unPAUSED with Dr. Mary Claire Haver - Lift Heavy, Protect Your Brain: Strength, Creatine, and Sauna for Women with Dr. Stacy Sims

Episode Date: July 17, 2026

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with exercise physiologist and nutrition scientist Dr. Stacy Sims, moving from what does not work to what actually does for women in perimenopause and menopause. They cover why strength training, not endless cardio, is one of the most powerful tools women have for protecting muscle, bone, and brain health at midlife, and Dr. Sims walks through exactly how to structure a 20 minute strength session for maximum benefit.The conversation turns to creatine, including why women between 18 and 65 see some of the strongest benefits for brain and heart health, proper dosing, and why timing and mixing matter for bioavailability. Dr. Sims and Dr. Haver also discuss why distance runners can still develop osteoporosis despite years of training, and how chronic under fueling and calcium loss play a role.Guest links:Dr. Stacy SimsDr. Stacy Sims (Facebook)Dr. Stacy Sims (YouTube)Dr. Stacy Sims (Instagram)Stacy T. Sims, PhD (LinkedIn)Dr. Stacy Sims NewsletterDr. Stacy Sims Microlearning CourseBooks“The New Perimenopause,” by Dr. Mary Claire Haver“The New Menopause"⁠ by Dr. Mary Claire Haver“Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond,” by Dr. Stacy Sims“ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life,” by Dr. Stacy Sims

In part one of my conversation with Dr. Stacey Sims, exercise physiologist, nutrition scientist, and author of Next Level and Roar, we challenge some of the biggest assumptions women have been taught about exercise and nutrition. We talked about why fasted workouts, endless cardio, and eating less often work against us. Not because we're doing something wrong, but because so much of the advice that we've inherited was never designed for female physiology. Today, we're taking that conversation one step further. If we know what doesn't work, what should we be doing instead? We dive into the kind of exercise that actually protects our brains and bodies as we age,

including our muscles, our bones, and our metabolism. We talk about why strength, not endless endurance, is one of the most powerful tools women have and exactly how just 20 minutes in the gym can make a meaningful difference. difference. We also tackle wellness trends dominating social media and separate what the evidence actually says from what marketing wants us to believe. We cover creatine, sauna, cold plunges, GLP1 medications, and peptides. If you've wondered where to focus your limited time and energy, this episode will give you a plan grounded in science and designed for women's bodies. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner.

I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life. The views and opinions expressed on Unpaused are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. How do you feel about GLP-1s? Oh, interesting.

It's a time and a place thing again. I love them for what they're doing for the OBC deputim. Not necessarily excited with the uninformed practitioner who is not pushing lifestyle. So we see that loss of lean mass. Because I can always, I think I told you this before, the Wally movie, where they're floating around, right? And he falls off. Yeah. And he can't stand up.

I'm like, that's where we're going. What I don't like, and I did an Instagram rant on this after the Grammys. And for me, it's not like, okay, maybe you have health reasons for using it. But for me, as the mother of a teenage daughter, who's very impressionable. And for so long, we have been really pushing strong, be strong. eat food, skinny is not good. Now all of a sudden you see all these Hollywood people who are backlashing and now super skinny is in. And the mental health damage that is doing to all the young people out there is astronomical because there's now putting women back in that box to be very

small and demure and not take up space. And that's what frustrates me. Because there's no real reason to be microdosing or to get super skinny. We don't know what the long-term outcome are if you don't need it for health. For normal way. Right. For healthy people. Right. And so it's more like the Wild Wild West.

And I feel like you can get GLP1s anywhere. Anywhere. Well, on that topic, you know, GLP1 is an FDA-approved peptide, but what do you feel about the whole peptide movement right now? Are we talking like BP? I'm talking about the gray market. Oh, yeah. Not Samoralin and not things that are FDA-approved.

I mean, for our listeners, insulin is a peptide. Like, peptides are just chains of amino acids that bind to receptors and do things in the body. And but I'm talking about the gray market, you know. And some of them are going to be fast-tracked, I think, under this administration, good or bad. But how do you feel, is this helping? Is this hurting? Do you have an opinion? Are they in New Zealand?

They are in New Zealand. They're not legal, though. You have to, like, I'm going to say anyway. Black market. Circa navigate to order from Australia and say it's for research only. You cannot get someone to compound it for you in New Zealand. And they're very tight on that because they're like, well, there's no real demonstrative evidence to show that they work, and it's banned by WADA. So we're not

letting you have it. Some of our professional athletes came back in with it, and they got arrested and put on probation because they were bringing in a legal substance end. So it's not legal in New Zealand, but very aware of it, because I have a lot of injured professional athletes are like, maybe I should get on these. These are going to help. Even when I tore my meniscus and hamstring, I was considering it, and I was like, oh, maybe I'll give it a go. So I have tried them and didn't see much. What worries me is, now that we are in this mass longevity market and everyone's clamoring to be in there

that they're overselling. They're overselling results and there's not science to back it up. We see stuff in rodent studies that may or may not be promising. We don't know yet. We don't have any real human trials. If you want to experiment on yourself, maybe, but probably not

because we don't have enough evidence. And that's where I see every time you go open up something with longevity and precision medicine is IV therapy, peptide therapy, all this stuff. I went to a longevity conference for women. And it was in New York and very excited to go and learn because, you know, I'm now treating patients in those last few decades of life. And what is the science saying? What's out there? And it was basically a menopause conference and people trying to sell gray market peptides.

Like there was no longevity science, like at least as far as what I was hoping for. And I'm like, Is this what women's health in our last three decades has become? Yeah. You know. And it's not just the peptides either. Now people are pushing rapamycin and methylene blue and mTOR blockers and all these kinds of things. It's like, where's the evidence and why do we need it? Let's first take care of all the basics here.

Yeah. And then let's go to a traditional route. Maybe we're going more holistic. We're doing acupuncture and dry needling and we're looking at how are we improving tendon health. Let's listen to Keith Barr where he's talking about how do we improve tendon health. for doing isometric work from the researcher who's doing the research. But no, and this is a case where marketing is louder than science. Now, let's talk about what works.

Creatine? Creatine works. Why? Why? Should all women be taking creatine? Yes. And I read an article. Boy, are you sure?

You said yes, so fast. So fast. I know. I'm going to say because I take creatine, full disclosure. Me too. Because I read an article this morning that just came across, and it was a systematic review that was looking at the benefits. of creatine and the people that benefit the most for using creatine are women specifically

ages 18 to 65. And this is not for athletic performance. It's for brain and heart health. And I'm like, finally, the research is catching up. I know Abby's trying. I know. Abby's doing such a great job on that. Yeah. So what is creatine? How does it work? How much should we take? Explain it to the listener. And it's cheap. I mean, it is very inexpensive when you get a really good one, which you have. I have. Yeah. So we look at creatine. As we were talking about glycolytics and glycolytic fibers and fast twitch, the very first energetic that happens is the breakdown of ATP to CP. So that's adininin trifosate and creatine phosphate. Creatine is part of that. So when you break it down, we need more creatine available to keep doing the ATP CP and recreating it so that we have

that fast energetics. Most people are not fully saturated. Our liver produces one to three grams a day, not a whole lot for all of our fast energetics. People aren't necessarily eating all of the creatine containing foods. And we see that women, by the nature of the way they eat and the fact that we don't have as much muscle mass as men typically, then we don't have as much creatine available. So if we are slowly increasing creatine by supplementing, so maybe three to five grams a day, very low dose, over the course of two to three weeks, we fully set. all of our tissues. So what does that mean? That means that we have increased all the stores of our creatine. So our brain works better. We see that there have been some RTCs that look at creatine and pressurface. Yes. Thank you. That look at creatine and depression and it helps people get out of a

significant depressive state a lot faster. They're looking at CBT, which is cognitive behavior therapy with creatine versus a serotonin re-uptake inhibitor. And the CBT and creatine works better. Wow. So there's lots of efficacy for using creatine, and the research just keeps flowing. And it's really exciting to see, you know, it affects some fatigue and jet lag. Like I am in the jet lag stage, so I'm dosing 20 grams in. And for those of you don't know, Dr. Sims lives in New Zealand and flew here to San Francisco this week. So she is in the jet lag base. So yeah, we're five hours behind, but a day ahead. But it's okay. So when we look, and I use this in my shift workers, too. It's like we want to, help the brain eliminate that fatigue and the feeling that it is so fatigued, it goes through a lot of glucose and it alters our carbohydrate metabolism, which is one of the problems that we see with shift work. So if we're looking at dosing creatine, specifically 0.38 grams per kilogram, which math. I know. Just tell me a number. So it's about 20 grams.

Woof. Yeah. And we take it over the course of the day. So it's the old bodybuilding idea of this for shipworkers. Yeah. five grams, four times a day, but also with jet lag because it increases brain energetics. It's fuel for the brain. So it reduces the fatigue. Cognition comes up. Reaction time is better. It helps with overall metabolism because now the brain is not being, it doesn't have the perception of being overly fatigued. So it is really incredible for brain and brain metabolism, brain health. How much? So if you're not a shift worker, you're just, you know, Jane and Ohio on the couch right now. How much does she be taking? Three to five grams a day. When?

Does it matter? Does it matter? We do know that if you mix it in, then it loses its bioavailability within three hours. So you don't. Mix in with food or mix in water? Or whatever liquid it is. Once you mix it in with something liquid, then it loses its bioavailability within three, sometimes five hours, depending on. So you need to drink it within three to five hours is what you're saying.

Exactly. Okay. Good to know. So don't mix it in the night before and then drink it the morning. The next day. So I walk on a treadmill in my garage. I cannot see the outside because I live in Galveston, Texas, and it's usually 95 degrees or higher with 100% humidity. So it makes it doable.

But what is the difference between walking outside versus walking on a treadmill? From an energetic standpoint, not much, but from a mental health standpoint, a significant difference. We see so much research now coming about green space in nature and how beneficial it is just to take a walk in nature for mental health. We see it releases more of the dopamine and we have more of a relaxation. We're able to get into more parasympathetic responses, which is great for sleep. And a lot of times when we are out in green space and just be in a park and there are other people around, we don't feel isolated. And isolation is another really big killer as we get older. So it's just being out in nature connects you to the environment, to the community, as well as being out in nature, really does

improve mental health status. So along the mental health line, we see, in my end, a doubling of mental health, depression, anxiety, rage, new things like misophonia and just a lot of disruption of your normal day-to-day ability to cope with things. Resilience, I call it. From your area of research now, of course, menopause to hormone therapy, we're learning leaps and bounds in perimenopause, how beneficial it can be for mental health specifically. But what are you seeing in your research around exercise and nutrition that we're missing? I get this question quite a bit because one of the newsletters we just put out was about brain health. And I didn't want to get into the whole MHT conversation, follow Lisa's work quite closely.

And we know there still isn't enough definitive research to say yay or nay, right? Yeah. But when we look at exercise and nutrition, we know there's definitive research. that will help change systems. So when I'm talking to people, like menopause hormone therapy, we see there's so many benefits, especially in pari menopause. But it's also in addition to the lifestyle.

And what is the lifestyle? We see women who are so focused from our generation on volume. Volume, volume, volume, volume. I want to be an ultra runner. I want to do this, this, this, this, marathons, Iron Man. It's like, why?

Why are you driving for endurance? Oh, because I have extra time or you really disseminate it down and it comes down to aesthetics. And it's like, no, we want quality. Like, if you want to do Iron Man, great. But let's look at your training. Because the long, slow volume of stuff is not going to be beneficial for body, brain, bone, mass, any of that. Talk about the rates of osteoporosis with distance runners.

I know. Funny. It's really shocking. I know. I shouldn't say funny as in ha-ha, funny in the irony. The irony of it. Yeah. Because people think that running is so protected. But it's not.

In many ways. Right. But not for bone. Not for bone. I dug into it a little bit because this happened to a very good friend who wants to do more ultra stuff. And she's got osteoporosis and not, she's not 50. From what I could find, there's probably chronic underfueling because you just can't keep up with calories when you're moving that much constantly. There's not enough time.

Right. You know. Exactly. So maybe that's one of the reasons. Yeah. And the calcium loss that you have with the impact of running. We saw this a lot in our younger. runners who were just coming out of Red S, relative energy deficiency in sport, low energy

availability, that taking tons before running helped with the calcium loss because then it was circulating. So there are things that you could do, but for the most part, people don't realize it because they've been told, oh, you know, running is protective, but it's not. It's not multidirectional. It's not enough to invoke a challenge to the bone that's going to create the signal to make it stronger and more resilient. And again, it's fueling factor. And so when I'm working with people who are doing long distance, it's like, we need to pull you right back. I know that this is your end game here. But if we want to get you there, we have to change up your training. We have to make sure you're fueling. We want you to be lifting.

We want to pepper in high intensity. Yes, volume is important because you're doing endurance. I've had so many women who have pee-beed in their endurance events have, there's a race down in New Zealand called Godzone. So it's a five-day multi-day race out. in the woods, multi-sport, all the things. And this woman's like, I've just been rucking with a heavy backpack. I've been lifting. I've been doing some intensity. I was worried because he didn't have a lot of time on my feet and volume, but we pee-beed by day. And I was like, fantastic. Amazing. So there's so many things that come into play when you start talking to people about what's your in game and how are we going to get there. But we have to look at the signaling that your body

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Receive an exclusive 25% off your first order with code Podcast 25. Visit musli.com or download the Musley app to start your menopause treatment plan today. Are women more fatigue resistant than men? They are. Why? Yeah. So this is really interesting research that comes out from, like, in utero. We know that when a mother who is pregnant with an X, Y, fetus, who's under a lot of stress.

That would be a boy. Right. I'm trying to be PC. Versus a woman who is under a lot of environmental and mental and physical stress as pregnant with a girl. That she'll most likely miscarry with an X, Y. So we see this. I did not know those. Oh, you didn't.

I'm an obstetrician and no one ever told me this. I'm going to send you the research. It's really cool. And we see that there is an epigenetic change that's happening within the XX fetus because of the dosing of the X chromosome that increases the resilience to stress. So when we take the baby out and the baby is born and we have an XX woman, the resilience to stress, is greater than the resilience of X, Y. So when we start looking at fatigue and fatigue resistance, yes, from a physiological and biological,

we can look at things like pain tolerance. We can look at muscle fiber factors. But it really comes down to the epigenetic change that we have with stress that makes women more fatigue resistant and more resilient. So I found that fascinating. That is amazing. What is the difference, you know, you touched on this?

But for our listeners, between oxidative muscle fibers and glycolycolic and, like, how, you know, a lot of women don't understand the difference here. Right. And I think it's because people just think that the body is more of an algorithm, right? So if we're looking at the way the body fuels itself, we think about glycolytic fibers. And this is our very fast energetics. This is anything that is from zero to 30 seconds, sometimes up to two minutes. And the body hasn't quite gotten up to speed enough to use oxygen. So when we're looking at the fuel for it, it's primary glucose, it's ATP, which is adinicin triphosphate, and you break it and you have a dynic. The cramp cycle.

Right. The cramp cycle, right? This is why we need creatine to boost. I'll talk about creatine later. Yeah. And so that's our glycolytic. It's not using oxygen. It's primarily using glucose.

And we're looking at breaking down glucose. This is also how we produce lactate when we're in high. high intensity. Oxidative is when we're at a lower intensity, we've had some time, and it might be four minutes onwards, and oxygen can come into play. So oxygen is really important when we talk about the Krebs cycle, right, for using fat metabolism and burning free fatty acids to use that as a fuel. So there isn't this automatic switch because they work in conjunction, right?

And so when we talk about glycolytic fast switch, women have less of that, and we need to work on that. We talk about oxidative women or by the nature of XX have a lot of that and are really good at that. But for men, they have a lot of glycolytic and not a lot of oxidative. So when we talk about the bro data and the male data, it's really why it's so hard to apply to women. Exactly. Exactly. What is power-based training? Power-based training, there's two aspects. When we're thinking about in the gym, power-based training, this is lifting under speed and working tempo. So you might go in your squat really one two three four pause and then explode out so that's power base ply metrics jump training anything that's fast explosive type stuff why is that important that's all

fast twitch and it's also really good for maintaining proprioception neural connections good metabolism we think med ball slams all that kind of stuff is just really accelerate and really pass powerful and we need that because not only are we seeing that having power and strength is a good indicator of how you're going to live your later years. But it's also really beneficial for our brain metabolism, for signaling to get rid of visceral fat, to allow us to not fall, to improve our balance and per pre-bore reception. So I go down to the gym and I have 20 minutes. Yep. What should I do? Well, I know that you have a history of string training. Yeah, do, right? And high-intensity work. So if I were to take you for 20 minutes,

and you're in your home gym, I would warm up five minutes with mobilization because this is part of the conversation. It's so bad at that, Stacey. I just want to get right to it. I know, but it's so important. We have to be able to move well. And if we neglect mobilization,

then we don't move so well. So what is mobilization? So this isn't stretching. This is like using resistance bands to what we call voodoo floss, the hamstring, so you have it attached to the rig so you can bend over and pull and distract the hip capsule, get into the hamstring. So it's not stretching, but it's opening up everything for a full range of motion.

You start to have a little bit of shoulder impingement. You can use the resistance band, pull back, get in, and pull the shoulder back. It helps prevent shoulder impingement, all sorts of things. So then if we say, okay, now we have 15 minutes left, I want you to do one compound movement. So are we working on our squats today? Then our mobilization is going to get in that full range of motion, opening up our hips or knees or ankles. And then we're going to build up our squats. And then maybe I'm going to have you do some pause squats.

So you're going to tempo down, two, three, four, paws at the bottom explode out. And we might, depending on where you are in your program, maybe you're doing four sets of that, maybe you're doing five sets of that on a heavier load. But we're trying to move with intent and some explosiveness. And then I'm going to have you finish with a little bit more mobilization because you've done some really hard explosive work in your squat. If we're not doing the explosive work and we're just, doing our typical squats.

Then I'd have you finish with some battle rope work or maybe some sprints on your treadmill just for a little bit more high intensity, done and dusted in 20 minutes. Wow. Okay. Most women, when I looked at the research, have never lifted a weight.

There's been really fun memes going around about women being the first in their generation to ever work on strength training, and I'm very certain. My mother jogged and jogged so much. She's had three bladder lifts and eight children, so that was definitely a part of it. But like she swam a little bit, but they had one of those machines that had the band that went around her ways.

Oh, yeah. And would shake. And then my dad would get on it and, like, my sister and I would sit there and watch them, like, shake their bellies. Yeah, yeah. And, like, that was their gym. Yeah. So. The vibration.

Yeah. Similar. My parents both jogged. My dad was push up stuff because of the, you know, the Army, you know, had to do calisthenics. We ended up with the Nordic track, and I think we had one of the Chuck Norris, you know, like, wrote police systems at some point. And then when I was a teenager, I found the firm, aerobic workouts with weights. Oh, yeah. Remember the firm? Yeah. So I think I was the first one. And then I got into going to the gym with my friend at 16

because her brother was a bodybuilder and we had to go meet him at the gym. So instead of hanging out, and we're like, okay, we're going to lift. And then I introduced my mom to the firm aerobic workout. with weights. She started doing small weights. And she's been doing small handheld weights, but trying to get her to build that weight stuff up is hard. Because it's not in, yeah, because it's not in the culture. How do you know, you know, for an absolute beginner, if she's like listening to this podcast, where does she start? Where does she start? I tell people, if you're just starting your journey, that you want to have a wellness meeting with yourself 10 minutes, three times a week. We don't break wellness meetings. Well, we don't break meetings. And we definitely don't break

wellness meetings with ourselves. If at first it's just the consistency of those 10 minutes, three times a week, and you're going outside with your cup of coffee and having time in nature to improve mental health, fantastic. But over the course of maybe two weeks, then I want you to start adding in some body weight stuff. That could be doing some air squats, could be doing some single-leg lunges, maybe you're doing balance on one leg, tree pose, push-ups against the wall, anything that's going to be resistance push pull for you as you start your journey. And you're going to find what you really like. And if you're like, ah, I really enjoy working out at home and I want to be outside,

then maybe you get a nap. Maybe you get into something like Peevalve. Maybe you get into like Haley Happens stuff. Like there are lots of different really good programs that you can do at home. But ideally you get a friend and you meet your friend. and you have 20 minutes together where you can catch up, but you're also working out. Isn't there mental health benefits? I mean, working out with a friend is better on multiple levels.

Absolutely. Absolutely. I do miss that. You know, I used to go to classes with my girlfriends, and there was a lot of dancing and fun involved and some weights and stuff, but it wasn't enough. And I got out of the habit, and the classes got really, really busy, and it was hard to find a spot. And so, but I do miss working out with friends, you know, just for that social aspect. Exactly.

And sometimes you can push yourself a little bit more when you're with your friends. Yeah. So that's how I tell women to start. And then if you're already on a journey and you have a consistent like cardiovascular program, let's try to take out one or two of those days and make it a circuit program.

So you already have it in your calendar what you're doing and you get up and maybe you walk every day. But let's go. We walk one day. The next day we're going to go on your walking route, but we're going to pepper it up with some body weight stuff so that we can get some circuit work in there. Just start changing it a little bit because the body really likes to adapt to change and that's how we get improvements. I've heard you talk about this and I think

our audience will find it interesting about core work and sit-ups. Yeah. Do we need to do set-ups? No, you don't need to do sit-ups. Thank God. Why? I like to tell people, sit-ups is like the lid on the box and sometimes you get presents and there's no lid and that's great and that's kind of what we want because all the stuff in the box is what you're after. So core is your spine and it's your abs and it's your posture. And when people think about core work, they're like, oh, I have to dedicate X amount of minutes to core. And it's not really that functional. If we're doing compound movements, like our deadlifts, our squats, our push press, our bench press, we end up using our core stabilization. And you'll find over the time of doing that that your core becomes very strong and you're like,

Who needs sit-ups? Because the idea of doing sit-ups is you're just working the very top part, and you're not actually invoking any change. You might build some more muscle there, and some people are like, yeah, I lose weight rapidly in my midsection, so now I have six-pack abs. But functionally, where in life do you do this, right? True, when you get out of bed. Right, exactly, when you get out of bed. So when we look at what is core, we want to look at stabilize our obliques. our spine, our lower abs so that we're not hinging all the time. So we sit up right, we open up

our chest, and you want to be like the bamboo straw, not the bendy straw. So in general, is cardio good or bad for women? Well, it depends. Right? It depends on what you're wanting. So cardio, yes, good, but extensive and not planned, not so much. Okay. So if we're in our younger years, we can get away with anything, right? We know this. This is great. As we get older, we want to optimize. So if we're looking at optimizing our health, then, yes, we need to pepper in some high-intensity work. If you're looking for cardiovascular benefits only, then you can also get that from strength training. If I have someone who's like, I want cardiovascular benefits, and I am very short on time, and I don't really like to run, I don't want to walk, I hate the bike, it's like, okay, well, let's do strength training. Why?

Because when we're looking at strength training and the capillization or how your muscles are getting blood, you are improving capillarization as you're building your muscles. You're also having different blood flow diversion when you're strength training, and all that increases the way that the heart is working, which improves cardiovascular health. And we also see that people who are doing lots and lots and lots and lots and lots of cardio, they have remodeling of their heart. And for women, it's different than men. And so I've had a lot of women recently who have been told by their doctors that they have a heart erythmia, and they have to stop exercising. And these are endurance athletes. And they're like, what's going on?

It's like, okay, well, let's look at the heart arrhythmia. And when you look, you're like, it's not an arrhythmia. This is an indication that your heart has remodeled as an endurance athlete as a female endurance athlete. Because women who do lifelong endurance exercise, so we see that from our generation, our chambers get bigger and the muscle around the chambers get stronger. But we don't have a risk for things like VT or a ventricular tachycardia. For men who are lifelong exercises, their heart remodels where the muscle gets super strong and the chamber doesn't get bigger. So they end up with dual innervation and they end up with these arrhythmias and VTAC and stuff.

But because the woman's heart hasn't remodeled like a man's heart, then she's deemed as the anomaly and the arrhythmia. So when we're looking at cardio, we have to say, okay, what's the purpose? What are we doing? A lot of people, myself included, is like it's mental health. I need to get outside. I want to ride my bike. I want to go for a run. I want to do all of these things that are more cardio-intensive because it's for me mental health. Great. Do it. But if you're looking for aesthetic outcomes or you're looking for cardiovascular outcomes, you're looking for brain health, there are different things that we can do. Cardio is part of it, but it's not the be all-end-all. Okay. Let's move on to some of the esoteric things. What is cold plunging? I see it trending everywhere on social media. And I hate to be cold. Like there's nothing. Nothing worse in my mind than sitting in an ice bath. So I've never done it.

Okay, good. I think Wim Hof actually hit back on me about it, but whatever. So we look at ice bath or cold plunging. It's the idea of getting into very cold water, zero to four degrees Celsius, so, you know, around that 32 to 40 degree Fahrenheit mark. And you're in there for 30 seconds to a minute and invokes a very strong response. When we look at the mail data, that strong response is an endocrine shift. So we have better endocrine health.

We have, meaning better hormone health. Metabolic health. Yeah, metabolic health. Get a better parasympathetic in that focus. But for women, it's such a strong sympathetic drive. It goes the opposite. So we're looking at that really cold water and cold plunge. For women, it's not ideal.

Our body does not respond the same. We look at maybe 55 degrees Fahrenheit, which is around that 14 degree mark Celsius. Women will start to get the same benefit. They don't need ice water to get the same benefit because we have different sex differences in thermoregulation. But those responses are not as robust as we see in male data. So the cold plunge thing, I'm like, what are we doing? Oh, it's male-centric again, and we're pushing. And it's a billion-dollar industry now.

All right. Let's talk about saunas. Saunas are great. Go to the other end. Go to the other end. So saunas are great for men and women. Again, why? We're looking at an environmental heat stress. and when we have any kind of stress on the body,

we have responses that improve health and health outcomes. So one of the factors that happens with hot or heat exposure, particularly the dry sauna, not the infrared sauna, is we have skin responses first. Skin gets heated up. We have vasodilation. Skin comes to the service, which means that our muscles and our heart and everything is like,

oh, wait, I need more blood. So one of the factors are heart rate increases, but that's a signal to improve all of our. blood volume. So we end up producing more red cells. We end up producing more plasma volume. We end up with better blood pressure. We end up with better endocrine responses, metabolic health. We see that you can use it 10 minutes after training to extend the training stress. We've had a very short session and you're like, I need to extend that for cardiovascular or whatever reasons. Then you can get in a son and extend it. And for women, it's a stronger stress because throughout our reproductive life,

our menstrual cycle in the second half, we have an increase in our core temperature because of progesterine. So our body's used to thermoregulatory shifts on a monthly basis. So if we go into the heat, we can sit there for a longer period of time. How long do you need to see benefit?

Yeah. So when we're looking for health benefits could be 10 minutes, three or four times a week at the most. If you're looking for adaptive benefits, where we're looking to go someplace hot and be okay, then we're looking at nine days in a row, 30 minutes in it. And a lot of people are like, I just want health benefits. Great. Pepper it up.

If you only hit it once a week, great. That's still a heat stress that your body's going to respond to. So I was gifted with a sauna blanket. It's like a giant sleeping bag that gets really, really hot inside. And I think it has infrared too. Am I fooling myself? Yes. Yes. Because your head is not in it. My head is not in it. Or my arms because I read. Yeah. Nope. But there is also benefit for being in a spa up to your neck. It's heat exposure and it takes longer to get the benefits because you have the circulation of water, which is not the same as being in a very hot environment and your head is not getting heated. But heat exposure is beneficial for all aspects of health for both men and women. And the responses for women are more robust than they are men. So cold,

men have more robust responses. Heat, women have more robust responses. Is there any low-cost version of a sauna that, you know, I mean, I've seen thousands of dollars for these boxes that people can go sit in at their house. Yeah. So low costs. I mean, can you just fill up your tub with hot water and soak in there? You could. Similar to like a hot tub. There are, I don't know, maybe not in Texas, but I'm not sure. There's lots of, yeah, go outside. There's also pop-up sonnas where they're like portable saunas that will go and they'll say, hey, you come for a sauna so you can look in your neighborhood and say, oh, well, is there a pop-up sauna to go to? That's a growing industry. For the cheap and dirty, you can always take the old-fashioned way that we used to acclomatize,

and that is put on lots and lots and lots of clothes and a hot garage and get on a treadmill or a bike and not have a fan until you start really overheating. And then sweat it out. Yeah, okay. Not a great way, but if you're really desperate, you can. Okay, we've covered a lot. We have. Breakfast before movement, protein coffee, meal timing, stray, sprint intervals, sauna, creatine, cold plunges. So if a woman can only do two things, so what's your top two things or three things

for her to take away from this conversation? Circadian rhythm alignment. Because then that helps with everything. Everything. So that's the thing. So that means don't fast in the morning. Right. Eat as soon as you wake up. And what is it? Eat like a princess for breakfast, a queen at lunch.

And then is it backwards? Yeah. As a queen, then it It's eat as a princess and then eat as a pauper. Okay. So like front load your meals. Front load your meals. For circadian. I never thought about timing of meals with circadian rhythm.

I knew about light, right? We learned that in medical school, but never around. And then get exposure to light as soon as the sun is up. You know? When you wake up, get that light. Yeah. Open your curtain to look outside. If you have a wall in your window and this darkness, turn on some bright lights,

stare at them. Okay. So that's circadian rhythm. What else? Movement. So if you haven't started any kind of movement journey, start. You have your 10-minute wellness meeting three times a week. Be consistent.

If you already have a movement journey and you're looking to increase the ability for your body to respond, we mix it up through intensity, either cardiovascular intensity or strength training intensity. Ideally, I want every woman to lean in the strength training. And I grew up as an endurance athlete as cross-country runner. I was on the rowing team. I've done Iron Man. I raced bikes professionally. I did Xtera.

All of the things as an ultra runner. But now I'm like strength training. We have to do it. And you learn to love it. Yeah. And then third thing. I would say it's the 80-20 rule, right? Because I sometimes am an absolutist and I don't want people to think that there are rules because life can be fun, should be fun.

So 80% of the time you're thinking about what am I doing now that's going to help improve my health so that when I'm 80, I can be independent. And then the other 20% is life. It's like going on vacation, great, enjoy it. Don't berate yourself. Don't have the guilt because women walk around with guilt and we berate ourselves all the time. Leave it. Okay. 20%. And if you're really trying to budge a needle, maybe it's a 90-10 rule. Okay. But don't neglect the fun part of life. What snacks do you keep in your bag? What do you travel with? I travel with border friendly foods. Oh. So I have dried fruit, and then I travel with dried edinami.

So I love those. Because that's border friendly. Protein powder, creatine, those are always the go to oatmeal. So sometimes that gets passed, but sometimes it gets confiscated, which is kind of strange. And then as soon as I land anywhere, I have pre-ordered groceries to be delivered to my hotel so that I have food. That is so smart. I haven't done that yet. So why should we avoid the ultra-processed foods?

Like the protein, this one cracks me at protein pop-tarts. I know. Funny, huh? Because it isn't really what your body means. Like we don't know all the ultra-processed stuff, how it changes the gut microbiome, increases the obesity genic phyla, all the extra additives. All the stuff that our body doesn't know what to do with and not meant to have. and the marketing on protein pop tarts,

we have protein potato chips. Protein popcorn. Just because it has protein on it does not mean that it is good for you. So if movement is the foundation of empowerment, stress, resilience, brain health, mental health, and really longevity. So, and she doesn't know where to start, what would you say to her?

First is not finding TV parking. And people are like, what am I, you know, in all the sitcoms from the 90s and early 2000s, whenever somebody had to go somewhere, they'd find parking right in front of the door. Don't find TV parking. It's like, let's incidentally move more throughout the day because that's going to keep our bodies active and it's going to eventually, like, it's going to set yourself up so that you're hungry during the day and you sleep well.

Don't get overwhelmed with all the things that you're supposed to do. Just pick one thing. And I often try to understand people's personalities, what drives you. So if you are really motivated by nutrition change, well, let's implement small nutrition changes over the course of three weeks. And each one is purpose-driven. So maybe we're looking at working with circadian rhythm. What are we going to plan to have first thing when we get up and what are we planning for breakfast? So those little things start to become a habit.

Then once we have established that, we can look at physical activity. What are we doing for physical activity? What do you feel like doing? What do you feel like your body needs? Do you need to be outside? and we want to go for a walk, great, let's start there. Or maybe you're like, it's really hot or southern hemisphere, it's snowing. Okay, well, let's look what we can do inside.

Let's find some space inside that is not where the kids are or the family is, and we can do a 10-minute circuit. So each step layers on to the other, because we find that when people start eating better, they start to feel better or they want to move. Or if they're moving more and they're feeling better, then they want the nutrition to match to help with that feeling. And then we also can't forget the mindfulness and the community.

And this is where I'm like, okay, mindfulness, part of that is the, you know, I'm consciously aware that I'm making this meeting with myself for movement and how am I going to put in some breathwork to help with the exercise. And then that becomes more natural. And we become more aware of our surroundings and we become more empathetic and we see how empathy has dropped off the face of the planet recently. So the more that we are in tuned and we have. have that mindfulness and more empathetic that we have. And it all comes with the package. And then

avoiding the isolation. And this is where I'm always like out in nature, a park, you see people, maybe grab a friend, get a workout buddy. Maybe it's your partner. I have a rule in my house. I don't train with my husband. Because it can often end in not so great things. It's a problem in my house. Yeah. The competitive athlete in both of us. Yeah. So just start somewhere. Okay. Well, Dr. Stacey Sims, you have given our listeners so much to think about. Thank you so much for coming on on Paused. It was amazing having you here. Oh, thanks for having me. It's super fun. Okay. You can watch full episodes of this podcast on YouTube at Dr. Mary Claire. Also, you can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and

navigating midlife at the pause.com. Unpaused is presented by Odyssey in conjunction with pod people.