Welcome to the huberman Lab podcast where we discuss science and science based tools for everyday life. I'm Andrew huberman, and I'm a professor of neurobiology and Ophthalmology at Stanford School of Medicine. My guest today is dr. Stacy Sims. Dr. Stacy Sims is an exercise physiologist and a nutrition scientist and a world expert in all things training and nutrition specifically for women in addition to working at Stanford and with numerous professional.
Rettig teams, dr. Sims has authored more than 100 peer-reviewed studies on exercise physiology. She has not only evaluated existing protocols for nutrition and fitness that are specific to women versus men, but she has also developed many new protocols that are now in practice with professional sports teams, but that can also serve people who are generally interested in Fitness and Longevity and in doing so the general public the tools that dr. Sims shares with us today are applicable to Fitness to
Changing your body composition and to overall health today. We discuss how hormones and hormones Cycles impact nutrition and fitness needs specifically in women of different ages. We have course discuss the menstrual cycle perimenopause and menopause but also female specific nutrition and training as it relates to things independent of hormones. For instance. We evaluate the evidence that women may not want to train fasted and the reasons for that we talked about how training might vary according to different.
Phases of the menstrual cycle and we discuss how women can design nutrition and training programs that are optimized for their specific needs. Not just because they are women but because they are women of a particular stage of life and women with particular goals as you'll soon see, dr. Sims is exquisitely skilled at explaining the human universals of nutrition and training that is the things that do not differ between men and women and their needs in terms of nutrition and training but she has also exquisitely skilled at highlighting the data showing that there
Or specific areas of nutrition and fitness for which women and men differ and women have specific needs. So today you will learn what those are and you will learn how to apply those specific protocols such that by the end of today's episode You Will Be armed with a tremendous amount of new knowledge about the biological mechanisms and the specific do's and do Nots that can guide you towards your female specific health and fitness goals before you begin. I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
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And now for my discussion with dr. Stacy Sims, dr. Stacy Sims, welcome thanks our podcast and I put out a lot of content about Nutrition Fitness cold exposure heat exposure hydration topics that are very near and dear to your heart and for which you have a ton of expertise, but for which you have an extra degree of expertise as it relates to females specifically
Yeah, so I'm excited to talk to you today because very often I will get questions in the comment section on social media or on YouTube was this study done in both men and women. How does it differ for men versus women and on and on and I rarely if ever have answers but you have answers I have answers for you great. So just to kick things off because this is a question. I get really often fasting. Oh, yeah intermittent.
Lasting yep, we need to distinguish between the two. Of course, perhaps the most common question. I get as it relates to males versus females is is intermittent fasting or time restricted feeding as it's sometimes called an eight hour feeding window a six hour feeding window attend our feeding window. Is that something that perhaps differs in terms of its impact and how well it works for?
Men versus
women. Yeah, that's the short answer. Great. Yeah. Yeah, so I'll put some parameters around it. Right? So if we talk about intermittent fasting that's where you have like the 20 hour non feeding window or you're holding a fast until noon or after and then we have time restricted eating and that's the fancy way of saying normal eating where you having breakfast and then you stop eating after are you don't have anything after dinner? Right? So you're eating with your circadian rhythm during the day.
Look at intermittent fasting where you're holding the fast up till noon or you're having days of really low calorie restriction. We see in active women. It's very detrimental unless you have PCOS or you have some other subclinical issue. And the reason for that is we as women have more oxidative fibers. So we hear about all the things about fasting to be to improve our metabolic flexibility to improve telomere length.
To improve parasympathetic activation but by the nature of women having more oxidative fibers, we are already metabolically more flexible than men we interesting. Yeah.
Didn't know that could you elaborate on more oxidative fibers what that is and how it relates to metabolic
flexibility or so oxidative fibers are muscle fibers that are more aerobic capacity. So those are the ones that you can go long and slow for very long period of time because it uses a lot of free fatty acids.
You need a little bit of glucose in order to activate those free fatty acids. So we look when a woman starts to exercise. She goes through blood glucose first and then gets into free fatty acid use she doesn't have so much into liver muscle glycogen, which is I think another misconception that happens. So we're talking about fasting or fasted workouts trying to improve that metabolic flexibility. It increases stress on the woman. And so when we're talking about overall stress, we're talking about cortisol increase and they can't hit intensities hiya.
Enough with no fuel to be able to invoke the post-exercise responses of growth hormone and testosterone which then drop cortisol. So from an overall stress perspective that fasted workout and holding that fast for a long period of time increases cortisol, but then when we look from like a hypothalamic point of view and we're looking at how the brain reads its we know that there's one area of Kiss pectin neurons in the brain for men but there are 24 women so the two areas
It's are distinct where One controls appetite and luteinizing hormone. And the other one is looking at estrogen and thyroid. So if you start having an exercise stress or a daily stress of getting up and going on with your day without fuel you perturb this case peptone neurons and down regulate them. So when you start down regulating them, we see that after four days you have a dysregulation of thyroid. We have a change in our luteinizing hormone pulse, which is really important to maintain integrity.
Function and we'll hear this. Oh, I've been fasting for so many years and it does great for me. But the other side of the question is well how much better would you be if you were to actually pay attention to your circadian rhythm and fuel according to the stress at hand and knowing that you're going to Garner less stress that way and if we're really tying in nutrition according to that profile instead of following a fast, we see better brain improvements as well.
See more cognitive function. We see less thyroid dysfunction and overall woman does much better when we're not in that facet State then when you look at population research that's coming out now, they're showing in both men and women who hold their fast till noon and then have an eating window from noon to maybe six pm have more obesity genic outcomes than people who break their fast at eight and finished their eating window by 4:00 5:00 p.m. So it's coming back to
chronobiology of we need to eat when your body is under stress and needs it unless we have a specific issue like obesity inactivity PCOS or other metabolic conditions, then we can look at using fasting as a strategic intervention to help with those modalities
super interesting to questions.
Is there a protective effect of starting the eating window and here I'm asking for both men and women starting the eating window at say 11:00 a.m. Or noon and ending it a little bit later. So not a 6-hour eating window or seven-hour eating window but extending that to 8 or 9 p.m. Under those conditions. Do you still see the obesogenic effect? Yes, because we're looking at the way cortisol responds. We know cortisol has lots of fluctuations throughout the day and it P.
About half an hour after you wake up, right? So if you're having that quarters all Peak half an hour after you wake up, but you're not eating then that is that higher Baseline sympathetic drive for women for men. It's not the same. So when we're looking at that obese agentic outcome, the actual timing hasn't been tested yet to see how can we expand or contract that eating window for men but for women because of that cortisol Peak that right after waking up,
Women tend to be already sympathetically driven. So then they walk around more tired but wired and have a really really difficult time accessing any kind of parasympathetic responses down the way where if you have something really small where you're bringing blood sugar up and it's signaling to the hypothalamus. Hey, yeah, there's some nutrition on board then we can start our day. So again, it has to look at that circadian rhythm and those hormone fluxes which people don't really either understand or talk about because all of our hormones flux through the day,
You have to look at where's the peak of cortisol? How does estrogen flux how does luteinizing hormone flux progesterone? All these things that have this tight interplay and the more we're doing the hormone research in the more were understanding these perturbations and how important it is to fuel for it to stay out of any kind of low energy availability stance regular listeners. This podcast will know this but just to remind everybody a sympathetic state has nothing to do with emotional sympathy. It's the sympathetic arm of the autonomic nervous.
Item, which drives more arousal and alertness and at higher levels stress sometimes called the fight-or-flight response parasympathetic being the other arm of the autonomic nervous system. Sometimes called the rest and digest arm of the autonomic nervous system. They work sort of like a seesaw or a push-pull pick your analogy. In any case. It sounds like intermittent fasting or time restricted feeding unless it's very well aligned to the Circadian rhythm is not going to be advantageous.
Just for women, that's what I'm hearing. I'm also hearing that if a woman trains while fasted so in the non feeding window so wakes up, maybe that's some hydration and trains that's going to further exacerbate the stress response in a way that's not going to be good. Exactly and I have to imagine that if she also is drinking caffeine in order to do that training because caffeine is a stimulant of the sympathetic arm of the autonomic nervous system.
That it will further exacerbate all these issues. So this is an eye-opener for me because I've had female training partners for years. I don't eat until 11 a.m. I like to hydrate and caffeinate before I train in the morning and then I like to eat starting around noon several of them have hopped on that schedule with me. Some of them eat breakfast for some of them don't they do as they choose of course, but now I'm thinking that's probably the
Which way to go and it
gets worse as you get older because we're seeing as women are getting into perimenopause which is in their 40s and we have more fluctuation of those hormones and an increase in Baseline cortisol. Anyway, then when you look at fasted training, it increases that cortisol drive and that sympathetic drive and because it's a point where you really need to polarize your training to get any kind of body composition change not having any
the fuel before high intensity workout puts them in moderate intensity. They just can't hit the intensities. They need to same with resistance training like you go in and a lot of women are now working on sessional rpe or rating of perceived exertion where you go in and say, okay, we need you to head an eight on the squat. So you have two reps and reserved and a sessional rpe of an eight. Well, if they're not fueled then we are seeing trends that they're missing around 2 to 5% of that top load so they're not really
In that zone that they need to be
and let's get people sorry to interrupt. Let's get people up to speed on our PE because this is a term that starting to circulate more outside the physical training community and to the broader kind of, you know, recreational exercise or Community, which I consider myself part of I mean I train regularly and have for years, but I'm not an actor. I'm not an athlete. I don't get paid to train and I know and so forth so reps in reserve perceived effort, it would just explain this I think
Only 95% of our listenership has never heard these
terms. Okay. So if we're talking about reps in reserve this is when you go in and if you say eight means you have two reps in reserve so you finished your eight and you should be able to complete two more with a really good form and then you hit
failure. So
Eight repetitions in good form and the person doing the exercise could in theory if they really dug in their grit their teeth could complete two more repetitions in good form before hitting failure the inability to move the weight anymore in good form exactly. Okay, but they're stopping at eight so they have two reps in
reserve exactly. And so we can correspond that with your rating perceived exertion. So for saying we need you hit an eight on our scale of one to ten overeating
Perceived exertion we see correlates with that 8 with two reps in reserve. So it's a way of quantifying what you're doing in the moment for a squat or deadlift or some other really heavy lift that you're trying to
accomplish as opposed to looking at say percentage of one repetition maximum. Yeah. Thank you. You're going to move 70% of your one repetition maximum for six repetitions seems like that's a great thing as well, but it's a little bit more complicated because you need to know your one repetition maximum doing
One repetition maximum can be dangerous. If you're not skilled in that specially with compound movements like squats and deadlifts. Okay. So is there an across-the-board recommendation for most people that they should generally train their sets in good form to failure to leave a couple reps in reserve. What do you suggest for? Let's say women, but this could also pertain to men
and then that also depends on the age of the woman. So we're looking at the reproductive years.
22:40 then it doesn't matter so much you can period eyes pretty much how normal periodization works with your mesocycles and your microcycle. So you're looking at what you're doing across the few months. What are you doing in the week? Are you lifting heavy power base training, but when we start to get to perimenopause and we're losing all the flux of estrogen and estrogen is woman's testosterone the key driver for strength and power. We have to look at lifting heavy. So this is where we really turn women on.
On to we want you to do something that is two reps and Reserve three reps in reserve because your one rep max also changes depending on what kind of training block you're doing. So you're finding that when you're talking about reps and Reserve then it allows people to lift more on the day so we can get women to get into that strength and power base type training rather than going let's lift to fatigue because then it might be 20 reps and that 20 reps doesn't invoke a big central nervous.
Response, which is what we want. It's more of that hypertrophy and muscle tearing. You will gain some lean mass but not as much strength as if you were to invoke That central nervous system response and that becomes really critical as women get older because we need to find that external response that's going to cause the same kind of strength and power adaptation that estrogen used to support interesting
lots to talk about in terms of exercise. But before we move on if the bad
In is a woman fasting drinking caffeine and training intensely. But as you told us not as intensely as she would be able to otherwise, what's the solution I imagine that solution involves ingesting some fuel. What is a good example of a you know, I pre-training meal if you will and we could put some variation on that for people with different, you know, Tendencies towards omnivore vegan or whatever but
What is the timing of that meal relative to training that works best or and I'm assuming there's some flexibility there.
Yeah. I mean like I'm the kind of person gets up and is out the door within a half an hour to go do whatever I'm going to do. So it's not like I'm going to have a full
meal. I've heard of people like you. Yeah, I mean it meaning identi move slowly in the
morning. So wish I could but the way my life is it doesn't work that way so that but I'm also one of the people that never really has an appetite to
11:00. Okay. So we're similar in that way. Yeah. So, how do you how do you square?
Where
that so I make a double espresso at night and I put some almond milk and a scoop of protein powder in there. So I the almond milk is sweetened and usually it's unsweetened but sweetened for the carb and then the protein powder for the protein because if I'm going to go do an ocean swim then I need some carbohydrate and protein on board. If I'm going to just go to the gym, then I'll probably just have the protein powder in the coffee. Yes, I'm caffeinated but I'm also getting the calories for the hypothalamus and getting more circulating amino acids.
Abby Smith Ryan out of UNC did some specific work looking at carbohydrate protein before and strength or cardio and found that if you're going to do a true strength training session, you only need around 15 g of protein before you go to really help you get into the idea that yes, you have some fuel on board and also increases your post-exercise oxygen consumption or your Epoch. So you're resting metabolism stays elevated giving you
a better chance for Recovery post exercises. Well, if you're going to do any kind of cardiovascular type work up to an hour, then you're adding 30 grams of carb to that. So it's not a lot of food and it's not a full meal other people were like I'm starving right before I go training then yes, you can have your meal giving yourself about a half an hour before but it doesn't have to be major food that we're talking about. But that's just enough to bring blood sugar up and in
Emulate the hypothalamus to say yeah, there's some nutrition coming in and then you have your real food afterwards. You have your breakfast afterwards within 45 minutes
as a neuroscientist. I find it. So interesting that at least some of what you're talking about with this pre-workout meal and perhaps most of it relates to how ingesting those calories impacts the brain protects those kiss pepped in neurons will talk more about kiss pepped in very interesting peptide as opposed to saying okay you need
Need X number of calories because you're going to burn X number of calories that conversation which is a very different conversation here. What we're talking about is the neural aspects of being able to generate intensity also blunt cortisol and get the most out of training without putting the body into kind of a an Emergency State. Yeah, and the longer someone with holds food after exercise and the greater they stay in that catabolic or breakdown State the more the brain perceives it as being in a low energy state.
So the first thing to go is lean mass when you start telling a woman that you know, if you're going to do fast it training and and or you're going to delay food intake afterwards while you're training because the first thing that goes is lean mass and is a really really hard for women to put on lean mass. So once you start really nailing that and then saying look you just need 15 g of protein to really help and be able to conserve that lean mass. It's a small simple fix people try and they're like, oh my gosh, I feel amazing. So small little things when you're
being with the whole system because I get tired especially around Christmas time when you're reading the all the magazines. It's like two cookies means you have to walk for 30 minutes on the treadmill like it doesn't it doesn't correlate like that at all. So that's why I was like, I hate the Cal conversation because it's just not
applicable. Right and it has its own kind of elements of being laced with neuroticism about calorie counting and then that can drift easily into the realm of Eating Disorders. I did an episode
About eating disorders some years ago. And as I was researching that episode, I learned that people with eating disorders women and men especially anorexia become like calorie calculators their eyes and their brain just are constantly evaluating the caloric load of food and it can be obviously very intrusive. It's also the most deadly of all the psychiatric conditions. So it's that's a long way from hopefully what we're talking about here, but but there's the opportunity for drift whenever talk
About calorie counting in and out we of course believe in the laws of thermodynamics and calories in calories out. But I love what you're describing here as getting the brain in a mode that the brain and body are protected. So that one can invest in that high intensity exercise and get the adaptations that one wants but not send everything down this pathway of just becoming a computer of you know, how much my exercising. What did I burn? What did I learn that? It's crazy. It's crazy.
As long as we're talking about food and food intake relative to training. What is this suggested post-training window in which one should either avoid or make sure they get nutrition meaning? How long does one have after let's say a resistance training session of about an hour. It seems to me that's what most people are doing. If they're investing in resistance training may be plus or minus a what 20 minutes? Yeah.
And they're hitting those high intensity sets where they have maybe just one or two repetitions in reserve may be going to failure on a few of those sites. What do you recommend women eat after they train
so we know that women who are in their reproductive years need around 35 grams of good protein high quality least teen-oriented protein within 45 minutes and we see that women who are perimenopausal onwards are 40 to 60 grams because we become more anabolic liras.
Sent to food and exercise as we get older when we look at like the recovery window for food. There are definitely sex differences because we hear all the conversation of there's no recovery window. It's you know, it's old science, but we look at the research of when women's metabolisms come back down to Baseline meaning that they have constant straight blood sugar levels versus men women. It's within 60 minutes and for men it's up to three hours. So when we're looking at the data that says,
There's no window per se for getting food in it's based on male data. So when we're looking at women women, we have this tighter window to stop that break down effect and start the reparation. So yeah, it's like when we're talking about the protein intake is really important not only to get that loosing content up in the muscle to start the reparation and repair but also again to signal that yeah. We're in a building State. We're not holding.
Being that catabolic State and increasing all the repercussions that come with it.
So women should try and get 30 or as much as much as 40 maybe 50 grams of protein depending on their age post training within an hour of training. Yep. Men seem to have a longer window. They could wait an hour or two hours maybe even three hours before ingesting protein. What about carbohydrate? We look at
mixed but for men, it's more important because
as they go through their liver and muscle glycogen so much faster than women. So when we look at women, we want to get around Point 3 grams per kilo of carbohydrate within two hours of finishing. So we look at protein and be like, wow, that's a big dose of protein. How do I get it all in it's like yeah. Well, you can look at how we mix all of these things. You're also getting carbohydrate in with that. So that's why I say you could have your next meal after your training session. Yeah, there's a time and a place for
Supplementation, but if you're getting that real food and then you're also getting you know, your magnesium and your potassium and your sodium and all the things that people supposedly lose and you're able to also repair a lot better
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Again, that's drink AG one.com hubermann at some point. There was a lot of discussion about training fasted burns more body fat. I think now most people accept that that's not the case that perhaps the percentage of fat as fuel is increased when one trains fasted but that overall in terms of loss of body fat. It doesn't matter if you train fasted or you train fed.
Ed correct. Okay, I think that can't be stated enough around by experts like you that doesn't mean that if one prefers to train fasted or with a minimum of food in their gut that they can't do that guy like to train fasted but what I'm hearing is that women should probably ingest at least some protein high quality protein and maybe drink the protein and protein shake. Yeah form if they don't want to ingest solid food.
Yeah. I think the easiest way for people to understand the
Basic idea of what low energy is and how this affects men and women is when we are looking at a Tipping Point for endocrine dysfunction. Four men were seeing that Tipping Point at 15 calories per kg of fat free mass for women's 30. So we're looking at Baseline calorie needs before you really get into that endocrine dysfunction when you're looking at those parameters, you can see why men do better in a fasted state or a low calories.
State but for women are intake and especially our carbohydrate needs are so much higher because we have so many other functions that are reliant on that kiss pepped an upregulation or down regulation. Preferably a regulation. So when we're just talking the basic calorie needs and what we're seeing. It's that dichotomy right? There are 15 to 30 and when you start telling people that they're like, oh, okay I get it is
A biological aspects like well, you could trace it all the way back where you know men went out to get the calories in most tribes in the women were home. And it was an advantageous to be pregnant under low calorie intake. That's why you have dysfunction when the calories are too low, but you know, you can also feed forward to modern day now and you're seeing that all this but turbines of hormone and the way we regulate hormone across the Circadian rhythm requires more calories for women than it does for men.
I know some men
And that basically don't eat all day and then eat one meal in the evening and they'll train in the morning that's inconceivable to me. Yes within an hour or so of training. I'm hungry which brings to mind what we mean when we say training I'm a big believer in people everybody getting ideally two or three resistance training sessions in per week and two, maybe three cardiovascular training sessions per week. That would be ideal one could potentially do more.
Probably not a whole lot less before you run into long-term health issues that you could offset, but I think most people can fit those in and I'm very angrily delighted that nowadays. There's such a push for women and men to resistant strain that wasn't the case when I was growing up, you know, I recall taking my sister the gym for the first time and like I think she was the only woman in the gym when we were in high school. Yeah, except for a few female bodybuilders, and she said well, I don't want to look like that and I said, well, don't worry. You're not going to look like that.
But now you go to a gym and women are lifting weights men are lifting weights.
It's great. It's terrific. I've seen the evolution right when I was 16. One of my friends Brothers was a bodybuilder and he took us to the gym kind of like what you did with your sister and so both of us were like, well we want to beat those guys. So we've got into weight training with him not to be a bodybuilder, but it's been like the Paramount throughout all of my athletic career used to be I'd be the only woman on the lifting platform and now it's like you have to
Wait, because there's so many women on the lifting platforms. I love it. It's great.
Yeah, it's awesome. As I mentioned before I've had female training partners and they kill it. Yeah, they it's a lot of fun to have a female training partner also because not only is it cool to see the progress they can make really quickly which surprises them often. You know, I think a lot of women think that okay. It's going to require external androgens or it's great you you know, and what you pointed out that
There are some barriers to women putting on mass quickly. I think I've noticed that strength increases can come really quickly. Yeah, why is that?
It's a central nervous system aspect. There's a lot of like if we look at the culture of how a lot of us grew up and saying us like 45 plus right the women were all the 90s supermodels don't show muscle that kind of stuff. So always been gravitated to cardio even now if you go to a gym and you're a new member you're signing up for
New member and your woman they'll say hey great. Here's all of our spin classes and our box fits classes still doing that. Yeah, and there's a cardiovascular machines a guy comes in like all right, how much do you want to put on here the lifting platforms all the you know, the weight trainings of the back starting to see a shift with Boutique type gems, but that's still the commonality there. So it's still that little bit of taboo. So when women start strength training they haven't been exposed to that kind.
End of central nervous system stress before in the whole aspect of getting the nerve and acetylcholine which are little vesicles that you know, hold the ability for the nerve to actually stimulate the muscle fiber all that gets trained really quickly. So the more that you train it and the more muscle fibers that are recruited for contraction. You see an increase in strength really rapidly and slowly building on that for increased muscle bulk.
Because it takes a long time for women to put bulk on because the driver for strength training is that central nervous system. So it's great when we see higher doses more volume. We aren't seeing huge hypertrophy. We're just seeing really good increases in
strength whenever somebody male or female is concerned about growing too big too fast. I always remind them that resistance training is
unique among different types of exercise in that because of the blood flow to the muscle during the exercise session. This will call Pump. Yeah, you get a window a transient window but a window nonetheless of what the hypertrophy could look like. If you do everything else correctly in terms of recovery. So provided that the size of the muscle during the training session is not aversive to you. Yeah, you're okay. You're good. Yeah, which is unique among no training. It's not like when you go running you get a sense of
Much faster. You actually did the opposite affect you you feel the burn in your lungs and the pain of the of hitting the wall of your limits. And then hopefully if the adaptation takes place then you can push past that next time but with resistance training you get a literally a physical picture and if n a somatic feeling for what that hypertrophy could look
like, yeah, that's why on your physique competitions in bodybuilding competitions there out the back pumping before they go on
stage. We've been talking about training, but we haven't really spelled out what you
Would suggest a novice perhaps an intermediate resistance training cardiovascular training program would look like in Broad terms. I realized we don't have time here to get into all the nitty-gritty details you've written about this elsewhere and will refer people to those terrific resources in the show notes captions. But what would you like to see women doing? And maybe we can break up the the age brackets because it sounds like this is something that is resurfacing again and again here.
Women let's say 30 and younger women 31 to say 40 and then let's say 41 to 60 and then maybe 61 and on in terms of how many sessions of resistance training per week. Is it whole body training how many sessions of cardiovascular training and when and what sorts of examples could you give?
Yeah, so if we're looking at that 20 20 to 30 year old a lot of times I really try to get them to focus on the
the whole movement aspect first. So we Face them in same with older women fayza men. Learn how to move learn complex movements so that when you are going in to do resistance training preferably three to four times a week, you can look at moving well and it doesn't have to be a long period of time if you're doing to failure which works really well when you're younger to increase strength and a little bit of hypertrophy. You're going to have to spend a little bit more time in the gym. So might be 45 to 60 minutes when
Looking at doing that four times a week. You can add in a Sprint interval training at the end of one of those to get that super high intensity, or you can look at putting in at the most to hit sessions from on separate days. If you're training specifically for something so if I work with a lot of endurance athletes still and they're like, well, how do I fit in it's like, okay. Well, we look at the Quality and how that fits into your training. So if you're training for a marathon you're training for a triathlon or
Or other endurance stuff you can take that high intensity work and put it into your training program. So ideally we look at three to four resistance training with really good movement when we're in the younger set with two high intensities when we start getting into our 30s, we start having an eye to how are we actually doing that resistance training instead of just going and doing a circuit really focusing on let's do some compound movements. Let's look at doing some
Have your work let's look at how we are period izing so we're having in a six-week blocks and we're building on those blocks because we want that base foundation. So when we get to be 40, plus we can actually go and do our power base training. If you're in your 40s, you've never done resistance training at all. Then we take between two weeks to four months to really learn how to move well because there's a higher incidence of soft-tissue injury.
An overall injury as we get into our 40s because the perturbations of estrogen and ideally when we get there we're looking at that around three minimum three resistance training with compound movements and either one Sprint interval or to Sprint intervals in one hit in a
week and just to remind people compound movements multi joint movement squats deadlifts chin-ups Rose overhead presses bench presses Etc as opposed to isolation movements.
Only one joint is it's moving. Yeah. Yeah and for everybody and all those age ranges that you described are you suggesting they train the same muscle groups three or four times per week or they do some sort of split where it's upper body lower body take a day off or upper body take a day off lower body. Take a day off. Whatever what might work for them. Yeah what works for them. If you're looking for short amount of time in the gym because of busy lives and you can split it if you're looking at okay. Well I
I can allocate an hour to an hour and a half in the gym. Then. You can do total body with adequate rest the key when you're younger is working to failure the key when you're older is working heavy. Yeah, so when we're looking at working to failure, we're trying to get more of that lean mass growth with strength when we get older because it's so difficult to put on lean mass. We really want to focus on the strength component because that becomes more important.
We're talking about longevity is if you're looking at the strength component from a central nervous system standpoint. We see it feeds forward into better proprioception attenuation of cognitive decline. And this is the other thing that you in Neuroscience would understand the sex differences in things like dementia and Alzheimer's there's some really interesting research looking at strength training and that power based stuff when we're getting into our older ages because we get more neural growth
'The patterns and more neural Pathways
even some interesting literature about emphasizing some unilateral movements as people get older not just do a limb movements or still live simultaneous movement. You always want to train both sides your body folks. But so if I understand correctly younger women should train to failure try and generate strength and hypertrophy as women get older. They should emphasize more strength training leave some repetitions in reserve but train heavier. Yes, it makes so
Sense what you're saying? Yeah, because what we know about the nervous system as we age is that there's some atrophy or at least in weakening of neuromuscular connections and the upper motor neurons in the brain that control the neuromuscular Connections in the spinal cord out to the muscle. Yeah. There's something really sticky about this idea in terms of longevity that I don't think anyone else has ever said no the thing about it is men aged more in the linear fashion whereas with
and we have a definitive point in our late 40s early 50s where all of a sudden things go to shit where it's that perimenopausal State and I can't tell you how many emails and GM's I get in a day from women who are like, I'm 46 or 47. I'm putting on body fat. I don't know what's going on. I can't sleep and then we say it's perimenopause you're like, what is that? And so when we're looking at perimenopause it is a huge.
Change in the body because you're having less and less of your sex hormones circulating more and more anovulatory Cycles means no progesterone or very low progesterone you're having a difference in the pulse of your estradiol to those Flatline aspects and because every system in the body is affected by this is why you see more soft tissue injuries, like two of the biggest things that women who are in their 40s or going to Petey's about her frozen shoulder and plantar fascia. This is a to really indicative.
issues that are happening in perimenopause so that whole section of mid to mid 40s to early 50s is a definitive aging point where I really tried to get women to get into the heavy lifting and get into the patterns of polarizing their training not putting an emphasis on Zone to just really looking at how my polarizing how am I affecting my central nervous system so that when they get into that one point in time of that perimenopause their body
He's already conditioned for the stress. That's coming. Whereas men. We see that kind of stuff happens in their late 50s early 60s. So the soft tissue injuries. The change in body comp comes at a later time. So yes looking at how we're scoping our strength training definitely something to think about in a longevity Factor, but for women, it's there's a better indication of the timing across the ages of when you should start implementing for men. I think you have a better.
Bandwidth of when you should start
implementing.
For women who are not on hormone replacement therapy and we did a previous episode about perimenopause menopause and hormone replacement therapy, but if it comes up again and again today, that would be wonderful because these are important under discussed topics for women that are not on hormone replacement therapy who decide to train heavier. Maybe do a bit more training volume not trained to failure. They're making sure to not let their cortisol Spike too much by making sure they have some pre
Workout nutrition some post workout nutrition would they be wise to be very careful and how much cardiovascular exercise they add to that meaning there seems to always be this risk of overtraining and as you pointed out for various reasons cultural reasons historical reasons around exercise. I my observation is that most women sort of unless they know better.
To cardiovascular exercise that supposed to resistance training. So if a woman in her 40s late thirties to let's say 50 is doing two to four sessions of resistance training workouts per week. And they also really like cardio or they feel they want to or should do cardio. Should they be careful about how much cardio they're doing? And is there a best form of cardio? Should they really emphasize the high intensity interval training? Should they avoid Zone to we should probably
We also Define for people what zone 2 is. Yeah, they don't already
know. So I am notorious for slamming things like orange theory and f45 because they Market specifically to that age group of women and it's not appropriate because it's not true high-intensity work when we're looking at women who are really trying to maximize body composition change in longevity and unfortunately default to cardio because they think oh that's going to help change. My body composition is going to help me Lou
Body fat it
doesn't this things like Soul cycle as well? Okay. I've never done any of these. Yeah, but I imagine there's a lot of spinning lot of moving a lot of sweating and a lot of quote-unquote calories burned emphasis.
Yes there is but it's it puts women squarely in moderate intensity where they're so stick leaving one of those classes feeling absolutely smashed that when you tell them actually that training doesn't work for you because it's putting you in a state of intensity that drives cortisol up.
Up, but it's not a strong enough stress to invoke the post exercise growth hormone and testosterone responses that we want to dampen that cortisol. So this is why we have that hyperbole of women who are in their 40s plus shouldn't do high intensity work. It's like, well, actually they shouldn't do moderate-intensity. They need to avoid that polarizing. Absolutely. That's what we want. We want true high intensity work, which is 1 to 4 minutes of 80% or more or if you're doing
Sprint interval its full gas for 30 seconds or less and you're doing that a couple of times a week. You're not doing it every day because you need to have enough recovery to hit those intensities truly because those are the intensities that are going to give you those post-exercise hormonal responses to drop cortisol when we're looking at women who are like, oh, well, I love going out for hours and hours on my bike and I love you know doing my spin classes. It's like
Okay, but we need to look at the big rock here. If you are looking for longevity and body composition change and cognition and all those things. You have to polarize your training and that has to be the focus. But soul food like I come from a long background of endurance. I now love riding my gravel bike on the weekends for long periods of time, which is not optimal for me my age that kind of stuff for all the things that I want to see improvements in but mentally it's great. So we
Talk about going out for that long stuff Zone 2 is at low conversation and that's fine for mental health and being out in nature, but for Optimal Health and well-being we don't want to do that. We want to look at resistance training is a bedrock and true high-intensity work to help with body composition change metabolic control insulin sensitivity brain health and dropping that cortisol.
I have family members who are women who are thin because they love to walk and they just walk a ton. Hmm and they well and enough but they are resistant to resistance training and if they do pick up a weight, it's usually some very light dumbbells do a few curls a couple tricep extensions and aren't really leaning into the higher intensity work. Yeah.
I think this is pretty common and my observation is that it's common not because
They couldn't be incentivized to do the higher intensity work. But that learning the complex compound movements like how to squat properly or even leg press properly dead lift properly can be a bit overwhelming especially when one walks into a gym. This is true for men to like the all this stuff all this equipment all these bodies and these people look like they know what they're doing. It's like if I were to go into an advanced like kitchen or Symphony and you know, they're all these instruments. I don't know how to play. Yeah, so,
What's the best line of attack for somebody who really wants to overcome this longevity barrier because clearly resistance training proper nutrition work. Yeah, and the cardiovascular exercise piece is a little bit more intuitive walking you do it faster. You're jogging you. Do it faster you running? Yeah. Yeah the bike the soul cycle class Etc. It's just it's easier in terms of the mechanics one can still get hurt, but it's just more straightforward. Is there a way that in the absence of a budget for a personal trainer?
Or that somebody can learn how to do these movements. And as you said he's into them over the course of even up to four months in a way that they can be confident that they're unlikely to get hurt. Yeah and really build up their capacity to do real work that can benefit them.
Yeah. This is where I love technology for one thing. But if we're staying really basic I look at some of my family members and I've gotten them started with just bodyweight stuff or loading a backpack with cans to add a little bit of resistance. So
I feel comfortable in their own house and they might be doing lunges or squats. Just keeping them up of like we're foot placement and knee and that kind of stuff. So they're getting used to that kind of movement. I love Kelly syrettes stuff with Mobility. So show them like here's how we do some of them ability to find where the sticking points are and then you can either direct them to some of the programs that are out there that like Haley happens has some really good ones for women over 40 plus
so does Brie and then Sonny Webster down in Australia, you can send in a video of what you're doing and he can critique you and tell you things to do there are other programs like that too. So there's lots of ways of getting help if you seek it. The personal trainer is very much a stumbling block for a lot of people and as much as I am not a fan of Planet Fitness is
A fan of the fact that they've made it really easy for someone to walk in who's interested in resistance training and they can go to a circuit one of the circuit things that they have the back and they can start resistance training on machines, which is another level up to learning compound movements. So there's lots of ways of breaking that barrier to entry you just have to find the motivation factor of what's going to incentivize the person to give up their time walking every day and taking time to go to the gym or take
Taking time to do garage based stuff that's going to improve their lean mass.
I'm a big fan of machines, especially plate loaded machines, but machines just create the close to correct or correct Arc of movement. Yeah that so
your size. Yeah. Yeah. Yeah
exactly and to really spend the time adjusting the seat height adjusting the various pins on the machine not just the weight in order to make sure that
Gets the best range of motion. I think this is something small but that is significant in terms of its impact people just plop down in a machine, especially if you're working in with somebody and feel especially beginners will feel pressured to move quickly and they won't adjust the seat height and so it's just all wrong for them and all it takes is a little bit of time to you know, and ask people, you know how to adjust the
machines. I'm also a fan of kettlebells in in the garage or light lighter dumbbells that you can do like thrusters or
Hank Lanes or something like that to give them the momentum and movement feeling because that's another good learning curve for people. So, like I said, there's lots of ways that you can Implement Things based on someone's intuitive like or dislike of resistance
training. So you've mentioned polarized training if I understand correctly. This would be a woman doing three or four days of high-intensity resistance training for 45 to 60 or 45 to 75 minutes per se.
And and then at the opposite extreme, maybe just walking a lot or jogging a lot yet. So that is that way you're talking about polarized training as opposed to these other forms of training where it's designed to get people sweating like crazy breathing hard for long periods of time, but neither putting them at the in the landscape of inducing muscle strength adaptations and hypertrophy adaptations nor really taxing the cardiovascular system enough to create, you know an increase in longevity.
For instance
when I talk about polarizing I look at the high intensity strength, like that's really hard on the central nervous system. And then we look from a cardiovascular standpoint of doing true high intensity work. So the walking is more of the recovery. So if you're going to go out and do something long, it has to be very very easy. If you are looking at cardiovascular and you want that big sweat, then we are talking true Sprint interval training. So what I have a lot of women do
Is a 20-minute lower body heavy set and then they'll go on the assault bike and do as hard as they can for 30 seconds and then recover as much as they need to to go then do another 30 seconds as hard as I can. Most people go home. I can do four or five of those after to they're completely guests because it's that hard at work and that's what I mean by polarizing you have very very low intensity for recovery and super super high intensity for metabolic and
and cardiovascular changes as what we're after.
I'd like to take a quick break to let you know that the huberman lab team has launched a new podcast with host. Dr. Andy Galpin and he is an expert in exercise science and Human Performance and has long been a fan favorite on the huberman Lab podcast. This new podcast is called perform with dr. Andy Galpin and it dives into topics such as how to build muscle and strength how to improve your cardiovascular health and how to optimize recovery and sleep for performance and much more.
Andy is an absolutely fantastic educator and true expert on all things Human Performance. I know you'll thoroughly enjoy his new podcast and learn a ton of useful Knowledge from it. So please check it out and give it a subscribe wherever you're watching or listening to podcast. Now again, the podcast is called perform with dr. Andy Galpin. Let's talk about the menstrual cycle. Yeah and how that impacts training at the level of Psychology and Physiology meaning mode. And of course the two are linked there.
inextricably linked
for instance. Is there a particular phase of the menstrual cycle where a woman should expect that motivation and or recovery would be more
challenging.
So this is the sticky point of recent science because we see all of these research studies and men analyses that coming out of the sport Science literature saying that there is no effect of the menstrual cycle on anything when you look at that population, it is specifically you Minner iack women might have a subject pool of 10 if you're lucky 12. So this is women who have quote-unquote normal menstrual cycles human Erick supposedly ovulating so they have a definitive low hormone and highwomen
Hormone phase and this is probably because these studies are being done on University campuses with uh with college undergraduate women.
Yes exactly,
which is a typically is in a given age range, right? Okay,
and they look at performance meaning that one point in time and we know that psychologically you can perform at any point in the menstrual cycle unless you have something like heavy menstrual bleeding when we're looking at a higher touch and looking not only from a molecular aspect, but also pulling in mixed
Methods and looking at the qualitative. We need women to track their own cycle and find their own patterns because we know that there are times where you feel like crap and you can't push intensity, but that might be on day eight for one woman in might be day 18 for another from a molecular standpoint. We know that the low hormone phase being day one is the first day of bleeding up through ovulation, which is Midway through your cycle. You have a greater capacity.
Capacity for pulling in and accommodating stress physical and mental stress. So if we're looking at doing heavier loads, we're looking at doing high-intensity work. We're looking at motivation. Then that low hormone phase is really optimal for trying to hit a PR trying to hit a new speed because you can take on that stress and your immune system handles it your muscles handle it your core temperature. Everything handles
it so for most women
In the weeks before their period they're going to feel more robust except right up until the point of of menstruation or the inverse.
It is day one a bleeding up through mid cycle the gonna feel great. Yeah, the sticky Point comes not every woman ovulates and this is a thing when we're looking at General pop. We have lifestyle stress. We have nutrition stress. We know that women for the most part have four.
25 anovulatory Cycles a year. So this is where when you're looking at that high hormone face. We can't say you're definitively in the high hormone phase. So this is where we need women to track their own cycles and understand their own patterns. Because in an Ideal World, we know that in the luteal phase is where we have the most change where we have a pro-inflammatory response from the immune system. We have inability to access
Hydrate as well. We have a higher sympathetic drive. So there's lots of things in there that aren't so fantastic for accommodating stress.
So broadly speaking the luteal phase has associated with more cortisol more kind of Baseline levels of stress would it make sense for a woman to try and offset some of that with a bit more nutrition during that phase a bit more perhaps complex carbohydrate. We know that some complex carbohydrate can blunt some of the cortisol response. Maybe just even a little bit more attention to
Eating.
Yeah, absolutely. I mean core temperature goes up. But the whole goal of the luteal phase is to build tissue. So this is where we're seeing a lot of shuttling of carbohydrate and amino acids to go to build that endometrial lining and that's the whole goal. So, yes, you need to eat more protein. You need to eat more carbohydrate. But again, the sticking point is did you ovulate or not? So if you aren't aware of if you ovulated or not, you're tracking your own patterns, then just be acutely aware that in about the week before your next period
Comes you really need to be amping up carbohydrate and protein because that's going to help you hit intensities. It's going to kind of level that playing field especially on days where you feel like you can really hit those intensities you feel great, but then you go to do something in your heart rates higher than it should be you don't feel that that you can hit those if you're offsetting it with some increased carbohydrate beforehand you're going to hit it. So it's again, it's really dialing it back down to the individual now because we don't have enough robust research.
Each to make generalized ideas because of the Nuance of have you ovulated or not. What are your ratios of estrogen progesterone in that luteal phase? So when we bring it back down to the general pop, it's like the best thing to do is to track your menstrual cycle over sleep over how you're feeling fine your own patterns and dial in your training in your days. According to what your pattern is.
How hard should a woman push?
Through the mental and maybe even physical resistance to train last or not trained during a given phase of the cycle
again depends on how she feels what we can't rely on are things like heart rate variability because we know that changes with the autonomic nervous system change progesterone. It's good indication that you've ovulated because your heart rate variability tanks, but it's not a good indication of what your body can do if you wake up I always say it's a 10 minute rule you wake up and you feel awful and I like I really want to do this workout, but I don't know how it's going to go.
Go give yourself 10 minutes. If after 10 minutes, you can't hit those intensities or you just feel horrible change it drop it down do something. That's more recovery do something that's not going to be so taxing because we do have a limited amount of that stress Acumen of how much stress we can handle. So if you're going to try to exert it all in a high intensity workout, what do you have left over for the rest of the day and then that compounds because if you're always fighting it then you're going to
This Baseline sympathetic drive because you're fighting the training you're fighting life. So give yourself that 10-minute rule if it happens three days in a row. That's okay because it's a very short period of time it's not going to last forever. So a lot of women have this internal conversation of I have to do this and it's really based on some kind of external. They think everyone's watching them. But internally, you don't have to if you give yourself permission you end up training.
I'm better recovering better and getting better
gains on the flip side. If a woman is feeling spectacularly good should she just really push it as hard as she can or is there anything about the relationship between the hormone fluctuations of the menstrual cycle and feeling really really great that training hard can somehow disrupt the cycle and this is actually kind of the the old lower probably myth. I would imagine that high intensity.
Resistance training is somehow detrimental to female hormone Cycles. I don't think there's any evidence for that. But I hear that from time to time. Why do you think that myth came to be? Why do you think it propagates? And what can we do to extinguish it? If in fact it's not
true. It's not true. We see comes from misstep and food intake and we also see that it's a cultural influence because we think about how Sports started it started as a way for men to demonstrate how
Powerful and aggressive they are and this is the original Olympics rate. There are no women allowed and as we feed forward into Sport and how became okay for women to be involved at the high performance level of woman walks in and shows any foul ability. Then she's immediately put on a lower stool, right? You know, you can't you can't play with the boys because you have a menstrual cycle. You're bleeding. You're a woman you're a delicate flower. So women would walk into that professional sport space and be excited if they are amenorrhea car didn't have periods.
Or they train hard enough and their period went away because then they were more like men and they could play with the boys. If you start bringing up menstrual cycle and professional sport. Now as of the past about four or five years, it's okay to talk about which is you know, what 2020 so that myth of high-intensity resistance training causing issues with the menstrual cycle one. It's a cultural Nuance for pushback against women being in that space But then the
Reality is women weren't eating enough to accommodate for that stress which then feeds forward to low energy availability may be relative energy deficiency and Sport perturbations and all of our menstrual cycle hormones. So it's not the act of the high-intensity resistance training. It's the act of not fueling appropriately for it and then getting the okay to not have your period because yeah now you're you're in with your training hard enough, you've lost it you're more like a man.
Wow, very interesting history there. Is it true then that if a woman maintains either caloric balance with her basically eating enough to support her energy output or even a slight caloric Surplus that it's unlikely that her periods will cease even if she's training very hard and very often correct. So it basically boils down to calories in calories out fuel for the task at hand.
Because some people want to have a slight calorie deficit even in high training and if that deficit is at night away from training, maybe 150 to 200 calories, then it's going to help perpetuate body fat loss not lean mass loss and it's not going to interfere with recovery. It's the fueling in around the stress meaning the exercise stress. It's really important, but women have been so conditioned to not eat and not take up space.
Base to be small, you know, all of these socio-cultural things that women are afraid to admit the fact that they want to eat and they should be eating. So this is a Nuance within the fitness community that we're really trying to change and get the mindset around you train hard you eat well and your body responds in kind appetite body temperature and hormones are very tightly linked. Yes. They are far too tightly for us to disentangle all of those.
Those in a single conversation here, but as you're describing the urgent need for women to fuel enough with the proper fuels to train hard enough to stimulate the correct adaptations that they need.
I imagine that the shift in appetite and body temperature that occurs across the menstrual cycle is also going to play into this meaning there will be phases of the menstrual cycle where women will be just naturally less motivated to eat enough carbohydrate enough protein in order to get the most out of their training what phases of the menstrual cycle are those so that women can pay particular attention to make sure that they're fueling enough. Yeah as estrogen starts to come up right before.
Violation that estrogen surge really dampens appetite it also has a an interplay with our appetite hormones, which is part of the reason why we don't have that great of an appetite. It holds after ovulation estrogen dips, you get hungry it comes up and people are like, I have some Cravings which are driven by progesterone because your body needs more calories, but at the same time with the elevation of estrogen, you're not hungry you have cravings, but you're not hungry interesting. Yeah.
So it's trying to disconnect those. It's like your appetite is something that will come back. Of course once you eat but Cravings are more of a that psychological capacity of yeah, I my body needs more but I'm not quite sure what so to get women to understand what's happening across the board. It's always coming back to Let's fuel appropriately for the exercise and even if you're not hungry if you are fueling appropriate appropriately.
At that point in time if you end up with less at least you've stopped that breakdown state that catabolic state so we don't get those perturbations in the hypothalamus. That's my biggest concern for women is really taking care of that signaling from the brain to the rest of the body. And if we have fuel on board, even though we have appetite perturbations, and if you go to a really hard workout in the heat, you're not going to be hungry either, but if you're having a cold protein drink after that hot workout
You're taking care of that immediate need to shut down the signals that we need to break down things.
Let's talk about one of the many third rails of discussions online, which is birth control. Yeah, and we need to Define exactly what type of birth control were talking about because there are so many different forms. Yes. They're iuds there the copper IUD is there's the ring there's a, you know, let's talk about oral contraceptives that
Are designed to prevent ovulation. So this is quote unquote the pill. Yep. So we're being let's for now limit the conversation to that so that there is some confusion share with us. If you will your thoughts on these how they impact any of the things that we're talking about or anything else from that for that matter.
We have another history lesson, please all right. I just gave a talk at home to some young athletes on contraception because someone might be on the depot and if there are
For more than two years they get bone mineral density loss. So then the question of Ok, well, how does the oral contraceptive pill come up? How does that affect things like? Well, let's look at the history of it initially came from Stanford was funded by Kathryn McCormick from McCormick family and feminist activist Margaret Sanger, but because they are women they couldn't get in the lab. So they got a guy from Stanford to develop the pill and he's like, you know what we need to put in a placebo week, so
At women feel like they're having a bleed. So if we're looking at the three active pills and then the one sugar pill week, it was by Design to make women feel like they are having control over their menstrual cycle and they would still have a bleed but it's not a true bleed as a withdrawal blade. So this becomes the confusing point for people who are on an oral contraceptive pill that like I get my period it's like no you don't because the idea of the hormones that are in an oral contraceptive pill is to down-regulate.
Our ovarian function so that you don't ovulate so you have a whole different hormone profile from someone who naturally Cycles. So this depends on the type of oral contraceptive pill you are using for the most part monophasic is the one that's most prescribed. So that means the three weeks of the active pill is the same dose of estrogen progesterone and then you have your sugar pill week or your withdrawal week and then you start again when we look at the Reaper.
Russians of using oral contraceptive pill in active women there's a higher amount of inflammatory responses and oxidative responses. So from a training standpoint, no one's done the study yet, but I would be interested in doing this looking at how that impacts adaptation. You do end up with a new Baseline of this when you start taking the pill, but we're not really sure how that impacts adaptation. We also look at the progestin component of the oral contraceptive pill because we
Four generations of progesterone first generation was really high dose and has a lot of risk factors not really prescribed that much second generation is the most prescribed and this is the one that people just take it's in your IUD. It's in your o.c. Has at least amount of side effects and then we have a third and a fourth generation. The fourth generation is primarily used for women who have really bad PMS or pmdd, which is your premenstrual dysphoria.
A disorder so significant mood issues because that progestin has a direct effect on a lot of the dopamine receptors in the brain as well. The third generation is very androgenic. So we see that in some pulmonary research that improves speed and Power by the second week of intake because it's accumulated. So we're looking directly at an oral contraceptive pill we can't make generalizations.
It's because you have low dose high-dose estrogen. We see that a30 microgram dose increases hypertrophy but not strength because estrogen increases this satellite cell aspect. So for my power and Olympic athletes Olympic lifting athletes, that's a detriment because they'll put on muscle mass but no strength. So we've had to look at changing their OC or getting them off for women who have breakthrough bleeding that higher incidence of or that higher intake of estrogen is really beneficial so we look over
Overall it how it impacts women from an athletic standpoint. It's so variable in the hormone profile that we can't make generalizations. We only look at the very high performance athletes and what's happening up there because that can make or break an athlete. So from the general touch point, we don't know enough like the beginning of this year 2024. There was a study that came out looking at changes in the amygdala that happens with oral contraceptive use its
Forcible and adults, but for young girls, we don't know because the brain is developing and unfortunately Physicians will pass out OCS as if it's candy Oh Sees oral
contraceptive contraceptives. And do you recall what the direction of the effect was on the amygdala for those that don't recall the amygdala bilateral brain structure meaning one on each side of your brain literally means almond and Latin its almond shaped and it's part of a larger Network associated with threat detection. Sometimes it's described.
The locus of fear in the brain, but it's involved in a lot of other things to both positive valence and - valence but nonetheless is part of the threat detection system elevated levels of arousal which is why it's often discussed in the context of fear. Anxiety Etc.
It increased fear in women who are on the o.c. Oral contraceptive pill made them less.
Willing to take chances and when they went off it they're like why couldn't I do that before so that's why they started looking at the amygdala and when I say we're looking at young girls. And again, we don't know what's happening. Is it reversible in young girls that are put on it or not? Because of the brain structure changes that are happening. So when we talk about an oral contraceptive pill, I want people to understand that it has a significant effect on the body not just
Active we don't know enough about all the other effects. So I have parents who say my daughter wants to go on the oral contraceptive pill. She's having irregular periods. She's a athlete we want to be able to control it and it's like if there's a issue with your menstrual cycle now, it's still going to be there when you get off it so we have to look and see what what's going on here. If you're looking to get on it to control your menstrual cycle. Why because we know that you can have an increase in your VO2 max and other
Iran has an aerobic capacity when you are not on it. So you have a better top-end capacity when you're not being blunted by these hormones and then the other conversations. Oh my skin is like what they have really good dermatologist that can help you with that. You don't have to go on an oral contraceptive pill, but unfortunately GPS don't understand all of that and if a girl comes in and says, I'm having a regular Cycles heavy menstrual bleeding. I want to go on the o.c. Here you go. So it is a huge conversation still.
Had I put it in the same category as menopause hormone therapy because there isn't enough research to address all the population needs and we see these big pendulum switches. So before it was that everyone be on the o.c. And as like maybe not and then it was no one Beyond menopause hormone therapy. Everyone should be on it, but we need to land in the middle and understand more of what's happening with these exogenously wormans.
Is there any evidence that other forms of female contraception can be let's just say problematic for the
Types of things we are discussing today
like the implant in the Depot
or IUD copper IUD
copper i d d and the marina or you know, your progestin laced IUD. Those are what a lot of my technical athletes will use because it doesn't have a systemic effect on adaptation or inflammation mood any of those things and it's a fit and forget so you can put it in for up to three to five years if you have a really heavy bleeding it really dissipates because the hole
Idea of an IUD is that then the endometrial lining? And so then you have a tough OG that takes care of the endometrial lining so you don't necessarily have a bleed the copper IUD is different because you do have really heavy bleeding for the first three cycles and then it attenuates
before we got started today. You mentioned some very interesting pioneering studies on evaluating menstrual blood itself as a window into some larger.
Larger themes about what's going on physiologically even psychologically now might be a good segue to just touch into that. We can always return to it again later. But let me just ask it more directly. What are some things that can be measured directly from menstrual blood that are informative for women and it sounds like there's a new generation of at-home test that might be interesting and informative for them to think about.
Yeah. Well if you think about
Extra fluid everyone thinks about it as a discard product, but it's a very good indicator of what's Happening from an endocrine standpoint gives a really good indication of what's Happening from it and do material standpoint. So if you're looking at all of the cytokines and the proteins and the tissue that comes from it, it's a huge indicator that's naturally discharged that we're now looking at for determining HPV. Do you have it or not? What about proteins are?
PCOS can we really identify PCOS or endometriosis?
We talk about PCOS for a moment. Most people have heard of it by now but polycystic ovarian syndrome its associated with typically elevated androgens. It's becoming more and more common or perhaps detected more based on better detection methods. I don't know which the prevalence of PCOS seems to be very very high.
Yes, it does and I think it's a combination of both.
We also see some rebound PCOS that happens when someone gets off an oral contraceptive pill, it's not necessarily true PCOS because what's happening now, your ovaries are producing eggs that have been down regulated for so long so under ultrasound in might look like PCOS, but it's not necessarily true indication. The other is more and more women are starting to eat more and so they're coming out of low energy availability. If you have more carbohydrate you end up with greater.
Low stimulation which also shows up as PCOS. So the true P cos. Yes. There is a high incidence from a reporting standpoint. But is it that rebound where it's not having all the Android genetic changes that still kind of up in the air at the moment but it is a big concern for women because it is an indication that something is going on and they might have some fertility issues. We see a really high incidence of PCOS in Olympic level athletes because of the logistics.
Higher androgenic aspect of PCOS so better recovery time a little bit higher Baseline testosterone. So yeah, it's a population specificity as well.
In the 80s and 90s there was a lot of excitement in the end of neurobehavioral Endocrinology Fields largely based on animal literature, but then expanding it to human literature that certain forms of activities could change hormone patterns and maybe even psychology and that makes sense. Yeah on the surface of it, but is there evidence that if somebody engages in say high intensity training or competitive scenarios? This has been explored a lot in men, but I'm wondering if it's also been
I explored now and women that androgens go up, you know, I mean, there's been these studies. I don't know how good they are of, you know people on the stock exchange, you know watching their stress fluctuations measuring testosterone. I think most of those studies were done in men but other competitive scenarios even showing for instance that exoticness testosterone can increase altruism in men if men are competing for who's like donating the most money at a philanthropic
Think of that but you put them in a different scenario where it's far less benevolent in goal. And then they'll exogenous testosterone drives competitiveness towards things that are more traditionally thought of as male-male competition. In other words. It's all context-dependent. Is there anything they got two Springs to mine of interesting studies as it relates to androgens or estrogens in women athletes and as it relates to exercise
they haven't done any specific studies like that and women we do see that under stress.
Is the cortisol increases and if you have an adequate response to it and your body can overcome it then. Yes, you get a boost in testosterone for women. We see this in a lot of the night Mission shift changes in tactical athletes. There is also I guess a lessening of circulating estrogen. So the pulse changes when we start getting to the end of a really strong training block because we're starting to have a little bit of
Down-regulation of our luteinizing hormone pulse and estrogen but it shouldn't be severe enough to cause menstrual cycle dysfunction. What we want people to do is look at the ratio of their estrogen progesterone and keeping track of luteinizing hormone. If they are at that point where they are going to have a really big training block. So we look at preseason during season end of season and people who might be at higher risk factor for becoming a mentor react then we keep track that way.
Because it is the stress component that can down regulate not actually causing a permanent change as we talk about menstruation. We should probably talk about iron stores and iron. Yeah, do women need to supplement iron given that they lose iron during menstruation. It's interesting because we have a change in hepcidin or hepcidin depending on which part of the world you come from because it is increased under times of inflammation.
And decreased under times of iron loss. So we see a significant change across the menstrual cycle. So I tell women if you are concerned with low ferritin, then we want you to take an iron supplement every other day starting at the first day of your blade for 10 days because that's going to really allow your body to absorb it and stay on top of it after that every other day. Yeah, but you're not going to be absorbing as much of
Of it because hepcidin starts to come up after ovulation. Again, you have a pro-inflammatory response. You have greater information do women blanket need to supplement know because we see fatigue isn't necessarily just iron related. There's so many other reasons why women are fatigued. The one problem is the Baseline levels for like ferritin for active women if you go in and you have a ferritin level of 22
G5 they're going to say it's normal, but we'd rather see you up around 50. So if you are in that low end of normal then supplementing will help you get up into that 50 and see if it makes a difference
if a woman is going to get a blood test to evaluate testosterone estrogen lipids metabolic factors Etc, and she can only afford to do that at one point during her cycle and compare at various times. Maybe every six months or once a year.
Year, even at that specific time of recycle. Is there a Best time in cycle to do that blood
test?
If I'm limited to say that then I would say five to seven days before her next period starts so mid luteal because then you can get a good indication of estrogen progesterone Peak testosterone doesn't fluctuate as much as those two. So you're going to get a good idea of what Baseline testosterone is and we know that there's a greater inflammatory response. So anything that's outside of the norm of that upper elevation of inflammation. You're going to be able to pick out. So yeah, I would say
If you could only do it at one point in time, that would
be the time to do it. And if she can add a second blood test at a different phase of the menstrual cycle, where would you place that second test
day 2 of the menstrual cycles as a bleeding to get a really good indication of what your true estrogen level is at
Baseline. And if she measures her hormones at those two times within the cycle, do you think that's sufficient to get 75 percent plus of the relevant?
Data, yeah, definitely terrific.
Caffeine. Yes in the old days meaning when I was a kid and not long ago. Yeah, it'll read three weeks ago. We would hear these crazy statements about caffeine. It pulls calcium out of the bones. It's the you know, you'd hear this stuff. I did a whole episode on caffeine. I'm a big fan of caffeine, but I do warn people that if they suffer from anxiety or they're going through a particularly stressful life event. It can raise the activity of the sympathetic arm of the
Autonomic nervous system, you'll feel more nervous. You're more prone to panic when you're drinking caffeine, but many people love caffeine. I think ninety percent of the adult population of the world in just some form of caffeine every single day. I'm in that 90% of likewise making it the most consumed drug worldwide.
Is caffeine safe for women? I suspect based on what you just said that the answer will be yes, but are there case conditions where women should be cautious about their intake of caffeine independent of this anxiety thing. I mean people probably shouldn't drink more caffeine than they can tolerate right psychologically. No one male female young or old.
Yeah. It's more of a genetic Factor than it is this X Factor. So I mean both men and women will be fast metabolizers.
Slow metabolizers or not have an effect that becomes the bigger Rock of them. What we do find is in that perimenopausal State women will become more sensitive to the blood sugar fluctuations that happen with caffeine. So they're used to having coffee in the morning and with something then halfway through their work out. They become a little bit hypoglycemic because there's changes in insulin sensitivity insulin responses. So there's changes also with
Trigger control and caffeine can exacerbate that. So if you are someone who's like, oh, I always have a double espresso before I go work out and then halfway through I'm really hypoglycemic. I'm really dizzy and lightheaded. I don't know what to do feel
sick or nauseous.
Yeah, eat some food need some food with it. What
about sipping caffeine through the workout, you know taking that coffee in and just having to sit between sets can that offset some of
that? I don't think so.
Okay. I hear a lot that people who drink caffeine before
Work out, you know Midway through the like, I don't
feel good. Yeah, they don't eat
for me that just stimulates the desire for more caffeine. But or even dare I say a half piece of nicotine gum, which I experimented with but I was told and this is why I'm not going to continue to do it. Not only is it very habit-forming. It actually is such a vasoconstrictor that I was told by a dermatologist that it's terrible force can even if you're not getting your nicotine by smoking.
Being dipping or snuffing. So this this big Trend now toward ingesting nicotine as a stimulant and cognitive enhancer and performance enhancer. I think people should at least be aware of the negative effects on skin
never would have known because I'm not a nicotine
person. I'll tell you that half piece of nicotine gum is the first time you do it. It's a it's an unbelievable experience. It's the it's like your first real cup of
coffee. Oh,
Oh really wakes you up?
Yeah, and I was you and I recommend nobody do it because it's it feels that Pleasant if you like
caffeine, I like schisandra for that reason schisandra. Yeah. What's your chandra's an adaptogen? I mean I should know what this is. You should know what this
is. Yeah. Well, I'm here to
learn. Okay,
Chandra
Chandra. Yeah, so it is an adaptogen eggplant. So, you know like ginseng Siberian ginseng maca.
Ashwagandha, all those buzzwords out there schisandra is another really well studied adaptogen and I friends you say it's like Adderall or you take it and its immediate Funk focus and function because its main goal is to regulate dopamine serotonin and cortisol. So it gives you gets women and men out of that brain fog gives them incredible Focus. Do you use it? Yeah, are you on it now? I put in my morning coffee. Okay, you just say
People down the rabbit hole the internet the internet. All right. Yeah. You heard it here first. Dr. Stacy Sims. Give it a try because the nicotine thing is an interesting one and there are some cognitive enhancing effects of nicotine that perhaps in people 65 and older might actually be beneficial for offsetting some forms of neurodegeneration, but that needs to still be explored and research don't cut that and clip it and put it out there like so that's happened already. Very interesting. Alright caffeine. We both agree as great Chandra.
You gotta try it. Check it out. Let me know. All
right will do cold. Yeah for reasons. I still don't understand people have Associated me or this podcast with deliberate cold exposure. I like deliberate cold exposure in the form of a cold shower or a cold plunge or an ice bath. Mostly for the effects that occur after word meaning more alertness a kind of semi euphoric Buzz that goes on a long long time. No, I don't think it increases metabolism significantly enough.
To have a meaningful difference, but the long-lasting increases in the so-called catecholamines dopamine norepinephrine and epinephrine to me are pretty impressive and I just like the way it makes me feel so that's the main reason I believe why people do deliver cold exposure and every time I do a post about deliberate cold exposure I get asked understandably. So how does it affect women differently than men and then I usually get questions about Raynaud's syndrome. Oh, yeah, so
So is there a difference in terms of how deliver cold exposure impacts women? I have to imagine the answer is yes given what you said earlier about vasoconstriction versus vasodilation but deliberate cold exposure like it hate it. What do you think? Do you recommend it for women?
I recommend it for Open Water swimmers who might experience that vagal response when they first dive into the cold I prefer heat for women. Everyone's a responder to the heat. You better adaptations from sauna. Yep sauna.
Yep, preferably a true Finnish sauna infrared doesn't it warms the skin but not the core we
want. Thank you for saying that. I'm not a big fan of infrared sauna doesn't he doesn't get hot enough? No. Yeah, you can bring an infrared light into a traditional sauna if it can tolerate the heat but Finnish sauna would be what something between 185 degrees Fahrenheit and maybe to 10 if you're really heated
opted. Yeah. I'm still working on Metric. Let me do the
conversion. I'm sorry. Yeah, you're living down in New
Zealand. So 60 to 80
degrees. I need to look every time I
try to do math on the fly in this
podcast and that's okay times 9 divided by five different 32. Yeah,
so people can look it up. Yeah. Okay
look it up. So the thing with cold water exposure is the whole conversation about ice cold ice baths and how cold it is. It's too cold for women because we're looking at that severe immediate jump into that icy cold. It causes such severe constriction and shut down.
So women do really well and get that whole dopamine response and everything if the water is around 16 degrees C, which is 55 to 56 degrees Fahrenheit, which is chilly. It's chilly now warm. Nah, it's go diving San Francisco Bay, right and that is enough to offset that severe constriction survival, but it is cold enough to invoke all the changes that we want.
With cold water exposure. So it's a temperature Nuance that set sex difference. And like I said when I have Open Water swimmers who are going to do a long swim or they're going to do a triathlon and the water is colder. I have them do cold water exposure especially face exposure into the cold water to get them habituated to that initial severe constriction and sympathetic activity that we don't want to happen before.
Or
rice with heat being the truth like true heat that were talking about with sauna. We see a lot of metabolic changes for women. So we're having better insulin and glucose control. We're seeing a better expression of our heat shock proteins and the uncoupling and and the rebuilding of those proteins that are cardiovascular responses and then for women as we get older and have the
Officer shoot of hot flashes night sweats that kind of stuff. If you're doing heat exposure, you're sending a stronger stimulus to the hypothalamus and you're also getting a better serotonin production from the gut because we have 95% of our serotonin produced from the gut which then leads to better temperature control and shuts down hot flashes. I
think some people might be confused by the idea of using sauna.
In order to reduce the hot flashes. So I'll just remind people that your brain has a set of neurons in the medial preoptic area that sort of a thermostat if you will controlling core body temperature and if you heat the surface of your body your medial preoptic neurons say, oh let's cool down the core of the body now if you stay in that heat too long, you'll cook your body to core body temperature will go up but conversely if the surface of your body is made cold the internal
You of your body will heat up because those medial preoptic neurons will say oh, you know this it this is like putting an ice pack on the thermostat which is what graduate students and postdocs used to do in the lab side working because it was a battle over the heater. Right? Some people ran hot something over and calls those voices this business in any event. So it's not that you disapprove of the using deliberate cold exposure. You just recommend that women do deliberate cold exposure with temperatures that are maybe in the low.
°F range as opposed to the really frankly just painfully cold for anybody, you know, 38 to you know, 50 degree temperatures so that right
we did a pilot study looking because when Hoff has been down to New Zealand quite a bit and so, you know his breathing and ice bath stuff has been making the rounds and working in the high-performance people wanted to do that, but we have few athletes that have
Have really severe endometriosis. It's like well, we could look at using cold exposure to help control that and what we found over the course of this study was that if we were to do deliberate cold exposure around ovulation and then hold it for 10 days over the course of three menstrual cycles. It attenuated that endometriosis because endometriosis is an inflammatory disease, right? So if we're looking at inflammation process and growing the tissue,
If we can dampen that information and create a response that learns that information and dampens it then it helps with endometriosis. So that's another Avenue that we really want to take when we're looking at Cold deliberate cold exposure.
Wow fascinating.
As a cautionary note if anyone is going to explore when Hoff type methods, please please please do not combine cyclic hyperventilation or hyperventilation of any kind with breath holds and water exposure. Not even in the depth of a puddle there have been drowning so associated with people doing cyclic hyperventilation in various context not just related to half breathing but basically people who are not skilled and even some who are skilled combining.
Cyclic hyperventilation breath holds and water in any form cold or warm water. Just don't if you're going to do any kind of cyclic hyperventilation breathing in my labs actually published on this in a clinical trial do it on dry land or don't do it at all. And if you're going to deliberate cold exposure limit your breathing to slow deep breaths, make sure that your well supervised and just stay alive, please.
Yeah, so we didn't incorporate any of the Wim Hof breathing. We just Incorporated the deliberate water.
Cold water
exposures cold and temperature generally is such a potent stimulus and it's exciting that people are trying to explore this especially the in my opinion the the sauna work one thing. I suppose that we should discuss very briefly before we move on since we've been talking about resistance training.
We've been talking about deliberate cold exposure. There is evidence that doing deliberate cold exposure not so much in the form of a cold shower, but in the form of a submersion up to the neck post strength or resistance training say in the for but probably the eight hours after resistance training because of the attenuation of the inflammatory response, which sounds like a great thing. It actually can inhibit some of the strength and hypertrophy games that one would otherwise experience. So if you're going to deliberate cold exposure best to not do it in the
Eight hours or even on the same day after resistance training geared towards developing strength and hypertrophy increases no problem to do it first. In fact, maybe even some performance enhancing effects of doing it first. There's some athletes at Stanford doing that but just want to throw that out there. Is there anything else you want to add to that which is different from heat exposure because heat exposure you want to do afterwards because it is a dilation. Yeah because it extends that training stimulus and also the passive dehydration.
From training will stimulate greater blood volume improvements. So
interesting. So after a good weight training session, if one has the luxury of doing it get into the sauna for
up to 30
minutes, make sure your hydrating
you want slow rehydration because part of it is that dehydration and the decrease of oxygen at the level of the kidney to stimulate more EPO. So with more red cell production you have natural increase in plasma volume, so it's a blood volume
expander.
So now we're getting into Real Performance enhancement. Is this true for men and for women, let's walk through this protocol. I like like this. This is this is not been discussed on this podcast. So somebody does their resistance training finishes up drinks 8 or 16 ounces of water with a little salt and it may be and then hops in the sauna for how
long up to 30 minutes. Okay longer no longer longer.
They'll probably be a little
Thirsty in there you're looking for a little low level dehydration. Is that right? Okay, the ranges that I've seen published in the Finish studies are as I recall and I'll double check these numbers 100 86 degrees Fahrenheit up to about 210 Fahrenheit and the higher end only being for those that are heated apted one can cover their head with a towel and actually feel more comfortable because the brain is insulated the surprises people. They think putting a
You know something on their head would make it excessively warm. Yeah, but you actually are protecting your brain from some of the
Heat and people will put a towel over so that they when they breathe it doesn't burn the inside of their nose and their mouth either. I'm always like if you're going to be in and it's that hot just moved down a level. So then lure yeah
and this stimulates the production of more red blood cells, okay, which then translates to what in terms of Athletics.
Formance you have an increase in your cardiovascular effort. And because you have a greater amount of blood volumes, you have greater amount of pretty much blood circulating. So you have more available for muscle metabolism heat loss. So it's akin to going to altitude so people will go to altitude to get that blood volume boost, but not everyone responds to altitude because you have responders and non-responders over responders.
Okay is why?
When I go to Colorado, I'm gasping for air while I do a walk but then I come back to sea level and I feel better. My endurance is better. But some people might not experience that
affect true This Is Us telling the guys before we started that I've been in our sauna at home in preparation for going to Park City because I live at a beach town and going to Park City. I am a significant responder to altitude and I won't be able to have coherent meetings at altitude if I am not adapted. So
yeah, so this explains why
When I've gone to meetings in Colorado at altitude, some people can have a drink that first night and they're perfectly fine, even though they normally live at sea level and I'm trying to trying to see the stairs correctly even though I don't
drink. Yeah, that would be it
very interesting. So you can use poast resistance training sauna exposure to improve
performance. Yeah, you can use it post cardio as well. So anything that is giving you that passive dehydration from training because you're not because you will
Will become passively dehydrated when your training right you can't keep in as much fluid. So I'm saying passive as in you're not able to stop that dehydration. And then you go into the sauna and you are extending that training stimulus because your heart rate is elevated. You're putting your body under stress from dehydration and the body responds in kind of we need more blood volume. So let's let's jump start
that love it logically.
And I'm going to give it a try. Yeah what other training tips tricks tips? Do you have up your sleeve? Dr. Sims
what you want to talk about?
Do you have any favorites besides I Delight in these and I know other people will as well do any come to mind. I mean you taught us about schisandra about post-training Saint exposure to improve performance by increasing red blood cell count. Is there anything else that got Springs to mind? Don't know no pressure.
I'm a fan of what I call the track stack that we used to use for track athletes, but then for really significant high intensity work, so track stack is kind of the idea from the old bodybuilding set where you're taking 200 milligrams of caffeine low-dose baby aspirin. Hmm But then I add beta alanine
used to be a Fed hren. I know so I'm old enough to remember when they would sell it as the triple stack with a
Ephedrine. Yeah, but some people drop dead and they took it off the market. Hey, it came back on the market in New Zealand last week it really yeah, it gets you going. Yes. It does. It's it's Speedy. Yeah, it's dangerous. Yeah, but the track stack which has beta alanine and not f adrene is really good at encouraging an extra top end effect because you're having the caffeine you're having a little bit of the blunt blood thin.
The aspirin and the vasodilatory properties and the carnosine aspect for muscle contraction from the beta alanine and so like training for gravel races in the top-end Sprint. You do a couple of Sprint sessions with that and it's increasing your training stress during the training. So your adaptation is to that higher stress
should anything be done in terms of recovery to make sure that you offset that additional stress that's achieved with this track stack.
Yeah.
Just making sure that you're not stacking two days in a row of high-intensity work like really making sure that you're recovering well because it is a significant stress on the body about sleep. We are so much these days about the importance of sleep for mental health physical health performance. I think this is a great thing a great Trend are there female specific requirements for sleep that vary across the menstrual cycle and or by age or just generally, you know, do men and women need to think about
Need for Sleep differently.
Yeah part of it is the obvious like when you're talking about sleep temperature right women and men have variations in their sleep temperature and what's optimal. So looking at that like you need to create an environment for you that is cool comfortable, which is probably going to be different from your partner who might be sharing your bed. So that becomes a sticky point. We talked about the menstrual cycle. There are definitive changes in sleep architecture. We're seeing
that in around the mid luteal to the premenstrual so, you know that about 10 days before your period starts significant change in your slow-wave sleep there's less of it latency is increased. So you have a longer time to get to sleep and you have more light sleep. So overall, you know less of that deep recovery sleep and this is where women tend to have more of their mood issues too because of estrogens play with
Learning in the brain. So we really need to nail down our sleep hygiene in that time period so looking at things like l-theanine and epogen and looking at your room temperature and the screens and all the things that you've talked about for the most part about sleep and sleep hygiene super important. And then of course as you get older in both men and women becomes more difficult to sleep, but we see a significant issue with insomnia and women who have
really bad hot flushes and significant menopausal symptoms. And again, this has to do with lots of the perturbations from temperatures of night sweats increased sympathetic load not being able to get into a parasympathetic state. So this is we're working with a specific sleep specialist might come into play we can also look at using some adaptogens the rhodiola stacked with theanine and looking at the cold temperature getting people to use
The non-slip depressed or Yoga Nidra or some other kind of meditative property that they can then access when they're in bed. So there's a lot of different things that we have to be aware of and again in that perimenopausal State. We see that significant change in sleep and sleep architecture and quality of the sleep but men don't have the same thing. So women have to be a little bit more aligned with what's happening from a hormonal profile standpoint because it does definitively affect serotonin. Melatonin.
In and sleep architecture because of the interplay that estrogen has on the brain and The receptors
makes very good sense will put a link in the show right captions to some zero-cost non-slip D breasts Yoga Nidra as we've put out a couple with my voice if you prefer a another voice, I'm a big fan of the ones by Kelly boys who's contributed to the waking up a Pat also has terrific non-slip depressed. Yoga Nidra is out there and there are others as well. You mentioned a few supplements theanine.
Apigenin which is chamomile extract. Yeah, maybe let's just have a general conversation about supplements. What's your thought on supplements? How do you place them into the landscape of nutrition? They are after all supplements not Replacements, but the word supplements I believe is a little bit misleading because there are food based supplements, you know, like a protein powder. There are supplements designed to achieve a specific outcome. And then there are supplements that are kind of a designed to be a more.
You know support for a bunch of things kind of insurance policy. What are some of your favorite supplements in any of those categories specifically for women and perhaps even specifically during certain phases of the menstrual cycle and or perimenopause menopause. I just threw my nine questions of you.
Okay. The number one is creatine creatine for women doesn't matter what age it's really important. We're seeing a lot for brain mood and
Got
health so 5 grams of creatine monohydrate per day sort of
typical 535. Yep, preferably, of course creapure because the way it's produced. So if you're looking at creapure, it's the German company that produces it uses a water-based wash to produce the creatine interesting. Whereas others use an acid-based swash and we see a lot of side effects with the acid-base
wash like gastric
distress. So people are like, I'm really bloated and I have nausea and stuff from taking creatine and Mike is it creapure actually, you know, it's like switch to creep.
Here and so they switch and they're like, oh my gosh, I feel so much better noted. Yeah and then vitamin D3 really important, especially when we're looking at all the information that's coming out from cardiovascular muscle brain everything that goes with vitamin D also with iron so vitamin D is really important for absorbing and maintaining iron stores. So those are the two big ones and then
sorry I just want to stop you for a moment.
As it relates to creatine I hear two general lines of concern one. I hear more often from women. My understanding is that because creatine brings water into the muscle as well as supporting the phosphor creatine system of the brain the water into the muscle component means yes people who take creatine 325 grams per day will gain a few pounds of body weight. That's solid body weight in the form of water within the muscle. So solid in air quotes.
It's water but it's within the muscle it's so they should know that
I got a given though interesting. It's not a given there's some women on the lower dose of three that don't experience the water gain.
Okay, and this is not bloat like water subcutaneous water. This is water within the muscles, right? So it will be stored within lean tissue and then I do hear concerns about creatine causing hair loss. My understanding is
There is zero evidence for that evidence. There is a smidgen of evidence that it might increase dihydrotestosterone levels, but it's like one study marginal increase and then people linked dihydrotestosterone to hair loss. And so then the conclusion people drew was that somehow creatine increases hair loss, but you're saying is zero
evidence. No evidence. We see that women who start taking it midlife are complaining about it, but it's actually a progestin driven thing. We see progesterone and
Equation progesterone can exacerbate any hair loss. So if women are experiencing that and they're saying oh, it's creatine. I've read all the stuff on Creatine. No, it's
not. Okay. So we've got creatine D3000 I use per day 5,000 IU's, I guess it depends a little bit.
Yeah being very close to Antarctica and the southern hemisphere in the winter, very low sunlight exposure looking around the 5000 same with
For Northern Hemisphere UK that kind of stuff plus you get to the Equator the less you need. The one concern is like a day here where it's foggy and supposed to be sunny and people are like great. I don't know don't have to worry about going out and sun exposure, but then the next day is bright and sunny and they're like, ooh sunscreen, so they put sunscreen on and not getting the right sun exposure. So then again it is a lifestyle thing. So basic is 225 thousand great Okay, so we've got creatine vitamin D3. What are some of the other?
That's that you that you take or that you don't know if we say suggest but that you perhaps suggests women consider. Yeah, so protein powder really good high-quality because the amount of protein that women should be getting is often difficult to eat. So again, supplementing not using it as the Mainstay that's one to consider and then again, I'm about adaptogens. So looking at the different adaptogens ashwagandha.
Is a good one? Holy basil or Tulsi is another one Chandra and then getting into some of your medicinal mushrooms lion's mane Rishi. Those are the two big ones that I look to and often have women use
if these adaptogens blunt cortisol because certain ones do like ashwagandha, which by the way, I do think people should cycle if they're going to take it high doses. Yeah, right because there are some issues with liver
and I write and thyroid
problems if people take
ashwagandha high doses for too long. So that's important to note. But assuming that the adaptogens are reducing cortisol levels in addition to doing other things. Is there a particular time of day or night that people should consider taking them should they avoid taking it early in the day? My understanding was that you you want a bit of that cortisol bump early in the day, but you certainly want cortisol lower later in the
day. Yep, and I think the problem is people think that they don't
On any cortisol and I think that would be bad. They don't understand that the body has fluctuations of cortisol throughout the day and that's normal if we're looking at having issues with sleeping and that anxiety provoked from that sympathetic drive an elevation of cortisol. Let it peak in the morning after your waking up and look late afternoon like 4:00 when it starts to dip to take your adaptogens then because then it feeds forward to being able to relax more which
It feeds board to better sleep for something like shaundra where you're looking for that brain Focus. You can have it in the morning. It doesn't necessarily have as big an impact on cortisol that you see with something like Tulsi or ashwagandha because she Sean does more stimulatory the other two are more calming. I put some in my morning coffee and then the afternoon when I need to pick me up instead of more caffeine all you Chandra because it gives you that boost without the effects of caffeine in it.
Doesn't interfere with sleep. So there's a time and a place to take them. And yes, I'm need to be cycled on something to be cycled off. But I tell women what are your main symptoms? What are the things you're looking to control and we can look and see what kind of adaptogens we can use and how we place them.
What's the story with pregnancy and training? Yeah. No, is there an official word on this, you know, assuming a woman knows that she's pregnant from the very beginning of missing a period
where she's in a position to make decisions about training or not training training at a given intensity or or not. What are your recommendations?
The human body is really interesting. And when you get pregnant your body tells you what you can do. So we see that you have a reduction in your anaerobic capacity on purpose your body's trying to be protective. You do have an expansion of your blood volume. So endurance is really good, but you can't do high-intensity when we're looking at the general.
Guidelines that are out there they've gotten rid of the heart rate rule. They are now telling women to be as active as they can be without creating injury and without trying to make gains. So that means if you're in the weight room, you're not looking to improve your looking to maintain if you're doing cardiovascular work and you have a specific class that you love to go to. Yeah, but don't beat yourself up that you can't hit that high intensity you're going for the social aspect. You're not trying to gain Fitness.
You're trying to maintain I think the very worst possible scenario is someone is Super Active and stops doing everything because they're afraid because then they get deconditioned and then they end up in a worse State than someone who was sedentary who's now encouraged to walk during exercise. It hasn't been well researched because you can't get ethics to study pregnant women very well. So we go on a lot on case studies in case study notes and the bottom line of it all is you stay
active and you can do resistance training you can do all the cardiovascular work and your body will tell you what you can and can't
do I've been asked whether or not pregnant women can do deliberate cold exposure. Probably no fewer than
2,500 times on social media and I never have an answer and but I always default to the cautious answer which is please don't until you talk to somebody who actually has an answer. Yeah, just because it sounds like a very precarious situation but in all honesty, I don't know. I'm just biding time there and anything please go ask somebody who can give you a definitive
answer. Yes, sir. We see women who have a high risk for miscarriage that anything that they do that's incredibly stressful for the first 12 to 20 weeks.
We'll put them at a higher risk for it. So I'll being very cautious especially with cold because we know that there are so many different nuances doing something like hot yoga when you're pregnant is not there is research so it's not detrimental because yeah, because when we're looking at blood flow diversion that way when you have slight hypoxia to the placenta and to the baby, there is a rebound effect that
Increases the vascularization so that the baby has better nutrients. We see this also with like exercise and exercise intensities. This is why people are now saying you need to have some kind of blood flow change and increase in core temperature to create these vascular effects within the placenta to improve nutrient and nutrient delivery to the developing fetus. So Heats good cold. I'm not so sure of but probably not extreme heat not extremely.
Oh, so that's why I mean like hot. Yoga is not going to the sauna Hot Yoga sits around 40 degrees celsius. So what does that just around 100 degrees Fahrenheit and in that situation, if you're feeling too hot you leave you lie down on the floor. Don't try to stay for the whole class, but it's not going to be detrimental unless you're pushing yourself too much again everything in moderation, especially when you're pregnant.
It's almost the inverse of what we know for males, which is if
Men want to conceive they should avoid the sauna because we know that he does detrimental the sperm viability in a real way so much so that I tell guys if they are trying to get their partner pregnant that they should bring an ice pack into the sauna. They should insulate that ice back and put it directly on the scrotum for other reasons, but that it's a you know, that the effects of heat the negative effects of heat on sperm are real. Yeah, but there's also an interesting it's not just a trend.
There's actually some research showing that cooling the testicles leads to increases in testosterone, which is on the face of It kind of counterintuitive because it turns out that it's about the vasoconstriction causing the subsequent increase in blood flow increased vasodilation. So the inverse of what you just said, which is that during the heating process the hypoxia induces more vascularization of
Of the placenta. So when talking about temperature one always has to think about the surface of the body versus the brain responds as we talked about earlier and then what's happening during the deliberate heater deliberate Cold versus what's happening after the delivery heat or deliberate cold, right? Everything in biology is a process not an
event and I should make full disclosure. I started as an environmental exercise physiologist and my PhD was all in heat and heat research. So I'm a little bit biased towards heat, but I've done a
Difficult amount of research in the hot and
cold. Thank you for the disclosure. I see it more as a as an indication of real knowledge. So thank you. This is an aspect of your training. I knew a little bit about based on your Publications, but I didn't realize the depth of knowledge. So we're all benefiting here including this earlier protocol of sauna post training you can bet a lot of people are going to start incorporating that I think we might need to name that I've done this from time to time named protocols because people are reluctant to name them after themselves. Maybe we call that the the The Sims protocol or
Something like that. The anyway your discomfort will be other people's benefit.
Now seems like a good time to address some specific questions related to the age brackets that you mentioned earlier in anticipation of sitting down with you today. I asked some different women that I know, you know, if you could ask the world expert in exercise physiology hormones and nutrition Etc as it relates to women one question. What would it be and one of the most common questions I got in the 50 and up category was
was what is the most efficient way for a woman older than 50 to train for the maximum health span and lifespan benefits.
I love this question because I get it all the time. We have to turn our brains away from everything that's been predicated before to this point. So if we're looking for longevity and we're looking at what we want to do when we're 80 or 90 we want to be independently living we want to have good proprioception balance. We won't have good bones and we want to be strong. So this is where we look at.
It 10 minutes three times a week jump training. So this isn't your Landing softly in our knees. This is like impact in the skeletal system a colleague and friend of mine Tracy crisil did a PhD and post not a postdoc but post research on this and is developing an app on it to show women how to jump to improve bone mineral density over the course of four months of this type of training people have gone from being Osteo.
Ow, Pina to normal bone density. So it's a different type of stress. So if your concern is that which a lot of women do have a concern because they lose about one-third of their bone mass at the onset of menopause. Yeah significant amount. Yeah, goodness. Gracious. Don't do something as an intervention. So we see a lot of women are like, oh I'm going to go on menopause hormone therapy to stop bone loss. Yeah. I can be a treatment, but I always look at an external stress.
That we can put on the body that's going to invoke a change without Pharmaceuticals. So jump training heavy resistance training and Sprint interval training. Those are the three key things and from a training standpoint and then from a nutrition standpoint getting protein protein is so important when you start telling women, they need to look at around 1 to 1 Point.
One gram per pound, which is around that 2 to point 3 grams per kilo per day. They're like, whoa, that's a lot of protein it is because we haven't been conditioned to eat it
but really scrambled eggs. Yeah some chicken breast at lunch. It's a small stake at dinner. Yeah plus other
things right? Exactly. It doesn't all have to be animal products. I mean you're looking at all the different beans and things that you can put together. That's the other big thing that in order to build the muscle and to keep the body composition and state that we wanted to keep.
Going for longevity. Those are the big rocks the Sprint interval training the heavy resistance training the jump training in the
protein. I'm thinking about this and I'm thinking about my mother who's 79 years old. She'll be 80 at the end of June and is in good health walks a lot Gardens does some yoga but does none of the things that you're describing. So Mom, please I'm gonna I'm gonna send it a listen to this in the same vein. What about
The women out there age 22, maybe make it the 22:40 bracket. And if we need to divide that more finally we can what is the most efficient way for them to train for health Vigor and Longevity
making things fun for the most part. I don't want people to think that it's a chore. So if you're someone who's been told you need to run and you hate running then don't run like that's common sense and I say that because I see little kids.
In non us countries that have to run across country and you see these kids when they're six years old and all running around the field and they're the kids that hate running that aren't natural Runners and then they hate physical activity for the rest of their life. So I put that in like when you were exercising you want to find something that you find fun when you're in your 20s to 40s you have more room to get away with things that might not be optimal for you when you start to get older bigger Rock again is resistance training.
Doesn't have to be heavy resistance training. Like I said earlier to failure your period izing if you want to do a block of Olympic lifting go for it. If you're like, I'm not comfortable doing that kind of lifting. I want to do more machine stuff great, but we want to make sure that you're changing it up all the time to keep things moving and shaking with regards to strength and hypertrophy and then it becomes more of are you training for something that's endurance. Are you looking for just longevity for brain health. We need to have some lactate production.
Because women as I said at the beginning of the podcast are more oxidative, we don't have as many of those glycolytic fibers. So what we're finding in older research is that there's a misstep and brain lactate metabolism because the brain hasn't been exposed to it, especially for looking at women who are being studied now, it hasn't been in a societal context to do that kind of work the younger we are and the more that we can keep our glycolytic fibers going by doing high intensity work the more we are exposing our brain to lactate.
The better we see fast forward to attenuating cognitive decline and reducing the plaque development of Alzheimer's this is why women who are in their 40s plus I want them to do the Sprint and the high intensity work for that lactate production start early because then you can take some of those type to be fibers that could either go more aerobic or anaerobic and make them more anaerobic. So those are the two big things for women who are younger and then you can play around with the other things if you want to be an old
her endurance athlete. Yeah, not really ideal. But yeah, you can do that. That's fine. You'll recover
well now forgive me because you've said it several times throughout today's discussion, but I really want to drive home the key point that I think for most people men and women is not obvious but is really important when you say high intensity, you don't mean a class or a run where you're drenched in sweat and gasping for air.
At the end necessarily correct? Let's disambiguation high intensity from what most people think of high intensity, which is a really hard workout a tough class where they had me moving the whole time doing a circuit etcetera. What is the appropriate high-intensity workout look
like? Okay. So if I talk about true high-intensity interval training if you're a runner, it's going to the track and doing sets of four hundred
100. Okay. So 400 a lap. Yep. 802
Laughs, right. So you're looking at between a minute and four minutes of of hard work at 80% or more with variable recovery. So that's why I use a track as an example. So if you do one lap and you're like I'm going to walk half a lap and then do it again. That's adequate recovery. So, yeah, it's hard right but it's not like you're going to be there for 90 minutes doing as many 400 as you can because you have that variable recovery. It might take half an hour to 40 minutes max, and then you're
Stout can't do it anymore. If we're looking at a gym situation. I look like to look at something like every minute on the minute where you might be doing ten deadlifts at moderate intensity weight and it takes repetition. Yeah, so it takes you 50 seconds to complete that then you have 10 seconds to move to the next exercise that might be thrusters. So, you know a squat clean Thruster. So it's a squat pulled the weight up overhead. So you're doing maybe eight.
Eight of those in that minute and you might have 10 second recovery you go to the next exercise that might be kettlebell swings and you're doing explosive kettlebell swings and you'll finish, you know ten seconds to go you go to the fourth exercise. I don't know toes to bar or some other kind of V up some other high intensity and then you have 1 minute completely off. So you've had four minutes of really heavy work with maybe 10 seconds to move to the next exercise one minute completely off.
And then you repeat that three
times and this is high intensity interval training. This is not what you would consider resistance training for sake of building muscle or strength. Correct? This is using these loads these machines the the pike, you know, hang from the bar and bring your knees up or else it or something as a tool to get the heart rate up. Continually. Yep, very different than resistance training them the way most people think about
it, correct. So this is the cardiovascular high-intensity interval training and the subset of that is Sprint interval training and
this is something that's really really hard and people don't get it. I don't necessarily mean running it can be whatever motive activity but it's 30 seconds or less as hard as you can go. So this is your 9 or 10 on your rating of perceived exertion 110% It's Max effort
on the rower on the airdyne bike. Yeah running if you
like. Yeah, okay of those the same year the battle ropes
battle ropes are big. So 30 seconds all out then rest what 10 15 seconds
repeat know.
I want to because now we're looking at that top end where we want regeneration of your ATP, you know all of that system and central nervous system recovery. So this is 30 seconds all out. Maybe two or three minutes of recovery. Oh nice because I'm not looking at Tabata where your 20 seconds on 20 seconds off because that's not the intensity. We want we want you to go all out and recover well enough to be able to go all out again. You're not leaving anything in the tank.
And so those are what I mean by high intensity interval training or when you're looking at polarizing your cardiovascular work. That's the top end. Those are the two examples of your top end and then your recovery is at long slow walking on another day where you're not going and doing a tempo run. You're not doing a 5k easy jog because that puts you in that modern intensity.
And if I heard you correctly earlier you are suggesting most women do one or two days of high intensity interval training.
Plus 3 to 4 days of resistance training for sake of building strength and muscle which looks very different. It's more warm up do a couple work sets, you know, 224 work sets of you know an overhead, press tour for work sets of maybe a barbell curl two or four sets of some dips or whatever whatever one's you know personal choices. Yeah. Okay. Got it.
Very different far in a way different than what most people men or women are doing out there which is a lot of StairMaster treadmill jogging maybe some Lifting for hypertrophy
because I look at the general consensus of what's out there in the fitness world is all based on Aesthetics and body composition. And so people have this mentality of I need to be hypertrophy to Get Swole and I need to do long slow stuff on the cardio machine to lose body fat.
But that isn't what we're after we're after let's create really strong external stress to create adaptations. Not only from a neural and a brain standpoint that's understanding it but also feeding down to metabolic change because if you have a really significant high stress, we see epigenetic changes within the muscle that increase the amount of what we call the glute for Gates. So, you know, the proteins that open up that allow carbohydrate to come in without insulin. So we're expanding
Acute glucose uptake through an epigenetic change. The other thing that it does is it causes an acute inflammatory response that your body learns to overcome and it's really important for women to do that because as we start to lose estrogen we lose a significant anti-inflammatory agent. So this is why we see that increase in the visceral fat, especially when we're hitting your mid-40s onwards is because now you have this increase in free fatty acids.
And the inability for inflammation to come down. So the muscle cell is going on. I don't know what to do with this. So get circulated to the liver and the liver stores it as the zero fat, whereas if you do that high intensity work, it creates that change within the muscle to understand pull that in let's use it. Let's also bring more carbohydrate in and more glucose and use that which helps use free fatty acids, and it also creates a significant anti inflammatory response.
Level of of the mitochondria and within the cell itself, which is what estrogen used to do. So if we look at those external stresses, it's not about body confidence that Express a it's about the molecular changes that we want to invoke to get that body composition and the brain health that allow us to be 80 or 90 in independently
living and in terms of nutrition. You mentioned women should shoot for 1.1 1.2 grams of
quality protein per pound of body weight what other types of foods do like to see women ingesting. So are you a fan of fruit? Yeah, great. Well these days you sort of have to ask and he circles vegetables. Yep. Yep fiber is important. Yeah, absolutely. And then in terms of starch is to to replace glycogen, especially if people are doing these high intensity interval training sessions and the resistance training, what are your preferred?
Sources depends on who I'm working with. I have some people who love Coco Pops and kids
cereal I cringed that stuff. But you know, I prefer I prefer rice and oatmeal and like a really good sourdough bread with butter or olive oil, you know Gil do that.
Yeah, but there are some people will like the ultra process stuff. So I'm like, okay, if you really really need it. Then you can put it on top of your yogurt after training as part of your carbohydrate updates the only time
because glue for levels are so high you're basically pulling everything in to go.
A kitchen at that point anyway,
but ideally carbs are all the different colorful fruit and veg and if we're looking at sweet potatoes or kumara, if you're from other parts of the world yams, all of those kinds of things sprouted bread fantastic quinoa Amorous all of those different types of things. It's just staying away from the ultra-processed and when we look at women, it's really important to have a very
Advocate diversity in the gut microbiome. So we see there's a definitive decrease when we start to have hormonal shifts because of the way the gut bugs help D conjugate or unwrap some of our hormones and shoot him back out in the circulation. So as much fiber colorful fruit and veg as you can but also it's the 80/20 rule right 80% of the time you're spot-on 20% is life because otherwise, where do we get our chocolate and our whiskey
and there's some data that chocolate is good for us it is.
The low sugar dark chocolates by look at his how it makes you feel makes you feel good. Right? Yeah one has to live. Yeah and fats. Where do you like to see women get their fats from again? I'll do a full disclosure. I have been vegan since I was in high school because if an incident of a field trip to a pig slaughterhouse and driving down the 5, but that's my own preference. So when we're looking at fats it can be from
Lot of different sources. I prefer women to have most their fats from plant-based stuff not because I am plant-based but because of the effect it has on the body, but there is a time and a place for animal fats to the whole fear-mongering of saturated fatty acids from dairy has been disproven. So for looking at what kinds of fats you want a conglomerate, but you want most of them D come from Whole Food plant-based not from ultra-processed and then of course you're reaching for some
real butter, you're reaching for some 4% fat yogurt or something like that to complement your avocados your nuts your seeds and your olive oils.
It all sounds very rational and delicious in my
opinion. Yes, it's too Common Sense people don't do it. I think if
people hear it from you they'll do it. I think people just need to hear it in the context of a non-diet context and you've done an amazing job today of explaining how
And fuels training training fuels changes at the level of the muscle the liver Etc that allow one to ingest more fuel. In fact a lot of what I'm hearing is that women should probably ingest more quality fuels in order to offset these cortisol spikes absolute and feel better while training and train more which everyone agrees provided it's done properly is is great for us kind of a fun. Hopefully fun question for you if you had a magic wand and you could get all the women on earth.
Now and going forward to make a change or changes. You don't have to pick just one in terms of nutrition how they think about their hormone cycle exercise healthspan lifespan. What would it be?
I think I would have everyone understand their intrinsic selves because we have been inundated so much with socio-cultural rhetoric and so much external noise that women have forgotten what it means to listen to themselves in their
Bees, I mean that's the one thing that I have to reteach women to do so often so if I could have a magic wand and have every woman understand what their bodies are saying and what their Cycles are saying and perimenopause is normal. It's everyone's going to go through it. If you have had a menstrual cycle just to intrinsically understand what their body is. So then they have the tool to be able to implement external stressors that's going to be beneficial for them.
Well, dr. Stacy Sims. This has been tremendously educational for me. And I know for everybody listening and are watching you've taken us on an amazing tour of the best ways to train with cardiovascular training and resistance training those tailored specifically for women as well as touching into some protocols for both men and women that are immensely powerful talked a lot about the menstrual cycle. I get asked about the menstrual cycle and how it relates to training and vice versa. So
So many times and thank you for providing clear actionable answers and you've also educated us on caffeine supplements including revealing some supplements that I didn't know existed which is which is not a common occurrence for me. Yeah, I went and many wins many many wins. Thanks to you and on and on so just such a rich data set here presented with such Clarity and in an actionable way so on behalf of myself.
And everyone listening and watching I just want to say thank you. I know. I know you've come a very long way from the other side of the Equator not just to see us but given that your time is so precious that you've come to visit us and share with us your knowledge. I just want to say a really deep heartfelt. Thank you.
Yeah, thanks for having me. It's been fun
and we'll have to have you back again. Maybe we'll come to New
Zealand. You should come down. Yeah, definitely.
Thank you. Thank you for joining me for today's discussion with dr. Stacy Sims to learn more about her work. Please see the links in our show note.
Ends, if you're learning from and or enjoying this podcast, please subscribe to our YouTube Channel, please also subscribe to the podcast on both Spotify and apple that's a terrific zero cost way to support us and on both Spotify and apple you can leave us up to a five star review, please also check out the sponsors that I mentioned at the beginning and throughout today's episode. That's the best way to support this podcast. If you have questions for me or comments about the podcast or topics or guess you'd like me to consider for the huberman Lab podcast, please put those in the comments section on YouTube. I
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