Just As Well, The Women's Health Podcast - Why Strength Training Is Non-Negotiable for Women in Midlife

Episode Date: January 6, 2026

What if almost everything you’ve been told about women’s fitness is wrong? In this episode of Just As Well, hosts Gemma Atkinson and Claire Sanderson, Editor-in-Chief of Women’s Health UK, sit down with world-leading exercise physiologist and nutrition scientist Dr Stacey Sims. This is a must-watch conversation for women who want to train smarter, feel stronger, and protect their long-term health. Dr Sims breaks down the science of female physiology in a clear, practical way, explaining why women should stop shrinking male fitness plans — and what to do instead. From lifting heavy and rethinking cardio, to fuelling workouts properly and navigating perimenopause, this episode is packed with actionable advice you can start using immediately. In this episode, you’ll learn: Why strength training is non-negotiable for women — especially in midlife How just two high-quality workouts a week can transform your body Why fasted training can sabotage hormones, muscle, and fat loss How your menstrual cycle affects performance, recovery, and hydration The difference between true HIIT and “hard-ish” workouts How lifting heavy can support brain health and reduce dementia risk Why protein timing matters more than calories The real benefits of creatine for women (strength, mood, bone & brain health) How to train smarter through perimenopause and menopause Whether you’re frustrated that your training “isn’t working anymore,” curious about optimising health after 40, or simply tired of fitness advice that wasn’t designed for women — this conversation will change how you think about exercise forever. 🎧 Listen, subscribe, and share with a friend who needs this. Hosts: https://www.instagram.com/glouiseatkinson/ https://www.instagram.com/clairesanderson/ Wellness video producer: https://www.instagram.com/chelia.batkin/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi, I'm Gemma Atkinson. And I'm Claire Sanderson, the editor-in-chief of Women's Health UK. Claire has just done an episode of our podcast just as well, and I'm gutted to have missed it, the one and only, Stacey Sims. I know. How was it? Dr. Stacey Sims. Oh, my gosh.

For those listening who may not be too familiar with Dr. Stacey Sims, she is probably one of the most, not probably is, one of the most well-known doctors globally in the world of women. women's physiology. We are super fans, aren't we? You were trying to get her for a while weren't you? Because obviously she's on a different time zone. She is. Because she's so busy. She's between New Zealand and L.A. and the UK. She's all over the place.

Yeah, she's always on a plane. And talks and she's so knowledgeable about every aspect of female health. I have transformed the way I train because of Dr. Stacey Sims. I've transformed the way I eat because of Dr. Stacey Sims. I think this woman is the Oracle. What I would say is that she is incredibly qualified and therefore some of what she says is quite science-dense.

Now, I tried to break it down for our listeners so everyone can understand because we all have varying levels of knowledge. But I hope that I broke it down so everyone listening can take something away. I would urge listeners to grab a pen when they're listening. Make notes. Because genuinely, every sentence that comes out of that woman's mouth

can improve your life Yeah, she's great I was jealous to have missed it I know we couldn't make the dates work but I'm very excited because I'm listening for the very first time like you guys are and if you like it

please subscribe please leave us a comment please share this with your friends and families Dr Stacey Sims genuinely can transform your life so here it is for decades women have been told to train harder

eat less or do more cardio Follow plans designed by men for men and adjust the weights down a bit. To push through pain, ignore their cycles and wonder why their bodies aren't cooperating. But what if almost everything you've been told about women's fitness is wrong? Today, we're speaking with someone who spent her entire career proven that women are not, and I repeat not, small men. Dr Stacey Sims is an exercise physiologist, nutrition scientist and one of the most important voices in women's health today. From her childhood in the Netherlands to research labs at Stanford University, she's dedicated her life to understanding the fundamental differences

in how women's bodies responds to training, nutrition and stress. She's the author of Raw and Next Level, books that have revolutionized how women's approach fitness across their lifespan, and her message is clear. It's time to stop shrinking male protocols and start honouring female physiology. In the next hour, we're going to go deep. talking why women need to lift heavy, especially in midlife, why fasting might be sabotaging your

hormones, how your menstrual cycle affects everything from electrolyte balance to performance, and why the answer to almost every woman's health questioned isn't more cardio, it's more strength. If you've ever felt like your body wasn't responding the way it should, if you're navigating perimenopause and feeling lost, or if you're simply tired of fitness advice that wasn't designed for you, this conversation is going to change everything. Welcome to Jess as well, Dr. Stacey Sims. No, thanks for having me. I'm looking forward to this. This is an absolute joy and a privilege for me. I have listened to almost every podcast you've been on, and if there are any that I haven't, I'd love you to signpost them to me later

because I am a genuine fan girl of your work. And I know that you work a lot with Women's Health UK and I know that you deal with our fitness director, Bridie Wilkins, quite a lot and you very kindly offer us your expertise and commentary. But to speak into you today, albeit remotely, because you're joining me from L.A., it's an honour. So thank you so much for taking time out of your very, very busy schedule. Oh, no problem. Like I said, the more that we can educate women, the happier I am. So we were just talking off camera about the thirst of knowledge, women have these days about their health and what they need to do to feel their best selves and to go down the journey of longevity and how much it's increased exponentially over maybe the

last decade. I've been at Women's Health UK for nine years and I've seen it increase in that space of time. What do you think that's down to? Part of it is the professional athletes It's coming out and talking about their menstrual cycle and hitting major news systems. And the other part of it is women have been pushing back. And they're like, well, I want to know more about my health. I want to be able to take care of it. Part of it is the health care systems across the world where we're seeing shorter and shorter times with physicians being gaslit.

And so people are looking for how do I optimize my health? And that leads down to, well, this was done on men. this was done on a sedentary population. This isn't right for me. You know, I want to get all the benefits out of exercise and nutrition that I can. So what do I need to do? Can you, we touched upon your background and your qualifications in my intro, but you are one of the most qualified women's physiologists globally and certainly one of the respected.

Can you tell me about your career and about your research and how you got the position you are today? I never had a plan, really. I started out at university as a Polysci French major because growing up in a military family, an opportunity to learn French at a young age and wanted to kind of pursue that. But the more that I got involved in that, the more I decided that wasn't for me

because primarily fell asleep in every Polysy class. And I was on the rowing team, our crew team at university, and my flatmate was in exercise physiology. and so all the conversations around what was happening with training. And she's like, you should actually transfer in the exercise phys. So when I did, I was coming in from the point of view as wanting to optimize what we were doing in the boat and training. And everything that was presented in all the classes of metabolism,

ex-phiz, the representation of women wasn't there unless you had a bone injury or you had anemia or some other pathophys component. And part of what you do as a student is you participate in labs. And we were in a teaching lab looking at fueling for exercise. And it was me and two other male classmates. And through it all, we did everything the same. But at the end, they threw out my results because it wasn't what they had expected for teaching lab.

And when I questioned the postdoc that was teaching the lab, he's like, well, it's because women's results are anomaly sometimes. so we just don't use them. We just use men's results and generalize to women. And as a female athlete, standing there, trying to learn what's happening with the body that just didn't sit well. So, you know, I know that I standardized. I know that I did everything right, coming from military family, and just really kind of taken aback from that.

And he's like, we don't know enough about men, so we don't really study women. And so that was another thing. It's like, okay, now we don't see the representation. And we're not being taught it. now our results are being thrown out. So that was a second cornerstone of me going, this is not right. So then went and did my master's in over-training,

specifically in female endurance runners, trying to see the difference between men and women, got out working in the world, seeing the difference in outcomes between male and female patients and in cardiovascular work, in obesity work, and then went back and did my PhD. And then as a professional athlete throughout it all, really trying to dig in and say, well, these things aren't working, getting questions from my

teammates, coaches. It's like, okay, now I have the opportunity to go to the lab to answer these questions, and I'm going to. And so really pushing through the why. Why are we seeing these things in men but not in women? And wanting to do right by my female teammates, right by the coaches that we're asking, right by me. So just really trying to create this whole environment, where we can answer those questions why specifically for women. So your mantra is women are not small men. But what are the differences between men and women

that go beyond hormones? Or is it just hormones that make us different? It's not just hormones. Everyone kind of puts that in that box, but we see sex differences from birth, even when we're seeing the developing fetus, like what's happening in a stress, environment or under low nutrition, we see that the female fetus tends to survive more than the

male fetus. And when we're looking at after they're born, just differences in muscle morphology. So we're looking at the type of muscle fibers. And then as we're growing, we're seeing a divergence in cognition, reaction, strength, all of the things that we encompass as being physically fit for activity, we see this divergence that happens. And it's not just because we have an expression of our sex hormones when we hit puberty, but also these undercurrents of sex differences. We see it right down to the molecular level. So there are inherent sex differences, and then you have the overlay of hormones. But remember that the hormone conversation for women, we spend more than half of our lives, not in a hormonal state. We have pre-puberty.

and we have postmenopause, and so the middle years is where we have hormone representation. Yes, that has a distinct interplay in how our bodies respond to things, but it's not the only thing. So let's talk about hormones and the different stages that we go through. So let's talk about your menstrual cycle and training around your menstrual cycle. And is that point in our life when we are menstruating, where we're at our biggest difference to men, and therefore need to pay the most attention to the way we're training and not like a man. So when we're looking at the menstrual cycle and we're looking at a normal menstrual cycle, we have to remember that there's variability from cycle to cycle in each woman,

as well as variability from woman to woman. What we're finding out now is that there are inherent body comp changes, their brain changes that occur cyclically with the menstrual cycle. So this is where we start to see individual differences in how we're, perform. So when we're looking at low hormone, you know, women can have times where they feel really fantastic versus maybe not so great. And we see that around the time the period starts, women might feel really bulletproof two days before and then when their period starts, they feel really flat. Maybe they have bad cramping. Some women aren't affected. So when we're

talking about training around the menstrual cycle, we have to bring it back to tracking how you feel and also having the overlay to understand your own patterns because we're seeing a greater and greater incidence of in ovulatory cycles. So you can't just rely on our menstrual bleed because we will still have a bleed if we don't ovulate, but it's different from normal. It's lighter, might not last as long,

but women don't necessarily understand that unless they've been tracking. So if you're tracking your bleed phase and you're actually tracking the length and how you feel over your entire cycle, that's when we can really dial in training and times where we really want to be more aggressive and be more confident

because we can see our hormones can work with us that way. And if we talked about training generally in that time of life, so I'm talking pre-perimenopause, which generally is 40 plus, isn't it? I was 41 when I started having perimenopause and symptoms. So we're talking about women in their 20s and 30s. How generally can they train and should train in that age group, which maybe differs as we move through the decades and we can come on to that? So when we're in our reproductive years, we can pretty much do what we want.

But in the caveat of we need a really good structured program, the undercurrent of that is knowing that women are born with and have less faster. Twitch fibers. So if we're trying to maintain power or build power, become faster, then we really need to work on that glycolytic system. So that's your lower reps, your higher weights, doing more explosive work. We see that if you are doing the higher rep range of 10 to 12 in the strength training arena, you're going to get some strength. You're going to build some mass, but it's not as optimal as if we are periodizing, right? So we're having times where we have a power base and we have times where we have a little bit more hypertrophy

and then we have definitely delodes. So we can play a lot around with that whole periodization and rep range scope when we're in our reproductive years. As we get older, it changes because of inherent changes within the muscle. Is it a case that your body can deal with more stress, the stress you put upon it in your reproductive years, whereas when you get 40s and beyond and your cortisol levels are starting to rise naturally, your body is less able to cope with the pressures of high-intensity exercise?

No, not really. So when we talk about high-intensity exercise, it's across the board, right? So if we don't have the right stimulus, meaning that we don't have the right kind of high-intensity, then we're not going to get the adaptation we want. So when we're in our reproductive years, we can do things like F-45 and Orange Theory, which is more of a moderate intensity and you come out feeling completely slammed. You'll get some benefit.

You'll see some body comp change because it is a calorie burn, but it's not optimal when we're looking at really having a polarization to get optimal change. So when we talk about high intensity, we have to say, okay, when we're looking at high intensity work,

we want to make sure that we are hitting 80% or more of our max for the intervals and we bring it right back down to recovery, which is about 50%. When we're in our reproductive years, that recovery can be variable. As we get older, we have to be very on point that we're recovering enough between the intervals so that each interval is just as strong as the first one

because we're looking for that top-end stress to invoke change and we need recovery to keep doing that top-end stress. And I think this is the disconnect when we talk about high-intensity interval work is that if you are doing high-intensity interval work that you're going to perpetuate a baseline cortisol elevation. When we get into our perimenopausal years, our body's already pretty stressed because of all

the hormonal changes. So we do have an elevation in our baseline hormone of cortisol. But if we think about as you get fitter across the board of your resting heart rate, right? As you get to fitter, your resting heart rate comes down. If we're looking at how we're taking care of the intensity and the stress in our paramedic years, we can do high intensity, but we have. to make sure that we are doing it properly, not in that moderate intensity, like the 45-minute

boot camp. We have to really polarize it so that we get a post-exercise response of growth hormone and testosterone that then subsequently drops cortisol. So then our new baseline starts to come down, and we can moderate our cortisol through high intensity and the post-exercise responses that we get. But we have to make sure that we're doing the intensity correctly. So what's the optimal time period that you're working in that high-intensity threshold and then recovering afterwards? So if we're looking at a high-intensity interval training versus a sprint interval training. So I like to bring it into if we're in the gym. So if we're doing a true high-intensity interval session, it could be something like five rounds of six minutes where one minute is one exercise.

So maybe you're rowing for a minute. The next one will be 10 burpees in that minute and whatever extra time you have left over recovery. Third minute might be thrusters, 10 thrusters, and whatever extra time you have left over in that minute is recovery. The fourth one might be walking lunges for 15 lunges and a little bit of recovery and then one full minute off. And that one full minute is to bring you back down to a little bit of a baseline

before you do the next round. So that ends up being about a 30 minute session with some peppered recovery in. That's a high-intensity interval session. If we look at a sprint interval session, which is different and it's not running sprints, it's intensity. It's 30 seconds or less as hard as you can

with maybe two to three minutes full recovery because we're trying to get central nervous system recovery as well as our fast-twitch energy component recovery. And you might only do four sprints that way because it's such a high intensity. So we're looking at the every minute on the minute is about 80% of your effort. If we're looking at a sprint interval session, we're looking at 100 to 110% of your effort.

So it's hard. And which of those is better? Or do they both have their benefits? They both have different benefits. So if we're looking in your reproductive years, you can pepper it in and do whatever you want, it doesn't matter so much. As we get into our pari and postmenopausal years,

we see that if we're doing more of the, Every minute on the minute, it gives us more of a metabolic change where we're looking at burning more or perpetuating more body fat burn. We're looking at bringing our cortisol down. We're looking at more production of VDNF, which is like the miracle grow for our brain. If we're looking at sprint interval training, this is where we get what we call an epigenetic change. So we are creating change within the muscle cells themselves to allow transatlantic training. location of a protein that pulls glucose in without insulin. So we get better insulin sensitivity. And we also have a stimulus for more neural plasticity so that we are keeping our brains really

going and preventing dementia. And we see that it's a strong stimulus for reducing visceral fat. So if we're looking at that deep minnow belly fat, then we want to do some sprint stuff. Both of them kind of have an overlap when we look at our blood pressure and the way that our vascular changes happen because they both increase what we call sheer stress in the vessels, blood vessels, because when we start losing estrogen, we start losing vascular compliance. So our blood pressure doesn't respond as well. We tend to not be able to vasodilate and constrict and move blood really well when we get into our peri and postmenopausal years.

But increasing the sheer stress during exercise creates more of what we call VEGF. so it's a vascular growth factor, which then allows the blood vessels and the endothelial cells within the blood vessels to respond really well. So it improves our blood pressure, improves our body's ability to dissipate heat. So they both work on the cardiovascular side of things. And how many times a week would you do those types of trainings? So you really only have to do one hit and maybe two sit in a week or just two hits. you're varying the weeks, as long as you're peppering it in throughout a month, then you are getting the benefit. What I want people to understand is we're talking about the quality of the work,

not the volume of work. It doesn't matter how long you're staying in the gym. We want you to be in there in a short amount of time and get really good quality work, not spending an hour and a half each time you go. So that's where we're looking at. Make it short, sharp, and with purpose, but you can't do that every day because you just don't recover. well regardless of your age. So you want to make a plan where on the days that you feel, you feel good and you want to go in and hit it hard, then you go and you hit it hard. The other days we look at what else are we doing? Are we doing just pure strength training? Are we doing technique? Are we going for walk in nature? So we have to be very specific on our training

and make sure that we show up with intent to do that intensity to get the benefit that we need. And to do that level of intensity, it shouldn't necessarily be done on the same day as strength training then. Because by the time you've done your strength session, you're not really going to have the energy to push it to the intensity that is required to get all the benefits that you've just described. Yes and no. So this is where we come into, okay, what is our goal? If our goal is to build muscle and strength, then yes, you do your strength training and you try to have your intensity on a different day. but some women don't have the opportunity to go to the gym or do something like that every day.

So we kind of look at the session. So if we have three times a week of 45 minutes so we can make it to a gym, then we do the first 10 minutes of every session as mobilization. So we're looking at getting into the joint capsule, opening it up, finding all the sticky points, really making sure that we're moving well. And then we can either do a plyometric high-intensity session.

So we're looking at some jump training and some explosive movements, and then we can finish with some heavier compound work if we're focused on metabolic change. If we're focused on strength and power, then we do the heavy compound work and finish with some sprints. So this is how we can try not to compromise, but get it in because also when you're hitting that high intensity under a little bit of fatigue, it's still that intensity. It might not be as high as when you are completely fresh, but it's still that intensity. So you mentioned heavy compound work there. I've heard you talk endlessly about the importance of strength training at any age,

but particularly for women as they travel through their perimenopausal and menopausal years and how women really should adjust how they strength train if they've historically not lifted heavy and maybe concentrated on the higher reps, lower weight, maybe class-based exercises that you've spoken about already. So can you take me through the ideal strength training program a woman should do in their perimenopause onwards? So I always preface it as if you are just getting into heavy lifting, know that it could take six to eight months to learn how to lift heavy properly. So it's an earned journey. If you're just starting out, then any kind of resistance training is good because we're learning how to move and we add load. When we are ready to lift heavy,

so we've been in the strength training and resist training for at least six months and know how our body works and we can work pretty well with heavy loads at five or six. We want to really look at doing three to four sets of maybe three to four reps at 80% or more of one rep max. So it's heavy. And the reason for that is we look at the changes within the muscle as we get older. And one of the things that really comes up for women who are perimenopausal, and I get this all the time of my running pace has slowed from a four and a half minute to a six and a half minute K pace over the course of six months. And I'm having a really hard time opening this jar of stuff that I used to be able to open.

It's because we're losing power. If we're doing our strength training in the traditional sense, where we're doing our higher reps, we're going to build some lean mass, but we're not addressing the power end. We're not addressing that pure strength part. So if we're lifting heavier, then it's a central nervous system response. And what happens there is it stimulates our contractile protein. So we have two really specific contractile proteins. One is mycine and one is actin.

and they work by coming together, bonding, and pulling our filaments together to create a muscle contraction. Estrogen is tightly tied to how myosin functions. And when we start having a change in the amount of estradial and the ratio of estrogen to progesterone, we have a dysfunction in that myosin. If we're lifting heavy loads, then we have an adaptive response from the central nervous system that says, no, we need myosin to work. So we're kind of overriding what was happening with estrogen by adding loads and having a different system come in until the muscle needs to work well.

So this is why we really want to push women who are in perimenopause and older to get into lifting heavier compound work, adding some tempo work, adding some power base, maybe some French contrast training where you're doing heavy loads followed by an explosive movement to really maximize those mice and acting connections. as well as keep our fast twitch going because we lose fast twitch as we age but it's not that we just not that they just shrink they actually go away so we need the stimulus to keep them and this is the heavier loading and the power-based work that's so important not just for maintaining function as we get older but also for attenuating things like dementia and cognitive decline because again central nervous system invokes different responses within the brain it keeps a brain active and moving in a positive way. So it's like doing Sudoku when you're sitting around, but instead you're getting body responses as well as brain responses that feeds forward

to being independently living when you're in your 80s and your 90s. I want to come on to the dementia and cognitive decline because this is very personal to me. But before we do, can you explain to our listeners or the people watching what a heavy compound move is? because there may be some people listening whom, as you've just said, are completely new or have maybe only ever been to, you know, a Barry's boot camp type class before. So what are the key heavy compound moves

that someone would have to learn to do? Because I agree with you that you can't just walk into a gym and suddenly start lifting weights, maybe in excess of your body weight, without potentially causing yourself injury. But what are the key moves women should learn to do? So when we talk about the key compound movements, We talk about a squat, back squat, front squat, single leg, anything that's using a barbell.

We talk about dead lifts either with a bar or hex bar, hip thrusts, anything that's going to be using your core and all the muscles around it. So we tend to think about as a Monday as your squat focus, knee hinge, so it's more of your back squat or front squat and all the things that go with that. You can think of another day is your push, pull, upper body, so you're doing a bench, press which is compound movement overhead push press uh you can do your bent over barbell row or or pendle row those are all your your compound kind of upper body stuff and then on another day you're doing posterior chain so this would be your hip thrust your deadlifts uh your bulgarian split squats any of those kinds of things are when we're looking at compound and using core you're using a whole bunch of muscles to activate in order to execute that movement properly. When we're looking at people

using machines and doing leg press, it's not a compound movement because you have the machine that's supporting you. We're talking about dumbbells, yes, but a lot of times the dumbbell work is done with more momentum. So you're not really activating everything. So we want to get under the barbell and we want to be able to do these big lifts properly and it doesn't matter how much load you're lifting when you start as long as you move well. And everybody's lifting heavy is relative too. So it could be that you can squat a 15 kilo bar at the start and that's heavy for you. You can get three really good ones. But then over the course of the year, that 15 all of a sudden becomes 50. So again, it's relative. Is there any merits in these charts that you find

online saying what your back squat should be relative to your age and weight. You know, you should be able to backscot 80% of your weight in your 40s or whatever. No, no. A lot of that comes from the bodybuilding world and primarily male data and has been generalized. Even the conversation that was going around maybe six to eight months ago about being able to farmers carry 75% of your body weight for a minute. There's no science behind that either. So it's just you want to be able to lift and be strong and that should be your focus. So a lot of these things become fact, don't they? The farmers carry one. That did the rounds

so much that you read it as fact in the end. Yeah. I want to come on to you talking about how lifting heavy can ward off things like dementia and Alzheimer's. My mother sadly passed away last year with Alzheimer's and so did her father, obviously a long time ago, and her older sister. So I've, it's a deep rooted fear of mine that's written in the stars for me. What I would say is she has three brothers, two older, one younger. The eldest one has passed away, not with Alzheimer's, and the two others are still here. And all three of them were in the army, so very physically active and then when they left the army they became firemen so they led a very physically active life and they haven't succumbed to it so it's not necessary that it's endemic in that entire

family tree it nevertheless understandably it is a fear of mine that it is written in the start that i am going to develop Alzheimer's like my mother so i try my damnedest to do everything in my arsenal to not develop it you know i'm one of the things i do is lift weights, but I'd love to dig a bit deeper into the science and research, the support that healthy living, lifting weights and nutrition, we will come on to nutrition, can help with diseases of the mind because it's quite a hard connection to make or a hard connection to grasp. It is, it is. So I had the honor and privilege of meeting Maria Schreiber a few weeks ago. And she has an Alzheimer's research group with Cleveland Clinic. And she's adamant.

She's like, right now out of the over six million people in the U.S. who have been diagnosed with Alzheimer's, four million of them are women. And we see this huge sex difference in the development of dementia in Alzheimer's, but we don't necessarily have all the research to understand why. What we do know is the group of women who have Alzheimer's now didn't grow up and have the same opportunities is the women who are 50 or so now. Your uncles who were army and then firefighters, your mother wouldn't have had that same opportunity, right? It just wasn't. So sat in a factory of entire life. So it wasn't the same. So now what we're saying with exercise and Alzheimer's and dementia, it's not just the plaque development that we hear about all the time. It's also a misstep

in brain metabolism. So if we're looking at the opportunities to affect brain metabolism, it's with things like strength training and lactate production through high intensity work. Because lactate is preferred fuel for the brain. It's not a waste product that we used to think about in the 90s. So if we are producing lactate, then the brain learns to use it and it helps with glucose metabolism and keeps metabolism of brain on point. So that's one way we can reduce the risk factor for dementia and Alzheimer development. With strength training. We are creating new neural patterns, and we're looking at how we are getting the central nervous system to innervate more muscle fibers in order to coordinate them, to contract

at the same time, to be able to lift the load. That takes a lot of direction from the brain to be able to create those patterns to coordinate. So if we are lifting and changing up what we're doing, and we're creating these patterns, it's keeping those neural, the neuroplasticity and the neural patterns always on its toes. So again, that's how we can keep the brain active and communicating to reduce a neural network disruption, which is another cause for dementia and Alzheimer. And so when we're looking at the empowerment of being physically active and challenging the body and the brain, it's one of the best things you can do to keep the brain tissue and the neural network, works actually being plastic and movable or malable, which is one of the key components to reducing

any Alzheimer and dementia risk factors. So we see that even if you have the APOE4 gene, which is a predisposition for it, that it doesn't mean you're going to get it. And this is why you lifting heavy and doing high intensity work, it's so fantastic to reduce your risk factor for getting brain dysfunction as you get older. because it's i've always thought if i if i have the gene and i don't know and i'm not going to get tested well it's it's my destiny but you're saying even if you have that gene you don't necessarily have to activate it that's exactly exactly and that's part of the issue when you start getting all these genetic tests that say hey you have the predisposition for xy z and people freak out

because then they think oh my gosh i'm doomed and i'm destined doesn't mean you have to turn it on we can look at lifestyle factors that can keep it off. It's an epigenetic change. So you have a genetic component, but if you are doing things to keep it off, that's an epigenetic change not to get that disease. Can we talk about nutrition? So, so important at every age. And the importance of protein and supplement, creatine, is the supplement of the moment that every, you know, certainly in the UK, I don't know if it's the same in L.A. and New Zealand, where you spend a lot of your time, but everyone's going mad for creatine. So can we talk about nutrition generally for women, reproductive years and perimenopausal years, any adjustments that they should make as they go through the hormonal cycles of life? And also, I'd love to get your take on protein and the volume of protein we're led to believe that we should be taken. And also, any core supplements that you feel are. absolutely necessary to live a long and healthy life. Yeah, so I approach nutrition differently than I think most, I guess, dietitians do,

where I'm looking at the undercurrent of our circadian rhythm, right? So if we're looking at all the things that can perpetuate change and shift in our circadian rhythm, then you can definitely do some damage if you're not paying attention to nutrition. So we see that the way that we shift our circadian rhythm is through day and night exposure and timing of our food intake. And what happens if we shift our circadian rhythm, especially for women, if we phase shift it later so that we're looking at our body is we wake up, we're not fueling and we're fighting and we're not having any food until 11 or 12, we have a whole disruption of our normal circadian rhythm,

pulse over hormones and the way that our body works in the day. So then we get shifted later and later for optimal sleep. So we know that women's melatonin peak happens about 9, 9.30 at night. And this is that sleepy time where we want to grasp it so that we can get into good, deep sleep, which is fleeting for so many people. If you're not eating until 11 or 12 and you phase shift, and that melatonin peak doesn't have until 11, maybe 12, so you're not able to get into sleep and into a deep sleep because everything has just been phase shifted. If we phase shift, we start to see things like accumulation of visceral fat.

We see change in body composition, even though we're exercising. We see more of an insulin resistance and higher blood glucose, higher blood pressure. So all of these metabolic perturbances that we're trying to stop by exercising and eating right can be completely undone if we're not even looking at when we are eating. So this is where we start looking across the board for women. We want to make sure that we're fueling during the day and then we stop eating two to three hours before bedtime. So this way we can work with everything that's happening from a cellular level. What I mean by that is our cortisol has a pulse. This is why we see cortisol peaks about a half an hour after we wake up and it comes down. And then

we have a different peak and then it comes down. Same with what we call our lutenizing hormone, which is really important for appetite, appetite control, and endocrine control because it helps with how our body is pulsing estrogen, after ovulation, how it's pulsing progesterone, and throughout our entire cycle how it pulses testosterone. And we also see our appetite hormones. We have an appetite hormone that's elevated with cortisol.

And if we're not dropping it, then we start to have a misstep And a lot of women are like, I'm not hungry when I first wake up. And it's like, well, that's a learned habit. So then when we start looking at what are we doing for fueling, yes, we want to try to get about two grams per kilogram of body weight of protein a day at regular space intervals. Really important for women to do that. One, because we want to keep amino acids circulating so that we can keep lean mass going. And we also have available amino acids for our immune system, for our nervous system. Carbohydrates really important. important. We see that as we get older, we have more sensitivity to more simple carbs. So in our reproductive years, yeah, make sure that you're getting a good mix of fruit and veg and grains, but you also have more availability for eating more of our simple carbs, our breads, and that kind of stuff. As we get into pari and postmenopause, we really need to focus carbs being fibery carbs. One, to help with our gut microbiome, because that also helps with our body composition, because we are keeping a good diversity of gut microbiome. And two, it helps with this change in insulin

sensitivity that we have. As we become older and go through perimenopause, we end up with more insulin resistance. So this is why, you know, when we talk about exercise invoking better insulin control, or glucose control, rather, then that's part of the reason because our bodies have changed into this. So nutrition is complex, and the way I like to break it down to women is eat during the day, like I said, trying to get fiber and protein in every eating opportunity. You want to make sure that you're fueling for and from your training because we want to look at training is the stress. We want to wrap it up in all the things it needs to overcome that stress to get fitter. So we are not getting fitter during exercise. We're creating a stress. And if we're not

fueling for that stress, we're not going to hit the stress we want to get better adaptations. So that's why we want to have some food before. And then we want food afterwards to have reparation, but also to tell the body, yes, there's enough food here. We want to bring down those breakdown hormones and start reparation. So we see women who delay food intake post-exercise end up in what we call low-energy state. So the brain is going, wait, there's not enough fuel available. So it starts down-regulating our thyroid, starts down-regulating our luponizing hormone and all of our appetite hormones, which then puts us in a new set point, and you cannot change body composition when you're in that kind of state. So, yeah, like I said, it's like, let's look at how we're

eating, the timing of the eating, and making sure we're getting fiber and protein at every eating opportunity. And what about training fasted? So I'm someone who has to exercise in the morning. I love exercise. I've exercised my entire life, but if it's later than 10 o'clock, I want to start making excuses and it won't just doesn't get done yeah it has to be done first thing in the morning but I've never been someone who is looking for food when I get up I've I've always been someone who delays eating until you know 10 11 o'clock not because I'm pointedly fasting it's just the way the way I am but I understand that training fasted especially at this age is not not optimal right right right

So when we bring it down to the way that women's bodies are attuned to nutrition, because we have a more complex endocrine system than our male colleagues, our body requires, I guess, a greater nutrient density. So this means that if we are fasting and we get up when do exercise fasted, one, we are not going to hit those intensities that we want to to invoke change. But two, we are creating a conversation within the hypothalamus that there isn't enough nutrition to support this exercise stress to recover from it and to keep our own body stress resilient enough to get through the day. Through a complex lens, we can talk about acylated garrulin, which is an appetite hormone, peptide Y-Y, which is another hormone that makes you feel full and cortisol. and the way they feed back to the brain, especially to the hypothalamus, to tell these neurons pepapton tea, they're upregulate or downregulate.

So that's a very complex conversation. The short and long of it is for women, when we wake up, we have appetite hormones that are also associated with cortisol. We want to eat, have something, not a lot, doesn't have to be a lot. This is where the protein coffee comes in or banana with. some almonds or half a serving of overnight oats, just enough to have some nutrition on board so that the appetite hormones and cortisol respond in kind. Cortisol comes down, our hunger hormone comes down, our satiation hormone comes up.

All that feeds back to the brain to say, yep, there's some nutrition on board. We can do this. So then we can go in and we can hit intensities that we want to. We can reduce the catacolamines or our stress hormones that are associated with exercise. to then perpetuate better reparation. If you don't really care about all that stuff, here's the big one. If you go in and you're exercising fasted, the first thing that happens is you start to break down your lean mass because lean mass is energy hungry.

And the way that women's bodies fuel is we go through a little bit of blood sugar. We get into some fat burning, but we really burn through amino acids if we don't have enough fuel on board. So women who start to go and try to exercise fasted, and they're like, I'm not building any tissue. Well, it's because you've done it fasted. I like to bring this example up from a woman that I was on a podcast with in Australia, and she's like, I do a Dexa every year on my birthday. And last year, I really wanted to focus on building lean mass.

So I spent the entire year doing really heavy lifting, trying to increase my lean mass. I was able to increase my overall strength. I can get into triple digit deadlift. I can back squat twice my body weight. I can do all these really heavy lifts. She went back for her dexia and she put on only 100 grams of lean mass. And through the conversation, I was like, oh, this doesn't make sense because she's an exercise physiologist.

She knows nutrition. It's because she fasted. She did fasted workouts. And she held that fast until 11 because that's what her partner did. And I was like, your goal now is to eat. see how much lean mass you can put on because all you did is yes you you did put on the strength through central nervous system but you didn't have the the fuel available to build tissue so women who are looking to get lean to build lean mass get strong build bone you need to eat but it needs

to be something protein based so you mentioned a banana but also almonds we see that when you're doing strength training just strength training that about 15 grams of protein before training is all you need. So what is 15 grams? It could be a half a serving of low-fat Greek yogurt. So if you get a single serving of skier or low-fat Greek yogurt, one of those has about 30 grams, so half of that. We can see that the protein coffee where you're taking a scoop of protein powder and putting into cold brew or a cold espresso and topping it up with whatever kind of milk for like a fortified latte in the morning. If you don't drink coffee, you can do the same thing with macha.

It doesn't matter. Or half a serving of overnight oats, the same thing. So you want some protein. If you're doing cardiovascular work, so you're doing a circuit or something like that, then you do need to add some carbohydrate. So that's maybe 30 grams. And what is 30 grams? 120 calories worth of carbohydrate, not a lot.

So this is where you can look at Okay, maybe I'll have a banana Maybe I'll use sweetened milk in my protein coffee Just bringing a little bit more on board I can see why women think that they Exercise Fasted because you just mentioned the word calories there And a lot of women are trying to change their body shape Or you know, trying to lose weight

Although weight is not necessarily the optimal weight to change your body shape because you can, you can change your body shape and not lose weight at all. But it's people do it because they, a lot of women want to eat less calories. And they see that eating before working out and then eating after because they're hungry, they've just worked out. It's just adding calories onto their day. And then the fear would be that they would gain weight. I know. And this is part of the 80s and 90s mentality of calories in calories out, right? I rarely talk about calories. I'm always about nutrient density and trying to get protein and fiber and not really looking at the whole calorie conversation.

When we're trying to lose body fat and gain lean mass, which is, I guess, the best way to talk about weight, if we're not eating, we don't lose fat. Because if we are putting our body under exercise stress without fuel, the body conserves fat and reduces our oxidation. of fat. We see even if in the research there's an increase in fatty acid oxidation, which means we're burning more fat in a fasted state during exercise, post-exercise, we're not. We're actually going through more blood glucose, we're going through more lean mass, and we're conserving that fat. We see that if you are having just a little bit of fuel before, any kind of high intensity and strength work actually extends that post-exercise oxygen consumption value, which

is fat-burning. So it's a mental reframing where I really want women to understand. It's not about calories. It's about nutrient density. And we want to fuel for the task at hand. And then the way that you do, if you're fueling for what's happening in the morning and you're fueling throughout the day, you end up having more incidental movement during the day and craving less simple carbohydrates. Because this tends to be the thing that you see, a lot of women who hold a fast in the afternoon, they're crashing and they're like, oh, I need sugar, I'm really hungry. And they're like, I don't understand, you know, I just ate.

But then a couple hours later, they're craving this more simple carbohydrate. It's that rebound effect that's happening with your appetite hormones from holding a fast and trying to exercise. And this is what I mean. we're working with our circadian rhythm and we're fueling for what we need to, we don't have the perturbanes. We see even in sedentary people, sedentary women who hold a fast-tale noon or after end up moving less and eating more simple carbohydrates just because the drive to eat from our appetite

hormones and her brain is one that can't be overcome. Even though you're like willpower and eat over, it doesn't happen. So this is why it's like we want to work with the way that our appetite. appetite hormones are functioning with our brain throughout the day. So we need to eat in and around what we're doing in the day, especially in and around training. And if you're still concerned about calories, then you take a small amount of food away from dinner. It could be the extra glass of wine that you want to have at night. Don't have it. Maybe it's a couple of nibbles that you're having before dinner. Don't have it. Right. So it doesn't take a lot because then you're

reducing the amount of food that you're having in the evening. you sleep better, you sleep, and when you sleep and sleep better, this is when you actually can invoke change. Because if we're looking at perturbed sleep and we're looking at perturvins in our appetite hormones throughout the day, we will not be able to change anything. Let's move on to supplements. Creatin, yeah, is it the golden egg? We've all been led to believe, especially for women at all ages, but especially for women in their 40s and beyond. Yes, it has primarily been that bodybuilding supplement that we've heard about for many, many years, right?

But we're starting to see more and more really interesting research come out in health space, creatine use for women across the board from, you know, time they're 20 and starting to exercise and be more conscious through pregnancy, all the way up through postmenopause, because it's so important for every fast energetic in the body. So what I mean by that is every zero to 20 seconds of energy that's used uses creatine. And women have 70 to 80% of the stores that men have. We tend not to eat as many as the creatine containing foods because we tend to eat less or maybe we're gravitating away from more of our animal products.

And when we start seeing the impact of creatine monohydrate on things like brain function, bone function, muscle function, just for a daily existence, it's really compelling the research out there to show, yes, you want to use creatine. It does help with mood and anxiety. We also see it helps with bone and bone strength. Of course, it helps with muscle performance. It also helps with things like gut and gut dysfunction for so many women who have IBS or some other kind of gut dysfunction. Creatine helps because it's one of the key important components of the mucosal lining keeping a leaky gut in check. We also see that it helps with gut microbiome and serotonin production.

So every system of the body can be affected by creatine. So if we're trying to invoke better health outcomes, then by saturating our bodies with more creatine, we're enabling that. And how much should the average woman take? Three to five grams. So that's half to one full teaspoon. a day and it doesn't matter when you take it. Just know that if you mix it in something, it loses its bioavailability after five hours. So if you mix it in your coffee,

don't put your coffee in the fridge overnight with creatine mixed in because it's not going to be working for you the next day. So I put it in my protein shakes. So it's fine to mix it with a protein shake. So I've recently managed to hit my 10 full press-up record because I'm rubbish at building upper body strength. I've got really strong legs and bum and all that. That's switch. Because I've been working really hard for lower body and all I do is get upper body. So I'm the opposite. I've got little puny arms. But I've recently seemingly out of nowhere can do 10 full pressups and I've never been able to do 10 full presses my entire life. And I think what has changed? Because I'm just getting older and I've, well, is it creating?

it be creating that has helped me achieve my 10 full press-up PB, and I'm going to go for 12 next week. I'm going to keep on increasing it. And it's not the acute application. It's you've saturated so you're able to get more of that training stress. And your body can function better under that training load so that you're able to get that adaptation at a more rapid rate. Otherwise, it takes forever. Like I tell the story of it took me 11 years to do one pull-up. and it's like why and then all of a sudden I really started focusing on it taking creatine and it's just the training load would be a little bit higher so that the recovery and the adaptation was a little bit better and this is how you can actually get better at what you're doing

so which other supplements do you think women should take non-negotiables oh are there any yeah so this is a thing where it's like for us who live in relationships kind of crazy away from equator like me down in New Zealand you guys up in the UK winter coming for you vitamin D vitamin D3 one of those things that's a non-negotiable because it helps with every system of the body and in the wintertime when we're really low on sun exposure it helps with mood function sleep all of those things and then we start looking at things like omega-3 fatty acids if you have more vegetarian diet then you want to look into that they have some vegan supplements but other hardcore ones you want to like iron get tested first because if you start taking iron

you have adequate stores it can come across as being anemic your symptoms so just kind of be careful also know that most of our performance supplements have not been tested on women we don't have the efficacy one of the ones that I like to bring into to play because so many people were so crazy with nitrates and beet juice doesn't work in premenopausal women it actually reduces the body's ability to hit higher intensities. But postmenopausal women looks great because nitrates have a direct effect on our endothelial cells. So when we lose estrogen, the nitrates help. But we have adequate estrogen stores, the nitrates interfere with it. So there are things that we have to look into before we start blanket taking them. Before we moved on to our final section, I put a call

out on the woman's health Instagram for questions for you. And there are many. And we're We are never going to be able to go through all these because we could do an entire episode, just you answering our audience questions, which maybe we should do at some point because there's clearly huge, huge want to get advice from you. So I'm going to cherry pick a few here for you to answer. So, oh, actually, I didn't want to take no questions, but I love her.

She's so knowledgeable, a great guest. So there you go. Someone's just thrilled that you're on here. We have actually covered a lot of these. Oh, how to exercise safely during different stages of IBF? That's interesting. Does a woman have to adapt how she's training if she's going through IVF? I don't know, actually.

From a physiological standpoint, you're going to have times where we feel rubbish because of the hormone function. But the best thing to do is just stay consistent and listen to your body, right? I know it's pretty archaic, but it's true. it's like the best thing to do to maintain health is be consistent and really listen to not push too hard when you feel like you can't because that's when we get injured.

Does contraception, the coil or the contraceptive pill, have an impact? Because if you have the hormonal coil, for instance, then you don't menstruate. So does that have an impact on how you can, on the different phases of your training? When we're looking at like the Marina IUD and has the localized progesterone, women will start to ovulate again after six to eight months after insertion. So you can use some of the products that are out there to determine if you've ovulated or not. But again, regardless of what kind of contraception you're on, if you're paying attention to your own patterns and how you feel, that's the best indication.

Because like I said, every time we go training, we want to put in as much training, stress as we can to get that adaptation. And that's like with the creatine and being able to get just a little bit more training stress, then you can get that adaptation. So if we're going in and trying to do a PB and a heavy lift on a day where we feel flat and we miss the technique, one, we can get injured and two, we're not going to hit that stress load that we want to get adaptation. So this is where we really want to listen and say, yep, I need to give myself permission to reduce the load today. because I'm just not feeling it. And I don't think women give ourselves enough permission just to take a pause.

This lady says, I'm over 50. Is it okay for me to train every day? With variation. So if you're having strength training three to four times a week, maybe a hit session once a week or a sit session, and then you can go for some nature walks. You're moving, sure, but make sure that's not the same intensity in the same kind of thing every day.

This lady says I'm 45 and trying to build muscle but instead I'm just putting on weight and I'm eating low calories. There we go. Yeah, eat more. Fuel for what you're doing. Yeah, exactly.

Yeah, so she's falling into that trap. At 45, but why is it so much harder to learn new skills like bar muscle ups for women? Because we've lost those fast-switch fibers, right? So if you're looking at a bar muscle up, it requires a lot of power. And if we don't have the fibers that can invoke that power, we're not going to hit the right technique. So again, it's taking it back, working on power production through strength work and explosive movements, and then learning the technique by using resistance bands and boxes and things. And then you can get

that technique as your power advances. This one says, what's the best training I can do? I'm very overweight and have sore joints, but I'm in need of fat loss. Movement, any movement, right? So we look at everyone's journey. So don't be so specific on if it's zone two or if it's strength training in the gym, just move. Just get up and have some consistency and movement. Maybe you're doing some body weight work. Maybe you're just going for walks and then slowly increasing your pace. But that's the biggest thing. Be consistent in your movement and then as you start to feel fitter and better you add a little bit more specificity zone two training you've spoken a lot about zone two became very the thing the fat everyone was

zone two training but i've heard you talk about you should move away from zone two training and actually concentrate more on the on the high intensity but in shorter in shorter intervals in shorter episodes i should say yeah so if we're looking at optimization so women who are already moderate to highly active we're looking to optimize so this is where we want to really focus on that quality work. For women who are just starting their fitness journey, like I said, any kind of movement is good. You can focus on Zone 2 because that's a little bit harder than just wandering movement. And that has its benefits, aerobic benefits. But when we're trying to optimize brain health, power, bone, this is where we have to really look at specializing

into that higher intensity, higher load range that I talk about. Well, thank you so much for your time today, Dr. Sims. I'm going to finish with some quick fire questions that are a bit of fun. I'm not getting heads up, but they're just a little bit of fun questions. I would normally be with a co-host, Gemma, who can't be here today, and we've been inviting ourselves to all our guests home for dinner. What are you going to cook us? Okay, so if you're coming over, then what I would normally do is a combination of roast cauliflower and asparagus on arugula and spinach with some berries and some nuts and some seeds as the main. And then the side, because my husband eats animal products and I don't. And my daughter doesn't really either. You can have grilled salmon or

barbecue chicken that you can put on the side with it. And then for dessert in our house, we are massive chocolate chip cookie fans, so you get homemade chocolate chip cookies. Genuinely, the best I've been offered so far. So it's a shame that you live in New Zealand because I can't come, but never mind. I'll send it over Uber Eats. Yeah, that sounds absolutely delicious.

You'll go into a desert island for 12 months, and you can take one thing. What is it? Oh, my vinyl collection and turntables. that's a great answer we've we've not had that so what type of music you're going to be playing to entertain yourself um so anywhere from boss nova to drum and bass drum and bass i wasn't expecting that either wow i was ready to drum and bass when i was in university in the 90s so we could continue this conversation yeah we could coffee or wine coffee what's the last thing that made

you belly love? This weekend, my mom and sister and I were in New York City for my mom's 80th birthday. She'll kill me for telling everyone in the world that. And the last part was we were taking pictures in front of this big sculpture garden, and we're all trying to sit on this little stool and take a selfie, and we're all like dilapidated and hair in the face. And then these two women walk by and go, are you Stacey Sims? and we just cracked up

because we're all in this like mixed up kind of photo and it was just the moment of being with my family that I don't get to see very often in a very random place doing random stuff to have someone walk by and go, are you a Stacey since? Did you have to stop? You're playing out of professional and go, oh yes, yes, I am.

Yeah, so it was just the accumulation of all the different things and the juxtaposition of where we were and who we were and then this outside like entity that we don't acknowledge in our family because I'm just Stacey and it was just so strange and we all just cracked up that was great and finally what's one thing women listening today can do to make themselves feel better does it have to be one or can it be two or we can be two be as many as you want one is give yourself permission to take up space and have wellness meetings with yourself

and the other is to be consistent. So that's what I mean by wellness meetings. You put it on the calendar, it's non-negotiable. That's your consistency. And giving your permission to have that and own it is the other thing. Well, thank you so much for joining me on Jess as well today. If for women listening, they want to find out more about you, get some information about your work,

where can they find you online? on the social media platforms as Dr. Stacey Sims and then our website, Dr. Stacey Sims.com. You can sign up for our free newsletter, keep track of everything that's going on, have a peruse of our courses and other things that are coming out and the research that I'm doing and to all that kind of stuff. So you can find me. Well, thanks for joining us today from L.A. It's been an absolute joy and a fascination. and I shall go away in action, a lot of your advice.

Thank you for joining us. Thanks for having me.