. It's really fascinating because they looked at heavy lifting versus moderate intensity, which is your body weight and your, and your lighter loads and, and, and longer rep ranges. So your 10 to 15s, and it was only the heavy end that affected prefrontal cortex, the moderate weight. The higher reps affected other areas of the brain, which is great. It's a good improvement, right? Because you're still affecting neural connectivity. But for the concern of cognition, we need that prefrontal cortex increased connectivity and functionality. So when we're looking at what are we doing to optimize health, that's one of the first things I say.

But is there, is there any understanding of the timing of this? In other words, if you start like when you're 40, obviously it's better, but can you start as late as 60?

Yep.

And is it gonna achieve the same benefits?

We don't know how robust it is, but that randomized controlled trial was looking at people who were 60+.

Oh, asking for a friend, 'cause I didn't start strength training until I was 59. So you're good.

You're excellent. You're protecting your brain. We're all gonna be having Zimmer frame races, not because of our brain and our bodies, because of our joints. So it doesn't matter when you start. We say start when you can. It's never too late to start.

Mm-hmm.

And we're having more and more research come out in 70, 80-year-old individuals that are showing the heavier rep range which is relative to what you can lift, improves not only bone and lean mass, but also brain health.

That's amazing.

It's like the one thing that everyone should be doing. And I come from a massive endurance cardio background and I've always had strength training as the undercurrent, right?

Yeah.

But now all the research is just pointing to how important it is in today's society where we don't move that much, that we have to do the push-pull motions and put our bodies under load. Not necessarily cardiovascular load, but actual load.

Yeah.

I'm gonna, on the video version of this podcast, I'm gonna give my team my picture cuz I had a, I was like a runner. I would, I was running like 5 miles a day for, from 14 until like 55 or 56, right? And I was riding my bike 100 miles a day or 40 miles or 30 miles. And I, I, and I was lean, but I wasn't strength training. And then I started when I was 59 and then I had a comparison picture of me at 42 maybe and at 62 and it's like you can't believe it.

Night and day, right?

Yeah. And I, I never would've thought that was possible.

Yeah.

But you know, So it's never too late.

No, it's never too late. I mean, I was full endurance too. I ran 19 marathons before I was 20. I did Ironman, I did XTERRA, I did bike racing, and I had strength training on the undercurrent, but I didn't let people know I was doing it because it wasn't appropriate for what I was doing.

I just wasn't doing, I, I was telling myself lies. Like, I've been doing yoga. That's like strength training. Yeah.

I heard that too. But we, I, you probably see this too. We get DEXAs and it's women that look healthy. Yeah. 'Cause they look lean and they're runners and stuff. Yeah. But you get the DEXA and they have a high amount of visceral fat.

Yeah.

Compared to what they should be. And their bone density is relatively low. And they're like, I don't understand. Yeah. I eat clean, I run, I do all this stuff. It's like you're not strength training and you're not eating enough. Because if you're not eating enough, then you're not supplying your body with the fuel that it needs to rebuild. So it's tapping into bone, of course, because it's part of the aging, but also the stress of exercise without enough fuel. And that higher visceral fat is cuz there's a change in our lipids in a conversation between the liver and the, um, fatty acids that are circulating that esterifies them to then be stored as visceral fat.

Yeah.

So we can fix that.

So basically what you're saying is, you know, women who look lean are what we call skinny fat.

Yeah.

Or we used to call it toffee, thin on the outside, fat on the inside. And, and, and you can tell that by doing a special kind of very, very low radiation X-ray called the DEXA scan that measures bone density for osteoporosis, but also measures fat in your body and muscle and the distribution, right? Because a lot of these scales, you can't really tell the distribution, these bioimpedance scales, and you can kind of, kind of get a rough sense, but like your arms and legs could be like, you know, 10, 15%, but your belly could be 30%.

Right.

And that's not good. No. And it, and you may look thin.

Right.

And, and that, and that actually leads to some of the same cardiometabolic risks of heart attack and diabetes and stroke as, as being overweight.

Right.

You're under, lean and overfat.

Exactly. And I often give an example cuz I'll get women who come in and we get the DEXA, we get their bloods and their LDL has suddenly shot up and they've never had problems with cholesterol before.

Yeah.

It's like, well, yeah, that's a dysfunction of estrogen cuz estrogen kind of helps with cholesterol and risk factors. And when you start losing that, if you are not eating enough and you're not doing, uh, exercise stress to help the body understand what's going on, then you're gonna have this increased lipid negative lipid profile as well as poor bones. Not really fantastic muscle quality, and we see this increase in visceral fat.

So let's sort of dig in on the, on the, on two bits of this. One is the food and one is the exercise.

Yeah.

Because those are independent variables that we have control over, right? We can't control our genes. We can't control our parents. We can't control our height, our age, but these are things we can control. So on the exercise front, you know, is there a difference in what women should be doing when they're 20, 30, 40, 50, 60? And if so, what is it? And, and can you unpack that for us? And, and what are the, what's the right mix of cardio, HIIT training or interval training and strength training and what kind of strength training? 'Cause I'm hearing there's like body weight, there's lightweight, there's heavyweights. Mm-hmm.

So can you kind of help us really unpack all that?

So when we're in our twenties and early thirties, pretty lucky, our reproductive years, we can kind of get away with everything. I really impress women when they're in their twenties and thirties to pick up strength training. And it doesn't matter what rep range you're doing, just as long you are doing strength training and have an eye to being muscle-centric. And you can do variations of high intensity, low intensity. Your body recovers really well because we have the benefit of our sex hormones. Women also have the benefit of having more endurant fibers. So we already have a robust amount of mitochondria and we have more proteins for mitochondria respiration, better antioxidation responses. And these are inherent sex differences. This doesn't matter if you have estrogen and progesterone or not.

We're not.

So we're already really endurant. We need to work on our fast twitch. We need to do a little bit of intensity and strength training. When you start to get into your—

so you can get away with a lot.

Yeah, you can.

It's the bottom line.

Yeah.

In your 20s. Yeah. Okay.

Yeah. That's why you're like, all the HIIT rocks people are like in their mid to late 20s. You're like, yeah, when I was back in my 20s, I'd probably pick that up too, but now not so much. But when you start to get into your late 30s and start having more anovulatory cycles, which means that you aren't producing as much progesterone cuz you're not ovulating and you have a, a change in your estrogen testosterone ratios. This is when we start to see a little bit of dysfunction in how you're training. You're—

just so people understand this, so, you know, when you're a— when you're a guy, you make sperm your whole life. When you're a woman, you're born with a certain number of eggs, and it starts declining from the day you're born until you go through menopause. And, and as you go through your 30s and 40s, you start to have less eggs, and you may not ovulate every cycle, which means you have estrogen but not progesterone.

Correct. And when we start seeing more and the— more more of those anovulatory cycles. People don't necessarily know that they're anovulatory because they'll still have a bleed. And this is why when we talk—

you might bleed heavier, right? You might have heavier bleeding because progesterone stabilizes the uterus. And then when you have just estrogen without the progesterone, you get like clots and heavy bleeding and more cramps and all that, right? And that's what happens is when we get in their 30s. Yeah.

And they're like, what's going on? So when we talk about like—

and then they get anemic.

Yeah. And then they get anemic. So they'll talk about like, menstrual cycle phase-based training. It's like, wait, no, let's, let's take that off the table. 'Cause that's one of the conversations you train according to your menstrual cycle phase.

As we get older, especially once we hit our forties and beyond, our bodies actually become less efficient at using protein. In functional medicine, we sometimes call this anabolic resistance. It basically means the same amount of protein that worked for you at 25 may not support your muscles the same way at 50. And that matters because muscle is one of the most important predictors of healthy aging.

Aging.

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And you're saying that's not a thing.

We can't say that because one, there's not enough robust evidence for a whole human to be able to do that is too generalizable because we don't know when someone ovulates. Every woman's cycle is very variations of when they ovulate. So it's more, we know you roughly have X amount of days in your cycle, see how you feel and you can tweak your training accordingly. Because if you know on day 23 you always feel really shitty, then you're not going to go do a hard session. So when you have reproductive years, that's what you do. Yeah. So when you start getting in your, into your mid to late thirties and you start seeing these inherent changes, mm-hmm. It's kind of an awareness factor of, oh, what's going on? So people start to feel a little bit less strong, they start to feel a little bit less like themselves, and they're starting to go, what's going— like, am I not training right? And unfortunately with the diet culture, most people say, oh, I need to increase my training and decrease my food cuz I'm starting to put on belly fat or I'm not responding as well. So they start to really kind of get into more of a low energy state. See this all the time, especially in recreational female athletes. And when we get into a low energy state, that means that we don't have enough food coming in to support daily life and as well as support training. So then we get a compounding variable of now they're going to put on more body fat and have more issues sleeping and definitely not recover well. So it becomes a negative feedback system.

Yeah.

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

So what should they be doing in that phase? Yeah.

So when we look from a sex difference, not a sex hormone standpoint, Women are already super, super endurant by the nature of being XX. So the long, slow zone 2 stuff is not something they need to do all the time. We look at, we need to now find an external stress that's going to create a signal in the body that's going to cause responses the same as estrogen progesterone used to do. Mm-hmm. So what I mean by that is we need to have really super high intensity work and resistance training because we want to signal to the body with high intensity work that we can use glucose effectively.

We need kind of like sprinting and yeah. Like that's called high intensity interval training.

Yeah.

Yeah.

Because it causes what we call epigenetic change. So we know that it's a lock and key. So high intensity work is the key to unlock the cells, to open them up, to allow glucose to come in without insulin. So it's a GLUT4 protein that translocates, opens up, and we see that insulin isn't needed for glucose to come.

I, I just wanna stop you there cuz this is such an important point you're talking about and most people don't understand it. People think that in order to get your blood sugar or glucose into your cells, you need insulin. Mm-hmm. But the muscle is a unique tissue.

Yes.

And can actually absorb glucose without insulin. Right?

Yes, exactly.

Okay.

Especially in the post-exercise state because now it's, and, and that's right.

And the way you get that is by having healthy, good muscle.

Right, exactly. Right. So I mean, one of the things that diabetics do is like a 10-minute walk after a meal because it helps stabilize blood glucose. And that's what you can do when you do high intensity, you get a permanent change in the muscle to have ability to have more GLUT-4 proteins translocate to improve insulin sensitivity because now you have other ways of getting glucose in without so much reliance on insulin. So it makes the body more sensitive to the insulin.

So it's a, it's a double benefit. You get insulin independent uptake of sugar or glucose in your muscles and you don't have to make as much insulin in order to drive this glucose into the cells. And when you don't have to make as much insulin, that's a good thing because insulin is the fat storage hormone and makes your or belly fat, which you were talking about.

Right.

Right.

So it's, uh, you know, like convoluted.

Yeah. It's a lot to unpack. I just wanna, yeah, because not everybody's a doctor or PhD like you or me. Like I just think we unpack it.

It's good.

I'm just helping out here.

Yeah. No, I appreciate that. That's your job. And then the other thing about high intensity work is if we go back to brain and brain metabolism, mm-hmm, we really do see a change in glucose reliance of brain fuel and tissue, um, because it's not as effective in the brain when we start to get in perimenopause. Cause. And we see that, that change in brain metabolism is also a risk factor for amyloid and tau plaques, or, you know, our Alzheimer's plaques. So if we're doing high intensity and producing lactate— lactate is a preferred fuel for the brain and the heart. So if your body's exposed to lactate, it starts to use lactate and not having such a reliance on glucose, which improves brain metabolism and again reduces the risk factor for developing and amyloid plaque.

So, so just people, what is that amyloid tau? That, that's basically the, the sticky proteins that cause dementia and Alzheimer's. That's, that's, you know, that's what we know is, is the downstream effect of whatever the insult is. It's not that amyloid causes Alzheimer's, it's that it's the result of some inflammatory or unhealthy process in the brain. It's kind of the body's bandaid, but, but what you're saying is the right type type of exercise will actually attenuate it, prevent that the, the development of these tau, like plaques and tangles in the brain.

I wouldn't use so much prevention, slows the rate if you have a risk for it. So you could actually have a few but not develop symptoms. There are a lot of people who have a variation of amyloid and tau plaques that don't have dementia symptoms, which is what we're after. Like you could have them as long as you don't have symptoms, right?

Yeah.

So we're looking at ways to improve brain metabolism, reduce inflammation. So if we are producing lactate, Then we're doing high-intensity work. That's great metabolism for the brain. But also when you do high intensity, you get a really strong post-exercise anti-inflammatory response because the cells have been inflamed from such high-intensity work and the body's reading it as a signal of, oh gosh, we have to be able to rebuild quickly in case that stress comes back. So it, it increases antioxidation and increases anti-inflammatory responses. We see a boost of growth hormone, we see a boost of testosterone post-exercise. So when we hear all the stuff how a perimenopausal woman shouldn't do high-intensity work. It's like, hold on, let's define high intensity because it's very beneficial if you do it correctly. But if you're doing a high intensity class, that is at all these gyms where they're like, let's go after the perimenopausal women. And we have these booty burns, we have Spin, we have Orangetheory, we have F45, all of those.

I know I've been there.

Yeah, yeah, yeah. It's moderate intensity. It's not truly high intensity because we've all been conditioned to get out of one of those classes feeling sweaty and completely smashed, thinking it was a good workout. But for true High intensity, you can't hold the intensity for as long as these classes.

No, you can only do it for 30 seconds to a minute, right?

Yeah. So that's the sprint. And when we look at the Norwegian 4x4, that's also a type of intensity, right? So 4 minutes at about 80%, and those 4 minutes are super slow. You're like, oh my God, hurry up. I can do it. I can do it. And then the 4 minutes recovery go too fast.

I wanna loop back on something you said, cuz it's also so important. You, you kind of said that the, the effect of of the exercise and the post-exercise effect is to reduce inflammation in the brain. And there's, I don't know if you know the work of Rudy Tanzi and others who really looked at, uh, the subtype of, of the population with some weird genetic variant where they have a brain full of amyloid and full of, of tangles and plaque and tau, but they have normal cognition and they have a weird mutation that prevents inflammation. Which is really wild.

Yeah.

So without inflammation, bottom line, Alzheimer's is an inflammation disease of the brain. So is heart disease, inflammation of the blood vessels. That's kind of what causes it.

Right, right. So we look at all the ways that we can reduce inflammation. I mean, that's why estrogen or estradiol internally is so protective because it's an anti-inflammatory agent. So when we start losing it and the body becomes more inflamed and systemically driven, and we see that we have more of the sympathetic drive, that it's also that hype at people who feel tired but wired. It drives even more inflammation. Let's look at how we can reduce that. People are like, oh, high intensity, I can't do that. It's gonna make me more tired. But they do it properly and like, oh, I feel amazing. I have this kind of euphoria.

And what is doing it properly?

So we have high intensity interval training and the subset of that is our sprint interval training. So we look at high intensity interval training. This is about 80% of your max when you're doing the intervals. So it could be 1 minute on, 1 minute off, and that 1 minute on is is 8 out of a 1 to 10 when you're looking at 10 being max and 1 being you're sitting on the couch. And then that 1 minute off is just really super cruisy so that you can do the next 1 minute at that 80%, or that's kind of how you start. And then ideally we're holding it for 3 to 4 minutes and then you have variable recovery, however fit you are.

Cuz if we can hold it for 3 to 4 minutes, you do like 4 times, like mm-hmm. I mean, 1 minute off, 1 minute on, like twice. That's 4 minutes.

No. So if we're doing 1 minute on, 1 minute off, we try to build build that up to, um, total of 10 to 15 minutes. So you end up doing 5 to 7 sets of the 1-minute on. Um, and then if we're looking at producing more lactate, then we do longer intervals with a shorter recovery as you get more tolerance to it. So this could be 3 to 4 minutes at 80% and 2 to 4 minutes recovery depending on how you're feeling and how fit you're getting. So the other way to think about it is on the, in the class situation, especially something like CrossFit or some of these other classes where they have every minute on the minute, where you have 1 minute that you might be doing burpees and then right into the next minute you're doing walking lunges with a weight. And then the 3rd minute you might be doing box jumps and then the 4th minute—

No recovery.

Right. The recovery is switching from minute to minute until the very last minute is a full minute off. So you have 4 minutes of hard work, 1 minute off, and then you can repeat that a couple of times. That's true on high-intensity And then the sprint interval is very short and effective. So this is your subset of high intensity where it's 20 to 30 seconds as hard as you possibly can go.

Like you're running from a tiger.

Yeah, exactly. Or a shark if you're in the ocean.

Yeah.

And then it's a full 2 to 3 minutes recovery. And I have a lot of women go, why do I need to recover that long? It's like, because if you don't recover that long, your central nervous system and your energy systems have not recovered enough to then be able to do that same intensity. Intensity at that running from a tiger speed that you need to do. Because if you are consistently doing 30 seconds and then a minute off, 30 seconds, a minute off, you are failing to hit that high intensity.

So how do you, how do you, how many times do you do that?

No more than 5. You work your way up. Some people are like, oh, no problem, I can do 5. And after 2, they're like, oh my God, I can't do anymore.

So like a minute and then 4 minutes off and then another minute and doing that 5 times.

Yeah. And then if you are doing a separate session of sprint interval cause they're two different sessions. Mm-hmm. So you can have a high-intensity interval training as one session, and then when you're short on time or you want more of your epigenetic change for glucose, then you're looking at doing the sprint interval stuff. That's a completely separate session. It might take 10 minutes total where you have a warmup, you do 2 to 3 sets of the 30 seconds on, 2 to 3 minutes off, and you're done.

Okay. So that's the, that's the cardio part.

Yeah.

And that you're saying when we should start start when? In their 30s, 40s?

In their 30s. You could start it earlier, but it's really beneficial when you start getting in your late 30s, early 40s.

And continue out through your life?

Yeah. Yeah.

Obviously your speeds are gonna reduce, but not that much.

Not that much. Right.

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

I love that.

And they actually were.

And then they went down, there's a group from Harvard went down and studied their VO2 max and their pulmonary fitness and their cardio, and they actually were better. And I think we've seen, we've seen this in, you know, these high translated people who were like, I started, you know, at 65 rowing, or I started biking at, you know, 65 and I'm now 105 and I'm like, I'm better.

Yeah.

And it's like, so the body is quite amazing that we think it is going to fail, but actually it can continue if you continue to take care of it.

Right.

I remember meeting this guy, it was my stepfather's shiva, which is like the, after the funeral. And he was 95 years old and he was like running around like a spring chicken. And he, I'm I'm like, he looks so fit and sharp. And I'm like, what are you doing?

He says, well, whatever I did yesterday, I do today.

If I did singles tennis yesterday, I do singles tennis today. And I'm like, that was a great lesson for me.

I love that. Yeah. Yeah.

Okay. So that's the cardio part. What about the, the strength part and how do women think about that?

So strength training is scary for a lot of women, especially in, in this age group because we didn't really grow up with being Jimsons. Right. It hasn't been kosher for women to have muscles or to be in the gym doing strength training.

Jane Fonda aerobics. Yeah.

Yeah.

Who's actually here at this conference we're both speaking at.

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Wait till you— I get to interview her tomorrow, and I'm going to dig into that. It's a very interesting way it came about, but oh, I won't tell everyone on the podcast.

Um, okay.

So when you think about strength training, and because people have been so conditioned to walking around with their pink dumbbells and thinking that strength training, it's really hard to get women to understand that that's not what we mean by strength training.

And yes, pink 5-pound dumbbells. I know.

The ones on the back of the Peloton where you're like trying to ride at the same time. No, that's metabolic cardiovascular work.

Uh-huh.

And when we look at strength training, gym intimidation is real. Like sometimes I get gym intimidation when I go to a new place. It's very real.

I know. I, I'm like, I go to the gym and I'm like, have my own little workout thing in my house. And I was in Venice, California, And I went to Gold's Gym and it's like, oh my God. Like it, it's like Arnold Schwarzenegger, Muscle Beach. Like everybody's like humongous and probably on so many anabolic steroids. And they have like videos of Arnold flexing in his prime on the video screens going while you're training. I'm like, and I'm, you know, I'm fairly muscular, but I'm, I'm 66 and I'm like looking at myself. I'm like, I feel like a 98-pound weakling here.

You know?

I know. I was like, I need to leave.

No, no.

But I, I stayed. I go at 6 in the morning and just gotta do it. And try to do it. Yeah.

I like try to find off hours, but then that's not even great cuz then everyone's looking at you. You're like, what are you doing on the lifting platform?

Yeah.

But yeah, because gym intimidation is real, I don't wanna like tell every woman you have to go to the gym.

Yeah.

So we start with wherever they are in their journey. It could be you 10 minutes a week where you wake up and you do a body weight circuit, right? And then as you get stronger in your body weights, you put a front pack of a backpack on, not back, because if you're doing a squat, you don't wanna lean forward. So if you put weight in a front pack, then it teaches you how to squat upright and you your glutes. So there's ways of like improving your technique while adding load. And then we know that isolation is killer. So if you have a friend who's also interested, well, there's lots of apps out there that are really powerful in getting women connected and actually have proper programming to improve from going bodyweight and lightweight to dumbbells to lifting a bar. So there's different ways of doing it. If you want to join a CrossFit gym, that's great because they'll teach you stuff. If you want to join a proper gym with a personal trainer, that's fine too. But I think the mistake that people have is not having a plan and relying on other people to tell them what to do. We need a periodized plan wherever you are in your journey. So if you're just starting with body weight, let's look at what that first 6 to 12 weeks is so that we can progressively overload you and get you comfortable in those movements, so then we can add load. If you are resistance trained, it's really hard to get gains. So how are we going to change up what you're doing so you can keep getting gains? If you're somewhere in the middle and you're used to doing 8 to 10 reps, well, don't change your program per se, but let's add more weight and reduce the reps. So it's looking— I can't give it.

You need a trainer to do this, or I—

how do you kind of— how do you get started?

It's like, I'm like, you know, I mean, honestly, I was so into it, I had to get a trainer because I didn't want to hurt myself. I was scared and I didn't want to just do something stupid.

Yeah, that's very be real, a lot of women are, are very afraid of getting hurt. That's why they don't go and do heavier weights. I work with a few people that have really fantastic apps we've written together, and so the program is designed that way so that you can go into the gym with the app, see the videos, get instructions to understand how to do it with video cueing. You can, um, like in New Zealand we have playgrounds that have like tires that you can do tire flips with your friends. We have outdoor classes, so people are there to tell you what to do. It's really finding your community that's going help you. And part of it also leans into isolation is a killer and a demotivator.

I mean, I— not isolating muscles, but social isolation.

Social isolation. Yeah, social isolation is a killer of motivation, and we know that it's not very good for anybody. So if you have a buddy, it makes it fun, you're— it makes it sustainable, and then you have ownership in what you're doing.

It's amazing. Okay, so I think— is there anything else we want to share about strength training or fitness training before we jump to nutrition?

Just get started. For a lot of people in our society, like, I was asked the other day about, you know, why do I have to do all the stuff that you're talking about when we see all these people who are 100 and they never did any of that stuff, right? Right.

Well, they, they lived in a way where they had to do this stuff.

Exactly. So I brought up the example of my grandmother who lived to be 106.

Yeah.

And she grew up on a farm, and then she moved into the city with my grandfather. He had his own business. She was running around doing the gardening, the house cleaning, looking after her mother-in-law, like always busy lifting, moving, that kind of stuff. And that was the lifestyle of the people who are now in their 90s and 100s. But our lifestyle now is not like that.

Yeah, my book Young Forever, I did some research and I went to Ikaria, or Ikaria, however you say it, in Greece. It's one of the blue zones. And I met this couple. He was like 97, she was like 87. And they live on the side of this sort of hill, mountain. And she She had like the most extensive, like I wouldn't even call it a garden, it was a farm. There were fruit trees, there was animals, there was like so much food she was growing. And she was like walking up and I couldn't keep up with her. She was 87 years old and, you know, showing me what she was doing and having to lift stuff and move stuff and take care of the whole thing. And I was like, wow, you know?

And if that had happened in our country, people would be like, oh wait, wait, no, don't lift that. I'll get that for you.

Right.

Right. Because we're so con— there's an editorial that came out a couple of weeks ago that was talking specifically to healthcare providers and to PTs that we need to stop the rhetoric of old is frail.

Yeah.

We need to stop pushing the 10 to 20 rep range as strength training. We need to really look at challenging the body 'cause it can handle it.

Yeah.

We know that.

But you have to be careful with tendons and ligaments. Yes, definitely. Because you're, you can, if you're not slowly building up.

Right, exactly.

I, I noticed that for myself when I started, I, I kind of overdid it 'cause my muscles could do it, but my tendons weren't ready. So then now I can do like, you know, double the weights Right. But I, I don't have the pain.

Exactly. So that's part of the whole periodized program, right? But if you know that—

and periodized means just like phases of training, like over time, like doing different things in different weeks, like a graded increase in strength training.

Right. So you, one, you don't get bored and two, you keep increasing load without getting injured.

Yeah.

And your body recovers properly. And it—

and are there good resources for people like that want to—

that want to jump in on this?

Yeah.

So there's a woman called the Betty Rocker and she's really good if you wanna get started with bodyweight Stuff. And she has some really good perimenopausal, menopausal programs. If you're looking to like get into lifting, Vonda Wright has a program with Haley.

Yeah.

That's Learn to Lift. And then if you're already lifting and really wanting to optimize, then you can go into Haley's Power Happens programs, which I helped her divide or devise and write.

Great. We'll put all those in the, in the show notes, links and everything. Let's talk about nutrition.

Yeah.

Because, you know, I think people are confused and, and, you know, there's all this sort of hype about protein, there's intermittent fasting, there's do we eat before exercise, only after exercise? Like what, what should people be thinking about and how do we, you know, how do we start to think about that? Yeah.

I always pull it back now to help kind of clear up all the confusion of chronobiology. So what are we doing for our circadian rhythm? And we know that women's circadian rhythm is different from men's.

Mm-hmm.

So if we're looking looking at even our cortisol peak, our cortisol awakening response. So that's how our cortisol comes up. Women have a higher peak than men, and it's tightly tied to appetite hormone. So we know that when cortisol in the morning comes up, we also have an increase in what we call acylated ghrelin, which is our active form of our hunger hormone. We also have an equivalent rise in peptide YY, which is a satiation hormone. But if we don't eat within an hour of waking up, there's dysregulation of those hormones. So as we go through the day, we start to feel feel more cravings for simple carbohydrates. So we get what I call the wall lean because we don't move as much incidentally throughout the day, start really feeling tired and hangry about 4 or 5, no matter if you've eaten a little bit later in the day. And then dinner is a little bit uncontrollable where you're like snacking before dinner and then you have dinner and then an hour later you feel hungry, so you're eating something before bed and you've effectively shift because you're eating in the wrong times. So regardless of the intermittent fasting, the keto, whatever it is, let's first go back to basics. Let's look how the body optimizes hormone pulse, how it optimizes melatonin peak to sleep well, how it optimizes how it repairs itself. It's all in the circadian rhythm. So if we eat during the day and try to front load our calories more towards the beginning and middle of the day, Then when we get to the evening, we're not as starving, so we can make wiser choices at dinner. And then we aren't wanting to have snacks after dinner, which then improves sleep. So I tell women, if you're having really horrible sleep and issues sleeping, it starts in the morning, like when you wake up and if you have food within the first hour or not. So we wanna drop that cortisol. We want to stimulate the hypothalamus to say, yep, there's some food coming in so we can have some more control of ghrelin and leptin so that it pulses properly throughout the day, and then your body's able to have more of an even blood sugar throughout the day. Yeah.

I think that's important. And what I, what I think when I think about intermittent fasting, I think for women it can be challenging because of the reason you're saying. I like to think about it on the backend. I like to think about it as not eating after dinner.

Right.

So if you eat dinner at 6 and you wake up at, you know, 7 and you eat at 8, that's a 14-hour fast.

Exactly.

So that's, that's, that's necessary. We want to have at least a 12-hour break in our bodies to allow our bodies to repair, heal, and do autophagy and all the cleanup stuff. But it doesn't have to be this 16-hour thing. It doesn't have to be like waiting till noon to eat. I mean, that's a bad idea for women.

Have you seen the research about early versus late fast break?

Mm-hmm.

So there's been some population research looking that for those individuals, both in women and men, but more robust responses in women who break their fast by 8 in the morning and and they finish their daily intake by 5:00 PM, that they do have metabolic control and all the things that you think about. Yeah.

It's just how I, I wrote my first book was called Ultra Metabolism, and I wrote a chapter there called the Sumo Wrestler Diet. Ah, and, and the joke was, you know, how do you have small little Japanese men become these enormous 300+ pound guys? Well, they have a science in how they do that.

Yeah.

They basically feed in this massive massive food called chanko nabe, which is like a giant stew of awesome, all kinds of rice and pork and this and that. It's not processed food, but it's like a lot of food. And then they make them quote, take a nap. And then they do the same thing at the end of the day, they, for dinner, and then they make them go to sleep. So basically if you eat before you go to sleep, it's all gonna store and you're not gonna burn it.

Right.

And so think of, I would sort of flip the intermittent fasting to be on the back end, like on the, yeah, the night before and not eating and snacking at night.

Right.

So that's the best way to do that is to front load your food so you're not starving at the end of the day.

Right. And so I explain the difference between intermittent fasting and time-restricted eating.

Mm-hmm.

What you and I are talking about is technically time-restricted eating. Mm-hmm. Because when you start talking about intermittent fasting, that's when people are like, oh, I'm not gonna eat till 11 or 12. Mm-hmm. And then I'm only gonna eat till 4 or 5. Yeah. In that window. One, you're not gonna get the micronutrients you need or the fiber that you need. You get a whole bunch of dysregulation. So let's just not even go there.

Okay.

This is a, this is a, this is a great take home for people. So if you're a woman and probably I would say anybody, you want to, you want to front load your, your, your calorie restriction, which is after dinner and don't eat after dinner and have an earlier dinner. If you can, you're gonna sleep better. You're gonna feel better. Your metabolism's gonna be better. You're gonna probably lose more weight. You're gonna have a better time and you're gonna feel better.

Now let's talk about protein.

Yes.

So protein is the thing. It used to be low fat, then it was low carb, then it was high fiber. Now it's like high protein. Like all this stuff. What's the deal?

I know.

I think we're running out of things to be high or low in.

I know. I'm wondering what the next thing's gonna be. Initially I was really happy that protein was getting its heyday cuz it has been under, underutilized.

Yeah. It's the only, by the way, it's the only macronutrient. Nutrient that we need in large amounts.

Exactly.

Like fat, essential fatty acids we need in small amounts, like gram amounts.

Mm-hmm.

Like maybe in milligram amounts. Carbohydrates, we have no actual essential carbohydrates.

Right.

But protein, we, we have a requirement for a fairly large amount of amino acids and carbohydrate and protein every day.

Right. And I always start protein conversations with reminding people that the RDA is a representation of the lowest amount of protein you need to prevent malnutrition. Yes, it is not optimal.

Yeah.

And if we are looking for optimal, we have to dig into the most recent research that shows that between 1.6 and 2 grams per kilogram of body weight is ideal. So that is about that 0.8 to 1 gram per pound a day.

So if you're 150 pounds, it's 150 grams, or, you know, maybe 130 or 120 to 150 grams of protein.

And then as you get older, you become more anabolically resistant, meaning that you can't build tissue and use it very well to protein and resistance training. So if we are going to try to build strength and lean mass, we have to be on the upper end of protein. And the timing of that is very important.

Yeah.

So when I just listened to this fantastic lecture—

can you stop? Because if people just heard anabolic resistance, they probably know what that means. Basically, when you're young, you have what we call trophic hormones. You have a lot of hormones that are helping you keep and of muscle. When you get older, they change and your muscles change and you need more protein and more strength training just to tread water.

Right. I often say I'm a living example 'cause every time I travel out of the country and I'm gone for a month or so, I lose about 3 kilos of muscle.

I know. It's a pain in the ass. It's awful.

And it's really hard to get back.

I know.

I went to the gym this morning. I try to get to the gym every day when I'm traveling, but sometimes I can't and I don't have my blender and I can't do my whey protein smoothies and I can't, like, I'm like, okay, I have 2 eggs, but I need like 6 eggs. I'm like, I know.

You know, it's like, You go down to the breakfast bar, you're like, all the eggs in your bag, you're like, I didn't take them off. Yeah, it's really hard. And so when people push back on the protein and strength training, I'm like, it is really, really difficult when you get into your 40s and beyond as a woman, and in your 50s and beyond as a man, to build and maintain your lean mass. And lean mass isn't just muscle, it's also bone. We know protein is really important for bone as well. And when we look at the stimulus for it, not a lot of the education out there is for the right stimulus to build build bone and maintain muscle. So if we're looking at strength training, we know the rep ranges and everything for strength training. And for bone, it's not walking. Yes, strength training can help, but we need to do hard landing jump training. So we need that multidirectional ground reactive force to go up through the whole skeleton to actually stimulate bone, um, growth and density. So when we're looking at protein is necessary to help with that too. So as we get older, we need to err on the upper side. And like I was saying, I listened to this fantastic lecture by Keith Barr, who is tendon and protein guy, molecular researcher out of California. And he was saying, yeah, this whole conversation about post-exercise eating is really interesting because most of it's been done on young men and some young women. And so there really isn't a window. I was like, yeah, of course. But as you get older, you're— it's more important. And when, when 1 or 2 hours after you work out, he says even Less.

Less.

Because if you are thinking about what you're trying to drive when you're exercising, you're driving signals to break tissue down, and the post-exercise response is to help repair that. To repair, you need nutrition. So if you're delaying that, then you're kind of muting those signals for reparation. So he really suggests that as you get older, in your mid-40s for women and mid-50s for men, that you really try to get that nutrition as close to the end of Exercise is interesting.

So I, let me ask you this, 'cause it's something I just don't know. I mean, I've talked to Don Layman who's a protein expert.

Yeah.

And my understanding was if you are well trained, like if you're starting out, for sure that's true.

Yeah.

But if you're well trained and do resistance training regularly, you have muscle, that it doesn't matter so much as to the timing. But what you're saying is, is different.

It is different. Yeah. And so when we're looking at all the studies that are promoting, there's no real difference. And we're looking at resistance training and resistance trained individuals, and you could have 100 grams of protein And that doesn't matter when you have it as long as you have it throughout the day. 'Cause Luke Van Loon put out one where it was the barbecue diet where he loaded people up with 100 grams of protein post-exercise and you were still having protein uptake for 24 hours after. Again, all done on men, younger men. So when we're really looking at the aging factor of muscle and tendon, mm-hmm, we want to use exercise as a signal and we need nutrition to help with that signaling. So that's the angle that a lot of us in this field are like, we're not looking at younger people who have the ability to repair without necessarily having a big wallop of food afterwards. We're looking at how do we optimize women and men who are aging and still putting in the effort and the work that if you're not fueling to help with those exercise signals, then you're reducing the response.

So bottom line is like, if you're older and getting older, 40, 50, 60, Whatever. When you strength train, make sure you have something within half an hour to an hour at the most.

Yeah.

Right. Like a whey protein shake or a piece of chicken or 6 eggs or some, some amount that's gonna be a, and the amount, does the amount matter that time? Is it 30, 40, 50 grams? Like, 'cause you can't eat, you can't eat a, a pound, a gram per pound of protein in one meal, right?

No, no, I wouldn't recommend that. We see that for older women it's 35 to 40 grams and for older men it's 25 to 30 grams. 10 to 15 grams.

Hmm. Okay. And more for women.

Yeah. Because we have more of an anabolic resistance to the protein.

Oh, interesting.

Abby Smith Ryan did some really interesting work of pre and post-exercise, and she found that for women who had 10 to 15 grams of protein before exercise, you still had the capability of, of, of, or of accelerating this, the post-exercise signals because you had more amino acids circulating. So if you know that you can't eat after exercise, if you have it beforehand, it's still helps.

And so, so let's talk about the beforehand. Yeah. 'Cause should you exercise fasted or fed? And if you are fed, how much? 'Cause I know I can't really eat too much before exercise. I get like sluggish and nauseous and I can't do it. So, so tell me about that.

It's okay for you, but not so great for women. Women should have something before. And when we look at the reason, we look at like energy availability. So we know that men can pretty much get it as low as 15 calories per kilogram gram of body weight without having dysfunction. For women, it is 35. So there's a big discrepancy right there. So we look at every eating opportunity. We know that if women have something before exercise, that they improve the signaling of the post-exercise responses because they aren't producing as much of the breakdown hormones, your catecholamines that help with muscle contraction and fueling and stuff. So your body, I wouldn't say is more relaxed, but it's not as highly stressed during exercise, so it can hit intensities it needs to, it can do what it needs to do. It can increase the signaling for post-exercise responses, especially if it's cardiovascular. If it's strength training, there's a little bit more of a leeway cuz it's not as metabolically heavy as cardiovascular training. But if you're gonna do a weight training circuit, then you do need to eat.

Yeah. I mean, when I do a circuit, I'm like going my, my, my heart rate's up like 140 most of the time. Yeah, exactly.

Yeah.

Wow.

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

What's a protein coffee?

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

So you put like whey protein in?

Your almond milk, and then I pour the espresso in. So it's like a cold protein latte first thing in the morning. Oh, don't ever try to do it hot because the protein gets all gluggy.

Oh, so it's like a, it's like an iced coffee.

Yeah.

Wow. Okay, that's a, that's a news to use.

And then when you're, when you're traveling, it's easy, right? Because you might have a coffee maker in your room, or maybe you can get a coffee and put your protein powder in, and then you're like, okay, good to go. And then you have your real breakfast when you get at home.

Or you travel with protein powder?

I do.

I knew it.

I travel with protein powder and creatine, and then I order groceries to get sent to the hotel or wherever I'm staying.

I got meat sticks. I got the Mountain Dew meat sticks in my bag. Oh yeah, I have creatine.

Yeah.

And I'm like, it's tough though, man.

It is very hard.

Like, and then my suitcase is heavy because I get this little portable blender. Sometimes I get—

it's like, I choose blender or French press, and I always bring the French press.

So what are the nutrition mistakes that women are making mostly now?

And they're listening to all bad diets and they're listening to the rhetoric that's on social media and they're not really paying attention to, okay, who am I? How do I respond? When am I hungry? I've retrained women, so many, so many women to listen to hunger cues because we've been conditioned not to. We're like, oh well, I've been told that if I delay food, it's good for me. I should have lemon water, hot lemon water when I first wake up. I shouldn't have coffee. I should delay my breakfast. And then they get into the whole circadian disruption and they're not sleeping. It's like, okay, well, let's reset. Yeah. Because if you aren't eating, we know that, you know, your body really responds to food and day and night to look at controlling your circadian rhythm. So if you're waking up and one, you're not looking at light, two, you're not eating, then your body's like, am I supposed to be up? And we see that it effectively phase shifts. So then your melatonin that starts to rise at 9 o'clock for women and 10 o'clock for men, you miss the boat. You don't get that. You get a blunting of that.

So women should eat in the morning and not do this lemon water thing and then delay their breakfast.

Correct. And try to look at the light.

And by the way, you mentioned people are listening to nutritionists on the internet or in social media. 40% of them are paid by big food companies to provide misinformation and to confuse people on purpose.

Correct. And sell something. It's criminal. I know.

It's actually criminal.

And sell something to fix it. That's why I, Mike, I don't partner with anybody.

So what do you think about the protein Cheerios and Dunkin' Donuts protein shakes and the Starbucks protein coffees?

And I know I laugh because being an expat living overseas, we don't have that.

Yeah.

Like we're really— you go to the grocery store and it's not apple season, you can't buy an apple, right? It's very seasonal, kind of how it usually is in, in the San Francisco Bay Area. But I come to the States, I go to Safeway, and I'm like, what is this? This is a, this is a store full of stuff that is food and you have protein Pop-Tarts, you have protein popcorn, you have all these ultra-processed things that have protein, protein, high fiber, and it's all additive. And I always remind people that we are not as smart as Mother Nature. So when you are engineering food, that's not the same as if you're eating the whole food, right? Because there are cofactors in the whole food that actually work in your body to make it work.

And this is, this is a, this is a tactic of the food industry called nutritionism, which is a term coined by Michael Pollan. About manipulating processed food to meet the latest food trend or fad, right? Whether it's low fat, low carb, high fiber, high protein. So like, I, I kind of want to go to see high protein Cheerios. I'm like, give me a break.

I know, you're like, how much sugar is in there too?

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

Yeah. So in New Zealand, one protein bar is anywhere from $5 to $10, so it's not really that affordable. Oh. And people are like, well, what should I have instead? I was like, why don't you just look at a Snickers bar? Because a Snickers bar actually has more protein than these protein bars and it's a dollar. So it's not like I'm promoting candy bars. But when the comparison— when you're looking, it's like, what are you actually getting when it says a protein on— or like protein bar on the label? Yeah, I— you can't really identify everything in there. It doesn't taste that great. Whereas if you know that you're hungry, you get a Payday or a Snickers bar that has some fat and protein in it. It's a candy bar, you're not going to have it all the time, but it's gonna probably fill you up better, and it gives you protein, and it's cheaper.

A Snickers bar.

I know, people have pushed back. I'm like, I know, desperate times calls for desperate measures. I'd rather you have almonds and a cheese stick, but if you're really in a gas station and you have the option of a $10 Musashi bar or a $2 Snickers bar.

If you were sort of advising women in the real estate now, which they are, a lot of my listeners are women, and they just need to start one thing today, what would it be?

I think the very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with the themselves because we don't know where they are in their journey. But if we have 10 minutes, 3 times a week dedicated to us, we start to find what we really need. So women who've never started a fitness journey, I tell them, your 10 minutes on your first day is just to turn off, no noise, go outside, look at the light, have your coffee in front of the window, just really try to like decompress and tune in. And then as you get used to those 10 minutes and you find out, yeah, I really like to stretch, or I like to move, or I wanna be outside, then we could tap into that and say, You wanna be outside? Okay, well let's go outside for 10 minutes. Maybe you meet a friend and you do stairs for 10 minutes, or maybe you're doing a bodyweight circuit. Is it cold and rainy and you don't wanna go outside? You wanna stay in front of the cozy fire? Great. Well, let's do a bodyweight circuit in front of that because it's your time and it's for you. And what do we need to do for you to keep that wellness meeting and know that you can't break it because it's the start of these habits that are gonna optimize.

Wellness meetings.

Wow.

What a concept. Wellness meetings. I tell my team, like, if my schedule, I don't care if the president of the United States is calling me, you've gotta make sure I have blocks of time where I can do my thing.

Me too.

In the morning.

Me too.

You know? All right. So let's do some quickfire questions.

Okay.

To wrap it up. What's the number one thing women should focus on for longevity?

For longevity. So this is really interesting 'cause it's a very big space and lots of like information out there. For longevity, I tell them to look at what are your risk factors, because there's so many different risk. You can look at family risk factors and know that you have your genetic code, but it doesn't have to dictate what's happening.

Yeah.

So if you have a family history of dementia, then we wanna focus on strength training. You wanna do everything possible so that you don't turn those genes on. If you have a family history of osteoporosis, then we focus on that. So that's the first thing. How are we gonna optimize? Look at family history. Let's work to optimize that.

Your genes Genes are predisposing you, but they're not predestined.

Exactly. And that's the thing. Oh, my father died of a heart attack. So am I. No, no. You know that you're predisposed. So let's do all the things cuz we have all these tools.

All right.

And so that starts you on your longevity.

Okay.

So what's the biggest mistake women are making in the gym?

They're following programs that aren't built for them or they're one size fits all. Yeah. Or they're not following programs. They're just going in and doing a class. What's more important, weight loss or muscle I'm always about what are you gaining, not what you're losing.

I'm with you, girl. I mean, I, I've been the doctor who's helped people lose hundreds of thousands of pounds, if not millions. I never tell people to lose weight.

Yeah.

I never focus on weight loss. I say, let's get healthy and here's how. And the weight loss is a side effect. How many days a week should women be training in the gym?

We see to maintain it's 1 to 2 if you're strength training, 2 to 3 to kind of get gains and keep moving forward, it's 3.

Is it bad to do 4 or 5 or 6?

The worry is overtraining or under recovery if you are doing that. Cuz if we don't have a right plan, you can do 4 or 5 or 6 if it's planned out and you recover well.

But basically, in different muscle groups so you're not doing the same thing every day.

And eat, please eat. You need abundance.

Yeah.

You need abundance to build muscle.

It's counterintuitive. Like you need eat a lot in order to lose weight.

I know, but I love it cuz people are like, what, what about this calorie deficit and calories in, calories out?

I'm like, that is an old idea. And still it, it, everybody believes it.

I know.

It's like the earth is flat and it looks flat and it's gonna be flat. Yeah. So it's like, no, what's the top tip to lose to, sorry, to prevent muscle loss as you age?

Protein and fiber at every meal and a focus on strength training.

How about bone density? What's the most effective way to protect your bones?

Jump training.

Jump training, which is what, jumping jacks, burpees? No.

So there's been some really cool research studies that have come out. One is the Lift More study out of Australia. The other is the Osteogain stuff out of New Zealand. And it is looking at low landing but landing hard. Ah, so it's not landing how we've all learned to absorb it in our joints. It's not plyometrics.

I can't do that. I had back surgery.

Yeah. Well, you could do a lift and slam your heels down.

Yeah.

So it's not actually jumping.

Yeah.

Yeah. So there's ways of doing, Or like you can look at med ball slams, right? Oh. 'Cause then you're absorbing it, you slam it or you slam it down. And so you're like really getting that isometric.

Oh, interesting. Interesting. Yeah. Amazing. Okay. What about creatine for women? Yes.

No. Absolutely.

And how much?

Oh, so I love this question because a systematic review came out 3 days ago and I was reading it.

Oh, I can't keep up with you, girl. 3 days ago, a month ago. I'm like, all right.

That's 'cause I'm always reading.

Yeah.

It went through all the creatine studies. That were not like bodybuilding type. And it said the people that benefit the most from creatine supplementation are women aged 18 to 65, and the lowest dose of 3 to 5 grams is optimal. And then there are variations with that, of course. So if you're looking for cognitive benefits, it can go up a little bit higher.

10.

Yeah. And then if you're looking at like fatigue and shift work, it's that 0.38 grams per kilogram, which ends up about 20. Wow. So there's different variations within the dosage depending on what you need, but the baseline is that 3 to 5 grams. 5 grams and takes about 3 weeks to fully saturate. And then you start getting all the benefit.

What's the biggest myth in women's health or fitness?

That we age the same as men and that we should be doing the same.

Yeah. And we unpack that pretty well.

Yeah.

And what's one nutrition rule that most women get wrong?

Oh, there's too many, too many rules.

Calories in, calories out.

Cal— let's go with that one. Yeah. Calories in, calories out. Yeah.

Okay. What's, uh, your favorite pre-workout? Workout snack? Um, your, your, your protein coffee. Yeah. And how about post-workout meal?

Uh, I always crave my bowl of Greek yogurt, nuts, protein powder, berries, chia seeds, and a double espresso.

Damn. So, so you do the double espresso before and after?

Oh yeah. And then I stop.

Okay. All right. And we didn't talk about this, but better workout in the morning morning or evening?

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

And knowing what you know now, what would you tell your 20-year-old self?

Oh my gosh, there's so many things. Because when I was 20, I was like fully endurance athlete, like a little bit of strength training, but just running and cycling and swimming and all of those things and not eating enough. Full low energy availability.

Probably not having your period.

Yeah, all this. Got it, lost it, got it, lost it. Um, stress fractures, all those things. So I would go back and and say, look, you don't need to do all this. Let's look at how you're gonna train for Ironman and XTERRA, doing it properly.

Amazing. Okay. Yeah. And your website is drstacysimms.com.

Yes.

With a Y. Stacy with a Y. Yeah. No E. No E. And where else can people learn about you and your work?

So socials, of course, the same, drstacysimms.com. And then our new company is Collective X, Collective X Health.

Okay. Give us a, give us a one, a rundown on that. Yeah.

Yeah. So we are going at, it's a women's Intelligence platform. So we're going after the problem with AI and the rhetoric of regurgitating poor information that's been based on male data.

So we have a research arm, we, so we have a patriarchal AI system and you're trying to fix that.

Exactly. We're going after the sports.

Got it.

To correct the sports outcome. We're looking at, um, the wearables, we're looking at the medical. So we're really going after it and it's a collective because we're partnering with all the other people who want to do the same thing.

Amazing. Well, Stacy, you're just a wealth of information. I learned so much, and I, I'm in this field, so you're, you're— I'm like just kind of leaving with all kinds of news to use and nuggets and wisdom. So thank you so much. Yeah, I'm gonna try your protein coffee. Awesome, I love it. Thanks, and, uh, and good luck with everything you're doing.

Thank you so much, it's been great.

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