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

welcome to the huberman Lab podcast where we discuss science and science-based tools for everyday [Music] life I'm Andrew huberman and I'm a professor of neurobiology and Opthalmology 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 a letic 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 to changing your body composition and to overall health today we discuss how hormones and hormone Cycles impact nutrition and fitness needs specifically in women of different ages we of 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 talk 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 exquisitly 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 is also exquisitly skilled at highlighting the data showing that there are 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

dos 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 it is however part of my desire and effort to bring zero cost to Consumer information about science and science related tools to the general public in keeping with that theme I'd like to thank the sponsors of today's podcast our first sponsor is Maui Nei venison Maui Nei venison is the most nutrient dense and delicious red meat available I've spoken many times

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30-day trial again that's waking up.com huberman to access a free 30-day trial 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 specific 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 inter mittent fasting y 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 8 Hour feeding window a six-hour feeding window a 10-hour 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 a short answer great yeah yeah um 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 um and then we have time-restricted eating and that's the fancy way of saying normal eating where you're having breakfast and then you stop eating

after or you don't have anything after dinner right so you're eating with your circadian rhythm during the day if we 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 oxida fibers so we hear about all the things about fasting to be to improve our metabolic flexibility to improve telal length to improve parasympathetic activation but by

the nature of women having more oxidated fibers we are already metabolically more flexible than men interesting yeah didn't know that um could you elaborate on more oxidative fibers what that is and how how it relates to metabolic flexibility sure sure so oxidated fibers are are muscle fibers that are more aerobic capacity so those are the ones that you you can go long and slow for a 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 tap so much into liver muscle glycogen which is I think another misconception that happens so when 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 intens high 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 fast did work out 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 it we know that there's one area of kisspeptin neurons in the brain for men but there are two for women so the two areas 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 those kisspeptin neurons and downregulate them and so when you start downregulating them we see that after four days you have a a disregulation of thyroid we have a change in our luteinizing hormone pulse which is really important to maintain endocrine 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 Improvement M ments as well we see more cognitive function we see less thyroid dysfunction and overall a woman does much better when we're not in that fasted State then when you look at population research that's coming out now they're showing in both men and women who hold their Fest till noon and then have an eating window from noon to

maybe 6: p.m. have more obesogenic outcomes than people who break their fast at 8 and finished their eating window by 4:00 or 5:00 p.m. so it's coming back to the chronobiology of we need to eat when our 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 two 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 6our eating window or 7h hour eating window but extending that to 8 or 900 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 Peaks about half an hour after you wake up right so if you're having that quol 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 obesogenic outcome the actual timing hasn't been tested yet to see how can we ex 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 ACC accessing any kind of parasympathetic responses down the way where if you have something really small where you're bringing blood sugar up then 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 and so you have to look at where's the peak of cortisol how does estrogen flux how does lutenizing hormone flux progesterone all these things that have this tight interplay and the more we're doing the hormone research and the more we're 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 of 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 system which drives more arousal and alertness and at higher levels stress sometimes called the fight ORF 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 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 has some uh 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 a opener for me because I've had female training partners for years I don't eat until 11:00 a.m. I like to hydrate and cinate 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 first some of them don't they do as they choose of course but now I'm thinking that's probably the worst way to go and it gets worse as

you get older because if we're seeing as women are getting into par menopause 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 fuel before a 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 perceived exertion where you go in and say okay we need you to hit an eight on this squat so you have two reps in reserve and a sessional RP of an eight well if they're not fueled then we are seeing trends that they're missing around two to 5% of that top load so they're not really lifting in that zone that they need to be in let's get um people sorry to interrupt let's get people up to speed on rpe because this is

a term that's starting to um circulate more outside the physical um training community and to the broader kind of you know recreational exerciser Community which I consider myself part of UMO I mean I train regularly and half for years but I'm not an I'm not an athlete I don't get paid to train and I you know and so forth so rep repsen Reserve perceived effort maybe just um explain this I think probably 95% of our listenership has never heard these terms okay so if we're talking about about reps in reserve this is when you go

in and if you say eight it means you have two reps in reserve so you finish 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 there grit their teeth could complete two more repetitions in good form before hitting failure the inab 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 if we're saying we need you to hit an eight on our scale of 1 to 10 of rating perceived exertion we see it correlates with um that eight with two reps in reserve so it's a way of quantifying what you're doing in the moment for a squat or a deadlift or some other really heavy lift that you're trying to accomplish as opposed to looking at um say percentage of one repetition maximum yeah saying 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 maximums can be dangerous if you're not skilled in that especially with compound movements like squats and deadlifts okay so is there an across theboard 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 uh and then that also depends on the age of

the woman so if we're looking at the reproductive year so you know 20 to 40 then it doesn't matter so much you can periodize pretty much how normal periodization works with your mesocycles and your micro Cycles 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 Based training but when we start to get to per menopause 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 to we want you to do something that is two reps in 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 in reserve then it allows people to lift more on the day so we can get women to get into that strength and power-based 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

system 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 def 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 situation 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 MH what is a good example of a you know a pre-training um meal if you will and we could put some variation on that for people with different you know Tendencies towards omnivore or vegan or whatever uh but what is the timing of that meal relative to training that works best or and and I'm assuming there's some flexibility there yeah I mean like I'm the kind of person that 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 mean meaning I tend to move slowly in the morning so I wish I could but the way my life is it doesn't work that way um so but I'm also one of the people that never really has an appetite till 11 o'clock okay so we're similar in that way yeah so how do you how do you square that so I make a

double espresso at night and I put some almond milk and a scoop of protein powder in there so the almond milk is sweetened and usually it's unsweetened but sweetened for the carb and then the protein powder for the protein because 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 caffeinating but I'm also getting the calories for the hypothalamus and getting more circulating amino acids Abby

Smith Ryan out of UNCC did some specific work looking at carbohydrate protein before and you know strength or cardio and found that if you're going to do a true strength training session you only need around 15 grams of protein before 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 your resting metabolism stays elevated um giving you a better chance for Recovery post exercise as well if you're going to do any kind of cardiovascular type

work up to an hour then you're adding 30 grams of carp to that so it's not a lot of food and it's not a full meal um other people are like I'm starving right before I go training then yes you can have your meal giving yourself about a half an hour before um but it doesn't have to be major food that we're talking about um but that's just enough to bring blood sugar up and and stimulate 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 kisspeptin neurons we'll talk more about kisspeptin very interesting peptide as opposed to saying okay you need X number of calories because you're going to burn X number of calories I hate that conversation right which is a very different conversation um 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 yeah and the longer someone withholds 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 fasted 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 it's really really hard for women to put on lean m M so once you start really nailing that and then saying look you just need 15 gram of protein to really help and be able to conserve that lean mess it's a small simple fix people try it and they're like oh my gosh I feel amazing so it's small little things when you're working with the whole system because I get tired especially around Christmas time when you're reading all the magazines it's like two cookies means you have to walk for 30 minutes on

the treadmill it's like it doesn't it doesn't correlate like that at all um so that's why I was like like I hate the calorie conversation because it's just not applicable right and it has its own kind of um 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 um I learned that people with eating disorders women and men um especially anorexia become like calorie calculators their eyes in their

brain just are constantly evaluating the caloric load of food and it can be um obviously very intrusive it's also the most deadly of all the psychiatric conditions so it's um that's a long way from hopefully what we're talking about here but but there's the opportunity for drift whenever we talking 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 um kind just becoming a computer of you know how much am I exercising what did I burn what did I earn it's it's crazy it's crazy um as long as we're talking about food and food intake relative to training what is the suggested posttraining um window um in which one should either avoid or make sure they get nutrition um meaning how long does one have after let's say a resistance training session of about an hour seems to me that's

what most people are doing if they're investing in resistance training maybe plus or minus a what 20 minutes yeah um and they're hitting those um high-intensity sets where they have maybe just one or two repetitions in reserve maybe going to failure on a few of those SES 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 highquality Lucine oriented protein within 45 minutes and we see that women who are per menopausal onwards are 40 to 60 grams because we

become more anabolically resistant to food and exercise as we get older um 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 UH 60 minutes and for men it's up to 3 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 breakdown effect and start the reparation um so yeah it's like when we're talking about the protein intake it's really important not only to get that Lucine 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 that catabolic State and increasing all the repercussions that come with it so women should try and get 30 or as M much as

40 maybe 50 grams of protein depending on their age m post training within an hour of training yep men seem to have a longer window they could wait an hour two hours maybe even three hours yeah before ingesting protein what about carbohydrate we look at mixed but for men it's more important because they go through their liver and muscle glycogen so much faster than women so when we look at women we want to get around3 grams per kilo um of carbohydrate within 2 hours of finishing so we look at prot and people like well 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 um yeah there's a time and a place for protein supplementation but if you're getting that real food in 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 as

many of you know I've been taking ag1 for more than 10 years now so I'm delighted that they're sponsoring this podcast to be clear I don't take ag1 because they're a sponsor rather they are a sponsor because I take ag1 in fact I take ag1 once and often twice every single day and I've done that since starting way back in 2012 there is so much conflicting information out there nowadays about what proper nutrition is but here's what there seems to be a general consensus on whether you're an omnivore a carnivore or a vegetarian or a

vegan I think it's generally agreed that you should get most of your food from unprocessed or minimally processed sources which allows you to eat enough but not overeat get plenty of vitamins and minerals probiotics and micronutrients that we all need for physical and mental health now I personally am an omnivore and I strive to get most of my food from unprocessed or minimally processed sources but the reason I still take ag1 once and often twice every day is that it ensures I get all of those vitamins minerals probiotics Etc but it also has adaptogens to

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health and physical health if you'd like to try ag1 you can go to drink a1.com huberman to claim a special offer they'll give you five free travel packs with your order plus a year supply of vitamin D3 K2 again that's drink a1.com huberman at some point there was a lot of discussion about training fasted burns more body fat uh 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 correct okay I think um that can't be stated Enough by experts like you um 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 I like to train fasted but I what I'm hearing is that women should probably ingest at least some protein high quality protein and maybe drink the protein in a protein shake yeah um 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're looking at um a Tipping Point for endocrine dysfunction for men we're seeing that Tipping Point at 15 calories per kilogram of fat-free mass for women it's 30 so when 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 calorie state but for women our intake and especially our carbohydrate needs are so much higher because we

have so many other functions that are reliant on that kisspeptin up regulation or down regulation preferably up regulation um so when we're just talking the basic calorie needs and what we're seeing it's that dichotomy right there of 15 to 30 and when you start telling people that they're like oh okay I get it is that a biological aspect it's like well you could trace it all the way back where you know men went out to get the calories in most tribes and the women were home and it wasn't 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 perturbance 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 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 because within an hour or so of training I'm hungry uh which brings to mind what we mean when

we say training uh 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 yep um 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 frankly delighted that nowadays there's such a push for women and men to resistance train that wasn't the case when I was growing up for you know I recall

taking my sister to the gym for the first time and was 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 um 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 of like what you did with your sister and so both of us were like well we want to beat those guys so we got into weight training with them not to be 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 they

kill it yeah they um it's a lot of fun to have a um female training partner also because um 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 going you know and 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 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 I'm 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 a new member and you're a woman they'll say hey great here's all of our spin classes and our box fit classes they 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 are the lifting platforms all the you know the weight trainings at 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 of central nervous system stress before and the whole aspect of getting the nerve and the acetylcholine which are 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 uh because the driver for strength training is that Central Nervous System um 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 um 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 the soc called pump yeah you get a window a transient window but a window nonetheless of what the hyper could look like if you do everything else correctly in terms of recovery so provided that the um the size of the muscle during the training session is not aversive to you yeah you're okay you're good yeah um which is unique among you know training it's not like when you go running you

get a sense of being much faster you actually get the opposite effect you you feel the burn in your lungs and and the pain of 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 train you get a liter Lally a physical picture and a and a sematic feeling for what that hypertrophy could look like yeah that's why on your physique competitions and bodybuilding competitions they're out the back pumping before they go on stage so we've been talking about training

but we haven't really spelled out what you would suggest a novice perhaps an intermediate um resistance training cardiovascular training um program would look like in in Broad terms I realize we don't have time here to get into all the DET you WR this elere and refer people to those teric resources and the show note captions but um 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 um is resurfacing again and again here um women let's say 30 and younger

women 31 to let's 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 what sorts of examples could 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 whole movement aspect first so we phase them in same with older women phase them in 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 it might be 45 to 60 minutes when we're 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 two 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 it 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 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 we're really focusing on let's do some compound movements let's look at doing some heavier work let's look at how we are periodizing so we're having you know six we 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 powerbase 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 and overall injury as we get into our 40s because of perturbations of estrogen and ideally when we get there we're looking at that around three minimum three resistance training with compound movement and either one Sprint interval or two Sprint intervals and one hit in a week and just to remind

people compound movements multi-joint movements squats deadlifts uh chin-ups rows overhead presses bench presses Etc as opposed to isolation movements where only one joint is is moving yeah yeah and for everybody in all those age ranges that you describe are you suggesting they train the same muscle groups three or four times per week or 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 that 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 then you can split it if you're looking at okay well I can allocate an hour to an hour and a half in the gym then you can do total body with adequate rest um the key when you're younger is working to failure the key when you're older is working heavy interesting 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 when we're talking about longevity because if you're looking at the strength component from a central nervous system standpoint we see it feeds forward into better appropri reception 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 patterns and more neural Pathways even some interesting literature

about emphasizing some unilateral movements as people get older not just um dual limb movements or dual limb simultaneous movements you always want to train both sides of your body folks but um 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 much sense what you're saying yeah um because what we know about the nervous system as we age is that there's some atrophy or at least some 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 um 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 age more in a linear fashion whereas women we have a definitive point in our late 40s early 50s where all of a sudden things go to where it's that per menopausal State and I can't tell you how many emails and DMs I get in a

day from women who are like I'm 46 or I'm 47 I'm putting on body fat I don't know what's going on I can't sleep and then when we say it's per menopause they like what is that and so when we're looking at per menopause it is a huge change in the body because you're having less and less of your sex hormone circulating more and more an ovulatory Cycles means no progesterone or very low progesterone you're having a difference in the pulse of your estrad to those Flatline aspect effects and because every system in the body

is affected by it this is why you see more soft tissue injuries like two of the biggest things that women who are in their 40s are going to ptas about her frozen shoulder and pler fascia those are two really indicative issues that are happening in Parry menopause 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 two just really looking at how

am I 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 is 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 a 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 per menopause menopause and hormone replacement therapy but if it comes up again and again today that would be wonderful because these are important underd discussed topics absolutely for women that are not on hormone replacement therapy who decide to train heavier maybe do a bit more training volume not train 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 in 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 um around exercise I my observation is that most women sort of unless they know better default to cardiovascular exercise as opposed to resistance training so if a woman in her 40s late 30s 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 two we should probably also Divine for people what zone two is if they if they don't already know um so I am notorious for slamming things like orange theory and f45 because they mark it 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 and Longevity and unfortunately default to cardio because they think oh that's going to help change my body composition is going to help me lose body fat it doesn't is this things like Soul cycle as well okay I've never done any of these yeah um but I imagine there's a lot of spinning a 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 used

to 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 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 four minutes of 80% or more or if you're doing Sprint interval it's 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 trly 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 two 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 as 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 um and they eat well um 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 um 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 movement like how to squat properly or even leg press properly y um deadlift properly can be a bit overwhelming especially when one walks into a gym this is true

for men too like 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 or um Symphony and you know 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 uh 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're running yeah yeah um 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 that somebody can learn how to do these movements and as you said ease 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 body weight stuff or loading a backpack with cans to add a little bit of resistance so they feel comfortable in their own house and they might be doing lunges or squats um just keying them up of like where foot placement and knee and that kind of stuff so they're getting used to that kind of movement um I love Kelly starett's stuff with Mobility so show them

like here's how we do some of the mobility to find where the sticking points are and then you can either direct them to some of the programs that are out there that um like Haley happens has some really good ones for women or 40 plus so does um uh Brie and then Sunny 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 um 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 I am 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 at 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 taking time to do garage based stuff that's going to improve their lean mass I'm a big fan of machines especially plate loed machines but machines just create the close to correct or correct Arc of movement yeah that um so for your size yeah yeah yeah exactly and to really spend the time adjusting the seat height adjusting the various um pins on the machine not just the weight in order to

make sure that one gets the best range of motion I think this is something small but that is significant in terms of its impact people just pop down in a machine especially if you're working in with somebody and feel um 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 kettle bells in in the garage or

light lighter dumbbells that you can do like thrusters or hang cleans or something like that to get the the momentum and movement feeling um because that's another good learning curve for people um 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 session and then at the opposite extreme maybe just walking

a lot or jogging a lot so is that what you're talking about polarized training as opposed to um 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 but 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 they can most people go oh I can do four or five of those after two they're completely gassed because it's that hard of 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 cardiovascular changes is 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 Andy is an expert in exercise science and Human Performance and has Longman

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 Mo and of course the two are linked they're inextricably linked for instance is there a particular phase of the m cycle where a woman should expect that motivation Andor recovery would be more challenging so this is the sticky point of recent science because we see all these research studies and met analyses that are coming out of the sports science literature saying that there is no effect of the menstrual

cycle on anything when you look at that population it is specifically you menic women might have an a subject pool of 10 if you're lucky 12 so this is women who have quote unquote normal menstrual cycles humanic supposedly ovulating so they have a definitive low hormone and high hormone phase and this is probably because these studies are being done on University campuses with with college undergraduate women yes exactly yeah 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 belief um 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 it might be day 18 for another from a molecular standpoint we know that

theow 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 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 you're 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 um of menstration or the inverse it is day one a bleeding up through midcycle that feel great yep the sticky Point comes not every woman ovulates and this is a thing when we're looking at will pop we have lifestyle stress we have nutrition stress we know that women for the most part have four to five an ovulatory Cycles a year so this is where when you're looking at that high hormone phase 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 ludal phase this is where where we have the most change where we have a pro-inflammatory response from the immune system we have uh inability to access carbohydrate 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 ludal phase is associated with more cortisol more kind of Baseline levels of

stress would it makes 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 ludal 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 ovulate it 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 um 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 and your heart rate's 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 and 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 to make generalized ideas because of the Nuance of have you ovulated or not what are your ratios of estrogen progesterone in that ludal 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 find your own pattern 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 less or not train during a given phase of the cycle getting 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 a 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 the 10-minute rule you wake up and you feel awful and you're like uh I really want to do this workout but I don't know how it's going to 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 work out 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 increase this Baseline sympathetic drive because you're fighting the training you're fighting life so give yourself that 10-minute roll 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 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 uh the old lore um 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 um 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 it comes from a misstep and food intake and we also see that it's a cultural influence because if we think about how sport started it

started as a way for men to demonstrate how powerful and aggressive they are and this is the original Olympics right there are no women allowed and as we feed forward into Sport and how it became okay for women to be involved at the high performance level if a woman walks in and shows any fallibility then she's immediately put on a lower stool right no 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 sports space and

be excited if they were a menic or didn't have periods or they trained 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 in 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 push back 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 maybe relative energy deficiency in sport perturbations in 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 you're training hard enough you've lost it you're more like a man wow um very interesting history there is it true then that if a woman maintains either um caloric balance with her basically eating

enough to support her energy output or even a slight caloric Surplus that it's unlikely that um her periods will cease even if she's training very hard 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 they exercise stress it's really important but women have been so conditioned to not eat and not take up SP space to be small you know all of these sociocultural things that women are afraid to admit the fact that they want to eat and they should be eating so this is a a 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 app tight body temperature and hormones are very tightly linked yes they are

um far too tightly for us to uh disentangle all of 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 um so that women can pay particular attention to make sure that they're fueling enough yeah um as estrogen starts to come up right before ovulation that estrogen surge really dampens appetite uh 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 of 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 the 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 do 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 um discussions online which is birth control yeah and we need to Define exactly what type of birth control we're talking about because there are so many different forms yes there are iuds there are the copper iuds there's the ring there's the you know let's talk about oral contraceptives that are designed to prevent ovulation so this is quote unquote the pill y so we're being let's for now limit the conversation to that so that

there isn't confusion um 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 can we have another history lesson please all right um I just gave a talk at home to some young athletes on contraception because someone might be on the depot and if they're on it for more than two years they get bone mineral density loss so then the question of okay how does the oral contraceptive pill come up how does that affect things it's like

well let's look at the history of it initially came from Stanford was funded by um Katherine McCormick from McCormick family and a feminist activist Margaret Singer but because they were 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 that 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 it's a withdrawal bleed so this becomes the confusing point for people who are on an oral contraceptive pill they're 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 downregulate your 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 repercussions 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 of 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 have 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 OC uh has the 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 um premenstrual dysphoria 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 in some preliminary research that improves speed and Power by the second week of intake because it's accumulated so when we're looking directly at an oral contraceptive pill we can't make generalizations because you have low dose highd dose estrogen we see that a 30 microgram dose increases

hypertrophy but not strength because estrogen increases the satellite cell aspect ECT um so for my power in 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 is really beneficial so we look overall at 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 amydala that happens with oral contraceptive use it's reversible in adults but for young girls we don't know because their brain is developing and unfortunately Physicians will pass out OC's as if it's candy OC's or a contracep contraceptives and do you recall what the direction of the effect was on the amydala for those that

don't recall the amydala bilateral brain structure meaning one on each side of your brain uh literally means almond in Latin it's almond shaped and it's part of a larger Network associated with threat detection um sometimes it's described the locus of fear in the brain but it's involved in a lot of other things too both positive veilance and negative alance but nonetheless is part of the um 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 were on the OC oral

contraceptive pill made them less um 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 Amala 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 um 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 reproductive 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 V2 Max and

other an anerobic 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 conversation is oh my skin it's like well they have really good Dermatology 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 irregular Cycles heavy menstrual bleeding I want to go on the OC here you go so it is a huge conversation still we

had um 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 like everyone be on the OC and now it's like maybe not and then it was no one be on 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 exogenous hormones is there any evidence that other forms of female contraception can be let's just say problematic for the types

of things we're discussing today like the implant in the Depot or IUD copper IUD copper I and the Marino or you know your progestin laced IUD those are what a lot of my tactical athletes will use because it doesn't have a systemic effect on adaptation or inflammation mood any of those things um and it's a fit and forget so you can put it in for up to 3 to five years if you have a really heavy bleeding it really dissipates because the whole idea of an IUD is to thin the endometrial lining and so then

you have autophagy that takes care of the endometrial lining so you don't necessarily have a bleed the copper IED 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 themes about what's going on physiologically maybe even psychologically um now might be a good time seg to uh just touch into that we can always return to it again later but let me just ask it um 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 tests that might be interesting and informative for them to think about yeah well if you think about menstrual 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 an endometrial standpoint so if you're looking at all the cyto 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 for PCOS can we really identify PCOS or endometriosis can we talk about PCOS for a moment most people have heard of it by now but polycystic ovarian syndrome It's associated with typically elevated androgens um it's becoming more and more common or perhaps detected more based on better detection methods I don't know which um the prevalence of PCOS seems to be very very high it does and I think it's a combination of both

uh we also see some rebound PCOS that happens when someone gets off the oral contraceptive pill it's not necessarily true pcus because what's happening now your ovaries are producing eggs m that have been downregulated for so long so under ultrasound it 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 folicular stimulation which also shows up as PCOS so the true PCOS yes there is a

high incidence from a reporting standpoint but is it that rebound where it's not having all the androgenetic changes that's still kind of up in the air at the moment um but it is a big concern for women because it is an indication that something's going on and they might have some fertility issues uh we see a really high incidence of PCOS in Olympic level athletes because of the higher androgenic aspect of PCOS so better recovery time a little bit higher Baseline testosterone um so yeah it's a population spec specificity as well in the 80s and

90s there was a lot of excitement in the kind of neurobehavioral Endocrinology Fields largely based on animal literature but then expanding into human literature that certain forms of activities could change hormone patterns and maybe even psychology and that makes sense on the surface of it but is there evidence that um 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 explored now in 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 um people on the stock exchange you know watching their stress fluctuations measuring testosterone I think most of those studies were done in men um but other competitive scenarios even showing for instance that exogenous testosterone can increase altruism in men if men are competing for who's like donating the most money at a Phil philanthropic event but you put them in a different scenario where it's far less benevolent in in goal and then they'll uh exogenous testosterone drives competitiveness towards um things that are more traditionally thought of as male male competition uh in

other words it's all context dependent um is there anything that kind of Springs to mind of interesting studies as it relates to androgens or uh estrogens in women athletes and as it relates to exercise they haven't done any specific studies like that in women we do see that under stress the cortisol increases and if you have an adequate uh response to it and your body can overcome it then yes you get a boost in testosterone for women um we see this in a lot of the night Mission shift changes in tactical athletes there is also

uh 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 a down regulation of our leutinizing hormone pulse and estrogen um 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 pre-season during

season end of season and people who might be at a higher risk factor for becoming a menic then we keep track that way um because it is the stress component that can downregulate not actually causing a permanent change as we talk about menstration we should probably talk about iron stores and um Iron yeah um do women need to supplement iron given that they lose iron during menstration it's interesting because we have a change in heepen or heidin depending on which part of the world you come from uh because it is increased under times of inflammation

and decreased under times of iron loss so we see a a significant change across the menstrual cycle so I tell women if you are concerned with low fertin then we want you to take an iron supplement every other day starting in the first day of your bleed for 10 days because that's going to really allow your body to absorb it and stay on top of it um after that every other day yeah but you're not going to be absorbing as much of it because hepsin starts to come up after ovulation again you have a pro-inflammatory

response so you have greater inflammation do women blanket need a supplement no 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 ferien for active women if you go in and you have a fertin level of 20 to 25 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 even at that spefic specific time of her cycle is there a Best time in cycle to do that blood test uh if I'm limited to say that then I would say 5 to seven days before her next period starts so mid ludal because then you 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 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 to pick out um 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

two of the menstrual cycle second day of 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 um get 75% plus of the relevant data yeah definitely terrific caffeine yes in the old days yeah meaning when I was a kid and not long ago 10 years three weeks ago um we would hear these crazy statements about caffeine it pulls calcium out of the bones it's 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 yeah when you're drinking caffeine but um many people love caffeine I think 90% of the adult population of the world ingests some form of caffeine every single day I'm in that 90% yeah 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 um case conditions where women should be cautious about their intake of caffeine independent of this anxiety thing I mean people probably shouldn't uh drink more caffeine than they can uh tolerate psychologically no one male female young or old yeah yeah it's more of a genetic Factor than it is a sex Factor uh 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 per menopausal 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 workout they become a little bit hypoglycemic because there's changes in um insulin sensitivity insulin responses so there's changes also in blood sugar control and caffeine can exacerbate that so if you are someone who's like oh I always have a double espresso before I go workout 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 yeah eat some food eat some food with it what about sipping caffeine through the workout um you know taking that coffee in and just having a SI between sets can that offset some of that uh I don't think so okay I hear a lot that people who drink caffeine before a workout you know Midway through they're like I don't feel good yeah yeah cuz they don't eat that for me that just stimulates the desire for more caffeine but um or even how 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 Vaso constrictor that uh I was told by a dermatologist that it's terrible for skin even if you're not getting your nicotine by smoking vaping 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 um 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 really wakes you up yeah and dials you in I I recommend nobody do it because it's it feels that Pleasant if you like caffeine I like Shandra for that reason Shandra yeah what's Shandra it's an adaptogen I me I should know what this is you you should know what this is I should know well I'm here to

learn okay um Shandra Shandra uh yeah so it is an adaptogenic plant so you know like jining siberian jining maah asaga all those buzzword out there Shandra is another really well-studied adaptogen and I have friends who say it's like Aderall where you take it and it's immediate fun 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 yep are you on it now I put it in my morning coffee okay uh

you just sent people down the uh the rabbit hole of the internet of the internet all right yeah yeah you heard it here first from Dr Stacy Sims I'm going to give it a try because the nicotine thing is an interesting one and there are some cognitive enhancing effects of nicotine that perhaps in um people 65 and older might actually be beneficial for offsetting some forms of neurod degeneration but that needs to still be explored and researched don't cut that and clip it and put it out there like so that's happened already um very interesting

all right caffeine we both agree is great Shandra you got to try it check it out let me know all right we'll 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 afterward 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 long lasting increases in the so-called catac colines dopamine or epinephrine 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 deliberate 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 rod syndrome oh yeah yeah so is there a difference in terms of how Del cold exposure impacts women I have to imagine the answer

is yes given what you said earlier about Vaso constriction versus Vaso dilation 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 get better adaptations so sauna yep sauna hot tub yep preferably a true finish 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 cuz it doesn't get hot enough no yeah you can bring an infrared light into a traditional sauna if it can tolerate the heat yeah but finished sauna would be what something between 185 degrees Fahrenheit and maybe 210 if you're really heat adapted yeah I'm still working on Metric let me do the conversion oh sorry yeah you're living down in New Zealand now yeah so 60 to 80 degrees C I need to look every time I've tried to do math on the fly on this podcast in my head it's like okay * 9

different processing mode yeah but people can look it up yeah okay look it up um 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 when we're looking at that severe immediate jump into that icy cold it causes such severe constriction and shutdown so women do really well and get that whole dopamine response and everything if the water is around 16° C which is 55 to 56 degrees Fahrenheit which is chilly it's chilly it's not warm no it's go

dive in 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's that 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 um to get them habituated to that initial severe constriction and sympathetic activity that

we don't want to happen before a rice with heat being the true like true heat that we're 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 uh a better um 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 offshoot 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 lends 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 um so I'll just remind people that your brain has a set of neurons in the medial preoptic area that's 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 your body core body temperature will go up but conversely if the surface of your body is made cold the internal milu of your body will heat up because those medial preoptic neurons will say oh you know this this is like putting an ice pack on the uh thermostat which is what um graduate students and post talks used to do in the labs side working because it was a battle over the the heater right some people were in hot

some people were in cold so there was always this this business in any event um so it's not that you disapprove of the of using deliberate cold exposure you just recommend that women do deliberate cold exposure with temperatures that are maybe in the um low 50° Fahrenheit um Range as opposed to the really H frankly just painfully cold for anybody um you know 38 to you know 50 degree temperatures right we did a pilot study looking because Wim 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 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 the 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 inflammation and create a response that learns that inflammation and dampens it then it helps with endometriosis interesting 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 Wim Hoff type methods um please please please do not combine cyclic hyperventilation um or hyperventilation of any kind with breath holds and water exposure not even in the depth of a puddle um there have been drownings associated with people doing cyclic hyperventilation in various contexts not

just related to Hof breathing but um basically people who are not skilled um and even some who are skilled combining cyclic hyperventilation breath holds and water in any form cold or warm water idea just don't if you're going to do any kind of cyclic hyperventilation breathing 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 do deliberate cold exposure um limit your breathing to slow deep breaths make sure that you're um well supervised and um 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 starting to explore this especially the in my opinion the the sauna work uh one thing I suppose that we should um 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 um submersion up to the neck post strength or resistance training say in the four 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 gains that one would otherwise experience so if you're going to do 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 that stand for doing that but just want to throw that out there is there anything else you want to add to that um which is different from heat exposure because heat exposure you want to do afterwards the phas of dilation yeah because it extends that training stimulus and also the passive dehydration from training will stimulate greater blood volume improvements oh 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 you're 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 o so now we're getting into Real Performance enhancement is this true for men and for women yep yeah uh let's walk through this protocol I like I like this this is uh this has not been discussed on this podcast so um somebody does their resistance training M finishes up drinks eight or 16

ounces of water with a little salt in it maybe and then hops in the sauna yep for how long up to 30 minutes okay no longer no longer no longer yeah they'll probably be a little bit thirsty in there you're looking for a little lowlevel dehydration is that right yep okay um the ranges that I've seen published in the finished studies are as I recall and I'll double check these numbers 186 degrees Fahrenheit up to about 210 Fahrenheit um and the higher end only being for those that are heat adapted yeah 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 but you actually 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 um I'm always like if you're going to be in and it's that hot just move down a level so on the floor y y um and this stimulates the production of

more red blood cells MH okay which then translates to what in terms of athletic performance you have an increase in your cardiovascular effort and because you have greater amount of blood volumes you you have greater amount of pretty much blood circulating so you have more available for um muscle metabolism heat loss um 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 you have responders non-responders over responders okay this is why when I go to Colorado I'm gasping for air while

I do a walk but then I come back to C Level and I feel better my endurance is better but some people might not experience that effect true this is I was telling the guys before we started that I've been in ARA 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 okay 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 y that would be it very interesting so you can use post resistance training sauna exposure to improve performance yeah you can use it um post cardio as well so anything that is giving you that passive dehydration from training because you're not because you will become passively dehydrated when you're 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 to 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 I love it logically watertight and um I'm going to give it a try yeah what other training T tricks tips do you have up your sleeve Dr Sims what you want to talk about um do you have any

favorites besides that I I Delight in these and I know other people will as well um do any come to mind I mean you've T us about Shandra um about posttraining sauna exposure to improve performance by increasing red blood cell count yeah there is there anything else that Springs to mind no no no pressure uh 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 uh lowd dose baby aspirin MH but then I add beta alanine used to be a fedrin I know so I'm I'm old enough to remember when they would sell it as the triple stack with a fedrin but some people dropped dead and they took it off the market y hey it came back on the market in New Zealand last week did it really yeah it gets you going yes it does it's um it's Speedy y um it's dangerous yeah but the track stack which has beta alanine and not ephedrine is really

good at encouraging an extra top end effect because you're having the caffeine you're having a little bit of the blun blood thin from the aspirin and then 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 um 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 what about sleep we hear 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 Andor by age or just generally you know do men and women need to think about the need for

Sleep differently yeah um 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 talk about the menstrual cycle there are definitive changes in sleep architecture we're seeing that in around the mid ludal 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 estrogen's play with serotonin in the brain so we really need to nail down our sleep hygiene in that time period um so looking at things like eleanine and appenine 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 significant issue with insomnia in women who have really bad hot fleshes and significant uh menopausal symptoms and again this has to do with lots of the perturbations from temperatures of night sweats increased sympathetic load um not being able to get into a parasympathetic state so this is where working with a specific sleep specialist might come into play we

can also look at using some adaptogens the Rola stacked with theanine um and looking at the cold temperature getting people to use the non-sleep deep rest 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 um and again in that par menopausal 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 and sleep architecture because of the interplay that estrogen has on the brain and The receptors makes very good sense we'll put a link in the show not captions to some zeroc cost um non-sleep deep breast yogan nras we've put out a couple with my voice if you prefer another voice I a big fan of the ones by Kelly boy who's contributed to um The Waking Up app it also has terrific um non-sleep deep breast yoga nras out there and there are

S as well um you mentioned a few supplements theanine um appenine which is chamomile extract um maybe let's just have a general conversation about supplements what's your thought on supplements um how do you place them into the landscape of nutrition they are after all supplements not Replacements but um the word supplements I I believe is a little bit misleading um because there are food-based supplements you know like a protein powder um there are supplements designed to achieve a specific Al come and then there are supplements that are kind of a um designed to be a

more you know support for a bunch of things you know kind of insurance policy um 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 Andor per menopause menopause I just threw about nine questions at 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 um and actually gut health so five grams of monohydrate per day sort of to five three to five yep um preferably of

course Crea pure because the way it's produced so if you're looking at Crea pure it's the German company that produces it uses a water-based wash to produce the creatine interesting whereas others use an acid-based wash and we see a lot of side effects with the acid base wash like gastric distress yeah so people are like I'm really bloated and I have nausea and stuff from taking creatine I'm like is it Crea pure actually no it's like switch to creapure and so they switch and they're like oh my gosh I feel so much better noted yeah

um and then vitamin D3 really important especially um 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 uh so those are the two big ones and then sorry I just wanted to stop you for a moment um 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 3 to 5 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 um so they should know that um it's not a given though interesting it's not a given there are 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 correct so it will be uh stored within lean tissue um and then I do hear concerns about creatine uh causing hair loss I my understanding is there is zero evidence for that no 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 the conclusion people drew was that somehow creatine increases hair loss but you're saying 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 fluctuation progesterone can exacerbate any hair loss so if women are experiencing that and they're saying oh it's creatine I've read all this stuff on Creatine no it's not okay so we've got creatine D3 um a th000 IUS per day 5,000 IUS I guess it depends a little bit yeah uh being very close to Antarctica in the southern hemisphere in the winter uh very low sunlight exposure um looking around the 5,000 same with upper Northern Hemisphere UK that kind of stuff closer you get

to the Equator the less you need the one concern is like a day here where it's foggy and it's supposed to be sunny and people are like great I don't you know don't have to worry about going out in sun exposure but then the next day it's 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 two to 5,000 great Okay so we've got creatine vitamin D3 what are some of the other supplements that you

um that you take or that you I don't know if we say suggest but that you um perhaps suggest women consider yeah so protein powder a really good high quality uh because the amount of protein that women should be getting is often difficult to eat um so again supplementing not using as the main stay uh that's one to consider and then again I'm about adap so looking at the different adaptogens ashanda is a good one holy basil or Tulsi is another one Shandra and then getting into some of your medicinal mushrooms Lions man 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 ashwaganda which by the way I do think people should cycle if they're going to take it high doses right cuz there are some ISS issues with liver and thyroid and thyroid problems if people take ashwaganda high doses for too long so that's um important to note but assuming that the adaptogens are reducing cortisol levels um 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 uh 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 want any cortisol and they think that would be bad 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 and elevation

to cortisol let it peak in the morning after you're 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 feeds forward to better sleep for something like Shandra 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 ashanda because Shish is more stimulatory the other two are more calming um I put some in my morning

coffee and then in the afternoon when I need to pick me up instead of more caffeine I'll us Shandra because it gives you that boost without the effects of caffeine and it doesn't interfere with sleep so there's a time and a place to take them and yes some need to be cycled on some need 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 you um is there an official word on this you know uh assuming a woman knows that she 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 um 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 Anor robic 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 um 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 you're 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 in 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 who superactive 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 um 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 um case studies and cas 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 2500 times on social media and I never have an answer and but I always default to the cautious answer which is uh 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 biing time there and just saying please go ask somebody who can give you a definitive answer yes so 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 will put them at a higher risk for it so 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 a research so it's not detrimental 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 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 Heat's good cold I'm not so sure of but probably not extreme heat not extreme heat

so that's why I mean like hot yoga is not going to the sauna Hot Yoga sits around 40° Celsius so what is 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 um 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 heat is detrimental to sperm viability in a 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 P don't put it directly on the scrotum for for other reasons but that it's a you know that the effects of heat the negative effects of heat on sperm are are real yeah but there's also an interesting it's not just a trend there's actually some research showing that um cooling the testicles leads

to increases in testosterone which is on the face of It kind of um counterintuitive because turns out that it's about the Vaso constriction causing the subsequent increase in blood flow increased Vaso dilation so the inverse of what you just said which is that during the heating process the hypoxia induces more vascularization of the of the placenta yeah so um when talking about temperature one always has to think about the surface of the body versus the brain response as we talked about earlier and then what's happening during the delate heat or deliberate Cold versus what's happening

after the deliberate heat or deliberate cold right everything in biology is a process not an event yeah 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 significant amount of research in the hot and cold thank you for the disclosure uh I see it more as a uh as an indication of of real knowledge so thank you this is an aspect of your training I 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 um because people are reluctant to name them after themselves maybe we call that the um the uh The Sims protocol or something like that the anyway your discomfort will be other people's U benefit now seems like a good time to address some specific questions

related to the age brackets that you mentioned earlier um 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 um 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 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 propri reception balance we want to have good bones and we want to be strong so this is where we look at 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 uh a

colleague in friend of mine Tracy kle did a PhD and um post not a postto 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 um pic 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 onethird of their bone mass at the onet of menopause wow yeah

significant yeah goodness gracious if you 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 um bone loss yeah it 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 1 G per pound which is around that 2 to 2.3 G per kilo per day they're like whoo that's a lot of protein it is because we haven't been conditioned to eat it few scrambled eggs it's a chicken rest at lunch it's a small steak at dinner plus other things right exactly and 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 and that's the other big thing that in order to

build the muscle and to keep the body composition in the state that we want it to keep going for longevity those are the big rocks the Sprint interval training the heavy resistance training the jump training and the protein I'm thinking about this and I'm thinking about my 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 going to um send her to listen to this s

in the same vein yeah what about the women out there age 20 to maybe we make it the 20 to 40 bracket um and if we need to divide that more finely we can um um what is the most efficient way for them to train for health Vigor and Longevity uh making things fun for the most part I don't want people 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 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 are 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 big rock

again is resistance training it doesn't have to be heavy resistance training like I said earlier to failure you're periodizing 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 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 misstep in brain lactate metabolism because the brain hasn't been exposed to it especially if we're 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 our glycolytic fibers going by doing high-intensity work the more we're 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 two B fibers that could either go more aerobic or anerobic and make them more Anor robic 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 ultra 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 a 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 uh where you're drenched in sweat and gasping for air at the end necessarily correct let's disambiguate 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 Etc what does the appropriate high-intensity workout look like okay so uh if I talk about true high-intensity interval training if you're a runner it's going to the track and doing sets of 4800s okay so 400 a lap yep 800 two laps 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 use a track as a as an example so if you do one

lap and you're like uh I'm going to walk half a lap and then do it again that's adequate recovery tough yeah it's hard right but it's not like you're going to be there for 90 minutes doing as many 400s as you can because you have that variable recovery it might take half an hour to 40 minutes max and then you're gassed out can't do it anymore if you're looking at a gym situation I look I I like to look at something like every minute on the minute where you might be doing uh 10 deadlifts at

moderate intensity weight and it Tak 10 repetitions 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 thrusters so it's a squat pulling the weight up overhead so you're doing maybe eight of those in that minute and you might have 10-second recovery you go to the next exercise that might be um kettle bell swings and you're doing explosive kettle bell swings and you'll finish you know 10 seconds to go you go to the fourth exercise

I don't know toes to bar or some other kind of vup some other high intensity and then you have one 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 you're using these loads these machines the the pike you know hanging from the bar and bring your knees up or lsit or

something as a tool to get the heart rate up continually y y very different than resistance training the mo 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 mode of activity but it's 30 seconds or less as as you can go so this is your N9 or 10 on your rating and perceived exertion 110% it's Max effort on the

rower on the airdine bike running if you like of those the skier the battle ropes battle ropes are big so 30 seconds all out then rest what 10 15 seconds repeat no you want to because now we're looking at that top end where we want uh regeneration of your ATP you know all of that system and central nervous system recovery so this is 30 seconds all out could be two or three minutes of recovery oh nice because I'm not looking at Tata where you're 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 all out again you're not leaving anything in the tank so those are what I mean by high-intensity interval training or 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 that 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 put you in that moderate 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 four 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 two to four work sets of you know an overhead press two or four work sets of maybe a barbell curl two or four sets of some dips or whatever whatever um one's you know personal choices yeah okay got it um very different Far and Away different than what most people

men or women are doing out there which is um 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 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 four Gates so you know the proteins that open up that allow carbohydrate to come in without insulin so we're expanding that acute um glucose uptake through an epigenetic change the other thing that it does is it causes a 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 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 I don't know what to do with this so get circulated to the liver and the liver stores it as visero 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 in use that which helps use free fatty acids and it also creates a significant anti-inflammatory response at the 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 comp and Aesthetics per se 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 and 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 you like to see women ingesting so um are you a fan of fruit yeah great well these days you sort of have to ask in these circles uh vegetables y yeah fiber is important yeah absolutely and then in terms of starches to um to replace glycogen especially if people are doing these high-intensity interval training sessions and the resistance training um what are your preferred sources it depends on who I'm working with uh I have some people

who love cocoa pops and kids cereal o i cringe at that stuff um but you know I prefer I prefer rice and oatmeal and I like a really good sourdough bread with butter or olive oil you know guilty of that yeah but there are some people who like the ultr processed 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 uptake it's the only time because glute four levels are so high you're basically pulling everything into glycogen at

that point anyway um but ideally carbs are all the different colorful fruit in veg and if we're looking at sweet potatoes or Kuma if you're from other parts of the world yams all those kinds of things sprouted bread fantastic kenoa amorth 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 significant 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 deconjugate

or unwrap some of our hormones and shoot them back out in the circulation so as much fiber colorful fruit and veg as you can but also it's the 8020 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 especially the the low sugar dark chocolates what I look at is how it makes you feel makes you feel good right yeah yeah we one has to live yeah um and fats um where do you

like to see women get their fats from again I'll do a full disclosure I have been um vegan since I was in high school because of an incident of a field trip to a pig slaughter house and driving down the five but that's my own preference so when we're looking at fats um it can be from a 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 too um um the whole fear mongering of saturated fatty acids from dairy has been disproven so if we're looking at what kinds of fats you want a conglomerate but you want most of them to come from Whole Food plant-based not from Ultra processed um 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 that all sounds very r and delicious in my opinion yeah it's it's too Common Sense people don't do it

I think if people hear it from you they'll do it um I think people just need to hear it in the context of a non-diet um context and you've done an amazing job today of explaining how nutrition 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 fuel to offset these cortisol spes and feel better while training and to train more which um 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 uh 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 Health span lifespan what would it be I think I would have everyone understand their intrinsic selves because we have been inundated so much with sociocultural rhetoric and so much external noise that women have forgotten what it means to listen to

themselves and their bodies I mean that's the one thing that I have to retach 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 per menopause 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 um 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 many times and um thank you for providing clear actionable answers and you've also educated us on caffeine supplements including um revealing some supplements

that I didn't know existed which is a which is a uh not a common occurrence for me yeah I win and um many wins many many wins thanks to you and on and on so just such a a rich data set here um 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 um that you've come to visit us and share with us your knowledge I just want to say uh 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 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 captions if you're learning from Andor enjoying this podcast please subscribe to our YouTube Channel please also subscribe to

the podcast on both Spotify and apple that's a terrific zeroc cost way to support us and on both Spotify and apple you can leave us up to festar 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 guests you'd like me to consider for the hubman Lab podcast please put those in the comment section on YouTube I do read all the comments for those of you that haven't

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