Live Like a Girl with Dr. Mindy Pelz - Strength Training to Cardio: A Comprehensive Movement Plan with Dr. Stacy Sims

Episode Date: August 5, 2024

Dr. Stacy Sims shares her insights on menopause, exercise, and nutrition for women. She underscores the importance of strength training, high-intensity workouts, and balancing cardio for women in perimenopause and postmenopause. Dr. Sims also elaborates on the key factors like sleep, circadian rhythm, and proper nutrition for optimal health. The discussion also touches on the nuances of plant-based diets, the significance of proper pre- and post-workout nutrition, the role of supplements like creatine, and how her differing view on fasting requires a nuanced interpretation.  To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visit https://drmindypelz.com/ep247 STACY T. SIMS, MSC, PHD, is a forward-thinking international exercise physiologist and nutrition scientist who aims to revolutionize exercise nutrition and performance for women. She has directed research programs at Stanford, AUT University, and the University of Waikato, focusing on female athlete health and performance and pushing the dogma to improve research on all women. Check out our fasting membership at resetacademy.drmindypelz.com. Please note our medical disclaimer.

On this episode of the Resetter podcast, have I got a treat for you all? You asked me, so I brought her to you, Dr. Stacey Sims. And what, there are so many reasons that I am excited to share this conversation with you. So let me start off with the first reason. So many people have tagged me in social media posts and have said, you need to talk to Stacey Sims because she doesn't think menopausal women should be fasting. And she has also been receiving the same posts. And yet I go and watch her content and I'm like, no, we are saying very similar things.

You have to look underneath the surface to see what she and I are talking about. But when we're looking at reels or quick social media posts, you miss the context that she and I are trying to share with the world. So I brought her on my podcast so that we could have this conversation. So for starters, Stacey is a PhD with a, I love this. This is the way she calls it or her team calls it. She's a forward-thinking international exercise physiologist and nutrition scientist who aims to revolutionize exercise nutrition and performance for women. Now, this part, by the way, is really important because you're going to hear everything she's sharing with you on this episode is through the lens of fit women, women who are athletic women going through

menopause. We do talk about, well, what if you aren't athletically inclined? Where's your door in to exercise through menopause, which I'll explain here in a moment? But she is definitely brings this beautiful combination of exercise and nutrition science together and then looking at that through a menopausal lens. Now, a couple things that she really deserves incredible credit for. She did a TED talk called Women Aren't Many Men. And that TED talk went viral and it's incredible. You can go listen to it. And she wrote a book called Roar, which is also incredible, which is, you know, a science-based layperson's book on exercise and nutrition and specifically for menopausal women. So that's the lens in which you're going to hear this conversation.

Here's where we went with it. For starters, I really wanted to talk with her about what, those of you that are in perimenopause, the menopausal transition, and post-menopause, what you really need to know about exercise, what type of exercise, do you need to eat before you exercise? Do you need to eat after you exercise? What would that nutrition look like? So we unpack exercise. And as you'll hear in this, there are three types of exercise

that she really recommends for menopausal women. And what's beautiful about the way she explains it is it's very much like these three types of exercise will actually act like your estrogen cream or your progesterone cream. Like it's really good. I love the way she put the hormones wrapped around these three types of exercise. Then we dove into fasting and I'm not going to give it away. I would like you to hear it directly from our mouths of where we agree and where we disagree

on fasting because I love where that part of the conversation went. So if you're confused when you listen to both of us and you're like, should I be fasting? shouldn't I? Again, I'm not going to give it away, but we really dive into the nuance on fasting that everybody needs to know. Then we land in the end on nutrition. And this I love, because a lot of the conversation on social media right now is omnivore is better than plant-based. And then the plant-based people are like, no, plant-based is the most ethical way and is the only way I'm going to eat. and then where does the conversation on protein come in? So again, I'm not going to give this away because there is a big surprise that she will share

with you towards the end around the conversation of plant-based and omnivore that you need to hear. So much, so much in this conversation. So thank you to all of you who asked me to bring her on. She and I loved it. And I can't wait to share this with you. And if it hits home with you, there's so much. here that needs to get out to menopausal women. So if you love it, send it to a friend.

Really important conversation that the world needs to hear it and you're about to hear it. So enjoy Dr. Stacey Sims. Welcome to the Resetter podcast. This podcast is all about empowering you to believe in yourself again. If you have a passion for learning, if you're looking to be in control of your health and take your power back. This is the podcast for you. So I just want to say welcome to my online home. I'm so happy to have you here. And I'm so excited for this conversation. So thank you, Stacey. I'm so happy you're here. Yeah. Thanks. I'm in the confines of my mother's office. But hey, it's in the state. I'm excited to read here. Yeah. Great conversations. I mean, think about it. How many great

conversations have women had in the bathroom, waiting at line in the bathroom, or when everybody's in the stall together. So great conversations can be had, you know, pretty much anywhere. So no worries on that. There's a lot to unpack. And I want to start with this idea. And it's such, it's so in the zeitgeist right now that women are supposed to be, going through menopause are supposed to be leaning into more strength training. Yeah. So what I would love to do. And I would love to be, do is start off with like if you were talking to a 50 year old woman who's maybe at the tail end of perimenopause starting to go into those postmenopausal years she's been through it all the whole transitional experience what would you tell her about working out what are some of like

the tried and true principles that she needs to know about her 50 year old body that it is not what her 48-year-old body was. Ooh, that's good. I mean, we go through all the, I feel like parimenopods every six months is different. Like your body changes rapidly, right? So that when you get to the tail end of it and you're starting to come out the other side, it's completely different than what you've just experienced, which is completely different from what your body was when you're like in your 30s.

So when looking at someone who's 50 in the tail end of perimenopies, I always pull out the big rock. I'm like, okay, so the three big rocks I always look at is sleep and sleep quality, because that's super important. We don't get any kind of metabolic or psychological or any kind of health control unless we have really good sound sleep. Then we look at physical and mental movement, and that's where strength training comes in. And then the third one is the big rock of nutrition. So we're looking at those and we're looking at sleep. Part of sleep is circadian rhythm, right? So we need to look at if we're exercising, if we're eating, and how we're working our circadian rhythm.

If the big rock of exercise for postmenopause and late paraminopause is strength training, we have to really look at that. Like, okay, what time of day we're going to do? We want to have the work with how you feel, right? Some people feel fantastic when they first wake up. Yeah, that's great. But if you're someone who gets more energy and motivation as the day goes on, well, maybe you want to try to fit in your 20 to 30 minutes later in the day. So we have to really look at how does your life work. And then, of course, you have all your other commitments over it.

So if you're a night person and only time you have to work out is in the morning, then we have to work with that too. But it's really trying to find that. And understanding that strength training isn't something that you're just going to do a six-week block of and then be great at it. Right. So I get people to understand. If you don't have a history of strength training, I'm not going to throw you in the gym and tell you to do deadlifts. We want to phase you in. And that phase in could be up to six months of doing higher rep, lower weight, body weight movement, that kind of stuff.

So you understand where your limitations are. If one side's weaker or the other, what your range of mobility is, what your confidence is. And we slowly build load over time. Because I get women saying, well, I don't know how to lift. It's too much and I'm going to get injured. No, that's not worried about. We're looking at, are you going to be lifting when you're 80? Because that's my goal.

I want everyone, every woman to have some strength training when they're 80, 90 onwards. So we have to look right now. If you have a long training history, sweet. Let's go in the gym. We're going to do some cluster sets. We're going to set it all up. So we're going to lift heavier loads and really get into that central nervous system response. But if you've never done any of that, then maybe we start with three times a week body weight stuff.

and then we add load with back. And then we look at using some kettlebells. And we slowly build as people get more and more confident. But I think the critical point here is we've all grown up with the strength training is bad because it gets you bulky. And you know, you want to do calories in calories out. How much cardio can you do? And I really want to try to get women to change that narrative and understand this strength

training isn't just an exercise. It's a way of life because if we're thinking about lifting loads, growth, being independent as we get older, we have to challenge our muscles, specifically our central nervous system for that motor pattern. Because when we're getting into that perimenopause, postmenopause, we're not looking at doing the higher reps to build muscle for muscle, quote, hyperchial. Because we don't have the impetus really for that. What we want is central nervous system. Because if, if we're, looking earlier days when we had lots of estrogen, then we had an impetus for really strong muscle contractions, really fast muscle contractions for speed and power. And we also had an

impetus for building lean mass because estrogen is tied to all of those factors. When we lose it, we need to find that external stress that's going to create that same mutation. And that's through the central nervous system. So if we're looking at lifting heavy loads that we're failing by the fifth level, then we're really instigating central nervous system to say, hey, wait, I need to have more nerve patterns and nerve conduction to be able to stimulate these muscle fibers and to actually create more muscle fibers to lift this load. So we're taking estrogen out of the equation, and we're creating a new response to get that strength and build that mass. So that's how we look at it. We're building to be able to be independent when we're 80, 90, 100.

I love that. I love that thought. I always tell people that literally every day I think about my 90-year-old self. And I'm like, okay, what do I need to do today to make sure that my 90-year-old self is who I want, you know, is the woman I want her to be? So I love that. Look at it through the lens of functionality. So, okay, so I have two questions on what you said. One is if we look at the patterns of testosterone, from what I can tell is that, and it may be more

nuanced for the menopausal woman, so this is why I want to bring this up, is that the biggest increase in testosterone happens in the morning. So is that accurate? And if a postmenopausal woman gets more testosterone in the morning, wouldn't that be a better time to actually do strength training? Well, testosterone is like all the other sex hormones, it has its own pulse. So we'll have boost in the morning kind of try to counter cortisol. But if you are doing strength training, you get a boost after strength training. If you do true sprint interval training, and we hear this rhetoric about how menopausal and perimenopausal women shouldn't do high intensity work, it's because a carry-through isn't there. If you're doing it properly, then you have a boost

of testosterone and growth hormone after that exercise. Exercise in itself is a stress, and your body response to that stress in particular ways to overcome it so that it gets stronger and fitter and can do it again. When we get into pari and postmenopause, and we don't have all the pulse signaling from estrogen and at some points progesterone and lutenizing hormone, it tends to look at what are my available sex hormones and what are my available steroid hormones. So it's like, okay, yeah, we need testosterone because it helps counter that exercise stress. It helps drop cortisol. We need growth hormone because we've just broken down all of this tissue. So we need to stimulate that to repair and testosterone and growth hormone kind of go hand

in hand. So we're looking at the pulse of the hormones. It's not just we see that it peaks in the morning and then kind of wanes off and then peaks again. There's ways of increasing the pulse of those hormones depending on what you're doing. So that's why like when we started this conversation is like understanding the woman and where she has the most energy so we can maximize those different pulses. A lot of women think that when they go to the gym, they have to come out feeling smashed. A lot of times if you're doing the strength training properly and you're not doing a metabolic stress of 10 to 12 reps, but you're actually staying on the lower power end because it's a central nervous system response, you come out feeling really good.

good and relaxed because you get that growth hormone, that testosterone, and a subsequent parisic response. So you don't come out feeling smashed. You come out feeling like, yeah, I feel worked, but I feel really good. And that's where we find, like, low energy. This is a way of increasing that energy and feeling like, yeah, it's more, because it's the brain effect, right? So you're like waking up the brain from that system. So you do a heavy load. And then you're like, I have clarity. I can do something. something else. Right. So, okay, so did I just hear then I'm 54, there would be no need for me to ever do a 10 to 12 rep set with my weights. I should always do the heaviest I can possibly lift in

five or six reps. Yeah, but we have to periodize that too. So when we're looking at what's the best, like, optimal range for, you know, so you're 54. You want to have the, base of it in that lower rep range, right? So you don't ever want to go over eight. What I try to get people to understand now, because looking at something like one repetition maximum is too hard to figure out. And your one rep max changes depending on how strong you feel. So I say, okay, you want to go in and you want to look at doing your weights with two reps and reserve. So that means you do enough of a load so that you could possibly eke out two more reps at the end. with good form, that's it.

So, you know, that could be six reps. It could be eight reps, but don't go over the eight. And this is how we can really load it and keep it in that power-based range based on how you're feeling in the day and what you can do. So we look at starting eight way and then we can go into different like macro cycles, micro cycles, what are you doing in the week? What are you doing over four weeks? How much loading are you? Where's your D-load? are we doing five reps? Are we doing three by twos? Are we doing cluster sets? There's so much you can do within

the programming there to stay in that bottom part without ever having to get into that 10 to 12 rep range. So then where does cardio fit in at all? So I will tell you, again, through my 54-year-old post-metaposal lens, I definitely notice the calm when I do really heavy weightlifting. Like there is this sense of like, somebody just gave me like a whole bunch of progesterone. Is that what it feels like? It's like a chill pill. It feels incredible. But then when my brain is racing, if I go for a walk, I love to run. I was a competitive tennis player. So I love to go run. And it just is my mood. It enhances my mood and brightens my brain. And I think that in the cultural conversation around strength training, we've sort of lost, well, what does cardio look like to benefit the menopause?

woman. And for me, I've gone from running long distance to walking long distance to hiking, to rucking, to, but there's still a different feel I get in my body when I do cardio. So what, what do you recommend for cardio for menopausal women? Yeah. So we look at polarizing your training. So we hear all that rhetoric about the zone two stuff. And to me, I might know, when we look at the basic physiology between men and women, women don't need to do a whole bunch of Zone 2 to get the benefits that is purported for Zone 2 of increasing free fatty acid use, mitochondrial use, all that kind of stuff. I tell women, Zone 2 is your soul food. Like I come from an endurance background. Airman, Xtera, bikes, everything, right? So I get a bike, I go out, I go out for hours. I love it.

That's my soul food. I get lost. I come back and feel fantastic. But that's not optimal for this 50-year-old body, right? And it's not optimal for women who are trying to lose abdominal adiposity, who are trying to get better insulin control, who are trying to change body composition. We need to look at that high-intensity work. The stuff that we've been pushed away from doing, just from a cultural nuance, the way we've grown up. So when we're looking at true sprint interval training, this is 30 seconds or less, as hard as you can possibly go, like full on, full out. Okay. The best way I can teach someone to do that is on an assault bike where you're looking at arms

and legs against resistance. Like everyone hates the assault bike, but 30 seconds, you're blasted. I was just going to say, my trainer pops me on that and I'm like, oh, fuck, we're doing the assault bike again. I know. So I make people chase meters. I'm like, how hard can you go for 30 seconds? And you have a couple of friends around.

go, go, go, go. And you see, and then the next one, which is three or four minutes later, because you want three to four minutes recoveries, you're chasing the meters, you try to push a little bit harder. Most people are like, oh, I can do three to five or eight of those. It's like, oh, we'll see, because usually it's like two. And they're like, I'm done. Because it's hard. That's what Sprint. Right. It's hard. Yeah. So when you're doing that, you're creating an epigenetic change within the muscle to open up more of what we call the glute four protein gates, which are the way that carbohydrate and glucose get into the muscle cell without insulin. It creates over the course of three to four weeks of doing this kind of work.

Now all of a sudden you have better insulin control because your body has said, hey, skeletal muscle is more sensitive to carbohydrate. We have more of these proteins that translocate to bring carbohydrate in. We don't have to rely much on insulin. When we look at high intensity interval training, which is just a step down from the intensity, where the intervals are one to four minutes at 80 to 90 percent with variable recovery. This is more of a mitochondrial response, where we're looking at increasing the capacity of the mitochondria to use carbohydrate and use free fatty acids to reduce those free fatty acids that are circulating that get wrapped up by the liver and stored as vizereal fat. So this is how we're

reducing the conversation of the vizirial fat in the body. The combination of the two is really, really important for metabolic health and body health. If we're doing that long, slow stuff all over the time, it's not a hard enough exercise stress to create these adaptations that we need to have that estrogen, progesterone, and some extent, testosterone used to do for us. We're looking for that external stress. that is above and beyond what the body can usually, you know, understand so that it creates all these new feedback pathways to benefit our metabolic and our psychological and all of these responses that go to shit when we hit pari and postmenopause.

Yes, they do. You know, when you go out on your long rock or like me going for a long ride, that's our soul food, right? Because that's how we just get rid of the stress and we get that. feeling of calmness. And that's endemic because of the backgrounds. But if someone hasn't been doing that, I'm not going to say, okay, now on the weekend, let's go for a four-hour ride or three-hour rock, because that's contra indicative to what we want for the body. Okay. So let me sum the up then. What I heard is there's three categories of exercise that we've

talked about right now. When you're doing strength training, you want to do heavy less reps. When you're doing cardio, you really want to do sprints that push you in short intervals. And when you just want to calm your mind and feed your soul, I love the way you said that, that's where you're hiking and you're walking and your riding come in. And they all are, we all call them exercise. But for the post-men or the menopausal woman, they all serve a different purpose. Exactly. Exactly. So where does something like yoga fit in or Pilates?

you know, or anything like that. Yeah, I put that as like you're part of the soul food because there's some people who love yoga and love the power yoga and the feeling from it. From Pilates, it's not pure strength training, but it's more the appropriate reception than the balance. Doing plios on the jump board is not true plymetrics. So because it's not loading the bone in different metrics,

but it is good. It's a complementary aspect for core strength functionality. So there's definitely a time and a place for it to fit in. But again, it shouldn't be the bread and better of it all. Because the other thing is brain health. Like if we talk and listen to a lot of stuff that Lisa said, we have to look at exercise and the way that it affects our brain and brain function. So if we're looking at neural pathways,

this is where that heavy lifting comes into play. Because if you're using central nervous system response, you're creating new neural pathways. So it's like doing Sudoku except your exercise. if we're doing that high-intensity work, that actually produces more BD and F or brain neurotrophic factor than water-intensity or low-intensity. And we're trying to increase the volume and the tissue health of our brain. So we're doing both of those. Right.

And we are really benefiting our brain health, attenuating dementia, attenuating Alzheimer's, kind of countering that amygdala change that happens with menopause. because you're creating that stress, the brain is responding to it as well. Yeah. You know, she brought, in our conversation, she and I talked about this grandmother hypothesis. And you've heard her talk about that? Yeah, yeah. Yeah. It's really interesting.

So I'm really fascinated. It's really interesting. So I actually have, I have a team of researchers that I will ask to go like scour pub med and find me research. So I was like, go find me stuff on this grandmother hypothesis after I talked to her. And, you know, the way I think about things is everything in the body makes sense once you understand it. And so in the grandmother hypothesis, there were two things that really were brought to my attention. One is that the postmenopausal woman was meant to go out and forage. This is what Lisa explained when I brought her on is actually meant to go out and forage for food to bring back to the cave while the hunter and gatherers were out trying to.

get a kill. So in that, there has to be a fitness benefit that we see in those postmenopausal years that our body is moving towards a different type of fitness because our brain changes so we can take care of the culture. That's what Lisa brought to us. But this fact that we were meant to go out and forage and pull tubers out of the ground, that's the part of the grandmother hypothesis, means there must be something that our body was meant to do differently from a fitness level. Do you see where I'm going with this? Yeah. Yeah. And we also look at it, it's like, when we look at the human body itself, it was designed to move, right? It's designed to have bursts of activity and to also go long and slow. But our society has globalized this whole sedentary aspect. And when we

look over the course of generations, it's an epigenetic change where now we're seeing things like obesity is just a given in certain family streams because of these genetic changes. So when we're looking at history and we're looking at how the metabolism, everything has changed, yes, right? So we see that metabolism and everything has created this, let's go slow and long have lots of endurance, part of the grandmother hypothesis. And we look at biomechanics and we look at when you take those hormones away. Yes, we're really good at fat burning, going along and slow, but we don't have to be that way because we're looking at the highest and fastest growing population in like ultra endurance are women who are 40 plus because they're naturally falling

into this go long and slow. But we lose fast twitch fibers quickly as we age both men and women. But for women, we end up losing more because we start with less. And this is where if we're using exercise as a creation of a different type of response, lactate metabolism is really, really important. So if we look historically, we would get lactate from sprints we'd have to do to get away from animals or, you know, even regardless of what age. Right. And that's really important for brain and heart health because that's a metabolite that the brain. that the brain and the heart really use.

So we look at some of the sex differences that are coming up in things like Alzheimer's. It has to do with the plaque development and lactate metabolism. So if we're looking at doing sprint stuff for neuropathways and attenuating Alzheimer's, we have to also look at the fact that we want to produce lactate to keep glial cell. The neurons working to keep the brain conversation going. So this is where we're looking historically, yes, the grandmother hypothesis makes sense. But as we go through what's happened from a global standpoint of sedentaryism and the more we know about aging, we don't have to age in this sedentary fashion to create all of these health issues that keep coming up that are such a burden on the public health system and burden on insurance.

Right. And we see it all the time. Thank you. I come back to the States. I feel like I have every. If I sit down to watch the evening news, I have diabetes, I have all this stuff, right? Because that's what's being thrown at us. But if we understand physiology and we understand the body is very plastic. We have neuroplasticity.

We have skeletal and muscle plasticity. Let's create those adaptive changes that allow us to have better metabolism to keep moving forward to maintain our power or speed, maintain our balance, maintain our bone strength. because we look at history to learn from it, but I don't think you do. A lot of people working at history and saying, hey, this is what we have to do. This is what's coming up. It's like, well, actually, now look at history, learn from it. And now we have all this other evidence and information that we can apply to have better longevity

and not be the burden on the public health care system. Yeah, yeah. I am so with you on that one because this idea that, As we age, we slow down and diseases kick in. A, that's a horrible life to live. But then, B, it is a burden on our health care system. What's interesting about this flip on the conversation that you and I are having and many other people around menopause is that the old thought was, oh, you went through menopause and then you just rested. And you sat in your rocking chair, right? And you just take back. You know? That's right. I'm like, no. I mean, that's my mother. My mother is

That's her. Like she doesn't have an athletic bone in her body. And yet what I'm hearing is now we're saying the 180 degree opposite, which is you're losing these hormones, but you can use exercise to actually make this transition smoother, bring them back a little bit like testosterone and growth hormone. And that is ultimately going to have a brain effect. And so if maybe in my 30s, I was exercising to look good. In my 50s, I'm exercising to make sure that I'm thinking properly. Right. Exactly. Because what's the thing that's been going around? You want to be the oldest person in the weight room, not the youngest person in the assisted care? I was like, yeah, that's right. Oh, I love that. Oh, my God. That's so good. Yeah. That's good. So, okay, so then, you know, before we go into the fasting conversation,

I would say the other challenge that we're seeing a lot in our community, I'm sure you're seeing it in yours, is that as collagen goes down, injuries become more prolific. And we're now living in a time where we're getting a lot of new information coming out about some of the musculoscal scalal injuries, frozen shoulder being the biggest. So is there anything a woman can do if she's listening to this? And she's like, okay, I'm going to go to the gym. I'm going to start lifting heavy weights. And I'm going to start sprinting up a hill. how does she make sure she doesn't injure herself? Yeah, soft tissue injuries, big, huge thing.

Planner fasciatus and frozen shoulder are the two biggest issues, right? Because they're all soft tissue tendon stuff. And we know how estrogen affects that. So one of my good friends is Kelly Starrett, and he started Mobility Wad stuff and now has the ready state. And he's looked a lot into tissue health. So I've turned to him and his wife, Juliet, to understand a little bit more about tissue health. So we're looking at a little bit of blood flow restriction through what they call voodoo flossing. So it's a, it's kind of like a theraband, but you have the ability to wrap around the joints of interest and do range of motion stuff with that wrapped and then remove it and do range of motion again.

And it's a blood flow response that then increases the actual blood flow to the joint. So you have better range of motion so that it reduces the friction and that car. heartilage issue, as well as enhances the, I guess, the responses within the tendon, because now you have more bloods up there. So I have women really, like, if you have arthritic onset of arthritis in your knees, then we do voodoo flossing before squats, or maybe we actually keep the band on as proprioception for squats. If we're going to do sprints, we have to do a really, really good sound warm up through mobility. So mobility becomes a key functionality. So this is your femoral. This is you're looking at right. It's not your static stretching. It's actually getting

into the full joint and joint capsule. So there are different techniques to really like pull the joint capsule, get more blood flow around it to enhance a tissue health in and around the joints. And this is how we look at avoiding soft tissue injuries. And then if you do have tissue injury like planar fascia, then there are specific things you can do with voodoo floss and with different types of massage to really enhance the blood flow to those tissues. Right. Is that like BFR bands or Katsu bands?

I've seen both of those or is voodoo floss in something different. Yeah, it looks really similar. Okay. I wish I was in the other room because I have one in the other room and pull it out and show you. Yeah. Yeah. You know, and I love that idea because I do think if we're going to start to have a whole culture going through menopause and strength training, we don't want to end up with a whole culture of injured women. And if it gets too many injuries, then all of a sudden now women are like, forget it, I'm going back to the couch. Yeah. So, you know, that's really, it's interesting to know that there are some other ways. we can look at it. And what I also heard in what you said was foam rolling, stretching, warming up becomes more important in these menopausal years than perhaps it did in our 20s and 30s.

Yeah, it used to be get up off the couch, run out the front door and go. But now it's like, oh, 15 minutes of mobility. And then I go do my sprints and then I come back and do some more mobility. Yeah. Yes. Okay. I love that. So, okay, now going back to the grandmother effect, And this is really, you and I talked about this before we started recording. One of the things Lisa said that has my brain really fascinated is that as women go through menopause, our brains become less sensitive to glucose. And it becomes more preferential, more receptive, I should say. I want to be really careful with the words I use to ketones.

So, of course, my fasting brain was like, well, that's interesting. then there is a place for fasting in the menopausal experience because Keith can help supercharge our brains. And that's honestly what we see in our community. So many women start fasting and they're like they drop weight and their brain comes back online. And then on the flip side of that, I've heard you talk about how it's hard on the menopausal body because of the cortisol stimulation of fasting.

So what I'd love to chat about. is, is there a middle ground here between getting our brain some ketones and not letting cortisol get so high that it tanks all the other hormones? What are your thoughts? So I come from it from, like, my lane is the active woman, right? So I know that most women are underfueled anyway. The way that I come from it is looking at the chronobiology, like we started conversation. And if we look, you know, cortisol peaks a half an hour after you wake up and then it dips. And you have these pulses throughout the day. So we need to have fuel available to kind of stimulate the hypothalamus to say, hey, you know what?

There's nutrition coming in. And we can have better appetite hormone control and we can drop cortisol. What I do tell women is that we have to go back to, quote, normal eating, where you have breakfast within a half an hour to drop that cortisol, stimulate the hypothalamus, go through the. the day eating really good quality foods, making sure you put a precedence on protein, and then you don't eat after dinner. So you have that overnight, quote, fast, which is just normal eating. So we're looking at that overnight fast, your body has an opportunity to repair, you're developing some ketones. And then when we get into that whole brain health conversation, where I'm looking at it at the new research and stuff that's coming out about Alzheimer's and dementia,

primarily, you know, lots of my friend's parents are experiencing it. My grandparents had dementia. So really interested. And we're seeing this cultural right first, right? So if we're looking at the population that's being studied right now with dementia and brain fog, it's the women that were not challenged because they weren't allowed or they weren't really proficient to go out and become doctors and lawyers and neuroscientists and all the kind of brain stem jobs that are available now. And they were not encouraged to exercise.

So now we're looking at, the research is coming out about fasting and stuff in postmenopausal women is a cultural nuance because they haven't had the same brain exposure challenges that we've had because of our availability. So we start looking specifically at brain metabolism and trying to get rid of, or stop the plaque development in Alzheimer's, this is where they start looking specifically at lactate metabolism to improve glial cell conversations. And lactate is the byproduct of a lot of glucose metabolism.

And this is where looking at the high-intensity work comes into play. When we look at ketones as well, for women who are not exercising and not producing lactate, and because we have this glucose misstep, then that's where the ketones come into play. So if we're looking at a non-active population, then yes, we can look at using fasting strategically for resetting our circadian rhythm and improving some of the brain metabolism. But in my pop of active women, we need to change up the activity and make sure that we are working

with our hormone pulses. We're producing lactate on a regular basis to affect the brain metabolism in a way that a non-exercising population would use with ketones. So this is where you and I have very similar ideas around what we want to do with metabolism, but our populations are different because I'm working within that population and looking at brain metabolism and longevity and body comp through that exercise stress as well as the fueling. And then you're looking at it from your practice and the general pop who doesn't really exercise, right? And so we're looking at two different relations that we want to have the same outcome,

but our methods of getting people there are a little bit different. So I think that... Yeah, that was so really brilliantly said. And, you know, again, to let the listeners in on what you and I talked about ahead of time is, you know, part of the reason we're having this conversation is because we have so many women that both follow us and what they're hearing is you're saying don't fast. And I'm saying do fast. And what I hate about social media is, you know, You need a conversation like this to understand that there's more nuance to this. And what you and I are both in alignment on is when you put yourself in states of hard and you push yourself, you will see your aging brain perform differently.

And that is a beautiful thing over time. And what I also hear from you is, so if I have a woman who's completely sedentary, she's never worked out before. And this is one that I've been really thinking about as this. this exercise conversation has come back online. Then short, I'm a fan of cycling fasting. That was the whole purpose of fast like a girl was like, don't fast the same way all the time. Look at it as tools. There are six different levels of fast that I saw in the research and I saw my clinic and online that worked. But just like you have a dumbbell and you have a sprint and you have the voodoo bands and all

this, they're all just tools that we get to pull out when we need them to push ourselves out of apathy, really, so that we age better than we've been aging before. Yeah. And like you said, the problem with social media is they put everything into one bowl and mix it. And so they're like, oh, you're a woman of a certain age. You need to fast. You need to exercise. You need to do this and that. and they don't mix because that's like taking the whole table, dumping it in and saying, all my tools are together, why am I not fixed? It's like, no, we look at what's on the table, right? We have some menopause hormone therapy over here. We have exercise over here. We have different metabolic control here. And we want to strategically use them when we need to.

I'm so happy we're having this conversation because that's exactly what I've been saying to my people. we can't take the tools. Like this is the way I look at it. If I had a toolbox and I was repairing my room and I took the toolbox into the room, I wouldn't pull the hammer out and the screwdriver and be like, well, the hammer's better than the screwdriver. I wouldn't put those two next to each other.

I would say, okay, there's a time to use the hammer and there's a time to use the screwdriver. I should probably figure out what those times look like. But just the sheer aspect of reels and shorts and the attention span of the public, we have all these tools that we are saying, this is good and this is bad. Right. And yet they're all just tools.

Yeah. I'll get questions from breast cancer patients. And they're like, my oncologist told me I should fast, but I exercise. And I hear from you that I shouldn't fast. I'm like, oh, wait a second. That's another population that's different. We want to use exercise during chemotherapy and radiotherapy as maintenance and keeping things going.

but fasting can be really powerful when we're looking at attenuating some of the cellular mechanisms that happen with cancer. But that's a conversation to have a oncologist, not through social media with me. So again, we have those different properties. Right? And so it's like, let's stick to this lane. I'm generalizing for the healthy woman who exercises. And there are nuances here and there are nuances there. But I can't explain all of that in a 20-second reel.

Yeah. Oh my God. I love you. You can watch my Instagram and Facebook over the next couple of days. I just put out a video where I'm like, I think we need a user's guide on how to navigate health information on social media. And the very first thing I said is you need to understand there's short form content and there's long form content. And if you're going to build your health strategies around short form content, you're really in for suffering because it's just little snippets of information. head on over to somebody's podcast, their YouTube, their book, like listen to the longer conversation so you actually get more context to this information. Now I have this image of like the short reel and a woman who's just off the catch, goes to the gym, tries to deadlift 200 pounds with a voodoo flas band not eating. And then those are all short reels right there. That's what's going to come out of the reels from this podcast. That's exactly what's going to happen.

That was so good. That was so good. So, okay, so then this leads me to the thought, which is, do you eat before you work out? And now, I will tell you, you actually have changed my mind on that, watching the, you know, the reels on you. Because I came from the era in my younger self where do you remember that book called Body for Life? Yes, I do. And the guy gave away, he gave away like a million. million dollars for the people who lose the most weight and his number one strategy is workout on an empty stomach because it forces your body to go fine. And it worked in my 30s. And then when I started to try to lift heavier weights, I was like, oh, this is not working to go in in a fasted state. So can you talk about proper nutrition going into a workout and then what's our recovery meal look like as well. Yeah. So as, you know, when we have our hormones working for us, we can get away with a lot. That's why we look at all these trends and people like, I don't really have an issue.

What are you talking about? But as we get older, our bodies become more sensitive to things. So eating beforehand is really important. I'm not saying a full meal. We look at the research and we see that 30 grams of carbohydrate with 15 to 20 grams of protein before a session that has cardio and strength is optimal because what we're doing is we are now telling the hypothalamus, which is really where our energy systems are, that there's some nutrition coming in so that we can raise our blood sugar. We have enough nutrition coming in so that we can hit intensities. And the hypothalamus doesn't go, oh, shit, we got to start conserving because here's this big stress coming in. We don't have any fuel, so let's start turning the thyroid and everything down. So we need that. And as we get

older becomes really important because, again, the first thing that goes as we get older, exercising facet is lean mass. And we know that it's so incredibly hard to build and maintain lean mass. Not only that, since we are losing our hormone pulses, our estrogen, progester impulses, because we're flatlining, the hypothalamus is in a little bit of a dysfunctional state because it's like, hey, wait, I don't have to create this pulse every day, but I still have that stimulus for it. So you bring food in to also let the hypothalamus work a bit better. So if we are having that little bit of nutrition before we go to the gym, brain is on fire, central nervous system is working. We can get more out of that workout. And then within 30 to 40 minutes afterwards,

we want to have a good hit of protein with a bit of carbohydrate. Protein more important, so after strength training, we need about 40 grams as women who are peripose because we're more what we call anabolic resistant to exercise and food. So we don't get same signaling with that 20 to 25 grams. We need more protein. And the protein is important because not only does allow the muscle to be flooded with leucine, which increases the triggering for building lean mass, but we also have an increased amount of amino acids circulating, which helps with metabolism, helps with the brain to recover, and to really help with that testosterone and growth hormone response

because it needs amino acids to actually function. So when we're looking at it from that whole recovery standpoint, we need some fuel. We want to go in to hypothalamic lifting so we can fuel our workouts properly, and then we need to refuel afterwards to get adaptation going, to help with brain function to keep those signalings going, and then we can move on with the rest of our day. Okay.

So how long before, just so I can recap, like 40 grams of carbohydrates and 15 to 20 grams of protein beforehand. Was that right? 30 grams before 15-ish. Oh, yeah. And, I mean, within the hour, but if you're someone who gets up and goes to the gym at 5.30 in the morning, I don't want you getting up to have food at 4.30. You could have it on your drive with the gym, right? Just as long as you have something in. Yeah. Okay. And then afterwards, the key really is bumping up to this 40 grams of protein. And what did you said, 30 grams of

carbohydrates, which it depends on what you did. If you're just doing strength training, then you could have your 40 grams within that 30 to 40 minutes and then your real meal up to two hours later and that takes care of the carbohydrate aspect. If you, done like a high intensity session and you've done a lot of fuel depleting type work, then you do need to look at getting 40 grams and

probably around 40 to 50 grams of carbohydrate. So it's almost a one-to-one ratio most exercise. And I mean, some people split their breakfast as well. So they'll have some before and then the rest of it after. So it's not increasing total calorie content, which

people get worried about. It's just really manipulating your food intake. Okay. Yeah, I go to the gym and if I have to run errands afterwards, I have a pack of beef sticks that I keep in my car. And I'm like, okay, I'll just eat a bunch of beef sticks to try to get to that protein level, which actually brings me to the next question, which is what do we do with our plant-based friends? Like, where does plant-based? Is there a room for your plant-based? Amazing. Okay, tell us because I am a believer that there's a win in all of this. We have to pull these pieces out and have deeper conversations about them. And I've seen a lot of post-menopausal women that are plant-based that are really healthy. So you're plant-based. Talk about this. Yeah. So, I mean, I've been plant-based since I was way before the trends. Oh, wow. My high school biology teacher took us on a field trip to a pig slaughterhouse. And that kind of did it for me.

And you were done. I was done. And growing up in San Francisco in all the kind of, like I went to high school outside of the hate. So there's lots of hippie influences. Oh, yeah. That's my environmental stuff. So, yeah. All the stuff that's trendy now is kind of why I went when I was 15 with the, but throughout my academic and athletic career, you know, looking at protein, protein intake hasn't really come up until about the past 10 to 15 years.

and we're starting to see more and more of plant-based stuff out. And it's not about mixing amino acids. It's about maximizing your protein intake. So when we're talking about plant-based post-exercase, it's the leucine content that's really important. So we need to get around 3 grams of leucine. And we see that's around 30 to 40 grams of way protein. And you can get that equivalent if you're looking at P-protein isolate

with maybe some hemp, or if you're not someone who's going down the powdered route, then we can look at things like chia seeds and nuts and oats soaked together with goat milk or almond milk. And so there's ways of building that protein intake with plant-based foods that are high of routine. But a lot of times we don't think about things like you can have a whole plate mixed of grains and nuts and seeds and green. green peas and Ed and I and you can get 40 to 60 grams of protein right there. So there's ways

of doing it when you are plant-based, but you kind of have to think outside of the box, but it's becoming much, much easier now with the awareness of all the environmental factors and health factors. So easier now than it was when I was 15, that's for sure. Yeah. So I love this conversation because it's funny, we have a fasting group on Facebook called The Resetter Collaborative. And it is of like over 100,000 people, and they're very active. The thing that shocks me is the carnivores and the plant-based people, they fight with each other all the time. And when I look at food through a hormonal lens, I'm like, okay, fiber is so important. Like, it helps us, right? Yeah. We cannot lose sight of food.

Yeah. And that's in seeds, like so important. So if I'm over here focused on all this meat, where am I making room for enough fiber from a hormonal lens? Super important. But then when you come over and you look at the omnivores, you know, they're like, well, how are you getting all your amino acids? And so you end up in this conflict of interest. And so I actually am putting on another book. I call it a food book in the fall. And it's called it a food book in the fall. And it's eat like a girl and I hired two chefs. I heard a plant-based chef and I heard an omnivore chef. And they're both to have their expertise. And I was like, okay, make me some recipes. And they're incredible recipes and there's room for both. Yes. So I think that fact that you're out

there talking about muscle and fitness and your plant-based is really important to highlight. It's just what I heard from you is you need to be very aware of the complex. you're putting together. Is that what I heard in your statement? Like, get a good variety of these. Absolutely. And it falls into the whole gut microbiome thing and the fiber thing that we see as one of the biggest changing factors in about three to four years before that one point in

time menopause. Like there's a lot of research coming out. Yeah. Because as you're losing hormones, you're losing a lot of the diversity of the gut microbiome. And the way you counter that is with fiber. Right. I see the carnivorous diet. I'm like, oh my gosh, what like the first thing to go is you've got microbiome. Come on, people. Let's be real. Yeah. And you don't want to like into the full nuance of just full plant base and then nothing either, right? Because then you can get into being too full before you get everything. So that's why when I talk about plant base, you have to be very conscious of what you're eating and how it fits together so that you're giving everything that you need, but you don't end up being too.

full before you get what you need. So I've written, like, in some of our groups, like with Haley, Babcock and our Haley Happens Fitness, we get these conversations all the time. So I'm like, okay, here's a day in the life of a vegan. Here's the day in the life of someone who eats meat. Here's a day in someone who eats dairy and eggs. And they all end up being between 150 and 160 grams of protein sitting right in that 2200 to 2,500 calorie.

And people are like, oh my gosh, really? We can do this. Make yes, we can do this. It's just being aware. Yeah. I love that. Yeah. Oh, my God.

I love that. Okay, so just so the plant-based people know, what are some of the lucene-rich plants that if you want to trigger that lucine, get that loosening amount? So interesting, we look at Ednamian green peas. So those two are really high. And people are like, what? It's like, yeah. And we look at spirulina.

So blue and green spirulina, like ounce to ounce is the highest plant-based. protein, almost complete protein that you can get. Plus it has iron. So if you're looking at making a smoothie, okay, well, you know what? If you put in frozen green peas and you put in some chia seeds and you put in some blue spirulina plus some berries, you don't even taste the green peas. And all of a sudden, here's your 40 grams of lucine-rich protein. I love that. It digs a bit. Yeah. I mean, well, the smoothie is great because you can hide anything in it. Like, you know, just put enough enough flavor in it and you can get all the good things and not even taste it. Do you think we got the conversation on soy wrong? I do because it's been taken out of context. Because if we look at

Fido-Westerns and all the good things that happen and the Japanese culture of longevity, it's not just the soy. It's how they live. It's the other things they eat. And then when you bring it over to the Western diet and you start adding soy, it's so ultra-processed that there's lots of side effects. If you're not sensitive to some of the side effects, then, yeah, implement it. But for me, like, I can't do tofu, but I can do tempe because of the fermentation aspect of it. I wouldn't use soy milk because it gives me too many of the negative side effects, but other people don't. So the Western idea of soy is very nuanced as well, because unless you are really following the ethos of the Japanese lifestyle and all the benefits it has,

then you could potentially have issues with soy. When I look at soy as a protein force, I was like it takes 50 grams of soy protein powder to match 20 grams of way, but it only takes 30 grams of pea protein isolate to match that 20 grams of way. And the thing with pea is just on the cusp of having enough leucing, So all you have to do is add maybe another half a tablespoon and then boom, you've hit that losing context. But with it's so much more. So again, I feel like you need to write a book about all of this, but I think it would take too much time.

Yeah, that's right. We'll just have conversation. Yeah, like the new. Yeah, I just say what would the book could be called like the nuance of menopausal nutrition? I'm like, here's all the things that you really, you really need to. No. Okay, I want to go back to the timing for a minute because I brought Sotchen Panda onto my podcast and we talked specifically about when you should eat like that first part of your meal. And so the question, he said you wait an hour. And what you said is within the first half hour.

So just so, because this shows up all the time, because we talk about fasting windows and eating windows within my community. and I'm like, you get to choose where your eating window goes. Like, fasting doesn't mean you skip breakfast. In my opinion, the best thing to do is eat in the light. And when it gets dark out, don't eat. And you sort of said this earlier on, make that middle part of your day you're eating window. So how do you feel about that theory of like matching your eating with light? And I'm sure you're aware that, you know, it's not that far off from eat with.

within the first half hour, but he basically says don't eat within the first hour. So do we have any way of rectifying those two statements? Yeah. So I look at, like I said, physiologists look at cortisol and when they peak. And if you're looking at that cortisol peak, that's a half an hour after you wake up. And for women who are already sympathetically driven and we're looking at lowering cortisol, you want to counter it. And the way you do that is with some protein carbohydrate. So that's why I'm like, you want to eat within that first half an hour to really bring that down. And if you're a coffee drinker, then you definitely want to have some food with it, right? Because if you're drinking coffee within that half an hour, then you're just going to perpetuate the breakdown effects of cortisol.

So when we talk about cortisol and the way that it nuances, especially in peri and postmenopausal women, and that increase in that baseline amount of cortisol, we want to do what we can with our circadian rhythm. and we can do that with food. So if we're looking at food and looking at dropping that cortisol to get less of a response over time, then we want to use food to do that. So that's how I look at. When we're looking at what Sachin's saying, he's looking at, you know, primarily male data and the difference in the sensitivity of cortisol.

And when we look at population research, we see in both men and women, those who have their eating window by 8 a.m. and then they stop by like 4. So 8 to 4 end up with all the health benefits that we see with the fasting research. But for those who delay their fast till noon and then they're eating windows from like noon to 8, they end up with more obesogenic outcomes because they're fighting their circadian rhythm. All the nuances because circadian rhythm isn't just a whole body thing. all your cells have its own circadian rhythm.

So if you're not working with that, then you end up with a whole misstep. So again, I come back to physiology, circadian rhythm. What are we looking, cellular circadian versus total body circadian? And I say that as I'm completely jet lagged from flying across the world, right? You're doing it. You're doing amazing being jet lagged. Yeah, there you are. So could it be as simple as putting some protein powder in your coffee?

if you don't love breakfast? Yeah. Like if you don't gravitate towards food. Yeah. I don't really get hungry until 11 or 12, but I get up at 6. So I'm like, okay, well, I have a cold brew coffee with a scoop of protein powder and some almond milk in there. So I'm getting some carbohydrate, I'm getting some protein.

Brain's like, yeah, there's some fuel coming in. And then I have something to wake me up. Yeah. Yeah. It doesn't have to be a lot. Amazing. But it is enough to get the signaling. going that there's stuff coming in. Yeah. I've done all kinds of weird things in my coffee.

And people always ask me, are you still fasted? And I always say, it depends on how you look at the fasted state and what you're trying to do in the fasted state. So you can put protein in and maybe you turn off autophagy. And that's okay because today's your strengths training day and you want to lean more into mTOR and more into protein. So you put a ton of protein, put tons of protein, put tons a collagen, put some MCT oil in your coffee, you have a little meal there. And you may actually still be in a mild ketogenic state. And that might actually work for you to go lift in the gym. I think, again, I love the idea of N of one. Like, be your own N of one. Take these principles and play with them. Find out what works for you. Then you'll get into a rhythm. The other concept is

the best health habit is the one you can stick to. Exactly. So it's like once you find, your rhythm, now all of a sudden it works. Right. One last thought was creatine. Everybody's talking about creatine. What do you think of that? It's great. It's one of the most studied supplements and it's so important for women.

I mean, we have 70% of the stores that men have anyway. And we do produce some in the liver. But when we look at a lot of the clinical research that comes out from a health standpoint, It's so important for muscle function, gut function, heart function, and brain function. There is a new website, Creatine for Health, that posts all the most recent studies on it. And it's everything from pregnant women all the way through old age and creatine, like, so important to improve all the fast energetics. And in particular, again, it comes back like I'm interested in brain health and it's so important for brain health. Yeah. And you can put it in your coffee.

You can. You definitely can. That's why I brought it up. I mean, there's a lot that can go in your coffee that really works and brings all these principles together. Exactly. Well, this is great. It's been fun. It's been awesome. And I just, yeah, I love geeking out with you. And I think people who have been following both you and I hopefully will now have some answers as to where we agree.

Yeah. Because I, again, I've been watching your stuff. I'm like, we're not saying different things. You're just taking them out of context. We're actually saying very similar things. We just need to put them into a greater conversation and hopefully this did that. Yeah. Yeah. It's been fun. Yeah. Awesome. Yeah. Thank you. So, okay, my last question that I've been asking everybody this season is, what is your definition of health and how do you know, like how do you feel, know that you are actually healthy? Do you have a measurement of that? Oh, I, like full disclosure, I am not in a healthy state this year because I've been so super busy, so I feel very flat and tired all the time.

For me, definition of health is waking up and having that energy to take on a new challenge every day, right and loving that feeling yeah and that can come through so many different avenues it can come through the physicality come through conversations it can come through good sleep a good adventure turning your brain down all of those things and when you have that ultimate feeling of peace and energy when you wake up that's to me is what healthy is but i've been so disjointed with so many different things going on that i'm like i miss that feeling so that's my priority over in hemisphere summer, southern hemisphere winter, is to get everything back in line so I can wake up feeling that way again. Oh my gosh. I am so with you. I hit a real wall about a couple, well, I've been, it's been hitting for a while, but like a month ago, I had this insight for my own self that I've actually given up my health to teach the world how to be healthy, which I hear is a little bit of what you have done as well.

And there's a moment where you have to just say no to everything so that you can take your health back. And I'm on that same journey right now for July and August. And a good portion of September, I'm just powering down and making myself a priority. So I hear you sister. I'm, yeah, I'm really in that same place. Yeah. So we need to teach health. Great? Yeah. Yes. We need a check in. We can hold each other accountable. Sounds good. But yeah, it's hard. It's hard when all the people are asking questions, and you're so passionate about what you do. And you want to help people, but then all of a sudden you're like, wait, my whole battery is drained. I don't even have the energy to have a conversation with my loved ones because I don't want to talk. Yes. Yeah.

Yes. Yes. God, it's like, I feel like, you know what? I've been going through that same thing. And finally, I just said there's no amount of anything you could throw at me that would want to take me away from rebuilding my health at this moment. moment because, you know, if you and I aren't healthy, we can't deliver a message. So I love that. Yeah. So check in. I'll be ping you and you ping me. How's it going? Perfect. I love it. We'll do. Well, thank you. And how do people find you? So if people, you know,

don't know who you are and what you're up to, how come my audience find you? Social handles, Dr. Stacey Sims on Facebook, Instagram, and TikTok. And then our website, This is Dr. Stichick. Good luck on there. I'm not a fan of TikTok, but I've been told we need to be on it. Me neither. Yeah. And then our website, just the Dr. Stacey Sims website,

updates for everything that I'm involved in and doing and all the things in one spot. Yeah, I love it. Well, Stacey, thank you so much. And I really enjoyed this conversation. I feel like now when we get comments of people saying, like, well, Stacey says don't fast, I'm going to send them this episode so that we can get off the 90-second reel and get into a deeper conversation. Yeah.

So thank you. Appreciate you. You too. Thanks so much. Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it. So please leave us a review, share it with your friends, and let me know what your big

takeaway is.