The Dr. Hyman Show - Women Are Not Small Men! Why Fitness Advice Is Failing Half the Population | Dr. Stacy Sims

Episode Date: May 13, 2026

Most health and fitness advice for women is based on research done in men. That’s something we need to rethink. On this episode of The Dr. Hyman Show, I sit down with Dr. Stacy Sims, an exercise physiologist and leading researcher in women’s health. Her work has focused on how female physiology actually changes over time—and how training and nutrition need to change with it. Watch the full conversation on YouTube, or listen wherever you get your podcasts. We explore: • Why eating less and doing more cardio can make fat loss harder • What actually changes in your metabolism in your 30s and 40s • How to train for strength—and why it matters for long-term health • Why most workouts aren’t building muscle (and what to do instead) • How to eat and time protein to support recovery, energy, and better sleep A lot of the advice women have been given doesn’t account for how the body actually changes. Adjusting how you train and eat can make a meaningful difference in your energy, strength, and long-term health. If you’re interested in learning more, Dr. Stacy Sims is offering my listeners 15% off her online courses with the code DRSTACYSIMS15OFF. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by Rho, Pique, Perfect Amino, Sunlighten, Korrus and Made In Cookware. Head over to rhonutrition.com and use code HYMAN to get 20% off their entire product line. Secure 20% off your order plus a free starter kit at piquelife.com/hyman. Go to bodyhealth.com and use code HYMAN20 to get 20% off your first order. Visit sunlighten.com and use code HYMAN to save up to $1600 today! Visit korrus.com/drhyman for 15% off their newest product OIO Sphere with code HYMANSPHERE15. Visit madeincookware.com and use code HYMAN10 for 10% off your order (0:00) Women’s unique health needs, fitness, and nutrition mistakes (0:56) Introduction of Dr. Stacy Sims (3:34) Women’s health and fitness through life stages (5:39) Navigating diet, exercise, and cognitive health for women (24:00) Benefits and misconceptions of heavy weight lifting for women (30:55) Understanding anovulatory cycles and high intensity interval training (HIIT) (35:47) Reducing inflammation and proper high intensity exercise (39:11) How to properly perform HIIT (46:06) Overcoming gym intimidation and starting strength training (50:12) Importance of community, support, and lifestyle on longevity (55:01) Optimizing nutrition: circadian rhythm, time-restricted eating, and protein (1:02:44) Post-exercise nutrition and fasted vs fed workouts (1:08:01) Common nutrition mistakes for women (1:12:17) Scheduling self-care and wellness meetings (1:13:43) Quick fire questions on women’s health and fitness (1:17:40) Benefits of creatine and favorite workout snacks (1:18:23) Morning vs evening workouts and advice for younger self (1:19:28) Where to learn more about Dr. Stacy Sims and Collective X Health (1:20:20) Closing remarks, sharing, and social media (1:21:15) Disclaimer, importance of healthcare practitioners, and sponsor gratitude

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as you age, check out Brain Shaping Academy at Dr.hyman.com for slash brain shaping. That's Dr.heimen.com or slash brain shaping. We have a culture that actually has ignored women in the research field. You have this great line, which is women are not small men. What the hell does that mean? But we're told that we just need to do what the men are doing. but we're still not getting the same gains that the men are. Almost all the stuff you know with exercise and nutrition has been based on male data

and generalized to women. What are the nutrition mistakes that women are making mostly now? They're listening to all the fat diets and they're listening to the rhetoric that's on social media and they're not really paying attention to, okay, who am I? How do I respond? When am I hungry? You're not going crazy. You're just being compared against the wrong baseline.

We need to stop the rhetoric of old as frail. What you're basically saying is that by lifting, heavy weights for women, it slows down Alzheimer's risk. The very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with themselves. For longevity, you have your genetic code, but it doesn't have to dictate what's happening. Dr. Stacey Sims is a leading exercise physiologist and nutrition scientist, whose research focuses on sex differences in training, nutrition, and health, particularly for women.

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over time, not just a quick jolt. If you want a smarter, more sustainable way to start your mornings, get up to 20% off non-DACA and begin your intentional wellness journey at peaklife.com slash hymen. That's P-I-Q-E-Life.com slash hymen. Stacey, welcome to the podcast. Thanks. Great to be here. All the way from New Zealand. Yeah, but I'm home. From New Zealand to home. You know, your work is really unique because you're not a doctor, but you're not a doctor, but You're an exercise physiologist, you're a scientist, and who doubled down on things that are health, not disease. Correct.

So most medicine, most doctors are focused on disease, not health. They don't even know about health. In fact, my joke is, you know, we never took a class in medical school creating health 101. Right. So we have no clue what health is. We just think it's the absence of disease, which it's not. And we don't know how to advise people on how to navigate the phases of their life to, induce, create health. And your work is so great because, you know, men have had a lot of focus.

We have a misogynistic culture. We have a patriarchal culture. We have a culture that actually has ignored women in the research field predominantly. And there are studies, but they're kind of like, kind of mostly in the margins. And what your work has done is really focused on how do we think about advising women to take care of themselves through the life cycles? you know, premenopause, paramedopause, premenopause, all the different phases that are important. And, you know, I worked for almost a decade of Kenya Ranch where most of my patients were, you know, 35 to 6-year-old women. And so I kind of had an immersion course in all the things that women were experiencing. And it was just so clear to me how woefully inadequate it was to just sort of

deal with them. And you really taken this on really setting a different conversation for how to thinking about women's health and fitness. And you have this great line, which is women are not small men. Right. Yeah, yeah. What the hell does that mean? I know. Other than the obvious things. Yeah. They're different. I find it funny that that's become like the resonating mantra and tagline because the origins were when I was at Stanford doing my postdoc was also doing some undergrad teaching. And in the afternoons, everyone's sleepy. And I would talk about training principles and practices and trying to go through all the systems that were sex differences. So I would open it up, women are not small men. And that was the subtitle of the class that I was teaching.

And you'd say that and people like, what are you on about? What does this mean? And I'd say, well, you know, the cardiovascular system, there are inherent differences. We know from Jennifer Trimmel's work that a heart attack comes on differently for women versus men. Why? So I'd get in all the nuances and hopefully enlightening all the students. And then when I started a sport nutrition company, I was like one of the very first people that was like, we need different sport nutrition for women than men. So we had a men's line and a women's line. And the tagline for the women's line was women are not small men. But it was way too early. So we got a lot of pushback, but still kept trying to pursue it.

And then I kept that tagline because people resonated with it so much. And basically it's like almost all the stuff you know with exercise and nutrition has been based on male data and generalized to women. And I don't find that appropriate, especially if I'm a woman. and I want to optimize my health in my life. And so I'm like, okay, I'm running with that. And that's how it kind of got out there. And you've been one of the few people who's really like taken on the task of researching women. Yeah.

Specifically, because most research has been on men, and that's come in a great cost to women, unfortunately. Right. Because we can't apply the same principles of health and nutrition and exercise to women as we do to men. So can you kind of talk about that a little bit? How I fell into that? Yeah. I'm a little bit bullheaded because maybe, maybe not. I grew up in a military family, and, I mean, that's kind of how we...

You wanted to be a Navy SEAL. I did want to be a Navy SEAL. I mean, it happened just about a mile from where we are. I saw my house this morning. And, yeah, growing up in a military household. I think you would have been a good Navy SEAL, actually. Maybe, but it wasn't allowable, right? I was told me, I shook your hand.

I was like, oh, okay. I can't wrestle this girl. She's like, she'll knock me down. Yeah. And so when you're used to not having any confines on you, you and you just, your friends are boys, your friends are girls, you do this, you do that. I was running cross country. My, uh, like, teammates and I would all go for a run. We're all men and women. And then you get divided into the two groups to run girls race or the

boys race. And your times aren't that difference. You're like, yeah, okay, whatever. It's just the way things are. But when someone tells you that you can't do something as an occupation because you are not the right sex or the right gender, it really throws you for a curveball. And you're like, what? So that sat with me and then when I got to university. And I'm, in exercise physiology, and all the PDFs and the journal articles and the textbooks represented he or they, and the only time they talked about women was in a pathophysiological standpoint, where they're like, they're anemic, they don't get their periods, they break their bones, they get stress fractures, they get overtrained. And I was like, this is not representative of me. Like, I am on the crew team and we're training hard, but I'm not getting anemic. I'm not breaking my bones.

like how do I train to prevent that? And no one could answer that question. And I was like, this is not right. Like, why do we put as much work into all the things that we're doing? But we're told that we just need to do what the men are doing. But we're still not getting the same gains that the men are. And so that was kind of the undercurrent, which kind of pushed the trajectory forward of doing research to answer these questions for me as an athlete. And then my friends who were athletes and then who became coaches and et cetera going on through.

the years of their careers too. Amazing. Okay. Well, let's get into it. Let's get into it. Because if women are not a small man, what's happening to them, you know, metabolically, hormonally, as they kind of move through their 20s, 30s, 40s, and beyond that. Yeah. So I like to tell people it really does start in utero when we're looking at sex differences versus hormonal differences. And then when we get to purity, we really start to see the effects of hormones because we see boys typically get stronger,

faster, more aggressive. Girls, their center of gravity changes, their biomechanics change, they put body fat on, and then, oh, here's your period, right? And they drop out a sport and activity. They start to feel very self-conscious, and then that carries forward. Then when we get into our reproductive years, you have either, there's no such thing as a 28-day menstrual cycle. There's all sorts of variation within length, right? And then we have hormonal contraception. What are you on? What's the formulation? What's the generation of the progestin? All of those things have a hormonal effect or are using an IUD or not. So there's so many different things in there. Do you have endometriosis or PCOS? All those effects do you as well? And then we get into

perimenopause and all the wide variations that happen with hormones and the undercurrent of aging, which also is another factor. And then we get to postmenopause. And then we think about the data that accompanies that, it's all male data who is in more of a linear fashion. So when we start unpicking it and we see all of these things where women think that they're going crazy, it's like you're not going crazy, you're just being compared against the wrong baseline. Yeah. And yeah, so when we get asked those questions, like, how do you differentiate what is endometriosis versus PCOS? I was like, actually in 2026, we don't have a definitive test.

We know that you have symptomology and you can go for an invasive test to find out, but there isn't anything simple to tell you. What are our symptoms? These are our symptoms. Do I really have it or not? You have to go to your physician to find out. Yeah, that's true. And there's a lot of changes. You know, I think, you know, my experience, you know, working at Canary Ranch, you know,

taught me that there's this kind of chaotic period of shift in hormones that happens in women in their late 30s, 40s, early 50s. And it's like the four horsemen. It's like insulin, which is all about blood sugar regulation. And that leads to increasing, you know, belly fat, which women tend to get. But it's not inevitable. No, it's not. And a lot of women think, oh, this just happens.

and they don't have to get that little belly, two, the stress levels go up because they're kind of in this generation of high-stress work. Their parents are getting older. Their kids are teenagers, and their marriages are stressed. It's like a pressure cooker. Yeah. And so that cortisol is going crazy.

And then they get thyroid, which also tends to go kind of sideways a lot of the times. And that can be caused by stress, and environmental toxins. and that's a big factor affects one in five women. And then you've got the sex hormones that are all over the place. Right. And they're affected by everything, especially lifestyle.

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

Okay. That sounds good. I'll unpack it all for you. Because I think the biggest thing is women think it's happening to them. And if you were born with the uterus, you're going to go through this. But if it's happening to you, it doesn't have to be negative. It means that you're going to go through this, but you can actually take control and see how you can improve and empower your body as it's going through this natural transition. And I think that's one of the biggest things that women don't understand. They just think that they're going to become like an unfit, really unhealthy person, even if they've been active. So if we look at what's happening, we know that in the early 30s, you're, you're, you're, you're, you're, you're fine. And then you're mid-30s, you're like, well, wait a second, something's happening here. The training that I'm usually doing isn't quite working. Maybe I'm not training hard enough. So they start to really question what they're doing and try to find different plans to help them lean up or, you know,

get a little bit stronger. And then we really see a definitive switch in the 40s. And this is because we start to see a fluctuation of our hormones. We start to see a decrease in ovulatory cycles. So we don't have as much progesterone. We also see a shift in our gut. microbiome because when you start having a change in your sex hormones, you start having a decrease in your gut microbiome diversity. And unfortunately, with that and the stress, we start to see a drive to increase the opacogenic phyla of the gut microbiome. And in English, that means bacteria that make you fat. Exactly. In your gut. Right. It like makes you crave simple. So I got to translate something. Yeah, no, no, that's good. Makes you crave simple carbs. You know, it extracts more energy from the food.

Yeah. And a lot of the. times in this mentality. What you said there, I just want to double click on that because you just don't think people are going to gloss over. Your bacteria can control your appetite. Absolutely. And if you have bad bugs in there, you got to figure out how to reset your gut in order to regulate your hormones and your appetite and your metabolism.

There's actually a whole thing called metabolic endotoxemia, which means you get basically insulin resistance and diabetes from bad bugs in your gut. Exactly. And it changes your neurotransmitters, as we know, like serotonin, melatonin, even dopamine, take hit when you have more of the obesity genic phylight going around. So then that confounds all the variables that are causing anxiety and stress and depression. So when someone starts coming to me and saying, what's going on, I'm like, well, these are all the things. We're having sex differences, of course, with aging. And we see that when we have the aging conversation that's happening right now,

we know there's a definitive difference between the way men's muscle and bone age versus the way women's muscle and bone age. For example, if I start to get a little bit geeky, I'll try to explain, we have two contractile proteins, so two proteins that grab onto each other to make the muscle fiber tighten to give you a contraction. One of them is myosin, the other is actin, right? So myacin and actin, they bond.

We have different what we call isoforms of myosin. And we start to have dysfunction. That means different subtypes of the muscle contracting fiber is called myacin, yeah. So the main one that really bonds with actin to create a strong contraction starts to become dysfunctional. Then when you also have a change in estrogen,

it further exacerbates or causes that change. So women's first complaint is they don't feel powerful. They don't have strength. Or runners go, I don't know what happened. My pace dropped from a seven-minute mile to a 9-30, and I just don't know what's going on. It's because we're having this dysfunction in our fast-switch fibers. Oh, wow.

So when we start going... The quality and the function of the muscle changes related to the hormonal changes. Right. As we get older, especially once we hit our 40s and beyond, our bodies actually become less efficient at using protein. In functional medicine, we sometimes call this anabolic resistance. It basically means the same amount of protein that worked for you at 25 may not support your muscles the same way at 50.

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visiting sunlighten.com and use the code hymen to save up to $1,600. That's Sunlighten, S-U-N-L-G-H-T-E-N dot com, and use the code Hyman. So when we start to see that happens first, and then you have cell death or loss of muscle mass. But for men, they don't have that. They lose muscle mass. So they maintain their fast twitch fiber function and their strength capacity. Yes, you have to work on as you get older because you're losing muscle mass. You're six of our work.

I'm 66, I can tell you. It takes hard. I got to work a little harder. Yeah. It does. But when we start talking about strength training and the conversation out there about strength training is not just about lifting weights to failure. To optimize women, we really have to get them to understand that neuromuscular connection.

Like, we want to work on the heavier end. But not only that, one of the other sex differences that's really apparent is dementia in Alzheimer's and cognitive decline. And that is exacerbated during perimenopause, partially because of the receptor changes with estrogen. dropping, but also we see like neuron connectivity or the way that the brain is wired starts to change when we're getting older as well as having hormone shift, which

causes anxiety and depression. But we see in some of the research that came out even last month that if you're doing heavier load lifting, which is that power range where you're doing heavy loads, 80% of what you think you can do five or six reps, then

it stimulates neural conductivity improvement in the prefrontal cortex, which is, you know, primarily driving cognition. And then you have other changes in other parts of the brain that help. But all of this helps attenuate or slow dementia and Alzheimer's risks. So we're looking to slow down it. So you just want everybody to hear what you just said. What you're basically saying is that by lifting heavy weights for women, it slows down Alzheimer's risk. Yes. Okay. And the reason for that is. I might stop you occasionally because like you're just like a cyclopedia and I might

to make sure if you will understand what you're saying. It's because I'm so excited about it. I want to know. If you don't mind, I'll just kind of pause occasionally. Yeah, that's good. Until you've got to translate. Yeah, because I'm like, part of the problem is we have brain metabolism change. So we know that glucose is not as effective as brain fuel as, you know, insulin resistance comes up. Glucose isn't as available for other systems of the body.

And we want to increase neuroplasticity. So that means how our neurons are forming and firing and talking to each other. And we create a new motor pattern or we need a stimulus to re-requist. to recruit more muscle fibers, that's that neuroconductivity. And that's what you get at the very low end and heavy strength training. It's a neural conductivity. And that's the important factor in the resistance training concept. I'm not telling people who've never done resistance training to immediately start on that end.

Any resistance training is great. You have your own. You don't want to start with a hundred pound weights. No. Start with body weight. Work your way up with the eye in two or three years of getting down to the heavier. Okay. But this is honestly, I feel like I know a lot of stuff.

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

that came out of 100,000 people that was just published from the UK last month. How forward it is really fascinating because they looked at heavy lifting versus moderate intensity, which is your body weight and your lighter loads. and longer rep ranges, so you're 10 to 15s. And it was only the heavy end that affected prefrontal cortex. The moderate weight and the higher reps affected other areas of the brain, which is great.

It's a good improvement, right, because you're still affecting neural connectivity. But for the concern of cognition, we need that prefrontal cortex increased connectivity and functionality. So when we're looking at what are we doing to optimize health, that's one of the first things I say. But is there any understanding of the timing of the timing of the? this. In other words, if you start, like when you're 40, obviously it's better, but can you start as late as 60? And is it going to achieve the same benefits? We don't know how robust it is, but that randomized control trial was looking at people who were 60 plus. I'm asking for a friend,

because I didn't start strengthening until I was 59. So you're good. You're excellent. You're protecting your brain. We're all going to be having Zimmerframe races, not because of our brain and our bodies, because of our joints. So it doesn't matter when you start. We say start when you can. It's never really late to start. And we're having more and more research come out in 70, 80-year-old individuals that are showing the heavier rep range, which is relative to what you can lift, improves not only bone and lean mass, but also brain health. That's amazing. It's like the one thing that everyone should be doing. And I come from a massive endurance cardio background. And I've always had strength and as the undercurrent, right? But now all the research is just pointing to how important it is in today's

society where we don't move that much, that we have to do the push-pull motions. And and put our bodies under load, not necessarily cardiovascular load, but actual load. Yeah, I'm on the video version of this podcast, I'm going to give my team my picture. Because I was like a runner. I was running like five miles a day from 14 until like 55 or six, right? And I was running my bike 100 miles a day or 40 miles or 30 miles. And I was lean, but I wasn't string training. And then I started when I was 59.

and then I had a comparison picture of me at 42 maybe and it's 62. And it's like you can't believe it. Night-day, right? Yeah. And I never would have thought that was possible. But, you know, it's never too late. No, it's never too late. I mean, I was full endurance too.

I ran 19 marathons before I was 20. I did Iron Man. I did X-Tera. I did bike racing. And I had string training on the undercurrent, but I didn't let people know I was doing it because it wasn't appropriate for a work. wasn't doing. I was telling myself lies. Like, I'm doing yoga. That's like string training. Yeah, I've heard that too. But we, you probably see this too. We get dexas and it's women that look

healthy because they look lean and they're runners and stuff. But you get the dexsa and they have a high amount of visceral fat compared to what they should be. And their bone density is relatively low. And they're like, I don't understand. I eat clean. I run. I do all the stuff. It's like, you're not strength training and you're not eating enough. Because if you're not eating enough, then you're not supplying your body with the fuel that it needs to rebuild. So it's tapping into bone, of course, because it's part of the aging, but also the stress of exercise without enough fuel. And that higher visceral fat is because there's a change in our lipids in a conversation between the liver

and the fatty acids that are circulating that esterifies them to then be stored as visceral fat. Yeah. So we can fix that. So basically what you're saying is, you know, women who look lean are what we call skinny fat. Or we used to call it toffee, thin on the outside, fat on the inside. And you can tell that by doing a special kind of very, very low radiation X-ray called the Dexas scan that measures bone density for osteoporosis, but also measures fat in your body and muscle and the distribution. Right. Because a lot of these scales, you can't really tell the distribution, these biompedin scales, and you can kind of get a rough sense.

But your arms and legs could be like, you know, 10, 15%, but your belly could be 30%. Right. And that's not good. And you may look thin. Right. And that actually leads to some of the same cardiometabolic risks of heart attack and diabetes stroke as being overweight. Right. You're under lean and over fat. Exactly. And I often give an example because I'll get women who come in and we get the dexia, we get their bloods, and their LDL has suddenly shot up and they've never had problems with cholesterol before. It's like, well, yeah, that's a dysfunction of estrogen because estrogen kind of helps with cholesterol. and risk factors. And when you start losing that, if you are not eating enough and you're not doing exercise stress to help the body understand what's going on, then you're going to have

this increased lipid, negative lipid profile, as well as poor bones, not really fantastic muscle quality. And we see this increase in visceral fat. So let's sort of dig in on the, on two bits of this. One is the food and one is the exercise. Yeah. Because those are independent variables that we have control over. Right. We can't control our genes. We can't. control our parents, control our height, our age, but these are things we can control.

So on the exercise front, is there a difference in what women should be doing when they're 20, 30, 40, 50, 60? And if so, what is it? And can you unpack that for us? And what's the right mix of cardio, hit training or interval training and strength training?

And what kind of strength training? Because I'm hearing there's like body weight, there's lightweight, there's heavy weights. So can you kind of help us really? unpack all that. So when we're in our 20s and early 30s, pretty lucky. Our reproductive years, we can kind of get away with everything. I really impress women when they're in their 20s and 30s to pick up strength training. And it doesn't matter what rep range you're doing just as long as you are doing strength training and have an eye to being muscle-centric. And you can do variations of

high intensity, low intensity, your body recovers really well because we have the benefit of our sex hormones. Women also have the benefit of having more endurance fibers. So we are already have a robust amount of mitochondria, and we have more proteins for mitochondria, respiration, better anti-oxidation responses. And these are inherent sex differences. This doesn't matter if you have estrogen and progesterone or not. So we're already really endurant. We need to work on our fast twitch. We need to do a little bit of intensity and strength training. When you start to get into your... So you can get away with a lot. Yeah, you can. This is the bottom of your 20s. Yeah. That's why you're like, all the high rocks people are like in their mid to late 20s. You're like, yeah, when I was back in my 20s,

I'd probably get that up too, but now not so much. But when you start to get into your late 30s and start having more an ovulatory cycles, which means that you aren't producing as much progesterone because you're not ovulating and you have a change in your estrogen progesterone ratios. This is when we start to see a little bit of dysfunction in how you're training. And just so people understand this. So when you're a guy, you make sperm your whole life. When you're a woman, you're born with a certain number of eggs.

and it starts declining from the day you're born until you go through menopause. And as you go through 30s and 40s, you start to have less eggs and you may not ovulate every cycle, which means you have estrogen but not progesterone. Correct. And when we start seeing more and more of those an ovulatory cycles, people don't necessarily know that they're inaudulatory because they'll still have a bleed. And this is why when we don't... You might bleed heavier. Right.

You might have heavier bleeding because progesterone stabilizes the uterus, and then when you have just, estrogen without the progesterone, you get like clots and heavy bleeding and more cramps and all right. And that's what happens is when we get in their 30s, yeah, 40s, yeah. And they're like, what's going on? So when we talk about like- And then they get an emic. Yeah, and then they get an emic. So they'll talk about like menstrual cycle phase-based training. It's like, no, let's, let's take that off the table because that's one of the conversations. You train according to your menstrual cycle phase. And you're saying that's not a thing. We can't say that because, one, there's not enough robust evidence for a whole human to be able to do that.

is too generalizable because we don't know when someone ovulates. Every woman's cycle is variations of when they ovulate. So it's more, we know you roughly have X amount of days in your cycle, see how you feel, and you can tweak your training accordingly. Because if you know on day 23, you always feel really shitty, then you're not going to go do a hard session. So when you have reproductive years, that's what you do. So when you start getting into your mid to late 30s and you start seeing these inherent changes,

is it's kind of an awareness factor of, oh, what's going on. So people start to feel a little bit less strong. They start to feel a little bit less like themselves, and they're starting to go, what's going? Am I not training right? And unfortunately, with the diet culture, most people say, oh, I need to increase my training and decrease my food because I'm starting to put on belly fat or I'm not responding as well.

So they start to really kind of get into more of a low energy state. See this all the time, especially in recreational female athletes. And when we get into a low energy state, that means that we don't have enough food coming in to support daily life as well as support training. So then we get a compounding variable of now they're going to put on more body fat and have more issues sleeping and definitely not recover well. So it becomes a negative feedback system. Yeah. And that becomes the worry. So then when they get into their 40s and really start to have issues, that plus the sympathetic drive of perimenopause, causes a complexity of issues that then they go to their physician,

and the physician is like, hmm, okay, maybe it's because you're in this period of your life where you're highly stressed, you're not taking care of yourself, do you exercise? Yeah, I exercise, keep doing it. But they don't realize that the exercise that they're doing isn't appropriate for their bodies when it's going through this phase. So what should they be doing in that phase?

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

Yeah. It's the call high-intensity interval tree. Yeah. Because it causes what we call epigenetic change. So we know that it's a locking key. So high-intensity work is the key to unlock the cells, to open them up to allow glucose to come in without insulin. So it's a glute-4 protein that translocates, opens up. And we see that insulin isn't needed for glucose to come.

I just want to stop you there because this is such an important point you're talking about, and most people don't understand it. People think that in order to get your blood sugar or glucose into your cells, you need insulin. But the muscle is a unique tissue and can actually absorb glucose without insulin, right? Yes, exactly. Especially in the post-exercise state because now- And that's right. And the way you get that is by having healthy, good muscle. Right, exactly, right. So, I mean, one of the things that diabetics do is like a 10-minute walk after a meal because it helps stabilize blood glucose. And that's what you can do when you do high intensity. You get a permanent change in the muscle to have the ability to have more glute-poor. proteins translocate to improve insulin sensitivity because now you have other ways getting glucose in without so much reliance on insulin. So it makes the body more sensitive to the insulin.

So it's a double benefit. You get insulin independent uptake of sugar or glucose in your muscles and you don't have to make as much insulin in order to drive the glucose into the cells. And when you don't have to make as much insulin, that's a good thing because insulin is the fat storage hormone and makes you store belly fat, which you were talking about. Right. So it's, oh, you know, like convoluted. It's a lot to unpacker. I just want to, because then I raise a doctor, a PhD like you or me, like, I just think. Unpack it. It's good. I'll just help it out here. Yeah. No, I appreciate that. That's your job. And then the other thing about high intensity work is if we go back to brain and brain metabolism,

we really do see a change in glucose reliance of brain fuel and tissue because it's not as a in the brain when we start to get in perimenopause. And we see that that change in brain metabolism is also a risk factor for amyloid and tau plaques, or, you know, our Alzheimer's plaques. So if we're doing high intensity and producing lactate, lactate is a preferred fuel for the brain and the heart. So if your body's exposed to lactate, it starts to use lactate and not having such a reliance on glucose, which improves brain metabolism and again reduces the risk factor for developing tau and amyloid plaques. So just people, what is that, amyloid tab? That's basically the sticky proteins that cause dementia and Alzheimer's.

That's, you know, that's what we know is, is the downstream effect of whatever the insult is. It's not that amyloid causes Alzheimer's. It's that it's the result of some inflammatory or unhealthy process in the brain. It's kind of the body's band-aid. But what you're saying is the right type of exercise will actually... Attenuate it. ...prevent that the development. of these plaques and tangles in the brain.

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

You could have them as long as you don't have symptoms, right? So we're looking at ways to improve brain metabolism, reduce inflammation. So if we're producing lactate, then we're doing high intensity work, that's great metabolism for the brain. but also when you do high intensity, you get a really strong post-exercise anti-inflammatory response

because the cells have been inflamed from such high-intensity work, and the body's reading it as a signal of, oh, gosh, we have to be able to rebuild quickly in case that stress comes back. So it increases anti-oxidation, it increases anti-inflammatory responses. We see a boost of growth hormone, we see a boost of testosterone post-exercise. So when we hear all the stuff how a perimenopausal woman shouldn't do high-intensity work, it's like, hold on, let's define high-inflammative work. It's like, hold on, let's define high intensity because it's very beneficial if you do it correctly.

But if you're doing a high intensity class, that is at all these gems where they're like, let's go after the perimenopausal women. We have these booty burns. We have spin. We have orange theory. We have F-45. All of those. I know. I've been there.

Yeah, yeah, yeah. It's moderate intensity. It's not truly high intensity because we've all been conditioned to get out of one of those classes feeling sweaty and completely smashed, thinking it was a good. workout. But for true high intensity, you can't hold the intensity for as long as these classes. No, you can only do it for 30 seconds a minute, right? Yeah. So that's the sprint. And when we look at the Norwegian four by four, that's also a type of intensity, right? So four minutes at about 80 percent. And those four minutes are super slow. You're like, oh my God, hurry up. I can do it, I can do it. And then the four minutes recovery go too fast. I want to loop back on something you said because

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

Yeah. So without inflammation, bottom line, Alzheimer's is an inflammation disease of the brain. So it's heart disease, inflammation of the blood vessels. That's kind of what causes it. Right, right. So we look at all the ways that we can reduce inflammation. I mean, that's why estrogen or estradile internally is so protective because it's an anti-inflammatory agent. So when we start losing it, and the body becomes more inflamed and systemically driven. And we see that we have more of the sympathetic drive. It's also that hype and people feel tired but wired. It drives even more inflamed.

Let's look at how we can reduce that. People are like, oh, high intensity. I can't do that. It's going to make me more tired. But they do it properly and like, oh, I feel amazing. I have this kind of... What is doing it properly? So we have high intensity interval training,

and the subset of that is our sprint interval training. So we look at high intensity interval training. This is about 80% of your max when you're doing the intervals. So it could be one minute on, one minute off. And that one minute on is eight out of a one to 10. When you're looking at 10 being max and one being you're sitting on the couch. And then that one minute off is just really super cruisy so that you can do the next one minute at that 80%. Or that's kind of how you start.

And then ideally we're holding it for three to four minutes. And then you have variable recovery, however fit you are. Because if we can hold it for three to four minutes. You do like four times. Like a minute, one minute off, one minute on like twice. That's four minutes? No. So if we're doing one minute on, one minute off, we try to build that up to total of 10 to 15 minutes.

So you end up doing five to seven sets of the one minute on. And then if we're looking at producing more lactate, then we do longer intervals with a shorter recovery as you get more tolerance to it. So this could be three to four minutes at 80 percent and two to four minutes recovery, depending on how you're feeling and how fit you're getting. So the other way to think about it is in the class situation, especially something like CrossFit or some of these other classes where they have every minute on the minute, or you have one minute that you might be doing. burpees, and then right into the next minute, you're doing walking lunges with the weight. And then the third minute, you might be doing box jumps. And then the fourth minute. No recovery.

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

or a shark if you're in the ocean. Yeah. And then it's a full two to three minutes recovery. And I have a lot of women go, why do I need to recover that long? It's like because if you don't recover that long, your central nervous system and your energy systems have not recovered enough to then be able to do that same intensity at that running from a tiger speed that you need to do. Because if you are consistently doing 30 seconds and then a minute off, 30 seconds a minute off,

you are failing to hit that high intensity. How do you, how many times do that? No more than five. You work your way up. Some people are like, oh, no problem, I can't do five. And after two, they're like, oh, my God, I can't do anymore. So like a minute and then four minutes off and then another minute and doing that five times. Yeah.

And then if you are doing a separate session of sprint interval training, because they're two different sessions. So you can have a high intensity interval training is one session. And then when you're short on time or you want more of your epigenetic change for glucose, then you're looking at doing the sprint interval stuff. That's a completely separate session. It might take 10 minutes total. Or you have a warm up. You do two to three sets of the 30 seconds on,

two to three minutes off, and you're done. Okay, so that's the cardio part. Yeah. And that you're saying when we should start when? In their 30s, 40s? You could start it earlier, but it's really beneficial when you start getting in your late 30s, early 40s. And continue out through your life?

Yeah, yeah. I'm sure speeds are going to reduce, but not that much, right? Much, right. Yeah. And that's what interesting research is. Like, most of us have this belief that as you get older, you decline and become more frail and slower and so forth. But I remember reading this book, I think it was a Deepak Chopra book, like maybe 30 years

or more ago, where he talked about the Tar Humara Indians in Mexico, where they had a belief in the culture that the runners, because they would run long distance and 100 miles, that the 20-year-olds are good, 30-year-old, 40-old, and the 60-year-olds were the best runners. I love that. actually were. And then they went down, there's a group from Harvard, went down and study their VO2 Max and their pulmonary fitness and they actually were better. And I think we've seen this and, you know, these isolated people who were like, I started, you know, at 65 rowing or I started biking at, you know, 65 and I'm now 105 and I'm like, I'm better. Yeah. And it's like, so the body

is quite amazing that we think it is going to fail, but actually it can continue if you continue to take care of it. Right. I remember meeting this guy, it was my stepfather's Shiva, which is like after the funeral. And he was 95 years old. And he was like running around like a spring chicken. And I'm like, he looks so fat and sharp. And I'm like, what are you doing? He says, well, whatever I did yesterday, I do today. If I did single tennis yesterday, I do single tennis today. And I'm like, that was a great lesson for me. I love that. Yeah. Okay. So that's the cardio part. What about the strength part? And how do women think about that. So string training is scary for a lot of women, especially in, in this age

group, because we didn't really grow up with being gym-centric, right? It hasn't been kosher for women to have muscles or to be in the gym during strength training. Jane Fonda aerobics. Yeah, yeah. Who's actually here at this conference, we're both speaking. For years, my diet and my fitness, we're pretty dialed in, and yet I still felt like something was missing, especially during the darker months, and light was the variable I struggled to get right. And chorus, the makers of Oyo, have spent years and millions of research and development to solve this. They didn't just build a light bulb. They figured out how to bring the sun indoors. Back my more than 530 patents and Nobel level science, oil bicariff, removes stimulating blue wavelengths at night so your body can do what it was designed to do.

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training. And yes. Pink five panda members. I know. The ones on the back of the Peloton where you're like trying to ride at the same time. Now, that's metabolic cardiovascular work. And when we look at strength training, gym intimidation is real. Like sometimes I get gym intimidation when I go to a new place. It's very real. I know. I'm like, I go to the gym and I have my own little workout thing in my house. and I was in Venice, California, and I went to Gold's Gym, and it's like, oh, my God. Like, it's like Arnold Schwarzenegger, Muscle Beach, like, everybody's, like, humongous and probably on so many antibiotic steroids. And they have, like, videos of Arnold flexing in his prime on the video screens going while you're trying to, I'm like,

and I'm, you know, I'm fairly muscular, but I'm, I'm, I'm, like, looking at myself, I'm like, I feel like a 98-pound weakling here, you know. I was like, I need me to leave. No, but I stay there. I go at six in the morning and just got to do it. And try to do it, yeah. I like try to find off hours, but then that's not even great because then everyone's looking at you. You're like, what are you doing on the lifting platform?

Yeah. But, yeah, because of gym intimidation is real, I don't want to like tell every woman, you have to go to the gym. Yeah. So we start with wherever they are in their journey. It could be you, 10 minutes a week where you wake up and you do a body weight circuit, right? And then as you get stronger in your body weights, you put a front pack of a backpack on, not back, because if you're doing a squat, you don't want to lean forward. So if you put weight in a front pack,

then it teaches you how to squat upright and use your glutes. So there's ways of improving your technique while adding low. And then we know that isolation is killer. So if you have a friend who's also interested, well, there's lots of apps out there that are really powerful in getting women connected and actually have proper programming to improve from going body weight and lightweight to dumbbells to lifting a bar. So there's different ways of doing it.

If you want to join a CrossFit gym, that's great because they'll teach you stuff. If you want to join a proper gym with a personal trainer, that's fine too. But I think the mistake that people have is not having a plan and relying on other people to tell them what to do. We need a periodized plan wherever you are in your journey. So if you're just starting with body weight, let's look at what the first six to 12 weeks is so that we can progressively overload you and get you comfortable in those movements so then we can add some load. If you are resistance trained, it's really hard to get gains. So how are you going to change up what you're doing so you can keep getting gains? If you're somewhere in the middle and you're used to doing eight to ten reps,

well, don't change your program per se, but let's add more weight and reduce the reps. So it's looking, I can't give a chance. You need a trainer to do this? How do you get started? It's like, I'm like, I mean, honestly, I was so intuitive. I had to get a trainer because I didn't want to hurt myself. I was scared and I didn't want to just take it. do something stupid. Yeah, that's very real. A lot of women are very afraid of getting hurt. That's

why they don't go and do heavier weights. I work with a few people that have really fantastic apps who've written together. And so the programming is designed that way so that you can go into the gym with the app, see the videos, get instructions to understand how to do it with video queuing. You can, like in New Zealand, we have playgrounds that have like tires that you can do tire flips with your friends. We have outdoor classes. So people are there to tell you what to do. it's really finding your community that's going to help you. And part of it also leans into isolation is a killer and a demotivator. I mean not isolating muscles, but social isolation.

Social isolation, yeah. Social isolation is a killer of motivation, and we know that it's not very good for anybody. So if you have a buddy, it makes it fun, it makes it sustainable, and then you have ownership in what you're doing. It's amazing. Okay, so I think is there anything else we want to share about strength training or fitness training before we jump to nutrition? Just get started. For a lot of people in our society, like I was asked the other day about, you know, why do I have to do all the stuff that you're talking about when we see all these people who are 100 and they never did any of that stuff? Right.

Right. Well, they lived in a way where they had to do this stuff. Exactly. So I brought out the example of my grandmother who lived to be 106. Yeah. And she grew up on a farm and then she moved into the city with my grandfather. He had his own business. She was running around, doing the gardening, the house cleaning, looking after her mother-in-law, like, always busy, lifting, moving, that kind of stuff.

And that was the lifestyle of the people who are now in their 90s and hundreds. But our lifestyle now is not like that. Yeah, my book, Young Forever, I did some research. And I went to Ikaria or Ikaria, I remember you say it in Greece, it's one of the Blue Zones. Yeah. And I met this couple. He was like 97. She was like 87.

and in the, they live on the side of this sort of hill mountain. And she had like the most extensive, like I wouldn't even call it a garden. It was a farm. There were fruit trees. It was animals. There was like so much food. She was growing. And she was like walking up and I couldn't keep up with her.

She was 87 years old and, you know, told me what she was doing and having to lift stuff and move stuff and take care of the whole thing. And I was like, wow, you know. And if that had happened in our country. people would be like, oh, wait, wait, no, don't lift that. I'll get that for you. Right. Because we're soaking. There's an editorial that came out a couple of weeks ago that was talking specifically to health care providers and to PTs that we need to stop the rhetoric of old as frail.

We need to stop pushing the 10 to 20 rep range as strength training. We need to really look at challenging the body because it can handle it. Yeah. But you have to be careful with your tendons and ligaments. Yes, definitely. Because you're, you can, if you're not slowly building up. Right. Exactly.

I noticed that for myself when I started. I kind of overdid it because my muscles could do it, but my tendons weren't ready. So then now I can do like, you know, double the weights. Right. But I don't have the pain. Exactly. So that's part of the whole periodized program, right? But if you never...

Periodize means just like phases of training, like over time, like doing different things in different weeks, like a graded increase in string training. Right. So one, you don't get bored and two, you keep increasing load without getting injured and your body recovers properly. And are there good resources? for people, like, that want to... That want to jump in on this? Yeah. So there's a woman called the Betty Rocker,

and she's really good if you want to get started with body weight stuff. And she has some really good perimenopausal menopausal programs. If you're looking to, like, get into lifting, Vonda Wright has a program with Haley that's Learned to Lift. And then if you're already lifting and really wanting to optimize, then you can go into Haley's Power Happens programs, which I helped her devise and write. Great. We'll put all those in the show notes, links and everything.

Let's talk about nutrition. Yeah. Because, you know, I think people are confused and, you know, there's all this sort of hype about protein. There's intermittent fasting. There's do you eat before exercise, only after exercise. Like, what should people be thinking about and how do we, you know, how do we start to think about that? Yeah. I always pull it back now to help kind of clear up all the confusion of chronobiology.

So what are we doing for our circadian rhythm? And we know that women's circadian rhythm is different from men's. So if we're looking at even our cortisol peak, our cortisol awakening response, so that's how our cortisol comes up. Women have a higher peak than men, and it's tightly tied to appetite hormone. So we know that when cortisol in the morning comes up, we also have an increase in what we call acylated garrulin, which is our active form of our hunger hormone. We also have an equivalent rise in peptide y-y, which is a satiation hormone. But if we don't eat within an hour of waking up, there's dysregulation of those hormones. So as we go through the day, we start to feel more cravings for simple carbohydrates.

We get what I call it the wall lean because we don't move as much incidentally throughout the day, start really feeling tired and hungry about four or five, no matter if you've eaten a little bit later in the day. And then dinner is a little bit uncontrollable where you're like snacking before dinner. and then you have dinner, and then an hour later, you feel hungry, so you're eating something before bed. And you've effectively pha-shift because you're eating in the wrong times. So regardless of the intermittent fasting, the keto, whatever it is, let's first go back to basics. Let's look how the body optimizes hormone pulse, how it optimizes melatonin peak to sleep well, how it optimizes how it repairs itself.

It's all in the circadian rhythm. So if we eat during the day and try to front load our calories more towards the beginning and middle of the day, then when we get to the evening, we're not as starving. So we can make wiser choices at dinner. And then we aren't wanting to have snacks after dinner, which then improves sleep. So I tell women, if you're having really horrible sleep and issues sleeping, it starts in the morning. Like when you wake up and if you have food within the first hour or not. So we want to drop that cortisol.

We want to stimulate the hypothalamus to say, yep, there's some food coming in so we can have some more control of garrulin and leptin so that it pulses properly throughout the day. And then your body is able to have more of an even blood sugar throughout the day. I think that's important. And what I think about intermittent fasting, I think for women, it can be challenging because of the reason you're saying, I like to think about it on the back end. I like to think about it. It's not eating after dinner. Right. So if you eat dinner at six and you wake up at, you know, seven and you eat at eight, that's a 14-hour fast.

Exactly. So that's necessary. We want to have at least a 12-hour break in our bodies to allow our bodies to repair, heal, and do autophagy and all the cleanup stuff. But it doesn't have to be this 16-hour thing. It doesn't have to be like waiting until noon to eat. I mean, that's a bad idea for a way. Have you seen the research about early versus late fast break? So there's been some population research looking that for those individuals, both in women and men, but more robust responses than women, who break their fast by 8 in the morning, and then they finish their daily intake by 5 p.m.

That they do have metabolic control and all the things that you think about. I wrote my first book was called Ultramatabolism, and I wrote a chapter there called the Sumo Wrestler Diet. And the joke was, you know, how do you have small little Japanese men become these enormous 300 plus pound guys? Well, they have a science in how they do that. They basically feed in this massive food called chankonabai, which is like a giant stew of all kinds of rice and pork and this and that. It's not processed food. It's like a lot of food. And then they make them, quote, take a nap.

And then they do the same thing at the end of the day. for dinner and then they make them go to sleep. So basically, if you eat before you go to sleep, it's all going to store and you're not going to burn it. Right. And so think of, I would sort of flip the intermittent fasting to be on the back end, like on the night before and not eating and snacking at night. So that's the best way to do that is to front load your food so you're not starving at the end of the day. Right. And so I explain the difference between intermittent fasting and time restricted eating. What you and I are talking about is technically time restricted eating because when you start talking about intermittent fasting, that's when people like,

oh, I'm not going to eat till 11 or 12. And then I'm only going to eat till 4 or 5 in that window. One, you're not going to get the micronutrients you need or the fiber that you need. You get a whole bunch of dysregulation. So let's just not even go there. This is a great take home for people. So if you're a woman, and probably, I haven't say anybody, you want to front load your calorie restriction, which is after dinner and don't eat after dinner.

and have an earlier dinner if you can. You're going to sleep better. You're going to feel better. Your metabolism is going to be better. You're going to probably lose more weight. You're going to have a better time and you're going to feel better. Now let's talk about protein. Yes.

So protein is the thing. It used to be low fat. Then it was low carb. Then it was high fiber. Now it's like high protein. Like what's the deal? I know. I think we're running out of things to be high or low in.

I know. I'm wondering what the next thing's going to be. Initially I was really happy that protein was getting its heyday. because it has been underutilized. Yeah, by the way, it's the only macronutrient that we need in large amounts. Exactly. Like, essential fatty acids we need in small amounts, like gram amounts, like even milligram amounts.

Carbohydrates, we have no actual essential carbohydrates. Correct. But protein, we have a requirement for a fairly large amount of amino acids in carbohydrate and protein every day. Right. And I always start protein conversations with remand. reminding people that the RDA is a representation of the lowest amount of protein that you need to prevent malnutrition. Yes.

It is not optimal. Yeah. And if we are looking for optimal, we have to dig into the most recent research that shows that between 1.6 and 2 grams per kilogram of body weight is ideal. So that is about that 0.8 to 1 gram per pound per day. So if you're 150 pounds, it's 150 grams or maybe 130 or 120 to 150 grams of protein. And then as you get older, you become more. more anabolicly resistant, meaning that you can't build tissue and use it very well, to protein and resistance training. So if we are going to try to build strength and lean mass,

we have to be on the upper end of protein, and the timing of that is very important. Yeah. So when I just listened to this fantastic lecture. Can you stop because people just heard anabolic resistance? They probably know what that means. Basically, when you're young, you have what we call trophic hormones. You have a lot of hormones that are helping you keep and build muscle. When you get older, they change, and your muscles change, and you need more protein and more strain training just to tread water.

Right. I often say, I'm a living example, because every time I travel out of the country and I'm gone for a month or so, I lose about three kilos of muscle. I know. It's a pain in the ass. And it's really hard to get back. I went to the gym this morning.

I try to get to the gym every day when I'm traveling, but sometimes I can't, and I, you know, my blender, and I can't do my weight protein smoothies, and I can't. I'm like, I'm like, okay, I have two eggs, but I need like six eggs. I know. It's like, you go down to the breakfast bar, you're like, all the eggs in your bag. You're like, I didn't take them off.

Yeah, it's really hard. And so when people push back on the protein and the strength training, I'm like, it is really, really difficult when you get into your 40s and beyond as a woman and in your 50s and beyond as a man to build and maintain your lean mass. And lean mass isn't just muscle. It's also bone. We know protein is really important for bone as well. And when we look at the stimulus sport, not a lot of the educational. out there is for the right stimulus to build bone and maintain muscle. So for looking at strength training, we know the rep ranges and everything for strength training, and for bone, it's not walking.

Yes, strength training can help, but we need to do hard landing jump training. So we need that multidirectional, ground reactive force to go up through the whole skeleton to actually stimulate bone growth and density. So when we're looking at protein is necessary to help with that too. So as we get older, we need to air on the upper side. And like I was saying, I listened to this fantastic lecture by Keith Barr, who is tendon and protein guy, molecular researcher out of California. And he was saying, yeah, this whole conversation about post-exercise eating is really interesting because most of it's been done on young men and some young women. And so really isn't a window. I was like, yeah, of course. But as you get older, it's more important.

And have a win one or two hours after you work out. He says even less. Less. If you are thinking about what you're trying to drive when you're exercising, you're driving signals to break tissue down. And the post-exercise response is to help repair that. To repair, you need nutrition. So if you're delaying that, then you're kind of muting those signals for reparation.

So he really suggests that as you get older in your mid-40s for women and mid-50s for men, that you really tried to get that nutrition is close to the end of exercise as possible. Interesting. Let me ask you this, because this is something I just don't know. I mean, I've talked to Don Lehman, who's a protein expert.

Yeah. And my understanding was if you are well trained, like if you're starting out for sure, that's true. Yeah. If you're well trained, you resistance training regularly, you have muscle, that it doesn't matter so much

as to the timing. But what you're saying is different. It is different, yeah. And so when we're looking at all the studies that are promoting, there's no real difference, and we're looking at resistance training and resistance trained individuals,

and you could have 100 grams of protein, and that doesn't matter when you have it as long as you have it throughout the day, because Luke Van Loon put out one where it was the barbecue diet where he loaded people up with 100 grams of protein post-exercise, and you were still having protein uptake for 24 hours after.

Again, all done on men, younger men. So when we're really looking at the aging factor of muscle and tendon, we want to use exercise as a signal, and we need nutrition to help with that signaling. So that's the angle that a lot of us in this field are like, we're not looking at younger people who have the ability to repair without necessarily having a big wallop of food afterwards.

We're looking at how do we optimize women and men who are aging and still putting in the effort and the work, that if you're not fueling to help with those exercise signals, then you're reducing the response. So bottom lines, like if you're older and getting older 40, 50, 60s, whatever, when you string train, make sure you have something within a half an hour to an hour at the most. Yeah.

Right? Like a weight protein shake or a piece of chicken or six eggs or something. Some amount that's going to be a, and the amount, is the amount matter that time is it 30, 40, 50 grams? Like you can't eat, you can't eat a pound of protein in one meal. No, no. I wouldn't recommend that. We see that for older women, it's 35 to 40 grams.

And for older men, it's 25 to 30 grams. Okay. And more for women. Yeah. Because we have more. more of anabolic resistance to the protein. Abby Smith-Ryne did some really interesting work of pre-and-post exercise, and she found that for women who had 10 to 15 grams of protein before exercise,

you still had the capability of accelerating the post-exercise signals because you had more amino acid circulating. So if you know that you can't eat after exercise, if you have it beforehand, it still helps. And so let's talk about the beforehand. Because should your exercise fasted or fed? And if you are fed, how much? Because I know I can't really eat too much for exercise.

I get like the sluggish and nauseous and I can't do it. So tell me about that. It's okay for you, but not so great for women. Women should have something before. And when we look at the reason we look at like energy availability, so we know that men can pretty much get as low as 15 calories per kilogram of body weight without having dysfunction. For women, it is 35.

So there's a big discrepancy right there. So we look at every eating opportunity. We know that if women have something before exercise, that they improve the signaling of the post-exercise responses because they aren't producing as much of the breakdown hormones. Your catacolamines that help with muscle contraction and fueling and stuff. So your body, I wouldn't say, is more relaxed, but it's not as highly stressed during exercise.

So it can hit intensities it needs to. It can do what it needs to do. it can increase the signaling for post-exercise responses, especially if it's cardiovascular. If it's strength training, there's a little bit more of a leeway because it's not as metabolically heavy as cardiovascular training.

But if you're going to do a weight training circuit, then you do need to eat. Yeah, I mean, I do a circuit. I'm not going. Yeah. My heart rates up like 140. Yeah. Wow.

And I tell people, it's not a lot. You don't have to think about having a full meal. I mean, there's a lot of us that are part of the 5 a.m. club. And the last thing in the world you want to do is get up at 3.30 to have a full meal before you go training at 530. Like, no. It's like I am infamous, you know, on the internet about protein coffee, right? So I love coffee and I'm not going to not have it. What's a protein coffee? I know. So I, people always ask me what I had. I'm like, I do a double espresso at night and I put it in the fridge. But I put it in the fridge with almond milk and a scoop of protein and I stir it up and then that's my

latte in the morning. And I'm drinking it as I'm going out the door to the gym or to So you put like weight protein in your almond milk. And then I pour the espresso in. So it's like a cold protein latte first thing in the morning. Oh. Don't ever try to do it hot because the protein gets all gluggy. Oh, so it's like an ice coffee. Yeah.

Wow. Okay, that's a new sea is. Yeah. And then when you're traveling, it's easy, right? Because you might have a coffee maker in your room or maybe you can get a coffee and put your protein powder in and then you're like, okay, good to go. And then you have your real breakfast when you get home. And you travel with protein powder?

I do. I knew it. I travel with protein powder and creatine and then I order groceries to get sent to the hotel or wherever I'm staying. I got meat sticks. I got the matting meat sticks in my bag. Oh yeah. I have creatine. Yeah. And I'm like, it's tough though, man. It is very hard. And I have to like, and then I'm like suitcase is heavy because I get this little portable blender. Sometimes I go. It's like. I choose blender or French press. And I always bring the French press. So what are the nutrition mistakes that women are making mostly now? And they're listening to all the fat. diets and they're listening to the rhetoric that's on social media and they're not really paying attention to, okay, who am I? How do I respond? When am I hungry? I've re-trained women so many, so many women to listen to hunger cues because we've been conditioned not to. We're like, oh, well, I've been told that if I delay food, it's good for me. I should have lemon water, hot lemon water when I first wake up. I shouldn't have coffee. I should delay my breakfast. And then they get into the whole circadian disruption and they're not sleeping. It's like, Okay, well, let's reset.

Yeah. Because if you aren't eating, we know that, you know, your body really responds to food and day and night to look at controlling your circadian rhythm. So if you're waking up and one, you're not looking at light, two, you're not eating, then your body's like, am I supposed to be up? And we see that it effectively phase shifts. So then your melatonin that starts to rise at 9 o'clock for women and 10 o'clock for men, you miss the boat. You don't get that. You get a blunting of that. So women should eat in the morning and not do this lemon water thing and then delay their breakfast.

Correct. And try to look at the light. And by the way, you mentioned people listening to nutritionists on the internet or social media. 40% of them are paid by big food companies to provide misinformation and to confuse people on purpose. Correct. And sell something. I know. It's actually criminal.

And sell something to fix it. That's why I'm like, I don't partner with anybody. So what do you think about the protein shirio? and the Dunkin' Donuts, protein cakes, and the Starbucks protein coffees. I know. I laugh because being an expat, living overseas, we don't have that. Yeah.

Like, we're really, you go to the grocery store, and it's not apple season. You can't buy an apple, right? It's very seasonal, kind of how it usually is in the San Francisco Bay Area. But I come to the States, and I go to a Safeway. I'm like, what is this? This is a store full of stuff that is in food. And you have protein pop darts.

You have protein popcorn. You have all these ultra-processed things that have protein, protein, high fiber, and it's all additive. And I always remind people that we are not as smart as Mother Nature. So when you're engineering food, that's not the same as if you're eating the whole food. Right. Because there are co-factors in the whole food that actually work in your body to make it work. And this is a tactic of the food industry called nutritionism, which is a term coined by Michael Pollan, about manipulating problems. processed food to meet the latest food trend or fat, right?

Whether it's low fat, low carb, high fiber, high protein. So I kind of want to go to high protein Cheerios. I'm like, give me a break. I know. You're like how much sugar's in there too. And they do it very fast. It's amazing how fast they reformulate. I know.

I'm like, wow. You know, and so I think people have to be really careful and stick the whole foods and not do all these weird protein kind of fad foods where they're out there. Some things are okay. something's out there but just be very discerning and read the ingredient list to make sure they're not full of weird things you can't recognize or pronounce or don't have in your kitchen. Yeah. So in New Zealand, one protein bar is anywhere from $5 to $10. So it's not really that affordable. Oh. And people are like, well, what should I have instead? I was like, why don't you just look at a snicker bar? Because a snicker bar actually has more protein than these protein bars. And it's a dollar. So it's not like I'm promoting candy bars. But in the comparison, when you're looking, it's like, what are you actually getting when it says a protein? or like protein bar on the label.

Yeah. Like, you can't really identify everything in there. It doesn't taste that great. Where is if you know that you're hungry, you get a payday or a snicker bar that has some fat and protein in it. It's a candy bar. You're not going to have it all the time. But it's going to probably fill you up better and it gives you protein and it's cheaper.

A stickers bar? I know. People have pushed back. I'm like, I know. Desperate times cost for desperate measures. I'd rather you have almonds and a cheese stick. But if you're really in a. gas station and you have the option of a $10

musashi bar or a $2 snicker bar. If you were sort of advising women in the real estate now, which they are, a lot of minuses women, and they just need to start one thing today, what would it be? I think the very first thing I tell every woman to do is to put some hard meetings in their calendar. That's a wellness meeting with themselves

because we don't know where they are in their journey. But if we have 10 minutes, three times a week, dedicated to us, we start to find what we really you need. So women who have never started a fitness journey, I tell them your 10 minutes on your first day is just to turn off, no noise, go outside, look at the light, have your coffee in front of the window, just really try to decompress and tune in. And then as you get used to those 10 minutes and you find out, yeah, I really like to stretch or I like to move or I want to be outside, then we can tap into that and say, you want to be outside, okay, well, let's go outside for 10 minutes,

maybe you meet a friend and you do stairs for 10 minutes. Or maybe you're doing a body weight circuit. Is it cold and rainy and you don't want to go outside? You want to stay in front of the cozy fire? Great. Well, let's do a body weight circuit in front of that. Because it's your time and it's for you and what do we need to do for you to keep that wellness meeting and know that you can't break it because it's the start of these habits that are going to optimize.

Wellness meetings. Wow, what a concept. Wellness meetings. I tell my team. Like, if my schedule, I don't care if they're president of the United States calling me. You've got to make sure I have blocks of time where I can do my thing in the morning. Me too. All right.

So let's do some quick-fire questions to wrap it up. What's the number one thing women should focus on for longevity? For longevity. So this is really interesting because this is a very big space in lots of like information out there. For longevity, I tell them to look at what are your risk factors? Because there's so many different risks. You can look at family risk factors and know that you have your genetic code, but it doesn't have to dictate what's happening. So if you have a family history of dementia, then we want to focus on strength training.

You want to do everything possible so that you don't turn those genes on. If you have a family history of osteoporosis, then we focus on that. So that's the first thing. How are we going to optimize? Look at family history. Let's work to optimize that. Your genes are predisposing you, but they're not predestined. Exactly.

And that's the thing. Oh, my father died of a heart attack. So I'm like, no, no, you know that you're predisposed. So let's do all the things because we have all these tools. All right. And so that starts you on your longevity. Okay, so what's the biggest mistake women are making in the gym? They're following programs that aren't built for them.

What size fits all? Yeah. Or they're not following programs. They're just going in and doing a class. What's more important? Weight, loss, or muscle gain? I'm always about what are you gaining, not what you're losing. I'm with you, girl.

I mean, I've been a doctor who's helped people lose hundreds of thousands of pounds. of not millions, I never tell people to lose weight. Yeah. I never focus on weight loss. I say, let's get healthy and here's how. And the weight loss is a side effect. How many days a week should women be training in the gym? We see to maintain it's one to two if you're strength training to kind of get gains and

keep moving forward. It's three. It's about to do four, five, or six? The worry is over training or under recovery if you are doing that because if we don't have a right plan, you can do four or five or six. if it's planned out and you recover well. But basically. In different muscle groups, so you're not doing the same thing every day.

And eat. Please eat. You need abundance. Yeah. You need abundance to build muscle. It's counterintuitive. Like you need to eat a lot in order to lose weight. I know.

But I love it because people are like, what? What about this calorie deficit? And calories in calories out. I'm like, no. Old idea. Yeah. And still, everybody believes it. I know.

It's like the earth is flat. And it looks flat and it's going to be flat. Yeah. So what's the top tip to, lose, sorry, to prevent muscle loss as you age? Protein fiber at every meal and a focus on strength training. How about bone density? What's the most effective way to protect your bones? Jump training.

Jump training, which is what, jumping jacks, burpees? No, so there's been some really cool research studies that come out. One is the Liftmore study out of Australia. The other is the osteo-gain stuff out of New Zealand, and it is looking at low landing, but landing hard. So it's not landing how we've all learned to absorb it in our joints. It's not pliometrics. I can't do that. I had back surgery. Yeah.

Well, you could do a lift and slam her heels down. So it's not actually jumping. Yeah, yeah. So there's ways of doing, or like, you can look at med ball slams, right? Because then you're absorbing it, you slam it, or you slam it down. And so you're like getting that isometric. Interesting. Amazing.

Okay. What about creatine for women? Yes. Absolutely. And how much? Oh, so I love the. question because a systematic review came out three days ago. And I was reading it. Wow, I'm like, Kinky Bubble you girl, three days ago, a month ago. I'm like, all right. That's because I'm always reading.

It went through all the creatine studies that were not like bodybuilding type. And it said the people that benefit the most from creatine supplementation are women aged 18 to 65. And the lowest dose of three to five grams is optimal. And then there are variations with that, of course. So if you're looking for cognitive benefits, it can go up a little bit higher. Yeah. And then if you're looking at like fatigue and shift work, it's that 0.38 grams per kilogram, which ends up about 20. So there's different variations within the dosage depending on what you need. But the baseline is at three to five grams and takes about three weeks to fully saturate and then you start getting all the benefit. What's the biggest myth in women's health or fitness? That we age the same as men and that we should be doing the same. Yeah. And we unpacked that pretty well. Yeah. And what's one nutrition rule that most women get? Oh, they're too many. Too many rules.

Calories and calories out? Let's go with that one, yeah. Calories and calories out. Yeah. Okay, what's your favorite pre-workout snack? My protein coffee. Yeah. And how about post-workout meal?

I always crave my bowl of Greek yogurt, nuts, protein powder, berries, tea seeds, and a double espresso. Damn. So you do the double espresso before and after? Oh, yeah, and then I stop. Okay. All right. And we didn't talk about this, but better work on the morning or evening? For consistency sake, we see that habits in the morning last longer. When you're looking at time press and you can do it at the end of the day, that's great because it's still getting it in. But we also then have to look at how close to bed it is. Because if you're driving your core temperature up, then that can lead to a couple of sleep issues unless you know how to drive it down.

And knowing what you know now, what would you tell your 20-year-old self? Oh, my gosh, there's so many things. Because when I was 20, I was like fully endurance athlete, like a little bit of strength training, but just running and cycling and swimming and all of those things and not eating enough. Full, low energy availability. Probably not having your period. Yeah, all this. Got it, lost it, got it, lost it.

Stress fractures, all those things. So I would go back and say, look, you don't need to do all this. Let's look at how you're going to train for Ironman and XTERA doing it properly. Amazing. Okay. And your website is Dr. Stacy Sims.com. Yes. With a Y.

Stacey with the Y. Yeah. No E. No E. And where else can people learn about you and your work? So social is, of course, the same, Dr. Stacey Sims.com. And then our new company is Collective X, collective X health. Okay.

Give us a one, two cents on that. Yeah. So we are going. It's a women's intelligence platform. So we're going after the problem with AI and the rhetoric of re-gurgitating poor information that's been based on male data. So we have a research arm. So we have a patriarchal AI system and you're trying to fix that. Exactly.

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

Stacey, you're just a wealth of information. I learned so much, and I'm in this field. So I'm like just kind of leaving with all kinds of news to use and nuggets and wisdom. So thank you so much. Yeah. I'm going to try your approaching coffee. Awesome. I love it.

Thanks. And good luck with everything you're doing. Thank you so much. It's been great. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out.

I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests.

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