Enhancing Female Fitness with Dr. Stacy Sims

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Women are not Small Men. That is the line that Dr. Stacey Sims has become famous for, and it was a line she used when she was teaching at Stanford University to explain the sex differences of men and women in exercise. And that's what we're going to be talking about today. We're going to be talking about women 40 plus. How should we be eating? How should we be exercising? Dr. Stacy Sims is an exercise physiologist. She's also a nutrition scientist. She is a PhD and she has really done some amazing work out in the world helping us see what we should be doing at each stage of our life as women to be able to have the best exercise gains and results safely and not hurt ourselves and how not to train like men, which could result in some problems. She's written two great books I highly recommend and I'll put them in the show Notes, Roar and Next Level. And she's also created some amazing courses, one menopause 2.0 that I grabbed and these are fantastic because again, we're going to talk through it today and you'll get a lot of this information but it's really helping you unpack. What should I do as a woman? Because a lot of the stuff you'll see out there as exercise recommendations is based on research on men. And again, like she said, men are not small women. So there's things that we need to do differently. There's ways we want to approach resistance training differently. There's ways we need to incorporate power training, we need to do the right type of cardiovascular training. And we're going to dig into that. We're going to dig into lactate training, what it is, how it could help reduce your risk of Alzheimer's. We're also going to talk about if you do want to change your body composition the way that you can do it. And she has got a really innovative approach and that can help you lose that body fat without any of the pain of dieting. So we're going to dig into all of that and more. I will be right back with Dr. Stacy Sims.

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Dr. Stacy Sims, I couldn't be more excited to have you on the show.

Thanks for having me. I'm looking forward to chatting.

Well, I have been stuck in your work for so long. It is just fabulous to have an amazing, super strong, super smart exercise physiologist, nutrition scientist in our world doing the work and uncovering all of the different things about women. And I think the best place to start. I'm sure you didn't realize you would get famous for the line, right?

No.

Women are not small men would be reverberating all over the globe. But it is, but it's so telling. So let's just dig in with that statement. And first of all, how did it come to be and what do you mean by it?

I don't know if it's ironic or not, but I was teaching a sex difference in training class to undergrads at Stanford, and it was always in the afternoon. And to wake people up, I would say we're doing cardiovascular, blah, blah, blah, blah. Because women are not small men. You know, just as a tagline to people cue in. I wouldn't use it all the time. It would just be if I had assessed a class was really kind of flat and I needed to bring something into it. And around the same time, I had the opportunity to launch a sport nutrition company and we had a specific female line and the tagline for that was women are not small men. And people kind of were like, what does this mean? What do you mean, women are not small men? And so that opened up the conversation to say, hey, you know what? All the research and everything that, you know, in sport and exercise nutrition has pretty much been done on men and generalized to women. But if we look inherently, there are sex differences. That's why I'm teaching a class about it. That's why we see outcomes for women aren't the same as outcomes for men. And then as you know, social media evolved and I did my TED Talk, it just became this thing, this resounding, women are not small men. And yeah, I've gotten some pushback where people are like, it's a very feminist thing to say. I was like, well, it's not about.

Oh, my God, how is that a feminist thing to say?

I'm like, it's not. It's just a statement. It is a statement and people take it and use it and use it however they want to really identify the fact that there is a gender discrepancy There's a gender data gap, and we need to step up and not keep pushing women out of research and out of the conversation, because that's how it's always been.

Thank you for leading that charge. So it would be great to start to look at what the differences are, because I think so much. First of all, I am so thrilled. I'm an exercise physiologist by training, and I always felt like we were sort of the peasants, you know? Right, yes. Right. So, I mean, I was doing my PhD in exercise phys nutrition and aging, and I jumped ship and started studying nutrition because I felt like this lowly exercise person.

Yes, exactly.

Now you look around, you look at longevity, and if this was a drug, it would be the most prescribed drug, no question. I mean, there's nothing that does more. Right. However, you then start to look at the prescriptions out there for this drug, and they're crazy. It's all over the place. And a lot of it, of course, is coming from the men. So what I would love to unpack is the differences and what that perfect prescription is going to be for that woman as she's heading into perimenopause and into menopause. So that's our mission for today, Stacy.

Okay, we can do that. That's fine.

All right, so let's start with just unpacking the differences that we see in exercise prescription and just training and all of that.

Yeah. There was a friend of mine who just did a systematic review of all the strength guidelines that are put out by the National Strength Conditioning Association. Different. Other platforms across the. And when you really look at it, there's nothing done on women. They might have done a couple of small studies done on resistance trained women, but it's not as robust as we have in men. So when we start looking at the actual prescription for something like strength training, you kind of have to take a pause and ask. Because when we look at muscle morphology, so that's the type of fibers that women and men have. There are sex differences from birth because we see that women are born with more of those oxidative aerobic type fibers, we have more mitochondrial density, we have better ability to use free fatty acids, and that's without the introduction of estrogen, which we know already enhances free fatty acid use. So when we're looking at fatigability, we're looking at strength production. There's a difference between men and women depending on, are we lifting heavy? Yeah, we are lifting heavy. So it's gonna take men more time to recover between sets because they're relying more on a glycolytic fiber. So that fast twitch where women don't need as much time between for recovery because we're not relying as much on ATP, cp, you know, the glycolytic stuff because we don't have as many of those fibers. So when we start looking at adaptation, we really need to disseminate it down and say, how are we going to optimally train women? So that's like kind of like the big beef right now when we're talking about strength training and all these things that are coming out where we're telling women, oh, you need to do 10 reps or 15 reps, you don't want to get big, you want to build muscle. And that's just so archaic because it's taking a page out of a typical hypertrophy type block that works for men. But when we look at women, how do we build strength versus how do we build lean mass? And they're two different things. And as we get older it changes again. So when we're looking at women who are in their, you know, their early twenties, all the way through their reproductive years, yeah, if you're going to do like pure strength building because you're doing CrossFit or bodybuilding, then you have to really periodize and do complicated things like cluster sets and French contrast and explosive training. But if you're the general woman who wants to get fit and strong, you have to put in some of the heavy power based training for central nervous system response to get that strength. And then if you want more of that defined look, it's not about doing massive amounts of reps and sets to failure, it's about how am I complementing the strength training that I'm doing with functional and some high intensity work to really make those muscles pop in a feminine way. And that conversation is never had. So as we get older, we definitely need to put more of that power based training in because we lose an impetus from estrogen for that strength and power. So the conversation of women always saying, oh, I don't want to do that because I get so bulky and I'm afraid of getting bulky, it's really, really, really difficult to put on a lot of muscle mass unless you specifically work on it. So when we see someone like Annie Torres daughter or Catherine David's door who are in CrossFit and they're really solid and big in a very powerful way, it's because they train for it. If we're looking at someone who goes to the Gym three times a week. And they're trying to get strong and they're trying for longevity. If they start putting some cardio in, that's going to kill any impetus to get bulky.

I will say, in 40 years of working with clients, I've never had a woman get bigger lifting weights.

No, me neither.

It's just never happened.

And as much as I try, I just can't. I'm like, I'm strong. I like hit PRs and my squats and stuff, but someone looks at me and is like, you look like an endurance runner. I was like, I don't want to.

The fast twitch, slow twitch thing, is that like, gender wise, does that mean that most women tend to have less fast twitch? More slow twitch?

Yes, absolutely. And the deviation there are type 2B's. So those are our oxidative fibers that can be trained to be more endurant or can be trained to be more fast twitch. And that's where we start to see that discrepancy, where we see women say, oh, you know, I can put on lean mass really quickly and I'm really good at sprints, or I can't sprint very well. It takes me forever to put on lean mass. It's that, that bit of type 2B fibers that have been trained a certain way. Of course, we have genetics too, because we have mesomorphs and ectomorphs and that kind of stuff that come into play. But in general, when we're looking at how we need to train women, we need to not look at volume with regards to endurance work or really, you know, if we're looking at volume. People say women respond more to volume and strength training, but it's not spending hours and hours in the gym, it's more frequent doses. So when we're looking at three times a week for men, maybe it's four times a week for women to get the same kind of adaptation. So there are definite, definite differences of the way that women should be treated.

So you mentioned that strength is different than hypertrophy. And I've kind of in my mind. And it was funny, when I was in graduate school, there was a. And I'm sure you remember this, the.

Hypertrophy range was this.

And they were very tight. And I kept going. The strength range was 1 to 5. And I kept. But the hypertrophy range was 8 to 15. And I thought, well, what happens between 5 and 8? Like, is there some weird. I know there's some magic.

What's a magic number? Yeah, there's magic happening right go after.

15 and then what happens? So what are these? Because you look at it and think, okay, if we're not using it, we're losing it. So as we're aging, we could be losing muscle hypertrophy, muscle size, muscle strength, muscle power, which I find the most concerning. So knowing that those are all our concerns and they're different in how we train, how would you have someone trained to maintain those. All those things and optimize them?

So, I mean, I'll bring it down, and you've probably heard this, and I'm just going to reiterate for all of the listeners, when we're looking at estrogen, estradiol, which is E2, this is the primary female sex hormone that's responsible for our muscle strength, power, and how much muscle mass we have. People talk about testosterone being the key hormone that is for men. Yes, women have testosterone, but our main anabolic, or muscle building hormone is estrogen. So as we start to get in perimenopause and we're losing the ratios, optimal ratios of estrogen, progesterone, and we're starting to lose absolute levels of estrogen, we have a change in what we call our alpha receptors. So those are estrogen receptors that are specific in the muscle fibers. So when we lose those and we are getting a decrease in the sensitivity of those receptors, then we're losing a main impetus for building lean mass. We're also losing a main impetus for how myosin and actin bond. So myosin and actin are two main muscle contractile proteins, and they kind of bind together. If you can think about climbing a ladder and you're putting one hand up and another hand, that's like myosin and actin coming together to pull those muscle fibers together for contraction. Estrogen is responsible for how strong myosin grabs onto actin. So we lose that and we start to lose some of our strength. Then we're thinking about speed, which is power. It's how fast that nerve conduction comes from central nervous system to jump over to the muscle to depolarize to create this contraction. Estrogen is responsible for how fast that happens as well. So like I said, when we start to lose estradiol, we lose three of those key components for strength, power, and the building of the lean mass. It's not because of the absolute levels of estrogen per se, but how our receptors are now not as sensitive or not being as expressed as much. So when we're looking at how do we mitigate this, or how do we really affect change. We have to look at that external stress from exercise that's gonna create a response the way estrogen used to. That's why we look at strength training. So that's why we look at that central nervous system, power based training and we look at all the history of strength training that's at low rep range. That is when we are really lifting heavy loads and we're looking at that 3 to 6 or 7 rep at that 80%, 1 rep max or more and we have adequate rest. So like for example, this morning I did hip thrusts and I did eight because I'm trying to get more explosive. So I did eight at 80% on the three minute. And what I did is I did the eight and then I did five box jumps and then I rested the remaining of those three minutes. So that's taking the central nervous system response from the heavy lifting, putting it into an explosive movement. So I'm trying to maintain my power and my strength through that kind of work. Done and dusted in 15 minutes. It doesn't take a lot, but this is how women who are 40 plus and losing estrogen and progesterone testosterone need to work that central nervous system so that you're really working on that strength development from central nervous system and that explosiveness that comes from really pushing after a heavy load. And this is what we mean by that external stress to create that impetus for improving power, strength and lean mass. When I think about lifting, I want it to be a whole body complex functional movement. So if we're doing squats, we're looking at how are we bracing, how are we aligning, how are we keeping our core tight, how are we putting our feet? Are we, you know, just all the technique orientation so that if you have to switch squat down to pick your groceries up, then you're not going to get a low back injury. So it's the same as what you're talking about. It has to be functional. And when we're looking at balance and proprioception, that becomes a huge, huge thing as we get older. But we also see that when you're doing more complex lifts and you're getting more muscles involved, it creates more neural pathways. So we're finding that is a really good way of attenuating or slowing the onset of cognitive decline. Especially when we see there's that sex difference in things like dementia and Alzheimer's. And we're seeing that it has primarily aspects to do with a decrease in neural growth patterns and the lack of metabolic challenge to the brain in Women, just because historically we haven't been pushed into doing high intensity work or strength training. So when we start to really change the training up, we see a decrease in that sex difference, and we're seeing a decrease in the in population stats of sex differences as our generation is aging up and we've been exposed to that high intensity and that strength training. So it's really important that we get all of those complex movements, and not just for stability and proprioception and balance, but also for brain health.

So that's amazing because I know I'm really good friends with Dr. David Perlmutter, and he was showing me the information on women and Alzheimer's. Are you saying there's research out there now? Because I just figured it was an estrogen problem.

No, that's the misconception. And this is where.

Wow.

Yeah, because if we look at brain metabolism, right, and this is where we're seeing more and more research coming out about lactate metabolism. And part of it is when we're looking at lactate as a preferred fuel for the brain, it really does create a conversation between the glial cells and the neurons. So when we don't have lactate metabolism, we lose that connection. And when we're losing that connection, this can be the onset of that plaque development. So if we're looking at doing that high intensity work and maintaining lactate production throughout our life, then our brain is like, yeah, I think we have to.

Back up and tell everyone what lactate production is. I'm just realizing, yes, I don't know that I've ever talked about it on this podcast.

So.

And that's a great introduction into hiit too.

So.

Yeah, I know. So when we're talking about lactate production, that's at high intensity work, and people like, oh, my muscles are burning, I can't maintain this pace. It's that high intensity work. Because when we're looking at how we fuel exercise, if we're just casually going for a walk or a steady state jog, or maybe we're out, we're doing Pilates or something, that's not so high intense. We're relying a lot on what we call our aerobic metabolism. So this means our body's using carbohydrate, it's using fat, it's able to break those molecules down and use them adequately as fuel. And the byproducts are brought back into the muscle and recycled and used. When we do high intensity work, it's the responsibility of the muscle for getting the fuel to maintain those Muscle contractions is higher than what our body can take oxygen in and deliver it and get into that system. So we have a byproduct of carbohydrate metabolism that's pyruvate. And if we can't bring that into the muscle and use it because we're doing too intense work, then that pyruvate is converted to lactate and lactate gets out into the blood. People used to think it was a waste product, and it's not. What we see is it's then recycled and used by the brain and the heart. And it's really important that the cardiac muscle in the brain tissue get exposed to lactate in order to optimize metabolism and fueling of the heart in the brain. So when we start looking at the nuances of how women have been told, if we think about the 80s and the impetus of low fat fat burning, long aerobic sessions, yeah, get in zone two or, you know, in that fat burning zone, none of that has really been beneficial for women except from that cardiovascular standpoint with regards to being able to maintain cardiac muscle because we increased our heart rate. But when we look at body composition, when we look at brain health, when we look at cancer, all these public burden diseases and things that everyone is super afraid of, we bring it back down to lactate metabolism. So if our body's exposed to lactate and understands how to use it and can use it appropriately, we're finding that it really does help attenuate some of these sex differences in these scary diseases. And we're seeing specifically in brain and brain health that the more we are exposed to that high intensity and lactate work, the less chance we have at developing the onset of the plaques that are associated with Alzheimer's. So there's some newer research, and I want to share it with you. So I'll send you some of the papers because it's really cool to read where you're like, finally, someone's talking about how exercise is good for the brain. Yeah, it's besides the, you know, everyone talks about bdnf. I'm like, yeah, BDNF is important, but that's a growth factor. Yes, but we want to look at the actual metabolism of lactate and how beneficial it is for women's brain.

I just never knew this. So with that in mind, then what would be a great exercise prescription for hiit to optimize that?

So there's two different ways of looking at it. Like, some women are afraid to hit that super top end because they don't like being that uncomfortable. Comfortable. And that's what we really want to do. We want to do that sprint interval training where you're like full gas 9 to 10 on your rating of perceived exertion of 1 to 10 for 20 or 30 seconds with about 3 minutes recovery. So you have that really high, high intense work. And then you have the 3ish minutes to accumulate the lactate before you hit it again. For women are like, I can't sprint, it's too hard. Then we look at a little bit lower intensity, but true high intensity interval training work. So this is where we have interval that's one to four minutes. And you're right at threshold or above threshold. So that means you're working at about 80% to 90% of your max.

And how would someone really know? Because from everything I've been reading, people don't really know what their reps are like. I think most people haven't gone and really figured out what their one rep max is.

Right.

So they underestimate all of this.

Absolutely. So one of the things I like to have people do is, you know, taking a page from CrossFit and Emom. So every minute on the minute, so you have four really specific higher intensity exercises and then one minute recovery, and you keep repeating it. So it might be something like you do 10 thrusters followed by 10 kettlebell swings and then 10 crock rows. And you have to do those 10 thrusters in a minute. And whatever kind of extra time you have at the end of that minute is your recovery. So people are finishing at 50 seconds and then they have 10 seconds before they move to the next one. So it ends up being four minutes of high intensity work, knowing that you have one minute of full recovery before you repeat it two or three times. And that really teaches people what that top end and what high intensity means. Because there's such limited recovery. When you hear people going, oh, I do high intensity work because I do tabata. 20 seconds on, 20 seconds off, I'm like, no, that's not right. That is not what we're talking about. That is not high intensity work. So when we start understanding what true HIIT is, knowing that you can't maintain it for 45 minutes, which so many of these classes have, are, then people are like, oh, I get it. And I feel good. I don't feel completely wiped out. I finish kind of on that runner's high and that's how you should feel. But we've all been so conditioned to feeling smashed after a quote, high Intensity session, that that's what we think we're supposed to feel like. And that's not true because that's really just putting you at a top end of moderate intensity where it's really too hard to be easy for any kind of recovery and it's too easy to optimize adaptations of high intensity work.

And that's really not good for women either, is it?

No. And this is a conversation and I need to write something about this because I get questions all the time on social media about how I can promote high intensity interval training and sprint interval with cortisol. Yes.

Oh, I'm so glad you're addressing this.

Yes. You know cortisol is like a heart rate, right? It does go up during exercise, right? Just like your heart rate goes up during exercise in steady state, it kind of stays at that place where you want it to be. In high intensity, it's very polarized. It learns to go up and down, up and down, up and down. Cortisol does the same. Well, it goes up during exercise, but post high intensity exercise, you have a subsequent growth hormone and testosterone response that drops cortisol pretty quickly and it promotes reparation. And, and so you have the signaling after that really high intense work that now we need to lower our baseline cortisol. Just like your heart rate gets lower, the fitter you get, your resting heart rate gets lower. So does resting cortisol. When you're doing moderate intensity work or a HIIT class that isn't truly hiit, your cortisol comes up, but you do not get that subsequent response of growth hormone and testosterone because it was not a great enough stimulus to invoke that response. So your cortisol stays elevated. And this is why we see so many women who are saying, oh, I go to Orangetheory, I go to CrossFit, I go to the local HIIT class and I'm tired but wired and I'm sympathetically driven and I can't bring my cortisol down. It's like, yes. And this is why high intensity work has gotten such a bad rap, because it's not true high intensity. So when we're looking at cortisol, it is an essential hormone that we need because it does create an adaptive response. But it's the follow through conversations that aren't being had about how do we train to optimize cortisol responses to then come down. So we have a lower baseline and a parasympathetic drive later in the day.

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So if someone was going to do, say, they had a sprint treadmill, because I. I got one of those. That was my 60th birthday present.

Love it.

Well, I know there's that. No one knows where. The citation is that after the age of 35% of us ever sprint again. Except there's no documentation. However, I was in the 95%. So I went, huh? And I actually went to an interval class that had sprint treadmills and destroyed myself in about five minutes and went, I clearly need a sprint treadmill.

Yeah, they're so hard. They are so hard.

And they're a little scary at first. But a sprint treadmill or a bike, what would be a great hiit workout?

If we're talking a hit or a sprint interval training Sprint.

A sprint.

A sprint. Interval strength. Okay.

Because that's really what we want to be doing.

That's what we want to do. So people are afraid for running sprints because their tendons and ligaments and everything is a bit iffy. Or their knees. I say we start with battle ropes. So if we have the gym with battle ropes, because it's a total body and it's isometric, but it's really high, intense. If we're doing 30 seconds of battle ropes, you're completely gassed, Right. And then you take two minutes of recovery or you're walking around bringing the heart rate down, trying to get full recovery before you do it again. If your second time, you're like, this feels great. Sweet. Do a third one. But if your second one, you're like, oh, my God, I'm going to die. Finish the second one. Because that's all you need to do for the day. When you're first starting, it's not about doing four, six, ten reps of it. It's about quality. So some people are like, but that's not long enough. It's like, it's the. It's the quality of the workout that we're after. And as you do it a little bit longer and you get used to it, then you're able to put in more reps. But you don't ever want to go over six to eight reps of this High intensity work. You don't need to. Your quality goes down after you hit that sixth one. Doesn't matter how fit you are. It does go down. And that's not. We don't want you falling into that moderate intensity work.

Right.

So you just switch from sit to hit when you did that and negating.

And then kind of negates it. I often have people do what we call a sit finisher. So if you're doing a lot of upper body work, so you're on Wednesday, you're doing overhead push and then you're doing bench press, maybe some rows. And so you're really focusing on that heavy, complex movement upper body. Then you finish with three rounds of battle ropes of 30 seconds each. With two minutes off, you're getting your sprint on top of that already fatigability. And those are your two workouts that you need to do that complement each other. And you feel completely wasted in a good way. Not wasted in. I'm completely gone for the day. So it's a way of implementing some of that sprint stuff without taking an extra time. And other people like, no, I want a real sprint workout. So then we're looking at warming up for a good five to 10 minutes with our mobility work. And then we can hop on a bike or rowing erg or sprint treadmill. And we're going as hard as we can for 30 seconds, maybe harder than we can for 20 seconds. And then you are recovering for that, you know, 90 seconds to three minutes until you can do it again. And it's the same concept. The mode isn't that important. It's how hard you can go that we're after.

And it should not feel easier. You should just push harder.

That's the most.

I remember when I first started teaching HIIT training, someone came back and they go, oh my gosh, it was amazing. I took your minute and I was able to go six minutes. I go, what?

Yeah. No, that's not what we're after.

That would not be it.

No, I know. Yeah.

Let's flip over to the diet side because there's a lot of fun stuff to unpack there.

Oh, yeah.

Well, what I'd love to start is kind of this intersection because when fasted workouts became all the rage, it was a head scratcher. So I'd love to talk fasted workouts and intermittent fasting. Fasting in general.

Yeah. Yeah. So not a fan. I am not a fan of fasted workouts. So when you look at the research, women do better in a fed state, regardless of age. And the reason for that is really nutrient sensitivity. So we're looking at the hypothalamus, where it controls our thyroid or endocrine and our sex hormones. We have two areas that are sensitive to nutrient density, specifically carbohydrates. And if we're doing a fasted workout, then we're signaling to the hypothalamus that we don't have enough nutrition to actually accommodate for the stress of exercise. So we get the signal to the brain that we're in a low energy state, regardless of if we're eating enough. If we're in a low energy state, our metabolism starts to turn down. Our thyroid goes down after four days of this kind of stimulus. If we're in our pre and perimenopausal years, it really disrupts luteinizing hormone pulse as well as estrogen and estrogen production. We see a disconnect of our appetite hormones. So we never really feel hungry, never really feel full. And so it's always kind of this, I don't know what to do. So it creates a kind of a disorder in our eating as well. And we're looking at it as we're doing subsequent days of fasted training. We look from a metabolic standpoint, women don't need to do fasted training because the whole idea of fasted training is to increase metabolic flexibility. I mean, that's one of the number one reasons why we hear about fasted training or intermittent fasting is metabolic flexibility. We look at women and as I said earlier, we have more of those oxidative fibers. So we already have more of the MCT1s, meaning that we have the capability of bringing in and using free fatty acids. We are very well adept with mitochondria mitochondrial respiration. We are born with more of the proteins responsible for mitochondria health. So if we're doing facet training, it's like meh. The body's like meh. I don't really know what to do with this because it's not creating any kind of real adaptation. When we get into late peri, early postmenopause with that change in estradiol, we see that estrogen because it dampens inflammation, that we'll start to have a misstep in how the mitochondria uses free fatty acids. And so this is why we see too many free fatty acids floating skeletal muscle, so can't really use it. It gets brought to the liver, the liver dumps it as the cereal fat. So if we're doing more fasted Training and we're increasing free fatty acid use, it's promoting that problem because the mitochondria is like, I don't know what to do with this, I can't bring any more in. So it kind of shuts stuff down. So we're seeing all these people saying fasted training, it's more of a calorie deficit that's creating change. It's not about the fasted training. So then when we start talking about intermittent fasting or time restricted eating, intermittent fasting, if we're talking severity of like the 16 hour fast or we're not eating until noon and our eating hours are from noon to 8, none of that really creates a metabolic efficiency for women. When we compare that versus normal calorie restriction, they come out the same. With regards to body composition change and metabolic control. What we do see in general population scope is if we break the fast early, by around 8 o' clock, and we eat with our circadian rhythm throughout the day, when we're stressed, not only from exercise, but life, we have dinner and then we don't eat after dinner. That creates a much better control from a metabolic standpoint as well as body composition and longevity, because then our body is aligning with hormone production with cortisol production, with melatonin for better sleep, and we're fueling when our body needs it. So I say, okay, if we need to use buzzwords, then we can say time restricted eating, which is really eat breakfast throughout the day, stop eating after, or you know, you know, eat dinner and then you don't have any more food.

It's like normal eating.

Normal eating, yeah, but people don't like that. That's too, you know, that's too normal.

Well, it was the eating we used to do before they introduced. I remember when Taco Bell here in the States started the billboards with the fourth meal that was like from 8pm on I go, yes.

Oh no. I know, it's crazy. I know. Because people don't know what it means to eat normally anymore. I take trips to Europe and you don't see people really eating in their car. It's part of the culture. But in the US and now it's become endemic here and in Australia as well, that it's eat anytime, everywhere, all the time. And people have disregarded what it means to sit down for a meal. And I think that's where we're starting to see all this disconnect between what food is and what it means to be nourished. And that's why we have all these buzzwords like intermittent fasting, fasted training, keto paleo, all of these different things that are just ways of creating an elimination of calories or different foods.

Well, if, if intermittent fasting gets people to eat back in the normal eating phase that I think we all grew up with was, you know, wake up and two hours later have breakfast and then come home from and have dinner and stop eating, great. You know, we had to put a name on it, but that's, that's normal now. So we talked fasting. What about where do you stand with carbohydrates? Because I feel like there's a lot of fear around carbohydrates, you know, especially how do you dose carbohydrates and protein. What's your thought on keto? I'm just going to throw all that out there.

Throw it out there. Okay, I'll start with keto. Keto is the way that it became a thing in the medical world for Perry and postmenopausal women. Is there or there were two papers that were circulating that were on a sedentary, obese, relatively sick postmenopausal women and they're put on the keto diet and they lost weight and they had better metabolic profiles. And if you're looking at it from a scientific standpoint, yeah, it's a really cool, well designed study. But if you're looking at, from practical standpoint, if anyone in that situation was put on a carbohydrate restricted diet because they were diabetic, they're gonna do better. And also if they're put on calorie restriction, they're gonna lose weight. But that wasn't what was taken out of the messaging. It was all postmenopausal women should be on keto. When we look at the other research around keto, the biggest problem is the gut microbiome. So the gut microbiome is something that isn't really discussed with regards to how it changes in this peri to postmenopausal state. We see a significant decrease in the diversity of the gut microbiome in around the four or five years before that one point in time menopause. And that diversity decrease stays if we don't do anything about it in postmenopause. The reason why we see this change in diversity is sex hormone metabolism. So when we are premenopausal and we are in a reproductive years and we have that fluctuation of estrogen, progesterone, it has a second pass through the liver. So second pass means Some of the estrogen metabolites and progesterone testosterone get bound up by sex hormone binding globulin in the liver gets shot with bile into the intestines and then we have little gut bugs that unbind it and shoot it back out to do some more work. When we start losing estrogen, progesterone, testosterone and the ratios change, we lose those gut bugs. Unfortunately, at the same time, the body's under a significant amount of stress. So this is where we hear tired but wired, sympathetic drive, elevated cortisol, all that feeds down to the gut microbiome to create a growth of the more obesogenic phyla that makes you crave simple carbohydrates, that has a misstep in vitamin production, that perpetuates the sympathetic drive. So if we aren't paying attention to the type of fruit and veg and deep fibrous foods that feed the gut bacteria, we create this really bad dysbiosis in the gut that perpetuates the cereal fat gain and metabolic dysfunction. So if we can look and say the best thing for perimenopausal into postmenopausal women to do is when they're eating, they look, how is this feeding my gut microbiome? Because I need my gut microbiome to be really diverse and if I don't work on creating that diversity, I'm going to end up with a of lot, lot of issues that I don't want to deal with with regards to bone mineral density, brain health, body composition, metabolic control, insulin, insulin resistance, BDNF production, all of the things that, that are creating headlines in the news at the moment. So when we look at keto, there's no fiber, right? It's just high fat. There is no deep fiber refoods coming in to feed that gut microbiome. Am and when people are professing how keto works for them, it's like, well actually what do you mean by works for you? Are you saying that it allowed you to lose weight? Well, let's have another look at that. Let's look at all the other metabolic profiles. Because the other thing that happens with peri into postmenopause is a change in our blood lipids because estrogen helps with inflammation, it helps with cholesterol, so we start to to lose that. We have an increase in our LDL and our triglycerides which also gets promoted with ketogenic diets. So that's the long winded version to say no to keto.

And so when we look at carbs and specifically because I know now we're looking at carbs, I look at carbs for the fiber, the polyphenols.

Yeah.

And one thing I especially love with exercises, we are eating more so we can get more nutrients in, so we've got better energy flux. But what is your recommendation in terms of how many carbs we should have? Carbs versus protein. Like where do you, where do you land on your protein prescription? Where do you land on your carbohydrate prescription?

So protein is really important because as, you know, as we get older, we become more anabolically resistant to protein and exercise. We see that women need on the upwards of 40 grams of high quality protein post exercise. And there is a recent study that came out that said up to 100 grams will help promote muscle protein synthesis 24 hours later. So we really need to put that emphasis on protein.

When you said the 40 grams post exercise, you know, I remember back in the day when we had the window and, oh boy, you know, and I was actually used to train and work out clients down at Gold's Gym in Venice, which is the bodybuilding mecca.

Yeah.

Literally everyone had their protein shakes. There was a place right next door that did chicken and brown rice and broccoli. That's the bodybuilder fuel. So because we thought we had this like limited 60 minutes that you had to get this in, which, you know, I know now is not the case, but what is the recommendation for protein intake? Like in what type of window? How much? I know you said 40 grams. I'm assuming that's 40 grams. Animal.

It's more about the leucine quality. So we're looking at 3.7 to 5 grams of leucine and whatever it is. So when we're looking at that post exercise window, we're looking more for women, especially when we're stressed in peri and postmenopause, how to drop cortisol and drop that catabolic state. So we look at that, you know, within an hour. You want to get that in ideally 45 minutes, because it really does help with that. Testosterone, growth hormone and protein all come together to really promote muscle protein synthesis and reparation across the board. We know that it's more about daily intake rather than distribution with protein. So we want to have women hit around that 1.1 grams per pound or 2 to 2.2 grams per kilogram in a day. And the way that I get women to try to really look at it is every time you go to have A meal you want palm and a half size protein and whatever that is, it doesn't have to be animal. It can be a combination of a whole bunch of things. So that's going to give you around that 40ish grams. And then every snack you want about a palm size. So that's about 20, 20 grams of protein. And that's going to allow you to keep your protein intake up. With regards to carbohydrate in the States, it's hard because I go home to the States and like walk into Safeway or grocery store. Like this is a massive building full of things that's supposed to be food, but none of it's edible except in the refrigerated fruit and veg department.

Yeah, it's wild.

It's crazy. So much ultra processed and marketing and sugar and prices and everything.

So just look what's happened in the last 20 years.

Oh my gosh. I know. I tried to explain.

I guess it all started with the Susan powder. The fat's the enemy. And then we got Snackwells and Snackwells.

Yes, downhill. It did. I know. But the snack wells away. Yeah. And now we have things like protein fortified pop tarts. No, that's not what we want. So carbohydrates, the more natural, you know, we go for. And carbohydrates are in a lot of things. But I always tell people carbohydrates are essential for women. Don't be afraid of carbs. Don't be afraid of things like sourdough bread. Because sourdough bread. Yeah, it might be white, but it is fermented, sprouted grains for the most part. There are things in it that are good for you. If you're someone who has real issues with insulin and insulin sensitivity. We want to look at having your favorite carbs after exercise in that acute window post exercise where we don't really need insulin. So that's around 30 minutes post exercise where we can eat some of those more simple carbs or some of the things that are really polarizing for our bodies and not have an insulin response or have to worry about insulin. Insulin. Because now we have things like our glute 4 proteins are translocated, open up the cells to allow that carbohydrate to come in. The rest of the time we're looking at really fibrous, colorful fruit and veg. And I always tell people I follow the 8020 rule. I hope everyone else does. 80% of the time you're on your nutrition and your training and everything. 20% is life. And so that's where, like, your booze and your, like, quick hits of carbohydrate lay. Maybe a couple late nights. And if you're having lots of problems, dial things in, then maybe it's a 9010 rule. But we can't forget that life should be fun. We shouldn't be all, like, have to be dialed in every day, all the time.

Well, I always find if someone's like that, then they're either all the way in or all the way out.

Right?

Exactly.

Well, so it seems so silly to admit this one, but I only recently became a creatine fan. Like, literally.

I know.

I'm embarrassed, honestly. I have some creatine shame that somehow. But I think it's because of the background of being with all the bros.

Yes.

Over at Gold's Gym in Venice and kind of going, that's a dude thing. And then a couple years ago, I started to look at it. I go, oh, my gosh, this is like, the ultimate, best supplement I've ever seen for a woman, 40 plus. Like, what the heck?

Yeah.

And so. But it's been interesting since I've been talking about creatine. The fear around creatine is something like. It's still shocking. Every day I get DMs around creatine.

Me too.

And fear around creatine. So I would. You've published some great stuff around creatine, so I'd love you to unpack it, the benefits of it, and why we should not fear creatine.

I think the first time I brought creatine up on any kind of social media that created a buzz is when I was talking to Annie Torres daughter during her first pregnancy, and she's talking about creatine. And I was like, oh, my gosh, you're pregnant. You should be taking creatine. And she's like, what? I was like, as long as it's creapure, you want to use creatine because it's. It is involved in so many of the fast energetics and is really, really beneficial during pregnancy. And people started shooting me DMs don't tell someone to take a supplement. I was like, no. Let's look at the literature of creatine. It is the most studied one out there. And there is so much efficacy around using creatine, especially in women during pregnancy and as they get older, full stop. We have around 70% of the stores of men, but yet we go through a lot of it from maintaining our gut microbiome and our gut mucosal lining. We need it to kind of stop and attenuate any kind of IBS or other symptoms and issues. Really, really important for brain health because of all the, we're to think about all the fast energetics, how fast the heart and the brain and everything and they all use creatine and people are afraid of the bro bodybuilding getting bulky, putting on that water weight. Well, if we look at the dosage and we see 3 to 5 grams a day for women really helps with mood and helps with depression, helps with brain health, gut health, heart health, all those things. And if we're not loading it like the typical bodybuilding idea of 5 grams 4 times a day with carbohydrate, you're not going to put on that water. Weight gain. The other thing that comes up with creatine are the side effects of like nausea and weight gain gain and some of the ill effects that people are talking about. And that comes from the process of how creatine is actually prepared or produced. So if we're looking at something like Creapure, which is a B2B or a business to business product, it is from Germany and they use a water based hydrolysis process to create creatine from some other chemicals. We look at the cheaper versions of creatine that are not creapure and they have to change the solution with an acid to be able to have the right reaction to create creatine. And it's that leftover acid that's in that creatine that's causing all the side effects. So if we're trying to like build out like what? Why am I having side effects? Why am I having these issues? Look at what you're using for one thing. But we're looking at the overall literature about creatine. It is so important for, you know, almost everyone, but really important for women. There's a new website called Creatine for Health and it lists all the most recent literature and they've done a big huge push on funding women's research with creatine. Abby Smith Ryan and Darren Carroll just put out. I'm just looking up at the top of my screen because I read it this morning. They just put out a really fantastic paper on creatine for women in the lifespan and really going after why creatine helps with brain health, why it helps with heart health, why it helps of course with muscle performance. And it is an amazing paper. I think anyone, any woman should read it to really understand why creatine is so important, important for health.

Now, isn't some of creatine. I can't believe there's a website. Because again, it's not like there's a bunch of money in creatine.

No.

So that is amazing that someone would do that. And we'll put that in the show notes. But isn't part of how creatine does this is that it will draw more water into your muscles?

Yep, that's part of it.

This is a good thing, right? Whenever I hear women comply, go, you want this? This would be a good thing, not a bad thing.

Yeah, it is a good thing. It's the same as when women start to eat more because now they're finally coming out of low energy availability. And like, I'm putting weight on and I was like, wait a second, that weight is water and glycogen. Because now you're finally eating. It's not fat weight, it's not extra tissue weight, it's what's in the muscle. It's a good thing. It's a good thing. So, yes, with creatine, you will have extra water stored, which helps with hydration as well. Yeah.

So one last one since you. I was gonna leave it with creatine, but you brought up weight. And for that person who hasn't been chronically under eating, maybe they've gone through menopause, they picked up some weight during menopause, now they would like to do something about it. What do you recommend on the diet side? How do you handle that?

I always really look at protein intake and making sure that we're having that higher protein intake because we see with a slight calorie restriction and higher protein diet, we maintain lean mass and we have a stimulus for losing body fat. So if I put someone in a calorie deficit, I make sure that it's at night, preferably at dinner. Right. So we're taking away extra 150 to 200 calories from dinner, fueling well through the day, keeping that high protein intake. It also helps with satiation and putting them on a good strength training program. Because if we're looking at strength training and how that really does create that conversation between skeletal muscle and things like the cereal fat and other subcutaneous and adipose tissue, the extra kinds really tell, you know, we don't need you. Fat go away. And it does not create that huge sympathetic drive or that increase in appetite per se. So it does help women understand that, yes, you can eat and you can train and you can have these things and still lose weight. So there's A huge learning process in that. So I work with people closely to get them to understand that, yes, we need strength training as a big rock. We need protein. And then we're going to change what you're eating at dinner depending on what your training of the day has been. If you haven't done much training, then we're really going to just have veggies as carbohydrate and a good hit of protein. If you had, you know, a really active day, then we're going to put veggies and some fruit and maybe some whole grains in there. But we're going to stay within that extra 200 calorie deficit. And the body fat really starts to come off after time. And when people are impatient, I always tell them, look, it took time for you to put weight on. It takes time for you to take it off if you want to keep it off.

Yep. I had a great mentor early on who'd say, you know, think how long you haven't felt well.

Yeah, that's right. Right.

It's been four years. You cannot give me four weeks. This is not going to work.

Right.

And I really like that pulling from dinner. I feel like the intermittent fasting world really started to emphasize, like these big dinners and I'm like, that's.

That's the worst. Yeah, exactly.

Never ever. Well, I'm going to put all of your books, social Media, everything@jjvirgin.com Sims S I M S I love your. I have a menopause course of yours, I think. What is it? Some kind of weight training menopause course that I've gone through online.

Yes.

So tell everyone what you have because I know you have a couple. I've got that course. I know you have some different online things. You have Next Level and Roar, which I've done the audiobooks. Great. I mean, you have great information, great social. So. And the courses, what are the courses that you have?

So our deep dive education courses. We have our Menopause 2.0. That's seven hours of lectures and, you know, learning material. So that's like kind of the deep dive. We have a youth course that's coming out. So that's for like all the girls and parents wondering how to navigate 11 to 20 and all that kind of stuff. And then we have the full spectrum of women are not small men. So that's pretty much the whole lifespan. So that's like our courses. But when we're looking at the implementation of strength training and stuff, I've partnered with Haley Happens Fitness. So she is really into strength training, strengthening modalities for women 40 plus. And we have what we call power happen. So it's all about the lifting heavy and the proper sprint interval training. It's a 12 week session and right now or 12 week course and they're around 60 minutes. We're putting a power happens express out because people are like, wait, I thought you said that we shouldn't go over 30 minutes. It's like, okay, well now here's our 30 minute option then for people are more CrossFit oriented and want the complex movements and the ollie lifting and love that whole like programming that CrossFit has. Then I have one with Annie Torstotter and Katrin, David's daughter called Empower. And so it's more of a page out of CrossFit where we're looking at Olympic lifts, heavier lifts, and then using stuff that's in the gym like assault bikes and assault runners. And so you definitely had to have a gym membership or be part of a CrossFit gym to use that program.

Awesome. We will put all of that in the show notes. So yeah, that's the one. I have the Menopause 2.0.

Nice.

Great information and I love that I have a resource to send women too for the power training. That's fabulous.

Yes, it's good.

Well, thank you. I really appreciate it was so worth the wait. And shout out to our buddy Bree Argod singer the Betty Rocker for picking us up.

She's awesome. Yes. Yes, she is.

She is.

So thank you again and it's gonna be jjvirgin.com Sims. Be sure to join me next time for more tools, tips and techniques you can incorporate into everyday life to ensure.

You look and feel great and are built to last.

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Hear, don't forget to leave a review. Your reviews make a big difference in helping me reach more incredible women just like you to spread the word about.

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Thanks for tuning in and I'll catch.

You on the next episode. Hey, JJ.

Here.

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