WHOOP Podcast - Dr. Hazel Wallace on Food, Fuel, and the Female Factor

Episode Date: November 16, 2022

This week Kristen Holmes, VP of Performance Science at WHOOP, is joined by author and nutritionist Dr. Hazel Wallace for a conversation around a holistic approach to nutrition and women’s health. The two discuss Dr. Wallace’s latest book The Female Factor (1:43), nutrition’s impact on health (4:09), the biggest misconception around nutrition (6:42), how to start creating better nutritional habits (8:44), the potential risks of disease and poor nutrition habits (10:59), how to manage cholesterol through nutrition and what it means for the body (13:28), metabolism during sleep and eating during shift work (17:31), eating meals late in the evening before bed (23:21), the link between food and mood (25:03), the nutritional differences between men and women (29:28), the act of sequencing foods (33:40), the difference between insulin sensitivity and insulin resistance (34:38), explaining what PCOS is (36:55), intermittent fasting and time-restricted feeding for women (41:14), understanding the body during the menstrual cycle (45:33), training and strain during the menstrual cycle (47:04), and the difference between probiotics and prebiotics (48:53).Resources:The Food MedicThe Female FactorSupport the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

What's up, folks? Welcome back to the WOOP podcast, where we sit down with top athletes, researchers, scientists, and more to learn what the best in the world are doing, to perform at their peak and what you can do to unlock your own best performance. I'm your host, Will Ahmed, founder and CEO of Woop, and we are on a mission to unlock human performance. On this week's episode, our VP of Performance Science, Kristen Holmes, is joined by Dr. Hazel Wallace, the founder of FoodMedic, registered nutritionist, bestselling author, and recently appointed member of the Woop Scientific Advisory Council. We've been getting a ton of questions from our listeners about nutrition and dietary habits to improve performance. So Dr. Wallace is here with her unique background as someone who thinks more holistically about how nutrition plays a role in health. This is the perfect guest to come on the show and help answer some of your nutrition questions.

Dr. Wallace and Kristen discuss why nutrition plays such a critical role in overall health, why nutrition is overlooked in certain medical school curriculums, exercise and nutritional health as it relates to disease prevention, how food can affect a person's mood, tips on how to maintain better nutritional habits, and how women should think about Nutrition. A reminder, of course, you can email us at podcast at whoop.com or call us at 508 443-4952, and we will answer your questions on a future episode. All right, without further ado, here are Dr. Wallace and Kristen Holmes. Dr. Wallace, it's so wonderful to have you back. How are you? I'm so well. It's so nice to be back. I loved our last conversation, so I'm really excited for

today's conversation. So much has transpired since last January. You published a book, The Female Factor. Tell me a little bit about just that process of writing a book. Yeah, absolutely. I think I remember last time we spoke, I was teasing the fact the book was coming out and it hadn't actually been announced or maybe it was on the way to the shelves, but yes, a lot has happened since then. So this is my third book. My first two were largely related to nutrition, which is how most people know me. online in the kind of wellness space is with a nutrition hat on. But I am also a doctor and a woman and I've doctored to many women. And I realized over the last couple of years that a lot of

the medical research we have is based on a male body. And so a lot of the guidelines we have and kind of treatment outcomes and diagnoses are catered for men or a male body and not for women. As we know, women are not small men. To quote Dr. Stacey Sims, he are very different. like not just from a reproductive point of view, but our differences in sex hormones and our physiology and our anatomy mean that we have different needs when it comes to nutrition, when it comes to movement,

when it comes to sleep, stress, and kind of our different experiences of diseases. And so I decided to write this book to really outline those differences, but make it as practical as possible. So it's centered around the pillars of lifestyle. So a chapter on movement, a chapter on nutrition,

a chapter on mood. and a chapter on sleep and what that means for a woman across the life span. And so it's a bumper book, but it's probably the kind of piece of work I'm most proud of today. It sounds like kind of the Bible for female physiology and health. Thank you for putting that out into the world. I think that is just incredible for women to have a resource of that kind, especially where to your point, it's so limited in terms of really understanding the unique features of female physiology and what that means for our lifestyle.

and just how to guide behaviors generally. So we're going to dig into nutrition. Really excited to be able to tap your knowledge here. You have this incredibly holistic viewpoint around nutrition. So maybe just start very, you know, kind of broadly, you know, how does nutrition, you know, what we're putting into our body just impact our health in general? Yeah. I think nutrition is something that we've really undervalued in medicine for many years in

terms of its role in health and disease. but it's one of the most core fundamental things when it comes to the kind of health of a human in terms of its role in malnutrition and obesity, its role in health and disease, in performance, in lifespan and longevity. I think when it comes to health, we often think about food or something that is something we should restrict or we need to cut out in order to be our healthiest selves. And the framework that I like to work through is more about like thinking about nutrition as how it can fuel you for performance for your daily life, not just for high performing athletes, but help us pull out our best. And having more of a mindset of nutrition by addition versus nutrition for restriction and that kind of approach. Because, you know, nutrition and energy availability and excess energy can obviously lead to issues like obesity.

and metabolic disease, but also we've got this kind of double-edged sword where oftentimes there's two things going on, where there's a worldwide pandemic of obesity, but at the same time, we've got a worldwide pandemic of micronutrient deficiencies. And so things like amemia, vitamin D deficiency, which all have knock-on effects to our health. And so I think it's a conversation that's definitely getting a lot more airtime. I know that within the UK now, medical schools now have nutrition kind of starting to be embedded into the curriculum, which wasn't the case when I went school. Amazing. It is. It's amazing. And they're partnering with nutrition associations. So you've actually got like qualified nutrition professionals informing the

medical curriculum. So it's not just doctors shooting in the dark because let's be honest, doctors who haven't done additional learning aren't actually very much rehearsed in nutritional sciences. And it's a whole science field in itself. It's very different to make them, very, very different. But it has the power to influence health and prevent disease massively. Yeah. Where do you feel like is the biggest gap in understanding? So if you were to just look at, you know, to kind of the general population, is it a lack of understanding around micronutrients, macronutrients? Is it what is the optimal caloric intake? Where do you think like the biggest pain point is? I think when it comes to the general population, most people know the general principles of a healthy balanced diet and what

they need to eat. But if you look at the research, most people aren't following the government guidelines of a healthy diet, be that like a food pyramid or a healthy eating guide or a plate, whatever country you're in. Most people aren't sticking to that. But if majority of people did abide by those guidelines, and I'm not saying they're perfect guidelines, I'd definitely tweaked it away but if they did we would have a much healthier population and also it would be more sustainable for the planet but we just don't stick to it you know like the foods that we consume especially in the western world are largely influenced by our environment and that is influenced by big food corporations because we don't want to think that but a lot of it's out of our control

because it's things that are external cues that influence what we're doing day to day also our lifestyles, how busy we are, the pressure that we're under, that will influence what we consume. So I think like a lot of it comes down to behaviour change and environmental change and shifts in that way. I think thinking about individual nutrients, oftentimes we overcomplicate it. We just need to simplify it. There are some people who really want to get more granular about it, especially if they're like into performance and things like that. And I think that's fantastic. But for Gen Pop, most people just need to stick to the basics, eat more plants, reduce the amount of processed foods that you're eating, try to cook more at home, include more variety in your diet,

cut down on red and processed meat. They're the basic fundamental things that most of us aren't doing. You know, I think nutrition science can get complicated very quickly, and there's a lot of conflicting evidence. So I do think a framework that is simplified is really important. For someone who is just starting out, where would you recommend they start? Where can they get the biggest kind of bang for their buck in your opinion? I think if you're starting out and you feel like you're completely lost, then just kind of start back the basics and think about making one change every month as opposed to all the changes at once. So maybe this is day one for you. Can you get five portions of fruit and veg in each day this week? And then build upon that.

I think more and more we're accumulating all this research that a plant-focused diet, I don't mean a vegan diet or, you know, excluding animal products. I just mean including more plants in your diet is going to benefit you in lots of ways. Because they're so rich in fiber, antioxidants, which benefits the gut, but also all of the processes in our body. Also, you get a lot more nutrients per calorie, so they're not that dense in terms of energy. Focusing towards healthy fats as opposed to high saturated fat food. like lords and butters and processed foods. So thinking about those kind of healthy fats

that you find in a Mediterranean-style diet. When it comes to carbohydrates, again, we're not demonising any food group, but we're thinking about the quality of foods that we're putting into our diets. So getting in those high fiber whole grains, and thinking about the low glycemic type carbohydrates versus the high sugar foods

that are going to taste good and give us loads of energy for a short period of time, but not sustain us, not leave us feeling satiated. making sure we're getting lean sources of protein at each meal time, if not at snacks as well, because I think also we often think protein is just important for those who are active or going to the gym, but it's really important for immune health, hormone health, longevity. So if you're starting from day one, focus on the basics and focus on quality of the food

that you're putting into your body, then you can build upon that. Like don't get bogged down about specific niche diets or cutting big food groups because it's not where you're making the most health gains. We don't want to terrify folks, but there is a very clear connection between nutrition, like what you're putting in your body and disease. Do you want to just talk? Because I do think being informed can help inspire behavior change as well. So I think it's important for folks to understand.

There's short-term implications, of course, but there's some really scary long-term effects of chronically putting food in your body that is not necessarily helpful. I think we know that highly processed foods are not beneficial for health. largely because they're very high in saturated fat and salt, which are two key nutrients which are detrimental for health in the long run. It's not about having these foods every now and then. It's about people that are having these foods most of the time.

And in the long run, that can lead to things like increasing your cholesterol, insulin resistance, both of which will kind of increase things like risk of type 2 diabetes and metabolic syndrome and cardiovascular disease. but also having diets that are low in fruit and vegetable, that increases your risk of things like colorectal cancer. It increases your risk of other health conditions like low calcium and vitamin D. We've got increased risk of osteoporosis in women. So having a poor diet is not just linked to things about everyday feelings of health

or performance or appearance or body weight. It's about like longevity and your risk of disease in the future. What you put in your body today will determine how long you're going to be. live in the future and the diseases that you may or may not experience. Nutrition is just as powerful as kind of preventing things and helping to manage certain health conditions. In medical school, we pay a lot of lip service to the role of nutrition and the prevention of heart disease, for example, but doctors today don't have the information to be able to advise on what you should and shouldn't be eaten if you're in that position. Or if you have osteoporosis, how you can support your bones.

if you're in that position. And I think that's the missing link that we have in medicine today. We know there's a role of nutrition, but the link between giving that advice and getting it to the patient is missing. And so people have to fill in the gaps by going online, on social media, asking friends, asking Dr. Google. And so it can become very confusing

and actually it can be detrimental to health because you could run down the wrong corridor. As a medical doctor, you know, I think there's a lot of different opinions out there in terms of cholesterol. What would you recommend, like if I were going to the doctor and recommending a blood panel, for example, I think what is currently offered in kind of a traditional family practice setting is probably not robust enough to really give me the right insight into how I'm trending.

You know, for example, APO little E, you know, how would you advise of just an individual who's going to the doctor and wants to get a really good understanding of kind of cholesterol and what would be the panel that they need? I'm not really sure I had to advise best in the States because I practice in the UK. And we tend to just do a panel that's largely focusing on HDL, LDL, and triglycerides and the ratios of things. So that would be kind of like where I would start. We often focus on kind of where we talk about LDL as the bad cholesterol and HDL as the good cholesterol. But the ratio of them is also important.

I also think it's really important to look at trends. And so if you are getting a blood panel and these kind of specific parameters, looking at how that's trending over a period of time, as opposed to just looking at one snapshot, because that will tell us a lot more. Cholesterol is largely influenced by our lifestyle, but also by our genetics. So it's really important that we see what's happening. Also, if we're watching trends, we can see what's working in terms of changing our diet. And there are so many nutritional strategies when it comes to improving cholesterol levels. You know, there's lots of clinically proven diets that can reduce your cholesterol levels. Medications can be powerful and there are a place for them, especially people who have familial

cholesterolemia or hypercholestrelemia. But nutrition is so powerful. So I really encourage people who are on that verge of having high cholesterol levels start now because something like 50 or 60% of people over the age of 35, this is in the UK anyway, have high cholesterol levels. So that is a very young age. And while you won't have any symptoms, you won't know that you have it, that will increase your risk of heart disease in the future. So it's something that you need to take seriously today. I wonder the relationship between, you know, kind of higher cholesterol levels and blood pressure and heart rate and heart variability,

I imagine there's probably a pretty strong relationship there. So if we improve cholesterol, if we find out our cholesterol's kind of at a balance, we improve it. I would imagine we might see improvements in our exercise capacity for sure, which, you know, would improve some of our cardiovascular markers that we track. Yeah, absolutely, because none of these things are in isolation. If you take the steps to improve your cholesterol levels by making dietary changes, it's likely those dietary changes are going to improve your blood pressure levels. They're going to improve your insulin sensitivity. It's going to like have a knock-on effect to your cardiovascular health and probably your fitness endurance. And so you just have, you know, this whole package of things.

So that's the kind of really beautiful thing about nutrition and about foods versus supplements because foods become, they come packaged in this vehicle of so many other nutrients that you're never just having one nutrient in isolation, whereas supplements are just one nutrient. And when it comes to the research around supplements, oftentimes, there's no evidence for them because taking one B vitamin, for example, is going to be very different to having the whole food from a whole grain, for example, which has fiber, a lot of other nutrients, carbohydrates, energy. So food first approach from me all the time. Yeah. I mean, I think there's a pretty big question as to whether or not we've evolved to even absorb and turn supplements into anything

of utility. I think to your point, there isn't a lot of evidence out there. I love the food first approach. I think that's foundational. And if you don't have that, right, you're just layering inefficiency on top of inefficiency. And that's very much principally important point for folks to recognize is that if we don't have nutrition, if we don't have the fundamentals, anything we try to layer on top of that is going to be kind of a house of cards in a lot of ways. So maybe this is a good segue to talk about, you know, sleep and metabolism. They're obviously inextricably linked. As, you know, you said very beautifully, you know, everything is interconnected and linked and they aren't in silos. And I think

understanding the relationship between, I think, sleep and nutrition is obviously really important. Do you want to just give kind of an overview of what we put into our body and how that might affect our metabolism during sleep? You know, what is kind of normal metabolism during sleep, what is abnormal, and how can we think about that more clearly? Yeah, I think there's a lot of conversation around this, and I'm sure Andrew Huberman would be able to weigh in a lot more than I would when it comes to the kind of sleep and nutrition research. But I think less of the work has been done around individual nutrients or foods or less of the research is compelling in those areas, but more around meal timing.

And a lot of this is coming from like shift workers, especially like the nurse health studies. And what we know is that, you know, just like we have a circadian rhythm that is linked with light. And so we're best primed physiologically in that day. The same is when it comes to nutrition and we get peripheral cues from our circadian rhythm through the food that we eat. So if we're eating, we're sending messages to our brain that it's daytime. But actually our bodies aren't primed to consume nutrients in the biological night. So what we've seen when people consume food during that nighttime is that they are less able to

manage things like glucose and saturated fat. So it increases the amount of fatty acids in the bloodstream. We are more insulin resistant in the biological night as well. And for, you know, you and I who may be doing this once every now and then if we're traveling from part of the world to the other, it may not have massive significance. It will affect our sleep, but it may not have massive significance to our health. But for people who are doing shift work, and so maybe they're doing three or four nights a week where they're consuming food in that biological night, that's been to have massive knock-on effects to their health in the long run. And so this is where like time-restricted feeding and that type of research is really interesting because we're starting to learn that actually

it's better for just consuming all our calories and foods within the biological day versus shifting it into the nighttime. But as someone who's worked a lot of shift work, I know it's not easy to fast at night because you're working and you're tired and you're emotional and if you work like as a healthcare worker it can be very demanding and I've definitely you know just depended on like vending machines to get me through shifts as a very young doctor but what I would say to those people is you know there's an optimal diet you can have and that's probably fasting during that time which isn't practical and then there's some somewhere in between where we can find some kind of positive of tweaks to me, which may offset that risk slightly. So make sure you're not having very high

fat foods during the biological night and having generally lower carbohydrate foods and opting for kind of high fiber, low GI foods. And what I mean by that is, you know, kind of low glycemic, whole grain foods, higher fiber that aren't going to push up that glucose and higher protein food so things like cottage cheese and blueberries for example or making a protein shake or having yogurts, Greek yogurt, fantastic food, making kind of like egg muffins, things like that that are high in protein will keep you going but are unlikely to push up your glucose or unlikely to push up that kind of fat level. And so that would be my best piece of advice. And then when you get home in the morning, then that's when you have kind of your main meals and you can start eating normally

again. Yeah. We're actually going to be recording a podcast here soon, specifically on shift worker. I think when we consider sleep in nutrition and movement and light viewing and, you know, all of the things that push around are circadian rhythms. It's a more complicated calculus, certainly when you're awake during the biological night, as you pointed out. But I think principally for folks who are sleeping during the biological night and awake during the day, you know, you've got an active phase of your circadian rhythm, which you described an inactive phase. So in principle, your active phase is when the sun is up. The inactive phase is when the sun is down. So if you can eat all of your food during the active phase, to your point, you're more prime to metabolize those food and you're just in a better position to turn that food into energy that can be used. So, and I think honestly, I mean, I think the literature is really exciting in this area that, you know, when you think about a place to start, you know, it's like, all right, eliminate or, you know, minimize the process food, you know, prioritize plant-based foods. And, you know, think about your feeding window to be during, you know, when the sun is up, you know, during the active phase of your circadian rhythm. I mean,

that gets you almost 60% of the way there, just those couple strategies. I think what's exciting is that, you know, as hard as behavior change is, I think when we simplify it like to those parameters, it becomes actually quite manageable and gets us a good part of the way there, which is exciting. You know, you mentioned when we're eating in our inactive phase. So the sun goes down and we're eating close to bedtime. That's going to impact our insulin sensitivity. And we're resistance. And I think what we've seen in the data, and this is an area that I'd love to do some more research with you, Hazel, specifically, is looking at, you know, what is happening when we're having, you know, huge meals close to bedtime. I mean, we've seen in a study we did

the 700, actually female collegiate athletes, and we saw a small effect because the data was not great in terms of logging exact foods, but we saw trending towards significance, deleterious effects, negative effects on heart rate variability and resting heart rate when there were meals close to bedtime. So we kind of go, you know, we have this thinking that, you know, eating a lot of protein before bed is going to help us build muscle and things that we need to be doing at night. Whereas I think that's a very, just a part of the story. And it seems that, you know, the sympathetic overstimulation that occurs with, in terms of just the process of digestion, right, is really effortful. It seems to actually have a real negative effect on recovery parameters for sure.

And we know that, you know, it can create kind of a pretty fragmented sleep experience to, you know, what would be your kind of take on just the relationship in terms of timing. Yeah, absolutely. I think like in general, like you shouldn't be eating within three hours of going to bed. It's really interesting when I say that a lot of people are quite shocked because some people will have, you know, maybe dinner at 8pm, 9 p.m. at night and then go to bed at 10. And even if you don't feel full or feel like you're still digesting, your food is still being digested from like three to four hours afterwards. And that can have a knock on effect, not just on kind of your sleep quantity, but your sleep quality. So you may not be very much aware that it's having

that impact, but you're going to have, like, less good quality sleep. You're going to have less deep restorative sleep. You're going to have less, you're going to have more wake times in your sleep. And I know anecdotally, using my woo, there are times that I've gotten home late and I've had no choice but to have my final meal later in the night, I will always have poor sleep. And I've chatted to my boyfriend about it. as well and he's the same so it's something that we really try to avoid like i have our last like 6 p.m which gives me about four hours of digestion let's shift a little bit and talk about nutrition's impact on you know our psychology and i think when we consider if we just reflect for a

second on you know when we have a lot of sugar and you know when we're maybe not prioritizing plants like i don't know if everyone makes these connections but it has a profound impact on mood certain and in the moment and then, you know, kind of a few hours later, maybe just talk a little bit about the connection between nutrition and, you know, cognitive functioning and as well as kind of emotional regulation. Yeah, absolutely. I think the best way to describe the link between food and mood is when we experience kind of butterflies in our tummy before something where we're nervous or excited or you get a really strong gut feeling about something and that's essentially the gut brain axis, which we're learning more and more about.

And that's not just the brain having an impact on the gut, but also how the gut influences the brain. And actually there's like research to say that when people are stressed, and this comes from students who are studying exams, it actually has a profound impact on their gut microbiome. So they've got like less numbers of healthy gut bugs when they're stressed versus times in different parts of the semester where they're not studying exams and they're a lot more relaxed. And so that's just like illustrating how profound that link is. But when it comes to food, is that the cortisol? Is that related to just the cortisol and just having that infusion of those kind of hormones that when there shouldn't be present? Yeah, absolutely. It's a combination

of hormonal factors, but also the vagus nerve is kind of that link. between our brain and our gut, which is very much implicated when it comes to stress. So we've got like multiple factors going on. And I think there's a lot of connections between the gut and the brain that we haven't fully teased out, that we need to understand more. But what I found really interesting was when they were in that particular study that I'm referring to, they were measuring different levels of gut bugs. and I think it was lactobacilli in stool samples

and how that changed from one part of the term to the other, from just starting off in school to finishing exams. And so that was the one factor that I changed. And I'm sure things that we can't control for, like changes in diet around that time, probably having more caffeine. But the impact of just the stress hormones on our gut and on our microbiome is really interesting.

And I guess whenever I talk about food and mood, everyone wants to know what is the best food to eat to improve mental health. And I wish I had the answer to that, but it's never that simple. I think when it comes to this area of research, one of the most landmark studies that everyone talks about is the Smiles trial, which was done in Australia. And this was a blinded study where they took a group of people with diagnosed depression and separated them into two groups. And one group went on a modified Mediterranean-style diet that was very high in fiber. And the other group went on a social support befriending type intervention. And what they found is in the modified Mediterranean diet group. So in the dietary intervention, they had something

like 33% remission in their depressive symptoms versus 8% in the social support group. Now, both groups stayed on their medication, but I think what this really illustrated to us is how powerful food can be in an adjunct for reducing symptoms of depression and anxiety and how powerful it can be in preventing that from happening. you know there's no single food that's going to cure depression but what the research seems to point towards and from everyone i've spoken to who are in this field of research it seems the Mediterranean diet comes on top again um so it's like you know your colorful fruits and vegetables your high fiber your oily fish your omega threes i think also what's really powerful about that way of eating is

it's also a focus around like how you eat and the people you eat it with and that kind of it's very slow and mindful and, you know, it's a very good relationship. The community aspect to it. Yes. Yeah. Creates a social connection. That's definitely underestimated when it comes to health. Let's shift a little bit and talk specifically about, you know, kind of women in nutrition. And I really want to be able to pull out, you know, some of the incredible nuggets from the female factor. What would you say are maybe just some of the primary sex differences, you know, between, you know, kind of males and females maybe just kind of start there what are these unique specific you know nutrient needs that women have yeah i found the nutrition chapter of the book almost the most difficult because when it comes

to food and female bodies again often the message is restrict make yourself smaller things like that and so i don't know about you but when i was growing up that was also the message that like i was hearing from friends or reading in magazines and things like that but actually nutritionist there's some key nutrients that are absolutely vital for women at certain points of the lifespan. You know, like going through puberty, iron becomes more important than it would be for males because of the menstrual losses. Women are more at risk of osteoporosis because of the lack of estrogen that we exposed after the menopause, but also some women may be in a low estrogen state even before then. So things like calcium and vitamin D are really important.

but nowadays a lot of women don't consume enough calcium because a lot more people are going plant-based and not adding that back in. Obviously around pregnancy and postnatally, there's really important nutrient needs that women have then. And I think also one of the things that we're learning more about now is how nutrition can support the menstrual cycle. And oftentimes we talk about the menstrual cycle as just a period or just the bleed but actually that is the you know there's four different phases happening really and those hormone fluctuations dictate our nutritional needs our energy requirements for example in that second phase the lute heel phase women tend to burn more calories at rest and some of the research says that this can be up to 300 calories more per day at rest and what we

see with that increase in energy demands is increase in cravings. There's a really interesting graph that I have in the book because as that metabolism increases, we see in tandem those cravings increase and we see in tandem progesterone increase. So it's literally driving up those needs. And women often report that they want more chocolate during that time. It's the most reported the craving because it's high in, high in energy, high in sugar and fine fat, and it obviously tastes really great. So we need more energy. Also, women will consume more caffeine during that time as well because it's a way of kind of dampening down those cravings. But what I say is actually, I want you to lean into those cravings and get in more foods that are going to sustain

your energy levels. So think about those complex carbohydrates. Think about those whole grains, those pulses and those kind of like whole meal breads and pastas and foods that are high in fiber that are going to sustain your energy levels and then you'll be less likely to depend on caffeine and chocolate to carry you through baked sweet potato fries are like my go-to during that time that was so good I mean it's about listening to those cravings and being smart about it and we also tend to oxidize more fat so burn more fat during that phase and rely less on carbohydrates. So make sure you're getting in lots of healthy fats,

omega-3s, you can also support with PMS symptoms. And we break down more protein as well. So especially if you're an athlete, right now, get in those regular kind of boluses of protein. So make sure you're getting in protein at every meal time, if not getting it in its snacks as well. And that will also help control those cravings. Yeah, I love that.

Do you think like eating, I kind of always like, I tend to eat my protein and vegetables kind of together. And then if I'm still hungry, then I'll have some, you know, kind of carbohydrate or whatever. The timing of, or like sequencing of foods actually matter. Like, what would you recommend there? There is to a degree, you know, we see that from CGM kind of studies and data that actually it will influence that curve of your body responds. I think it's more important for people who do have, you know, insulin resistance or our risk of it.

so maybe women with PCOS and, you know, it's really important that we get our protein and our veggies in their kind of key nutrients. So if you're prioritizing them, they're important. But also I'd say like, you know, carbohydrates are incredibly important because that's where we find our fiber. That's where we find like a lot of really important nutrients. So it's not as important. It is important for some people. But what's really interesting as well is thinking about the luteal phase, we also are more insulin resistant in that phase as well. So maybe around that time we need to be slightly smarter about our carbohydrate choices and about our pairing.

So we do know that when you're having a carbohydrate-based meal, if you pair it with protein and you pair it with fats, that will blunt the insulin response. Right. And maybe just a quick, because some of the sisters might not understand the difference between insulin sensitivity, which is good in insulin resistance, which is, you know, not optimal. maybe just explain the difference real quick.

Yeah, I mean, it's so easy because we chat about it all the time that you kind of, so your insulin sensitivity is absolutely what we want. But when we talk about insulin resistance, this is often kind of the place that you'd be at if you are approaching type 2 diabetes. And what this means is that your body is pre-diabetic. Your body is less responsive to insulin. And so when we consume glucose, we obviously need insulin to be produced by the the pancreas and that allows glucose to be taken up by the cells in our body to be used

to as energy, that's a normal thing we like that. But if our body is insulin resistant, the cell isn't taking that up as well. And so you've got more glucose basically around in your bloodstream and your body's pumping out more insulin to get more glucose into the cells essentially. So we don't have a very effective mechanism because if we've lots of glucose floating, around in our bloodstream all of the time that can lead to poor health problems like kidneys eye problems like that and which we see in diabetes so it's in our interest to make our body as responsive to insulin as possible and things like resistance training so getting strong and building muscles are really important yes muscle is the best it is one of my friends who

kind of works in this space always says you know muscle is a great glucose sponge, and that's what it is. So if you have been told, it's one of the best ways to make sure your body's using glucose is lift weights. Yeah. I don't know the percentage of men versus women, but I think it's like something like 74% of the U.S. population is pre-diabetic. It's kind of estimated in the U.S. which is insane, right? So a lot of these, I think, strategies you outline just around sleep and meal timing and prioritizing, you know, plants and getting enough protein and limiting processed foods. I mean, that you can reverse your situation really, really quickly, even in two weeks, you know, the research shows. So, you know, I think that

that this is, it's worth the effort, you know, to kind of get to a place where we're not, you know, kind of trending down this path of, you know, diabetes is once you're there, you're there, you know, and it's, things become really difficult. PCOS, if you just want to explain real quickly what that acronym is and why it matters for women. Yeah, so PCOS is polycystic ovary syndrome. basically it is hormonal and reproductive condition and it is typically diagnosed when women have absent or regular periods have evidence of raised testosterone levels and that can be on a blood test or it can be with evidence like growing male pattern hair so having lots of facial hair for example, and other kind of symptoms that women would have are things like infertility

or difficult to getting pregnant, and obviously the kind of polycystic ovaries. You don't need to have them to be diagnosed with PCOS, and also some women do have cysts on their ovaries, but aren't PCOS. And so there's like a number. So the criteria is basically having two of three of those things I mentioned, raised testosterone or androgen levels. And, and irregular absin periods or polycystic ovaries on ultrasound. And so typically women will be diagnosed via that way. It's quite common. It's one of the most common reproductive conditions. So one in five to one in ten women across the world have it. I am one of them. And when I was at medical school, I was always thought that, you know, it was a certain phenotype that would come

in, the clinical picture of a woman who's very overweight, hair everywhere, balding, unable to get pregnant. That is not the case. There's lots of different phenotypes emerging. We have kind of obese PCOS and lean PCOS. And while having a higher body weight can increase your risk of it, it is definitely not the cause of it. So it's really important that we recognize that and, you know, as practitioners and things like that and people listening, it's just there's a lot of old age thinking when it comes to PCOS. And so we need a lot more research and conversation is really important. And also, there's so many lifestyle interventions that can massively improve symptoms. You know, insulin resistance is one of the, like we just spoke about, is a huge part of it

for a lot of women. So I think up to 80% of women with PCRS have insulin resistance. And so diet is so important. But again, it's not something that there's a lot of information about. A lot of the things that we spoke about in terms of what to do for people who have insulin resistance. So thinking about the quality of carbohydrates, thinking about getting lean sources of protein and healthy fats and pairing that in, Mediterranean's diet, resistance training. So thinking of glucose as that sponge. And sleep and stress are also hugely implicated when it comes to insulin resistance. And then there are some other kind of bit more niche nutritional strategies and supplements like enocetal and things like that, which I go in a lot more

detail on my website and for women who want to learn more about that. We'll make sure we'd link to that. Yeah, for sure, because I know that it seems like quite a niche topic, but affects so many women that I feel like it's something that we really need to talk more about. Yeah. I gosh, I feel like we just keep talking for hours and hours. But one question that I really wanted to get to is actually a question from one of our members. Her name is Deborah and talking about intermittent fasting. And I know you have a really strong point of view on this. When I talk about, I think it's really important to understand. that there is a difference between time-restricted feeding and intermittent fasting. When I talk about

narrowing your feeding window or identifying a feeding window, I'm talking about time-restricted feeding. And I'm really talking about when I talk about my own kind of feeding behaviors, I am talking about restricting my feeding window generally for when the sun is up. So I can really capture, so I can really try to maximize my circadian rhythms and really kind of ensure that they're in line with kind of the natural light, dark cycle. That's what I'm talking about. So I just wanted, Debra, just clear that up. I'm talking about time restricted feeding. But Hazel, if you could actually really talk about what is, you know, for intermittent fasting for women and just your point of view on it as a medical doctor, how would you frame that for women who are trying to think about this

maybe as a dieting strategy? Yeah, absolutely. I think that's a really important point that there's huge difference between IF and time speeding and even within those two types of protocols. There's also lots of variations to it and they can be totally yeah four hours eight hours 10 hours yeah absolutely so there's extremes of these things and I think when it comes to health benefits and things like that there's a lot of really positive interesting research when it comes to the impact of time restricted feeding for example and our kind of body clock our circadian rhythm and also when it comes to things like cardiometabolic health and I think that's really interesting and I'm excited to see more research come out about that. But I think when it comes to intermittent fasting as a weight

loss protocol compared to a standard calorie restricted diet, there is no benefit in terms of weight loss achieved. The reason I talk about it a lot on social media is because when it comes to fasting, women tend to be a lot more sensitive to the impacts of that, especially women who are at risk of low energy availability and that will be very like active women or women who are on calorie controlled diets or athletes because we need regular intakes of nutrients to support hormonal health and I know Dr. Stacey Sims talks about this all the time but especially women who have found that their menstrual cycles are irregular and that has been linked to their nutrition or their exercise, I would definitely recommend not fasting, even if you think that it's a quite

like risk-free approach, especially around things like training, we need energy on board so that we're not drawing from those less available resources. And so that would be the only caution I have. I think, you know, like you said, there's various different protocols and some of them are like a lot lower risk. I talk to Tim Specter, who is one of the biggest research, which is over here in the UK, he is actually doing a big IF study at the moment and recruiting. And I was chatting to him because he was like, Hazel, can, you know, we're recruiting. Can you send this out to your followers and get more people on board? And I was like, absolutely.

But I'm just going to come up with the recommendation that I don't advise it for all people. And he's like, absolutely, I'm on board with this. Actually, their fasting protocol is like within a 10 or 11 hour window. So it's very achievable. For sure. And do you know that average Americans are eating inside a 15-hour window? That's it. I mean, no wonder we have an epidemic.

I mean, it's just craziness. So that's it. It's, you know, when we talk about these things, we have to caveat. We have to talk about the, you know, what timeframes are we talking about? Who are we talking about? What is the individual at risk? You know, because there will be some people who will really benefit and there will be some people who it will not benefit. Yeah.

Yeah. I think that's really, I think that's such an important point is that there's so much variability between, you know, women and men. And I think we have to figure out, like, really what works for us and use objective feedback. You know, I mean, I get blood panels, you know, twice a year. And I'm really fortunate that I can afford that and I can do that. And, you know, and I track all of my metrics. And I think it's really figuring out when you think about, when you kind of have your checklist of like, am I getting a regular period? Am I able, do I have consolidated sleep? Do I have energy? When I I want to be alert. Am I able to be alert when I want to go to sleep? Can I sleep? I mean, to me, if I can answer those questions, like, I know I'm kind of on the right path. You know, can I be a generous, loving human? You know, like, I mean, just like the simple foundational stuff, right? But what's amazing, I think the opportunity for us is that nutrition's going to feed all of those things, you know? And I think that's, I think the point that you've made really clearly on this podcast today that what we put in our body is going to affect really every aspect of our life. And I think you've given us some incredible frameworks on how to think about that broadly across the population and then some really, I think, important points for women specifically. Is there anything else in terms of kind of female physiology, female nutrition that you want to kind of tap into that we, that isn't hit on enough that you think is really important for our female members to understand? I think just in addition to getting enough calories. And so kind of that conversation around low energy availability, I think that the biggest marker, the first marker that women often see is that they've lost their menstrual cycle, but, you know, a lot of women are on

hormonal contraception, and so they won't have that as an indicator. Just to kind of reemphasize what you said is think about the other parameters in your life, like have you hit a training plateau, are you more irritable, are you sleeping well, are you having good issues like bloating? These are all indicators that you could be running into a state of low energy availability, which doesn't just affect your hormones, that will affect your bone health, your heart health, your performance. You know, I always say to women, it's not just a period. So if you lose it or it becomes a regular or anything happens, that's a sign that your body's going under significant stress. And that's a sign that you should go speak to your healthcare provider. Yeah. And I'd be remiss not to mention,

you know, all the work that we're doing in this area, you know, menstrual cycle coaching, you know, just acknowledging that, you know, the very different things happening in the phlicular phase. versus the ludial phase and being able to kind of, you know, adapt our training to account for some of these, you know, variations in our physiology is, I think, a really, is really powerful. Is there anything that you'd want to say just around that in terms of kind of this four-week cycle and what does that mean for our training and even, you know, what we put in our body during those times? Yeah.

It's, I'm so grateful for the work that, you know, that you guys are doing in terms of menstrual cycle health. It's just, it's so important, and to be involved in that is amazing. I think the research around training in terms of strength, endurance, performance, and the menstrual cycle is fascinating, but it's emerging and conflicting, and we need a lot more. I think, you know, what the evidence tells us is that at certain points of our cycle, we are like, you know, a lot stronger, especially in that follicular phase just before ovulation.

You know, women tend to be a lot stronger. and more motivated and train at their best, then kind of later in that late Luteal phase, when PMS symptoms start to creep in, progesterans high, we're bloated, our temperature is higher, we recover slower. And so you've got all these factors against you, but the best piece of evidence is evidence that you can get from yourself. And so tracking your own cycle and listening to your body is the best thing to do

because some women feel great at that part of the cycle and who will want to say that you're not going to. Having a menstrual cycle tracker, like using WOOP, and being able to track your behaviors and see what your strain's doing, see what your recovery is doing. That's such a valuable piece of information for any woman. Hazel, how about we finish the podcast with a listener question?

It comes from Carrie, and she wants to learn more about probiotics and prebiotics. Curious to know more about prebiotics and probiotics. I know they are different, and I know they are both very important, but I am not clear on how I would even distinguish between these and both foods and vitamins. What is too much for probiotics versus prebiotics? If you don't have one, is the other hurt? What's the deal? This is a great question, and I get asked this all the time,

and it doesn't help that they sound very similar, probiotics, prebiotics. And now there's also postbiotics. So probiotics are basically live microorganisms. which can give us health benefits. And you can find these in supplements. So there are so many different supplements in the markets, but you can also find them in yogurts, which contain live bacteria. So they have like different cultures of bacteria. And also you can find foods which are fermented, which may have probiotics, but there's less evidence for them in terms of how they impact our gut and overall health. That's not to say they aren't good for you. But we

just can't say they offer us the same benefits. You can take those probiotics and they will repopulate and help to support the microorganisms and the gut bugs that you already have. And so they can be beneficial in times of, say, you've been on antibiotics or you have had a bet of traveller's diarrhea. And there's lots of evidence for them there. There's also evidence for them in things like IBS, irritable bowel syndrome, inflammatory bowel disease, also lactose intolerance and a couple of other conditions. The evidence for taking probiotic supplements in healthy individuals but no gut issues isn't really there. So if you're just thinking about taking them for the sake of it, I would say it's probably better to focus on lower hanging fruit when it comes to gut health,

like getting in more plant-based foods, thinking about your stress levels, reducing the amount of kind of like processed foods in the diet. And that would probably offer you greater benefits than adding probiotics. And you could maybe just start adding in probiotic rich foods like yogurts and fermented foods instead. And then prebiotics are basically a type of fiber that act as like a fertilizer for our gut. So basically the bacteria ferment those fibers because we can't break them down. So we need the gut bugs to break them down. And so that's why sometimes they can make us a little bit gassy, a little bit bloated, because that's basically the gutbugs doing their work.

Yes, you can find them in supplements, but you can find them in so many different plant-based foods that I generally would advise you start there first. Foods that are typically high in prebiotics would be onions, garlic, artichoke, weak bran, oat flakes or porridge oats. if you have ibs you will probably struggle with these foods because they are very high in fiber and so supplements may be necessary in that instance but if you can tolerate those foods just get in as many plant-based foods as possible and then i've just briefly mentioned postbiotics it's not something that you know people need to worry about but a lot more people are talking about it now and postbiotics are essentially the byproducts that the gut bugs produce when they ferment prebiotics. So it's basically these beneficial chemicals or short chain fatty acids that they

produce when they feed on these prebiotics. And those postbiotics can kind of travel in our bloodstream and work around our body. And they have impact on like our heart health, our brain health and our immune system. And so we're starting to learn more and more about those things like butyrate and things like that. So I guess like top line advice is unless you have a specific indication to take a probiotic supplement, start with food first, and the same goes for prebiotics. But yeah, really fascinating area of research. Good. Well, I think everyone should follow you on Instagram. I think the information you put out is just, you know, I think you take some really complicated information and research and you distill it down and to really consume.

practicable, you know, ways of just thinking. And I personally appreciate it so much. And I know that our members will really take a ton from this podcast. You've been just so generous with your time and just a lot of incredible insights. So just thank you very much. Thank you. Big thank you to Dr. Hazel Wallace for joining Kristen today and talking all things, nutrition and health. If you enjoyed this episode of the WOOP podcast, please leave a rating, a review. Please subscribe to the Woot Podcast. check us out on social at whoop at will omit if you have a question you want to see answered on the podcast email us podcast at woup.com call us 508 443 4952 we'll answer your questions like we did

today regarding nutrition and we're going to be taking a break next week on Thanksgiving holiday in the U.S so happy Thanksgiving to everyone celebrating and then we will be back in two weeks enjoy everyone Thank you.