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So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors.

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The first question is, why does muscle matter as a woman in particular?

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Muscle matters because it helps your brain produce more neurons and that's super important for brain health.

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As far as protection as we age, it's directly correlative to the amount of muscle that we have.

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And if you have something like PCOS or endometriosis, it's even more important for you.

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Because building muscle, it's gonna fight insulin resistance and inflammation.

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I've got two questions to ask. Should women exercise differently across the menstrual cycle?

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And what is the reason why women hear what you guys say and they don't do it?

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I'm so glad we're having this conversation.

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We're back with the leading voices in women's health to unlock the specific insights, data, and tools needed to combat the growing challenges women face throughout their lives.

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For women, forever it was all about aesthetics.

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I'm healthy, I'm thin.

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Because they are under the assumption through sociocultural ideas that a woman is coming to the gym to lose weight, not to get strong, not to gain muscle.

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But what we've ended up with is an epidemic of osteoporosis and frailty, really dementia.

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We're 40 to 50% of women will have low bone density, 70% of all hip fractures happen in women.

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And when you have that, 30% of the time you have a chance of dying in one year.

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Because most of it is based on male data.

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And I see a large number of women trying their hardest to be healthy.

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But what they are choosing to do is actually having a negative impact on their hormonal health.

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And it's not your fault. And this is where we have to educate.

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And it starts now.

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It brings me to questions from the audience.

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Like, what's the best and healthiest way to lose weight?

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Is there a diet for fatality? Should women fast?

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Is there a link between environmental toxins and early manopause?

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We think so.

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Also, if you were to design perfect workout regimes for menopause and carry menopause,

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what would you, oh, you stasis clapping?

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Go ahead.

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This is part two of my conversation with four of the world's leading experts and women's health.

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And in this episode, we go even deeper into actionable practical things you can do to improve your health.

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And by the way, if you're a man and you've been sent this episode by a girlfriend, a wife, a daughter,

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whoever it might be, I know you might not think this conversations for you,

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but more than 50% of this planet are women.

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You have a tremendous advantage in your relationships at work and just being a human being going through life.

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If you understand the majority of the population.

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And for so long, women's health, women's bodies, women's anatomy, their psychology and physiology,

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has been a mystery because there hasn't been the same amount of scientific research done to understand them.

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So in this conversation, we're going to demystify all of that so that you can understand your wife, your partner,

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your daughter, your colleague, your mother, your grandmother, even better.

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So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors

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and all the things that we kind of alluded to when we were referencing hormones and menopause,

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but in a more actionable sense.

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And I guess the first question is similar to the first question in part one, which is,

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why does it matter for us to have a conversation about women in this context versus fitness generally or nutrition generally?

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Sport and exercise science in itself is a small subset of sports medicine and medical research.

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And most of the research has been done on men.

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We look inherently at most of the recommendations of exercise, recovery, nutrition is based on male data.

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And we established earlier that that's not generalizable.

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So when we really want to get into the nuances of how do we create an adaptive stress for women, we have to look at it differently.

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To look through the female lens, understand the female physiology, and acutely how hormones can affect adaptations

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and how women respond to different environmental cues than men.

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Yeah, our hormones distinctly control a lot of our environment and our other cells that are not what we think of as our hormone cells work with our hormones.

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So if we think about the gut, we think about the liver, our immune system.

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A lot of this is so hormonally derived, but it's a two-way street, meaning your hormones influence what is happening in your gut,

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but your gut influences what is happening in your hormones.

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And because women have different hormones than men, as far as what's predominant and when they are, we have to come at this and approach it a different way.

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There's so much to do with messaging that women receive as far as their health goes.

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And this, you know, be small at any cost, you know, get to that number on the scale.

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And I see it on social media that the conversation is changing.

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Hopefully, you know, GOP ones is tampering this a little bit, but strong over skinning, nutrition over calories, like we are trying to build bigger, stronger bodies and take up more space,

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is the message that needs to happen.

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I mean, forever it was all about aesthetics.

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You have to look young, feel young, be young, anti-age, you know, all those things.

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And what we've ended up with now is an epidemic of osteoporosis and frailty and really dementia.

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Should women exercise differently across the menstrual cycle?

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So this is the nuance. And this is something if you'd asked me maybe five years ago, I would have said, sure, from a molecular level, we see that there are certain things that happen with estrogen being in isolation for the most part.

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And then when you have estrogen progesterone, we see their metabolic shifts, we see their temperature shifts.

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But the caveat is, we don't know if women ovulates or not.

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And I'm sure that Natalie can, you know, give some stats about the Anne ovulatory incidences in most women.

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If we were to understand and know when a woman ovulates, in addition to how she fuels across her cycle, then she can individually tailor her menstrual cycle to her training.

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But for general plan, we can't do that.

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I think it's important that, you know, building muscle, using muscle consistency is a huge part of effectiveness when it comes to exercise or to building strength.

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And so one fear we have when we say, do this in one phase of your cycle and do that in another phase, is that if, you know, 15% of patients are not ovulating or they have no idea when their follicular and luteal phases are,

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are they then doing overall less because they're waiting on this directive to tell them what?

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What is not untrue though, and how I frame this to patients is that strength and resistance training should be the core of what you're doing, regardless of the phase of the cycle you're in, regardless of your pregnant, regardless of we're doing fertility treatments, building muscle, using your muscle.

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Now, what you do on other days is where you should allow yourself to say, how do I feel this day? What do I need this day?

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And be okay with giving yourself the grace that that may look different on your period, in your follicular phase, in your luteal phase, and saying doing something and moving your body is still ultimately we're all going to agree better than sitting on the couch.

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Exactly. Many women will say they have more energy in that late follicular phase.

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And so if you are looking at your workout structure, this is a day I want to try heavier weights or more reps.

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It can be smart to put that in a time where you have a higher chance of being successful.

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That's how I explain it. I'm like, if you have your own data and you know what stays, you feel really fantastic.

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That's where you want to put your higher intensity, your heavier lifting, because you know that you're going to hit those training metrics.

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What we don't want is for someone to go in to do a high intensity session on days if you're flat, because they won't hit the metrics that they need to get the stimulus we're after.

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Can you explain this to me like a 10-year-old, in terms of where in the cycle, typically women will have more energy and really be able to push themselves?

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Right here, five to seven days before ovulation.

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Some women feel really great around ovulation. Some have a transient where they'll feel really awful on an around ovulation and maybe 24 hours later.

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They feel really fantastic. Most women are variable through the early loodial phase.

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So if we think about day six to 14, that's when we see women feel really robust and strong and feel like they can take on the world.

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Because estrogen is rising.

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Yeah, exactly. And you see the physiologic changes, heart rate variability, resting heart rate.

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Your immune system is more prone to taking on virus and bacteria. It's not pro and flammatory.

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So you have that working for your core temperatures lower. You can ask access carbohydrate a lot easier.

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So you have more availability for fueling to hit high intensities.

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Then when we see with ovulation, like I said, some women feel really fantastic right around the time of ovulation because of the estrogen surge.

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Some have transient where they don't feel so great.

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When that follicle ruptures and the egg is released, the granulosa cells that are surrounding it, which is what actually makes estrogen get disrupted.

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And so some women feel that transient breakage and their estrogen is dropping before it reforms to become the corpus ludium and make again.

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So you have this high peak estrogen and then some women are really sensitive to these hormonal changes and they feel that drop.

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So that ovulation day may not always be your very best feeling day, which makes women feel like it should be and like something's wrong with them.

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On a side note, we did a survey on women experiencing pain on ovulation because it's something was never talked about.

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Middle schmarts.

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Yes, exactly. Middle schmarts.

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We had, so you can feel the follicle rupturing and that's called middle schmarts.

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So it's German for in the middle because it tends to happen in the middle of your cycle when you ovulate.

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And it's a painful.

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It's a pain. It can't be. It's just a pain.

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It's just bursting inside your body and then some women are down for the count because of it.

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So they can't, they don't plan any physical activity around that because they just can't from a physical and mental standpoint put themselves through anything.

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So that's why I'm saying like ovulation, some women feel bulletproof, other women who have this transient feeling of really flatness and pain.

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And then afterwards in these early luteal phase, so day 16 to about day 22 is a variable.

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Well, some women will feel like on top of the world still other women will feel I can't quite hit eye intensities.

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And then in general, these few days, about day 24 to 27 before those hormones actually drop.

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This is where you have your PMS, your pre-minstrual syndrome and cramping and fatigue and a lot of women are like, not so great.

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That's when you're progesterone.

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You win both of them drop.

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I just love how you guys explain it because what I see on social media is absolutes.

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You must do this doing funicular. You must do this at ovulation.

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You must. And I'm just like, really?

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You know, and so I love how you're like, well, some women, it may affect them this way.

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In others, this we generally tend to see x, y, z.

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So rather than like, you absolutely have to do this at these different times.

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I think learning to listen to your body and the signals that it's giving you across the stages of your life,

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that's really key to so many of the questions that we're talking about because you want to understand your own response.

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And where many women are falling short is that they've been suppressing their cycles.

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They don't know about it. And they were not taught all of these different changes that are perfectly normal.

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And so it's very hard to then hear a social media post that says, only do this in the follicular phase.

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And don't ever do cardio in the luteal phase.

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And you get a lot of mixed messages when in fact, there's no absolutes.

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No.

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And in terms of training, some people think moderate training is better for women.

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Some people think high intensity training is better throughout the cycle and sort of also considering what goals you might have in fertility.

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What would you say there is, should I be doing high intensity interval training if I'm a woman or throughout the cycle and throughout my life?

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So this is where we have to think about periodization first lifestyle, but also how women is feeling.

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We don't want people to do high intensity interval training every day because that's just not going to create an adaptive response.

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We have to think about the reason why we're exercising is to create a stress that the body is going to respond to.

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We don't get fitter during exercise.

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We get fitter from the stimulus of exercise and the recovery from it.

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So if someone's doing high intensity interval training every day or five days a week, they're not ever going to get that subsequent recovery to be able to hit those high intensities and that stress that we want.

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We talk about high intensity during our reproductive years, you can pretty much get away with whatever you want to do during your reproductive years because you have the benefit of our hormones working for us.

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We start getting into a parimenopause and we start getting into menopause.

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This is where we have to really carefully look at volume versus intensity.

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So that means if we're doing lots of stuff or we're doing really purposeful high intensity versus low intensity because we're trying to create what we call a polarization of the training.

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So that when we hit high intensities, we're actually hitting the intensities we need to create change.

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But on the other side of it, we want to hit really low intensity so that we can have recovery.

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It gets harder to recover as we get older regardless of your male or female.

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But in parimenopause, we don't have the benefit of estrogen supporting anti-inflammatory responses.

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So we have to be very cognit that we need more recovery.

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So I'll give you an example.

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So my office, my orthopedic office is in a fabulous performance center.

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Outside my windows, I floor to ceiling windows, there's a football field inside.

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That field is filled seven days a week with people taking a class I called Ignite.

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Ignite has a lot of midlife women in it who are never exercising at low enough intensity to recover

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and never exercising at peak intensity to change their body.

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So what happens five or seven days a week, they're out doing moderate mid-range intensity training.

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But they're not seeing body changes. They're not seeing recomposition.

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They're hurt every three weeks and in my office wondering why they're hurt.

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Because they're doing a lot of reps of medium intensity.

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So they're not really recovering.

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And they're not intense enough to really change their physiology.

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But that's really common.

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There are whole brands built around mid-intensity.

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And that falls into the whole sociocultural thing where we've grown up that

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if you don't have a good sweat sash and feel completely smashed when you leave, it wasn't a good workout.

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But that's a misconception.

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So they are smashed. They're stripping a sweat.

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But it's not at peak heart rate ranges for short bursts of time.

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So I know. Look, it's very confusing because I don't know.

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20 years people have as they've switched from only cardio.

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They're like, now we're going to do high intensity, which is fine.

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I'm not opposed to that word. It's just that how do you define that?

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What is high intensity?

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And so like you, because I've read your books, that we're exercising people at pretty low heart rate,

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where they're about to flip from burning fat to carbohydrates,

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because that's really metabolically healthy.

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But not so intense that people are going to get hurt.

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And I also prescribe really peak sprint-interval training.

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And I did that myself in mid-life, you know, to recompose my body,

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sprint-interval training, because it's intense and lifting, right?

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It's the advice different for different women at different stages of life here.

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So if I'm before perimenopause.

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You get away with most stuff.

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Assuming you have a regular menstrual cycle.

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Right. I think there's different time periods,

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which we've mentioned before, PCOS, hypothelamic amenorrhea,

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time periods where you're not making estrogen or making it reliably,

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you can get away with less.

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And so we want to protect a little bit of that.

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When it comes to exercise, a variety is the name of the game.

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You want to adapt, so you shouldn't be doing the same thing every day.

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That doesn't mean you can't have a plan.

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There's seven days in a week.

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You don't have to move every single one, but you should pick these different activities

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based on your life, your schedule, what you want to accomplish.

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And it will vary some in different phases of your life,

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because your goals are going to be different.

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And so when it comes to exercise, we always have to think about what needs to happen.

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Are you somebody who is overweight and needs to lose weight?

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Are you somebody who's underweight and is trying to gain weight?

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Are you trying to get pregnant or going through fertility treatments or in menopause?

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So there's nuance to it, which always makes it hard.

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But there's not a one, do this one exercise every single day.

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That's pretty much not the answer.

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So the most popular class for females right now,

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I just saw the statistic somewhere is Pilates.

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And my daughter loves her lagre and gets on that machine slide.

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But where does that fall in all of this?

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I have a lot of Pilates.

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There's a social aspect to it.

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There's people hate you.

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Yeah, because we did this real talking about how Pilates was not appropriate as strength training,

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especially as we have.

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When we look at Pilates, it's a compliment to true strength training.

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What I mean by true strength training is you're lifting a load that's heavy in multiple planes.

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With Pilates, it's really good for high symmetric control, core strength, balance,

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proprioception, but it isn't a stress that's going to create adequate muscle gain

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and strength of the bone, which is what we want from strength training.

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So just like yoga Pilates has a place, it does definitely fit in the scheme of things,

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especially from the social and the fact that does give you control and proprioception,

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but it isn't the be all in all for strength.

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People that do Pilates frequently will be shouting.

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It hurts so much.

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Well, I'm sure it's hard.

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The times I've done it, it's not easy, but it doesn't set you up not to be frail.

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It is not building strength and power.

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And I have women who have done so many Pilates.

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1500, it's like a badge of they count their classes.

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1500 at the deficit of anything else.

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It's all that goes on.

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And I think that is another, you know, you've got to mix it up.

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Number one, number two, I say the same thing.

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So I'm not very popular in those crowds, but it's great for the standard that I ask people do

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of flexibility and joint range of motion so that you don't become really stiff and hunched over

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and shuffling old person.

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But it will never give you strength and power in the way to protect yourself from falling down.

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Because there's not enough weight.

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For the most part, yes.

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And we also have to think about when you're doing strength training, you're creating a multi-directional force

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through the muscle and the tendons and the bones.

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With Pilates, especially if you're looking at the reformer, it's not multi-directional in the movements.

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Each movement is one plane.

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And you can be in different planes, but each motion isn't multi-planar.

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So if we think about what are we trying to get out of Pilates, we're getting neuromuscular control,

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we're getting core strength, we're getting some breath work and all that has been official.

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But again, if we're trying to grow muscle and bone, take up space, be strong,

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it doesn't quite hit the points that we need to in order to create this new strength

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to bring us to that health span that women are looking for.

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So do it a couple times a week.

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Yeah.

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Not seven days a week.

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Correct.

252
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So if my partner, she's 33 years old, so she's not quite a perimenopause yet.

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If you were to design a perfect workout regime for her at that phase of her life,

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what would you...

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Oh, your state is clapping.

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Go ahead.

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So if she has three days that she can go to the gym,

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and I should say three one hour sessions that she could have at the gym in a week over seven days,

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each one would start with mobilization, so using resistance bands,

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or maybe you're doing a Pilates Reform or Warm-Up,

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so you're getting through the range of motion.

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What?

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Just to open up the joint capsules, make sure you don't have any restriction

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so that you can get really good range of motion for the movements you're going to do next.

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The next movements would be...

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Does that actually work?

267
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I do wonder this.

268
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So many of my friends are getting injured at this age because they're my age and a bit older,

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because they walk into the gym and they start picking weights up.

270
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Oh, yeah.

271
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No, I mean, I spend more time mobilizing, I think, than I do actually training now.

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Just to keep range of motion going and keep the joint capsules open.

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And so that's using the heavy resistance bands to stand and distract all the joint capsules to increase range of motion.

274
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Stretching doesn't do that.

275
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Stretching will get to an endpoint of the muscle to allow you to have more flex in the muscle,

276
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but it's not actually stretching in the joint capsule to give you range of motion.

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So when we talk about mobility work, we want to get into that full range of motion.

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So if you have a stiffening, so as I was saying earlier about the guy in my voodoo flossing,

279
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well, voodoo floss is a way where you're creating some blood flow restriction.

280
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Then you go in a range of motion and a blood flow restriction,

281
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you take the voodoo band off and the blood flow comes back and you go in the range of motion,

282
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get deeper in that range of motion.

283
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So it's all about accessing the tissues and making the tissues more viable for increased range of motion,

284
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so that when you go do the lifting, when you go put on a heavier load,

285
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you have better control, better range of motion,

286
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and avoid the small little sticky points that cause injuries.

287
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The microtairs?

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Yeah.

289
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So it's the microtairs that are going to lead to injury,

290
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and the microtairs come when I haven't warmed up properly.

291
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Here's why it's older, what would that look like?

292
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If you were your shoulder, I wish I had a rig.

293
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So you could take one of those thick big bands,

294
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the big and wrap it around a rig or something,

295
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and you can pull and descend.

296
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So you're actually pulling the shoulder out in different ranges,

297
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so you can rotate, roll, pull, extend, pull, extend.

298
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What about this?

299
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So this is more trying to work the muscle.

300
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Okay.

301
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And you have paleo press as well,

302
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where you're working rotation,

303
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but that's not getting into the joint.

304
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So if you're descending, you're pulling back,

305
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you're not bending your elbow.

306
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You're actually pulling through the shoulder and distracting.

307
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And then the band is going to pull you forward

308
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to give your resistance to pull your shoulder joint out.

309
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And it's not a painful,

310
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but you're just really getting into that full joint capsule.

311
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You can do that with the hips, you can do a band of pigeon stretch,

312
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just so many different ways of getting into the joint capsule,

313
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which not only gives you more range of motion and prevents injury,

314
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but it also gives you more of the flexibility

315
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of the flexibility that people think they get when they're stretching.

316
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The reason this is important as we age

317
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is because ligaments and tendons and the capsule,

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the inside skin of a joint is made of collagen.

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And the covalent bond, collagen is like,

320
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if you envision strands of rope,

321
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the covalent bonding,

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meaning the bonding between those strands,

323
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becomes stronger as you age,

324
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and you become more and more stiff.

325
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Well, when we lose joint range of motion,

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we're injured more.

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It's why we start shuffling down the street, hunched over,

328
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shuffling instead of striding,

329
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because we have full hip range of motion,

330
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or full knee range of motion.

331
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And so, one reason to do this

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is to maintain full range of motion

333
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through all of our joints.

334
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We want full range of motion,

335
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not only to avoid injury,

336
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but, for instance, if your knee is stiff,

337
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whether it's an injury,

338
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or because you just haven't maintained your motion,

339
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it will change something called your kinetic chain,

340
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meaning we really are from our big toe

341
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to through our spine connected,

342
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the big toes connected to the foot bone,

343
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the foot bone,

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because the way each of those body segments works

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activates the next body segment.

346
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So if you've got a glitch in the system

347
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because your knee doesn't move,

348
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or let's take this one,

349
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this is easier.

350
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Your ankles get stiff,

351
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because we've never worked on it.

352
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Your calves are tight, right?

353
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You're a jumper.

354
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You've got tight calves.

355
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Your ankle doesn't flex.

356
00:24:46.000 --> 00:24:48.000
Well, then your shin bone

357
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or your tibia is not going to interlink rotate.

358
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Well, without that,

359
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your knee is not going to bend as much,

360
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and your femur, your thigh bone's not going to rotate.

361
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You must have the rotation of these bones

362
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to activate your glute.

363
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So if you're not activating your glute,

364
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your butt muscle,

365
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people are very hurt,

366
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or they're not getting as strong,

367
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or they start having lateral thigh pain,

368
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so everything works together,

369
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and it starts with,

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among other things,

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the flexibility and range of motion exercises

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we're talking about it right now,

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so that the body works like a chain.

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Just give me 30 seconds of your time.

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Two things I wanted to say.

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The first thing is a huge thank you

377
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for listening and tuning into the show,

378
00:25:33.000 --> 00:25:35.000
week after week, means the world to all of us,

379
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and this really is a dream that we absolutely never had,

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and couldn't have imagined getting to this place.

381
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But secondly, it's a dream,

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where we feel like we're only just getting started.

383
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And if you enjoy what we do here,

384
00:25:45.000 --> 00:25:47.000
please join the 24% of people

385
00:25:47.000 --> 00:25:49.000
that listen to this podcast regularly

386
00:25:49.000 --> 00:25:51.000
and follow us on this app.

387
00:25:51.000 --> 00:25:53.000
Here's a promise I'm going to make to you.

388
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I'm going to do everything in my power

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to make this show as good as I can,

390
00:25:57.000 --> 00:25:59.000
now and into the future.

391
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We're going to deliver the guests that you want me to speak to

392
00:26:01.000 --> 00:26:03.000
and we're going to continue to keep doing

393
00:26:03.000 --> 00:26:05.000
all of the things you love about the show.

394
00:26:05.000 --> 00:26:07.000
Thank you.

395
00:26:07.000 --> 00:26:09.000
If I lose my range of motion

396
00:26:09.000 --> 00:26:11.000
because I never did all these things,

397
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can I get it back when I'm 50?

398
00:26:13.000 --> 00:26:15.000
So 33 now, I'm like, damn,

399
00:26:15.000 --> 00:26:17.000
I've not been doing enough of this stuff.

400
00:26:17.000 --> 00:26:19.000
Unless you're having bone changes

401
00:26:19.000 --> 00:26:21.000
due to arthritis and it's blocked.

402
00:26:21.000 --> 00:26:23.000
Yes, you can.

403
00:26:23.000 --> 00:26:25.000
So I can start if I could theoretically start at 40.

404
00:26:25.000 --> 00:26:27.000
Because if you think about your muscle

405
00:26:27.000 --> 00:26:29.000
and you're picking up a weight and you aren't right,

406
00:26:29.000 --> 00:26:31.000
you're going to build a muscle.

407
00:26:31.000 --> 00:26:33.000
So if you're creating a force within the tendon

408
00:26:33.000 --> 00:26:35.000
and the ligament and the collagen

409
00:26:35.000 --> 00:26:37.000
and as a repetitive force,

410
00:26:37.000 --> 00:26:39.000
a positive force, you're going to invoke change.

411
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So people that...

412
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So people that think they're stiff

413
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and they say, you know, I can't touch my toes

414
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and they can work on it.

415
00:26:47.000 --> 00:26:49.000
They can get it back.

416
00:26:49.000 --> 00:26:51.000
Here's another reason.

417
00:26:51.000 --> 00:26:53.000
So what happens in midlife, men and women actually?

418
00:26:53.000 --> 00:26:55.000
They remember what they used to do.

419
00:26:55.000 --> 00:26:57.000
They're like, I'm going to start working out.

420
00:26:57.000 --> 00:26:59.000
And I'm going to start there.

421
00:26:59.000 --> 00:27:01.000
Start there.

422
00:27:01.000 --> 00:27:04.000
This is when I get people who just show up on the basketball court

423
00:27:04.000 --> 00:27:07.000
after not having been there for quite some time.

424
00:27:07.000 --> 00:27:11.000
And they return to their memories of success.

425
00:27:11.000 --> 00:27:13.000
But because they haven't linked in their tendons,

426
00:27:13.000 --> 00:27:15.000
their joints aren't moving quite so well.

427
00:27:15.000 --> 00:27:17.000
They rupture tendons

428
00:27:17.000 --> 00:27:19.000
because the load outstrips

429
00:27:19.000 --> 00:27:23.000
the ability of the tissue to be compliant.

430
00:27:23.000 --> 00:27:25.000
And that makes sense.

431
00:27:25.000 --> 00:27:27.000
My friends have been getting injured

432
00:27:27.000 --> 00:27:29.000
and I think that's in part why

433
00:27:29.000 --> 00:27:31.000
because they're trying to work out like they used to work out.

434
00:27:31.000 --> 00:27:33.000
Yeah.

435
00:27:33.000 --> 00:27:35.000
And listen,

436
00:27:35.000 --> 00:27:37.000
they can return to a really high level

437
00:27:37.000 --> 00:27:39.000
but you can't stop.

438
00:27:39.000 --> 00:27:41.000
You can't start where you left off 20 years ago

439
00:27:41.000 --> 00:27:43.000
or 10 years ago.

440
00:27:43.000 --> 00:27:45.000
It takes a few weeks for me.

441
00:27:45.000 --> 00:27:47.000
It takes a minute.

442
00:27:47.000 --> 00:27:49.000
Yeah.

443
00:27:49.000 --> 00:27:51.000
So in mouse 33,

444
00:27:51.000 --> 00:27:53.000
every day.

445
00:27:53.000 --> 00:27:55.000
So I'm assuming,

446
00:27:55.000 --> 00:27:57.000
and I could be wrong,

447
00:27:57.000 --> 00:27:59.000
this year she already has a strength training history.

448
00:27:59.000 --> 00:28:01.000
Yeah, she does.

449
00:28:01.000 --> 00:28:03.000
Okay. So we do the mobility work for about 10 minutes.

450
00:28:03.000 --> 00:28:05.000
Really warm up well.

451
00:28:05.000 --> 00:28:09.000
Then we pick one compound movement we're going to work on.

452
00:28:09.000 --> 00:28:11.000
So it could be squats on the Monday.

453
00:28:11.000 --> 00:28:13.000
So we're going to work on loading

454
00:28:13.000 --> 00:28:15.000
in a squat pattern.

455
00:28:15.000 --> 00:28:17.000
So that's your knee forward,

456
00:28:17.000 --> 00:28:19.000
you know,

457
00:28:19.000 --> 00:28:21.000
you could do Bulgarian split squats.

458
00:28:21.000 --> 00:28:23.000
So we're adding load.

459
00:28:23.000 --> 00:28:25.000
And we have a periodized program.

460
00:28:25.000 --> 00:28:27.000
So this is just a snippet of one day in a periodized program.

461
00:28:27.000 --> 00:28:29.000
What if she didn't have that strength training history?

462
00:28:29.000 --> 00:28:33.000
Well, then we work on adding load through our,

463
00:28:33.000 --> 00:28:37.000
I want to see how she moves first.

464
00:28:37.000 --> 00:28:39.000
And we want to make sure that you're moving well before you add loads.

465
00:28:39.000 --> 00:28:43.000
So this is where we work with lighter loads and more reps.

466
00:28:43.000 --> 00:28:45.000
What if she doesn't have you there?

467
00:28:45.000 --> 00:28:47.000
Yeah. That was my question.

468
00:28:47.000 --> 00:28:49.000
If you're not there, what if she went around?

469
00:28:49.000 --> 00:28:51.000
Yeah. So this is still like, how do you squat?

470
00:28:51.000 --> 00:28:53.000
Where are your sticking points?

471
00:28:53.000 --> 00:28:55.000
So you can assess, self-assess.

472
00:28:55.000 --> 00:28:57.000
If you've done your mobility, then you'll know,

473
00:28:57.000 --> 00:28:59.000
like, oh, my hips are really tight.

474
00:28:59.000 --> 00:29:01.000
So I need to work on that.

475
00:29:01.000 --> 00:29:03.000
So let me do some air squats to see how I move.

476
00:29:03.000 --> 00:29:05.000
Then the next time you go in to do squats,

477
00:29:05.000 --> 00:29:09.000
maybe you're picking up to 10 pound dumbbells

478
00:29:09.000 --> 00:29:11.000
and you're holding them and doing air squats with your dumbbells.

479
00:29:11.000 --> 00:29:13.000
And eventually you're going to move to the barbell.

480
00:29:13.000 --> 00:29:17.000
So it's all about small progression under load

481
00:29:17.000 --> 00:29:19.000
to get to a point where you feel more confident

482
00:29:19.000 --> 00:29:21.000
to use a barbell back squat,

483
00:29:21.000 --> 00:29:23.000
to get into more of those compound movements.

484
00:29:23.000 --> 00:29:27.000
Why don't people exercise specifically,

485
00:29:27.000 --> 00:29:29.000
if we just focus here on women,

486
00:29:29.000 --> 00:29:31.000
what is the reason why people hear what you guys say

487
00:29:31.000 --> 00:29:33.000
when you're talking about exercise?

488
00:29:33.000 --> 00:29:35.000
And they don't do it.

489
00:29:35.000 --> 00:29:37.000
They don't start.

490
00:29:37.000 --> 00:29:39.000
It's hard.

491
00:29:39.000 --> 00:29:41.000
What set of reasons make it hard?

492
00:29:41.000 --> 00:29:43.000
It's set up in a gendered environment.

493
00:29:43.000 --> 00:29:45.000
Like I always use the example of a woman

494
00:29:45.000 --> 00:29:47.000
who is an interest in strength training.

495
00:29:47.000 --> 00:29:51.000
If they go to a typical 24-hour fitness

496
00:29:51.000 --> 00:29:53.000
or another brand gym that's out there,

497
00:29:53.000 --> 00:29:55.000
they'll walk in and they'll say,

498
00:29:55.000 --> 00:29:57.000
yep, I want to join.

499
00:29:57.000 --> 00:30:01.000
And the membership person most often will say,

500
00:30:01.000 --> 00:30:03.000
great, here's a class schedule.

501
00:30:03.000 --> 00:30:05.000
This is where we have our spin classes.

502
00:30:05.000 --> 00:30:09.000
This is where we do our boot classes.

503
00:30:09.000 --> 00:30:11.000
They never direct them to the lifting platforms.

504
00:30:11.000 --> 00:30:13.000
They never look and say, hey,

505
00:30:13.000 --> 00:30:15.000
here are the way to get strong.

506
00:30:15.000 --> 00:30:17.000
Because they are under the assumption

507
00:30:17.000 --> 00:30:19.000
through sociocultural ideas

508
00:30:19.000 --> 00:30:21.000
that a woman is coming to the gym to lose weight,

509
00:30:21.000 --> 00:30:23.000
not to get strong, not to gain muscle.

510
00:30:23.000 --> 00:30:25.000
Not to recompassition.

511
00:30:25.000 --> 00:30:27.000
Right. But if a man walks in,

512
00:30:27.000 --> 00:30:29.000
then it's always the great.

513
00:30:29.000 --> 00:30:31.000
Here's the lifting platforms.

514
00:30:31.000 --> 00:30:33.000
We have X amount of barbells.

515
00:30:33.000 --> 00:30:35.000
We have X amount of bumper plates.

516
00:30:35.000 --> 00:30:37.000
How much weight do you want to gain?

517
00:30:37.000 --> 00:30:41.000
Do you want to work with someone to help you build that mass?

518
00:30:41.000 --> 00:30:43.000
Fund, why does it matter?

519
00:30:43.000 --> 00:30:47.000
Because there's a big social pressure on women

520
00:30:47.000 --> 00:30:49.000
to look a certain way.

521
00:30:49.000 --> 00:30:51.000
And it doesn't typically involve muscles,

522
00:30:51.000 --> 00:30:53.000
especially in the upper body.

523
00:30:53.000 --> 00:30:55.000
No.

524
00:30:55.000 --> 00:30:57.000
So we're still living under the times

525
00:30:57.000 --> 00:30:59.000
of being as small as you can.

526
00:30:59.000 --> 00:31:01.000
But small doesn't mean lean.

527
00:31:01.000 --> 00:31:03.000
There's a concept of skinny fat,

528
00:31:03.000 --> 00:31:05.000
which you know,

529
00:31:05.000 --> 00:31:07.000
you can be as tiny as tiny,

530
00:31:07.000 --> 00:31:09.000
but you can be 50%.

531
00:31:09.000 --> 00:31:11.000
You can have a body fat of 50%,

532
00:31:11.000 --> 00:31:13.000
which means you're neither strong.

533
00:31:13.000 --> 00:31:15.000
You're not metabolically healthy.

534
00:31:15.000 --> 00:31:17.000
You're just little, right?

535
00:31:17.000 --> 00:31:21.000
So there is also a misconception

536
00:31:21.000 --> 00:31:23.000
that lifting heavy

537
00:31:23.000 --> 00:31:27.000
is going to automatically turn you into a physique model,

538
00:31:27.000 --> 00:31:29.000
or a bodybuilder's shape.

539
00:31:29.000 --> 00:31:31.000
If that's your goal,

540
00:31:31.000 --> 00:31:33.000
that's probably going to take you five years or a decade.

541
00:31:33.000 --> 00:31:35.000
It's a lot of hard work for a long period of time

542
00:31:35.000 --> 00:31:37.000
with proper nutrition.

543
00:31:37.000 --> 00:31:39.000
So for a woman

544
00:31:39.000 --> 00:31:43.000
who's wants to feel better,

545
00:31:43.000 --> 00:31:47.000
the goal is to build muscle to be lean.

546
00:31:47.000 --> 00:31:49.000
To recompose, not lose weight, right?

547
00:31:49.000 --> 00:31:51.000
I'm not really interested in somebody's weight.

548
00:31:51.000 --> 00:31:55.000
I'm interested in their body fat percentage

549
00:31:55.000 --> 00:31:57.000
and their lean muscle mass.

550
00:31:57.000 --> 00:32:01.000
Because it's what you're made of that matters, right?

551
00:32:01.000 --> 00:32:03.000
Not the size of the shell.

552
00:32:03.000 --> 00:32:05.000
And why does muscle matter

553
00:32:05.000 --> 00:32:07.000
as I age as a woman in particular?

554
00:32:07.000 --> 00:32:09.000
It matters for everyone,

555
00:32:09.000 --> 00:32:11.000
but for muscle matters

556
00:32:11.000 --> 00:32:13.000
because it's not just part of locomotion.

557
00:32:13.000 --> 00:32:15.000
It's not just part of moving you around.

558
00:32:15.000 --> 00:32:17.000
It is a metabolic organ.

559
00:32:17.000 --> 00:32:21.000
It is critical for glucose metabolism.

560
00:32:21.000 --> 00:32:25.000
It's critical for insulin sensitivity.

561
00:32:25.000 --> 00:32:27.000
It talks to the bone.

562
00:32:27.000 --> 00:32:31.000
Bone and bone and muscle are endocrine organs,

563
00:32:31.000 --> 00:32:33.000
which cross communicate all the time.

564
00:32:33.000 --> 00:32:37.000
So both bone and muscle have access to the brain, right?

565
00:32:37.000 --> 00:32:41.000
Muscle will produce a hormone called irisin,

566
00:32:41.000 --> 00:32:45.000
which has multiple functions in the body.

567
00:32:45.000 --> 00:32:49.000
The access between muscle and brain helps your brain

568
00:32:49.000 --> 00:32:53.000
produce more neurons, right?

569
00:32:53.000 --> 00:32:57.000
Bone's access to the brain has a role in satiety.

570
00:32:57.000 --> 00:32:59.000
Isn't that amazing?

571
00:32:59.000 --> 00:33:01.000
Which means not hungry anymore.

572
00:33:01.000 --> 00:33:05.000
Why would you think these locomotive structures,

573
00:33:05.000 --> 00:33:07.000
if that's what you limit them to,

574
00:33:07.000 --> 00:33:09.000
would even have those functions?

575
00:33:09.000 --> 00:33:13.000
It's because we put organs in a box.

576
00:33:13.000 --> 00:33:17.000
So to answer your question, muscle in men and women,

577
00:33:17.000 --> 00:33:19.000
but women in particular for this conversation,

578
00:33:19.000 --> 00:33:21.000
we need as much muscle as possible

579
00:33:21.000 --> 00:33:25.000
to fight the insulin resistance that we get when estrogen walks out the door.

580
00:33:25.000 --> 00:33:29.000
We need muscle for glucose metabolism.

581
00:33:29.000 --> 00:33:33.000
We need muscle for the pure strength of it

582
00:33:33.000 --> 00:33:39.000
because we do not want to become frail

583
00:33:39.000 --> 00:33:43.000
and be one of the two thirds of nursing home residents who are women

584
00:33:43.000 --> 00:33:47.000
because we can't do something as simple as get up out of a chair.

585
00:33:47.000 --> 00:33:49.000
But I could just get muscle when I'm 70.

586
00:33:49.000 --> 00:33:51.000
You can, actually.

587
00:33:51.000 --> 00:33:53.000
So why does it matter for Mel to be thinking about it when she's 33?

588
00:33:53.000 --> 00:33:55.000
Well, here's a great part for Mel.

589
00:33:55.000 --> 00:33:57.000
Is she still has all her estrogen?

590
00:33:57.000 --> 00:34:03.000
Estrogen has a profound effect on muscle protein synthesis.

591
00:34:03.000 --> 00:34:07.000
It is a significant anti-inflammatory.

592
00:34:07.000 --> 00:34:11.000
So high inflammation, chronic inflammation

593
00:34:11.000 --> 00:34:15.000
if we've talked about decreases muscle synthesis,

594
00:34:15.000 --> 00:34:19.000
the decreases bone synthesis because inflammation

595
00:34:19.000 --> 00:34:21.000
with its high cytokine level,

596
00:34:21.000 --> 00:34:23.000
I've mentioned them before,

597
00:34:23.000 --> 00:34:25.000
IL-6 tumor-acrosis factor,

598
00:34:25.000 --> 00:34:29.000
those are all detrimental to these normal metabolic pathways.

599
00:34:29.000 --> 00:34:33.000
So the wonderful thing for Mel who is entering

600
00:34:33.000 --> 00:34:35.000
what I call the critical decade,

601
00:34:35.000 --> 00:34:37.000
which is 35 to 45 estimated,

602
00:34:37.000 --> 00:34:43.000
it's the prime time to set your physical activity standards

603
00:34:43.000 --> 00:35:09.000
and to build as much as you can

604
00:35:13.000 --> 00:35:15.000
and you can use it better.

605
00:35:15.000 --> 00:35:19.000
If you have another thing that is pro-inflammatory,

606
00:35:19.000 --> 00:35:21.000
such as PCOS or endometriosis,

607
00:35:21.000 --> 00:35:23.000
it's even more important for you

608
00:35:23.000 --> 00:35:25.000
because your inflammatory burden

609
00:35:25.000 --> 00:35:29.000
by default of what's happening at a cellular level is higher,

610
00:35:29.000 --> 00:35:31.000
we now need to not just say,

611
00:35:31.000 --> 00:35:33.000
I need to not make it worse by being exposed to things.

612
00:35:33.000 --> 00:35:35.000
We have to say, I need a plan to fight this

613
00:35:35.000 --> 00:35:39.000
because my world is pro-inflammatory on a daily basis.

614
00:35:39.000 --> 00:35:41.000
What is my game plan to fight this?

615
00:35:41.000 --> 00:35:43.000
And building muscle,

616
00:35:43.000 --> 00:35:45.000
it's not just exercise is better than no exercise,

617
00:35:45.000 --> 00:35:47.000
but specifically building muscle

618
00:35:47.000 --> 00:35:49.000
because as everybody's saying,

619
00:35:49.000 --> 00:35:51.000
it has a metabolic function in your body

620
00:35:51.000 --> 00:35:53.000
is going to help you the most.

621
00:35:53.000 --> 00:35:55.000
There's a term called geroprotective.

622
00:35:55.000 --> 00:35:57.000
So geroprotections.

623
00:35:57.000 --> 00:35:59.000
So geroprotections is the term used for aging.

624
00:35:59.000 --> 00:36:03.000
So gerontology is the part of medicine that focuses

625
00:36:03.000 --> 00:36:05.000
on the elderly patients.

626
00:36:05.000 --> 00:36:07.000
So when we look in females

627
00:36:07.000 --> 00:36:09.000
and the organs that are, you know,

628
00:36:09.000 --> 00:36:11.000
are the most geroprotective,

629
00:36:11.000 --> 00:36:13.000
it is the muscle

630
00:36:13.000 --> 00:36:15.000
and the ovary and the ovaries go away.

631
00:36:15.000 --> 00:36:17.000
We have a shelf life in our ovaries.

632
00:36:17.000 --> 00:36:19.000
So then we're just really left with our muscle

633
00:36:19.000 --> 00:36:21.000
as far as protecting us

634
00:36:21.000 --> 00:36:23.000
in those elderly years as we age.

635
00:36:23.000 --> 00:36:26.000
And it's directly correlative to the amount of muscle that we have.

636
00:36:26.000 --> 00:36:28.000
Because if you have a lot of muscle,

637
00:36:28.000 --> 00:36:30.000
you're going to have stronger bones.

638
00:36:30.000 --> 00:36:33.000
And this is where the intensity part

639
00:36:33.000 --> 00:36:37.000
where Dr. Rice is talking about seeing the ignite class

640
00:36:37.000 --> 00:36:39.000
and everyone's in that moderate intensity all the time.

641
00:36:39.000 --> 00:36:41.000
With moderate intensity,

642
00:36:41.000 --> 00:36:43.000
you don't have the post-exercise

643
00:36:43.000 --> 00:36:45.000
anti-inflammatory response.

644
00:36:45.000 --> 00:36:47.000
So if we're trying to build muscle

645
00:36:47.000 --> 00:36:49.000
and we're trying to dampen inflammation,

646
00:36:49.000 --> 00:36:51.000
if we're always doing this moderate intensity cardio,

647
00:36:51.000 --> 00:36:55.000
then we're not one going to be building the muscle we want.

648
00:36:55.000 --> 00:36:57.000
And two, we're going to have this baseline elevation

649
00:36:57.000 --> 00:36:59.000
of total body inflammation.

650
00:36:59.000 --> 00:37:01.000
So we need to mix it up

651
00:37:01.000 --> 00:37:03.000
and have that precedence on being muscle-centric

652
00:37:03.000 --> 00:37:05.000
and building that muscle,

653
00:37:05.000 --> 00:37:07.000
one to help with aesthetics.

654
00:37:07.000 --> 00:37:09.000
I mean, that's the byproduct of lifting weights.

655
00:37:09.000 --> 00:37:11.000
You tend to look better.

656
00:37:11.000 --> 00:37:13.000
But it's more than that.

657
00:37:13.000 --> 00:37:15.000
We see it improves brain health

658
00:37:15.000 --> 00:37:17.000
because of the neuroconnections

659
00:37:17.000 --> 00:37:19.000
and the neuroplasticity of the brain.

660
00:37:19.000 --> 00:37:21.000
And I tell all of those things.

661
00:37:21.000 --> 00:37:23.000
You get an incredible parasympathetic response

662
00:37:23.000 --> 00:37:27.000
when you've done a significant heavy lifting session

663
00:37:27.000 --> 00:37:29.000
or a sprint interval session

664
00:37:29.000 --> 00:37:31.000
which you don't get with that moderate intensity

665
00:37:31.000 --> 00:37:33.000
cardiovascular work.

666
00:37:33.000 --> 00:37:35.000
Two questions to add to what you're better say here is,

667
00:37:35.000 --> 00:37:37.000
am I right in thinking that

668
00:37:37.000 --> 00:37:39.000
at the end of that golden decade

669
00:37:39.000 --> 00:37:41.000
that you referenced 45 years old

670
00:37:41.000 --> 00:37:43.000
because you have changes in estrogen,

671
00:37:43.000 --> 00:37:47.000
one will expect to see a natural decline in muscle.

672
00:37:47.000 --> 00:37:51.000
And an increased chance of osteoporosis,

673
00:37:51.000 --> 00:37:53.000
osteopenia bone issues later in life.

674
00:37:53.000 --> 00:37:55.000
This is several questions I apologize,

675
00:37:55.000 --> 00:37:57.000
but do women then also tend to have

676
00:37:57.000 --> 00:37:59.000
more frailed bones in late life?

677
00:37:59.000 --> 00:38:01.000
And is that linked to the muscle loss?

678
00:38:01.000 --> 00:38:03.000
So this is how it works.

679
00:38:03.000 --> 00:38:05.000
So both men and women build bone and peak

680
00:38:05.000 --> 00:38:09.000
about up to 25, sometimes 30.

681
00:38:09.000 --> 00:38:11.000
And then bone loss plateaus

682
00:38:11.000 --> 00:38:13.000
for a little while,

683
00:38:13.000 --> 00:38:15.000
men continue to lose about 1% a year.

684
00:38:15.000 --> 00:38:17.000
So men do not arrive

685
00:38:17.000 --> 00:38:21.000
with hip fractures or devastating fractures

686
00:38:21.000 --> 00:38:25.000
until their 70s or 80s or older.

687
00:38:25.000 --> 00:38:29.000
Women also decline slowly

688
00:38:29.000 --> 00:38:31.000
until we lose our estrogen.

689
00:38:31.000 --> 00:38:33.000
And then the rate of decline

690
00:38:33.000 --> 00:38:35.000
and I'll tell you why it happens for bone,

691
00:38:35.000 --> 00:38:37.000
doubles or triples, such that you will lose

692
00:38:37.000 --> 00:38:39.000
15 to 20% of your bone density

693
00:38:39.000 --> 00:38:41.000
during your perimenopausal period,

694
00:38:41.000 --> 00:38:43.000
just from loss of estrogen alone.

695
00:38:43.000 --> 00:38:47.000
Because estrogen plays many roles.

696
00:38:47.000 --> 00:38:49.000
I've already talked about estrogen

697
00:38:49.000 --> 00:38:51.000
being a huge anti-inflammatory.

698
00:38:51.000 --> 00:38:53.000
Bones are very sensitive

699
00:38:53.000 --> 00:38:57.000
and inflammatory chemicals in your body.

700
00:38:57.000 --> 00:38:59.000
Estrogen also directly affects

701
00:38:59.000 --> 00:39:01.000
the balance of the two main cells

702
00:39:01.000 --> 00:39:05.000
that subtract minerals from bone,

703
00:39:05.000 --> 00:39:07.000
the osteoclast,

704
00:39:07.000 --> 00:39:09.000
and the cell that builds the bone,

705
00:39:09.000 --> 00:39:11.000
the osteoblast.

706
00:39:11.000 --> 00:39:15.000
And in well-hormoned times,

707
00:39:15.000 --> 00:39:17.000
there is a balance.

708
00:39:17.000 --> 00:39:19.000
The body loves balance.

709
00:39:19.000 --> 00:39:21.000
We take what we need, we build it back.

710
00:39:21.000 --> 00:39:23.000
And estrogen has such a profound effect

711
00:39:23.000 --> 00:39:25.000
on the osteoclast,

712
00:39:25.000 --> 00:39:27.000
the Pac-Man bone-eating cell.

713
00:39:27.000 --> 00:39:29.000
There's an unbalance.

714
00:39:29.000 --> 00:39:31.000
And we take more bone

715
00:39:31.000 --> 00:39:33.000
than we're capable of building.

716
00:39:33.000 --> 00:39:35.000
We're still building bone.

717
00:39:35.000 --> 00:39:37.000
But the rate cannot keep up with this.

718
00:39:37.000 --> 00:39:39.000
So with the inflammation,

719
00:39:39.000 --> 00:39:43.000
with the direct effects on the osteoclasts,

720
00:39:43.000 --> 00:39:45.000
women will lose bone density

721
00:39:45.000 --> 00:39:47.000
if they do nothing.

722
00:39:47.000 --> 00:39:49.000
Well, number one, they're going to lose bone density.

723
00:39:49.000 --> 00:39:51.000
But they must do something about it.

724
00:39:51.000 --> 00:39:55.000
So critical for a 33-year-old

725
00:39:55.000 --> 00:39:57.000
is because you still have your estrogen.

726
00:39:57.000 --> 00:39:59.000
So let's learn how to lift heavy.

727
00:39:59.000 --> 00:40:03.000
Let's take advantage of the estrogen circulating.

728
00:40:03.000 --> 00:40:05.000
Let's learn to have a jumping practice

729
00:40:05.000 --> 00:40:07.000
and impact our bones.

730
00:40:07.000 --> 00:40:11.000
So the way our body tells our bones to build more

731
00:40:11.000 --> 00:40:15.000
is there's another little cell

732
00:40:15.000 --> 00:40:17.000
called the osteocyte.

733
00:40:17.000 --> 00:40:19.000
It sits encased in bone.

734
00:40:19.000 --> 00:40:23.000
It sits encased to these other cells

735
00:40:23.000 --> 00:40:25.000
by little tunnels that contain fluid.

736
00:40:25.000 --> 00:40:27.000
When you jump,

737
00:40:27.000 --> 00:40:29.000
the biomechanical impulse

738
00:40:29.000 --> 00:40:31.000
of that fluid shifting

739
00:40:31.000 --> 00:40:33.000
in the little tunnels

740
00:40:33.000 --> 00:40:35.000
is translated

741
00:40:35.000 --> 00:40:37.000
into a biochemical stimulation

742
00:40:37.000 --> 00:40:39.000
that tells the bone,

743
00:40:39.000 --> 00:40:41.000
oh my god, she's jumping around.

744
00:40:41.000 --> 00:40:43.000
I need to build more bone.

745
00:40:43.000 --> 00:40:45.000
So we need that impact

746
00:40:45.000 --> 00:40:47.000
to stimulate

747
00:40:47.000 --> 00:40:49.000
what you were describing.

748
00:40:49.000 --> 00:40:51.000
Many women are that far away

749
00:40:51.000 --> 00:40:55.000
in terms of bone mass.

750
00:40:55.000 --> 00:40:57.000
So this is showing the fact

751
00:40:57.000 --> 00:40:59.000
that because of the way testosterone interacts

752
00:40:59.000 --> 00:41:01.000
with a man's bones,

753
00:41:01.000 --> 00:41:03.000
he will peak at a higher bone mass

754
00:41:03.000 --> 00:41:05.000
than a woman will.

755
00:41:05.000 --> 00:41:07.000
So he's starting at a higher level.

756
00:41:07.000 --> 00:41:09.000
So I would want young women

757
00:41:09.000 --> 00:41:11.000
to do everything humanly possible

758
00:41:11.000 --> 00:41:15.000
to start at the highest possible level.

759
00:41:15.000 --> 00:41:17.000
But I see lots of 20-year-olds,

760
00:41:17.000 --> 00:41:19.000
30-year-olds, really young women

761
00:41:19.000 --> 00:41:21.000
with poor bone density

762
00:41:21.000 --> 00:41:23.000
for a lot of reasons.

763
00:41:23.000 --> 00:41:25.000
And so I'm a big proponent

764
00:41:25.000 --> 00:41:27.000
for having bones measured early.

765
00:41:27.000 --> 00:41:29.000
Don't wait until you're old

766
00:41:29.000 --> 00:41:31.000
so you know where you're starting.

767
00:41:31.000 --> 00:41:33.000
But that's not the standard recommendation.

768
00:41:33.000 --> 00:41:35.000
No, the standard recommendation is 65,

769
00:41:35.000 --> 00:41:37.000
which...

770
00:41:37.000 --> 00:41:39.000
South of our long way.

771
00:41:39.000 --> 00:41:41.000
For that.

772
00:41:41.000 --> 00:41:43.000
But because I do do either a dexascane

773
00:41:43.000 --> 00:41:45.000
or sound a look at bone quality on everybody,

774
00:41:47.000 --> 00:41:49.000
we can catch it earlier.

775
00:41:49.000 --> 00:41:51.000
And that's really important to get in front of it,

776
00:41:51.000 --> 00:41:55.000
because it's estimated research says that

777
00:41:55.000 --> 00:41:57.000
in order to affect bone density,

778
00:41:57.000 --> 00:41:59.000
if you're going to use estrogen, for instance,

779
00:41:59.000 --> 00:42:01.000
you need to have do it for 10 years.

780
00:42:01.000 --> 00:42:03.000
And why should people care about bone density?

781
00:42:03.000 --> 00:42:05.000
Everyone cares about muscles,

782
00:42:05.000 --> 00:42:07.000
but very few people talk about bones.

783
00:42:07.000 --> 00:42:09.000
Can't carry a muscle around if you have weak bones.

784
00:42:09.000 --> 00:42:11.000
So without bone,

785
00:42:11.000 --> 00:42:13.000
muscle is just a heaping pile of

786
00:42:13.000 --> 00:42:15.000
steaming metabolic tissues sitting there, right?

787
00:42:15.000 --> 00:42:19.000
There would be no bicep to complement, right?

788
00:42:19.000 --> 00:42:21.000
Because it has to be connected to a bone.

789
00:42:21.000 --> 00:42:23.000
So they're important for locomotion

790
00:42:23.000 --> 00:42:25.000
and giving support to the muscle.

791
00:42:25.000 --> 00:42:29.000
But bone is an endocrine organ that secrets hormones

792
00:42:29.000 --> 00:42:31.000
that go to your brain to help build neurons,

793
00:42:31.000 --> 00:42:33.000
to your pancreas,

794
00:42:33.000 --> 00:42:35.000
to be active in insulin release,

795
00:42:35.000 --> 00:42:39.000
to the muscle for glucose metabolism.

796
00:42:39.000 --> 00:42:43.000
In men, to the testes, to build testosterone.

797
00:42:43.000 --> 00:42:45.000
And that's only one of the many hormones

798
00:42:45.000 --> 00:42:47.000
that the bone produces.

799
00:42:47.000 --> 00:42:49.000
The bone is not only structural,

800
00:42:49.000 --> 00:42:51.000
not only hormonal.

801
00:42:51.000 --> 00:42:53.000
I've already talked about it being a storehouse,

802
00:42:53.000 --> 00:42:55.000
but it's an incubator.

803
00:42:55.000 --> 00:42:59.000
In our palvus is where we build all of our blood cells.

804
00:42:59.000 --> 00:43:03.000
And so it has these multi-functions.

805
00:43:03.000 --> 00:43:07.000
But to marry Claire's point for women,

806
00:43:07.000 --> 00:43:11.000
40 to 50% of women will have low bone density.

807
00:43:11.000 --> 00:43:13.000
And when you have that,

808
00:43:13.000 --> 00:43:15.000
50% of the time you'll break a bone.

809
00:43:15.000 --> 00:43:17.000
So if we're looking around at this table,

810
00:43:17.000 --> 00:43:19.000
if we all have osteoporosis, which we don't,

811
00:43:19.000 --> 00:43:23.000
one in two of us will fracture.

812
00:43:23.000 --> 00:43:27.000
When that fracture is a hip fracture,

813
00:43:27.000 --> 00:43:31.000
which is very common, 70% of all hip fractures happen in women.

814
00:43:31.000 --> 00:43:35.000
30% of the time when you hit the floor

815
00:43:35.000 --> 00:43:37.000
and something breaks,

816
00:43:37.000 --> 00:43:39.000
you have a chance of dying in one year,

817
00:43:39.000 --> 00:43:41.000
this quick, your life changes.

818
00:43:41.000 --> 00:43:43.000
50% of the time,

819
00:43:43.000 --> 00:43:45.000
even if you survive,

820
00:43:45.000 --> 00:43:47.000
you will never return to pre-fall function,

821
00:43:47.000 --> 00:43:49.000
meaning you can't go home.

822
00:43:49.000 --> 00:43:51.000
And that puts your family

823
00:43:51.000 --> 00:43:55.000
in this situation of having to figure out

824
00:43:55.000 --> 00:43:57.000
24-hour care,

825
00:43:57.000 --> 00:43:59.000
or you move in with your eldest daughter,

826
00:43:59.000 --> 00:44:01.000
or you go into a facility

827
00:44:01.000 --> 00:44:03.000
where you use your life savings

828
00:44:03.000 --> 00:44:05.000
until you have no more.

829
00:44:05.000 --> 00:44:07.000
And then you have to apply for Medicaid

830
00:44:07.000 --> 00:44:09.000
and the government will pay for it.

831
00:44:09.000 --> 00:44:11.000
These are terrible situations

832
00:44:11.000 --> 00:44:13.000
to get at something

833
00:44:13.000 --> 00:44:15.000
that we could have prevented

834
00:44:15.000 --> 00:44:17.000
had we started early enough.

835
00:44:17.000 --> 00:44:19.000
So you want to start early?

836
00:44:19.000 --> 00:44:21.000
So I have malts.

837
00:44:21.000 --> 00:44:23.000
Malts is going to be doing strength training,

838
00:44:23.000 --> 00:44:25.000
not just for the muscle benefits,

839
00:44:25.000 --> 00:44:27.000
but also because it's going to help

840
00:44:27.000 --> 00:44:29.000
build strong healthy bones

841
00:44:29.000 --> 00:44:31.000
in that critical decade.

842
00:44:31.000 --> 00:44:33.000
Jump training.

843
00:44:33.000 --> 00:44:35.000
So apply a metric type work,

844
00:44:35.000 --> 00:44:37.000
or if we're looking at

845
00:44:37.000 --> 00:44:39.000
not having the robustness

846
00:44:39.000 --> 00:44:41.000
of doing straight plios,

847
00:44:41.000 --> 00:44:43.000
then you can do band-assisted pogos,

848
00:44:43.000 --> 00:44:45.000
you can do low-death jumps,

849
00:44:45.000 --> 00:44:47.000
so you're getting some impact,

850
00:44:47.000 --> 00:44:49.000
the bone, because as Dr. Roy is talking about,

851
00:44:49.000 --> 00:44:51.000
it's a multi-directional stress.

852
00:44:51.000 --> 00:44:53.000
People think, oh, I run,

853
00:44:53.000 --> 00:44:55.000
I'm going to have strong bones,

854
00:44:55.000 --> 00:44:57.000
but running doesn't do it.

855
00:44:57.000 --> 00:44:59.000
You need multi-directional stress.

856
00:44:59.000 --> 00:45:01.000
So it's called the ground reaction force

857
00:45:01.000 --> 00:45:03.000
that comes up through the bone

858
00:45:03.000 --> 00:45:05.000
to create that strength.

859
00:45:05.000 --> 00:45:07.000
So that ideal situation

860
00:45:07.000 --> 00:45:09.000
in a workout for her would be

861
00:45:09.000 --> 00:45:11.000
some ability, some heavy lifting,

862
00:45:11.000 --> 00:45:13.000
for doing plio that's also

863
00:45:13.000 --> 00:45:15.000
sprint type training

864
00:45:15.000 --> 00:45:17.000
so you're getting a metabolic stress.

865
00:45:17.000 --> 00:45:19.000
So you're hitting all the major factors

866
00:45:19.000 --> 00:45:21.000
in one hour workout.

867
00:45:21.000 --> 00:45:23.000
I read that there was a study

868
00:45:23.000 --> 00:45:25.000
done with some Australian

869
00:45:25.000 --> 00:45:27.000
elderly ladies on bone growth.

870
00:45:27.000 --> 00:45:29.000
On lifting and bone growth?

871
00:45:29.000 --> 00:45:31.000
Yes. Yes.

872
00:45:31.000 --> 00:45:33.000
And the lift more study.

873
00:45:33.000 --> 00:45:35.000
But Dr. Beck,

874
00:45:35.000 --> 00:45:37.000
she was trying to dispel the myth,

875
00:45:37.000 --> 00:45:39.000
which I hear every day,

876
00:45:39.000 --> 00:45:41.000
that you've got osteoporosis,

877
00:45:41.000 --> 00:45:43.000
you can't lift weights.

878
00:45:43.000 --> 00:45:45.000
And so her study,

879
00:45:45.000 --> 00:45:47.000
because we're big proponents

880
00:45:47.000 --> 00:45:49.000
of teaching people to progressively

881
00:45:49.000 --> 00:45:51.000
lift heavier and heavier,

882
00:45:51.000 --> 00:45:53.000
and that scares people,

883
00:45:53.000 --> 00:45:55.000
but especially if you think you're going to break.

884
00:45:55.000 --> 00:45:57.000
You have reps, five sets,

885
00:45:57.000 --> 00:45:59.000
under a supervised situation.

886
00:45:59.000 --> 00:46:01.000
So five reps means

887
00:46:01.000 --> 00:46:03.000
that it was heavy enough

888
00:46:03.000 --> 00:46:05.000
that at five reps they were near failure.

889
00:46:05.000 --> 00:46:07.000
Right?

890
00:46:07.000 --> 00:46:09.000
So these women,

891
00:46:09.000 --> 00:46:11.000
all osteoporotic,

892
00:46:11.000 --> 00:46:13.000
not only were capable of lifting heavy under supervision,

893
00:46:13.000 --> 00:46:15.000
none of them broke.

894
00:46:15.000 --> 00:46:17.000
And they built bone.

895
00:46:17.000 --> 00:46:19.000
Yep.

896
00:46:19.000 --> 00:46:21.000
So that answers the question.

897
00:46:21.000 --> 00:46:23.000
Right. Can you lift? Yes.

898
00:46:23.000 --> 00:46:25.000
And the other thing that

899
00:46:25.000 --> 00:46:27.000
isn't really brought up into these conversations

900
00:46:27.000 --> 00:46:29.000
is when you hit parimenopause.

901
00:46:29.000 --> 00:46:31.000
Not only is estrogen

902
00:46:31.000 --> 00:46:33.000
sort of the stimulus for satellite cell,

903
00:46:33.000 --> 00:46:35.000
where we're building muscle cell.

904
00:46:35.000 --> 00:46:37.000
But it has a distinct,

905
00:46:37.000 --> 00:46:39.000
I guess, influence on myocin.

906
00:46:39.000 --> 00:46:41.000
So myocin and actin

907
00:46:41.000 --> 00:46:43.000
are two contractile proteins.

908
00:46:43.000 --> 00:46:45.000
So if you think about a sliding filament

909
00:46:45.000 --> 00:46:47.000
or coming together,

910
00:46:47.000 --> 00:46:49.000
you have myocin and actin that bond together

911
00:46:49.000 --> 00:46:51.000
to then pull a move,

912
00:46:51.000 --> 00:46:53.000
and pull a move,

913
00:46:53.000 --> 00:46:55.000
and that's how you have a muscle contraction.

914
00:46:55.000 --> 00:46:59.000
Estrogen is responsible for how tightly myocin bonds

915
00:46:59.000 --> 00:47:01.000
to actin.

916
00:47:01.000 --> 00:47:03.000
When we start to lose estrogen

917
00:47:03.000 --> 00:47:05.000
or we start to have variability in our estrogen,

918
00:47:05.000 --> 00:47:07.000
we get myocin dysfunction.

919
00:47:07.000 --> 00:47:09.000
So that means we're not going to get

920
00:47:09.000 --> 00:47:11.000
a very strong contraction.

921
00:47:11.000 --> 00:47:13.000
So we get weaker.

922
00:47:13.000 --> 00:47:15.000
And this is one of the very first things

923
00:47:15.000 --> 00:47:17.000
that people complain about to me.

924
00:47:17.000 --> 00:47:19.000
I can't...

925
00:47:19.000 --> 00:47:21.000
my group's strength is gone.

926
00:47:21.000 --> 00:47:23.000
But their body composition hasn't changed yet.

927
00:47:23.000 --> 00:47:25.000
So if we think about lifting heavier loads,

928
00:47:25.000 --> 00:47:27.000
it's a neuromuscular response.

929
00:47:27.000 --> 00:47:29.000
And that direct stimulus

930
00:47:29.000 --> 00:47:31.000
creates the adaptive change in myocin

931
00:47:31.000 --> 00:47:33.000
that now estrogen isn't responsible for.

932
00:47:33.000 --> 00:47:35.000
It's a different

933
00:47:35.000 --> 00:47:37.000
external stress that creates

934
00:47:37.000 --> 00:47:39.000
that change in myocin to go,

935
00:47:39.000 --> 00:47:41.000
yep, I have to grab on to actin

936
00:47:41.000 --> 00:47:43.000
and have a very strong contraction.

937
00:47:43.000 --> 00:47:45.000
So we see that this dysfunction happens first

938
00:47:45.000 --> 00:47:47.000
before we start seeing a change

939
00:47:47.000 --> 00:47:49.000
in our lean mass development.

940
00:47:49.000 --> 00:47:51.000
So if we are already in the habit

941
00:47:51.000 --> 00:47:53.000
of lifting heavier loads,

942
00:47:53.000 --> 00:47:55.000
then we can offshoot some of that

943
00:47:55.000 --> 00:47:57.000
myocin dysfunction that occurs

944
00:47:57.000 --> 00:47:59.000
with the estrogen change.

945
00:47:59.000 --> 00:48:01.000
So when my patients come in

946
00:48:01.000 --> 00:48:03.000
and they are looking to prevent osteoporosis

947
00:48:03.000 --> 00:48:05.000
or they've gotten a diagnosis of low bone density,

948
00:48:05.000 --> 00:48:07.000
you know, what can they do?

949
00:48:07.000 --> 00:48:09.000
I've discussed the lift more trial.

950
00:48:09.000 --> 00:48:11.000
The new study just came out

951
00:48:11.000 --> 00:48:13.000
May of this year of 2025

952
00:48:13.000 --> 00:48:15.000
and they looked at very similar

953
00:48:15.000 --> 00:48:17.000
to the protocol used in lift more.

954
00:48:17.000 --> 00:48:18.000
So there was a control group

955
00:48:18.000 --> 00:48:19.000
where they just did nothing.

956
00:48:19.000 --> 00:48:21.000
Then a group that did the

957
00:48:21.000 --> 00:48:23.000
they did three days a week

958
00:48:23.000 --> 00:48:25.000
and they did resistance training and jump training.

959
00:48:25.000 --> 00:48:27.000
And then the third group did

960
00:48:27.000 --> 00:48:29.000
all the same exercises and added HRT

961
00:48:29.000 --> 00:48:31.000
and depending if they had a uterus,

962
00:48:31.000 --> 00:48:33.000
they got estrogen or estrogen plus a progesterogen.

963
00:48:33.000 --> 00:48:35.000
And so, of course, as expected,

964
00:48:35.000 --> 00:48:37.000
the do nothing group lost bone.

965
00:48:37.000 --> 00:48:39.000
You gained bone as expected

966
00:48:39.000 --> 00:48:41.000
in the resistance group,

967
00:48:41.000 --> 00:48:43.000
it would be synergistic

968
00:48:43.000 --> 00:48:45.000
when we added hormone therapy

969
00:48:45.000 --> 00:48:47.000
and the resistance training together,

970
00:48:47.000 --> 00:48:49.000
they grew even more bone.

971
00:48:49.000 --> 00:48:51.000
They had even better results.

972
00:48:51.000 --> 00:48:53.000
So when my patients are like,

973
00:48:53.000 --> 00:48:55.000
I want to hedge my bets,

974
00:48:55.000 --> 00:48:57.000
my mother fell in fractures,

975
00:48:57.000 --> 00:48:59.000
she's broken her hip,

976
00:48:59.000 --> 00:49:01.000
in a nursing home, whatever,

977
00:49:01.000 --> 00:49:03.000
and I'm trying to avoid this.

978
00:49:03.000 --> 00:49:05.000
I'm we're hitting all the points

979
00:49:05.000 --> 00:49:07.000
and the only medication event.

980
00:49:07.000 --> 00:49:09.000
Now we have other medicines

981
00:49:09.000 --> 00:49:11.000
that are more effective.

982
00:49:11.000 --> 00:49:13.000
So to me, prevention is always

983
00:49:13.000 --> 00:49:15.000
better than cure.

984
00:49:15.000 --> 00:49:17.000
So I'm trying to get them

985
00:49:17.000 --> 00:49:19.000
and get them early.

986
00:49:19.000 --> 00:49:21.000
I just ignore the guidelines that say

987
00:49:21.000 --> 00:49:23.000
you have to wait till 65

988
00:49:23.000 --> 00:49:25.000
unless you have some chronic medical condition

989
00:49:25.000 --> 00:49:27.000
to get a bone density.

990
00:49:27.000 --> 00:49:29.000
I'm telling patients,

991
00:49:29.000 --> 00:49:31.000
you can find it for about $99

992
00:49:31.000 --> 00:49:33.000
around what I work in Houston.

993
00:49:33.000 --> 00:49:35.000
And that is worth the investment

994
00:49:35.000 --> 00:49:37.000
for you to go get your baseline bone density.

995
00:49:37.000 --> 00:49:39.000
So if you have osteoporosis,

996
00:49:39.000 --> 00:49:41.000
who thinks 65 is a good idea?

997
00:49:41.000 --> 00:49:43.000
So if your listeners are like,

998
00:49:43.000 --> 00:49:45.000
oh, well, my insurance won't pay for it,

999
00:49:45.000 --> 00:49:47.000
I'm like,

1000
00:49:47.000 --> 00:49:49.000
there are centers popping up now

1001
00:49:49.000 --> 00:49:51.000
where you can go and get a Dexascan

1002
00:49:51.000 --> 00:49:53.000
and just pay out a pocket

1003
00:49:53.000 --> 00:49:55.000
and get a great, you know,

1004
00:49:55.000 --> 00:49:57.000
and figure out where your starting base is.

1005
00:49:57.000 --> 00:49:59.000
A Dexascan is a bone scan

1006
00:49:59.000 --> 00:50:01.000
to see your bone densities,

1007
00:50:01.000 --> 00:50:03.000
the easiest way to describe it.

1008
00:50:03.000 --> 00:50:05.000
And your muscle mass.

1009
00:50:05.000 --> 00:50:07.000
And you have a lot of people

1010
00:50:07.000 --> 00:50:09.000
who are very, very menopause

1011
00:50:09.000 --> 00:50:11.000
that there are women of reproductive age years

1012
00:50:11.000 --> 00:50:13.000
who have profound periods of low estrogen,

1013
00:50:13.000 --> 00:50:15.000
who are also at risk for serious problems

1014
00:50:15.000 --> 00:50:17.000
with their bone density both now and down the road.

1015
00:50:17.000 --> 00:50:19.000
And so if you come to me

1016
00:50:19.000 --> 00:50:21.000
and you say, oh, I haven't had a period for seven years,

1017
00:50:21.000 --> 00:50:23.000
no big deal,

1018
00:50:23.000 --> 00:50:25.000
well, that is a big deal.

1019
00:50:25.000 --> 00:50:27.000
And depending on the reason why,

1020
00:50:27.000 --> 00:50:29.000
many of the causes will result that

1021
00:50:29.000 --> 00:50:31.000
you had low estrogen

1022
00:50:31.000 --> 00:50:33.000
and you were not ovulating

1023
00:50:33.000 --> 00:50:35.000
the graph you showed,

1024
00:50:35.000 --> 00:50:37.000
while you're building your bone,

1025
00:50:37.000 --> 00:50:39.000
that person's on a different trajectory.

1026
00:50:39.000 --> 00:50:43.000
And those women do need bone scans much earlier

1027
00:50:43.000 --> 00:50:45.000
so that we can see where they are

1028
00:50:45.000 --> 00:50:47.000
and see what treatment we need.

1029
00:50:47.000 --> 00:50:49.000
But it's one of the biggest reasons

1030
00:50:49.000 --> 00:50:51.000
bone health is one of the most acceptable medical reasons

1031
00:50:51.000 --> 00:50:53.000
for why we should put younger women

1032
00:50:53.000 --> 00:50:55.000
who have low estrogen time periods

1033
00:50:55.000 --> 00:50:57.000
onto estrogen treatment

1034
00:50:57.000 --> 00:50:59.000
because it can so profoundly change

1035
00:50:59.000 --> 00:51:01.000
their bone health long term.

1036
00:51:01.000 --> 00:51:05.000
My niche of active women,

1037
00:51:05.000 --> 00:51:07.000
we see there's a very, very high incidence

1038
00:51:07.000 --> 00:51:09.000
of recreational active women

1039
00:51:09.000 --> 00:51:11.000
and low energy availability,

1040
00:51:11.000 --> 00:51:13.000
meaning they're not eating enough

1041
00:51:13.000 --> 00:51:15.000
to support daily life as well as their training.

1042
00:51:15.000 --> 00:51:19.000
So the subclinical aspect of not eating enough

1043
00:51:19.000 --> 00:51:21.000
creates a myriad of issues

1044
00:51:21.000 --> 00:51:25.000
that does create lower bone density,

1045
00:51:25.000 --> 00:51:27.000
menstrual cycle dysfunction,

1046
00:51:27.000 --> 00:51:29.000
greater inflammatory responses.

1047
00:51:29.000 --> 00:51:31.000
So, you know, the end result would be

1048
00:51:31.000 --> 00:51:33.000
hypothalamic amenorrhea

1049
00:51:33.000 --> 00:51:35.000
so their periods have stopped,

1050
00:51:35.000 --> 00:51:37.000
which is that low estrogen standpoint.

1051
00:51:37.000 --> 00:51:39.000
So, you know,

1052
00:51:39.000 --> 00:51:41.000
keeping track of your period

1053
00:51:41.000 --> 00:51:43.000
make sure you're eating enough

1054
00:51:43.000 --> 00:51:45.000
is one of the first stop gaps

1055
00:51:45.000 --> 00:51:47.000
that we have in the athletic realm.

1056
00:51:47.000 --> 00:51:49.000
It's like, we want you to eat enough

1057
00:51:49.000 --> 00:51:51.000
and if you're looking at book ending,

1058
00:51:51.000 --> 00:51:53.000
our calories on either end of the day,

1059
00:51:53.000 --> 00:51:55.000
that's not appropriate.

1060
00:51:55.000 --> 00:51:57.000
We have to look at how your circadian rhythm works

1061
00:51:57.000 --> 00:51:59.000
with the circadian rhythm,

1062
00:51:59.000 --> 00:52:01.000
like we talked about in the first half

1063
00:52:01.000 --> 00:52:03.000
was about the pulses of our hormones.

1064
00:52:03.000 --> 00:52:05.000
So, for holding our calories on either end of the day,

1065
00:52:05.000 --> 00:52:07.000
then there's this big space in the middle of the day

1066
00:52:07.000 --> 00:52:11.000
where your body thinks it's under a starvation threat.

1067
00:52:11.000 --> 00:52:13.000
So, you start to have this downturn

1068
00:52:13.000 --> 00:52:15.000
of all of our metabolic functions.

1069
00:52:15.000 --> 00:52:17.000
We see after four days of low energy availability,

1070
00:52:17.000 --> 00:52:19.000
there's a direct impact on thyroid function.

1071
00:52:19.000 --> 00:52:21.000
So, we have to be very cognit

1072
00:52:21.000 --> 00:52:23.000
that women who are saying

1073
00:52:23.000 --> 00:52:25.000
I haven't had a period in seven years

1074
00:52:25.000 --> 00:52:27.000
or my periods are really irregular,

1075
00:52:27.000 --> 00:52:29.000
we have to bring it back to the energy function as well.

1076
00:52:29.000 --> 00:52:31.000
So, I know, unfortunately,

1077
00:52:31.000 --> 00:52:33.000
we're still in this environment of aesthetics

1078
00:52:33.000 --> 00:52:35.000
and I'm always like, we need to eat.

1079
00:52:35.000 --> 00:52:37.000
And if you eat in and around your training

1080
00:52:37.000 --> 00:52:39.000
and fueling appropriately for what you're doing,

1081
00:52:39.000 --> 00:52:43.000
it has a positive impact on body composition.

1082
00:52:43.000 --> 00:52:45.000
You're not going to gain body fat,

1083
00:52:45.000 --> 00:52:47.000
you're going to gain lean mass,

1084
00:52:47.000 --> 00:52:49.000
you're going to gain bone

1085
00:52:49.000 --> 00:52:51.000
and you're going to see a decrease in body fat.

1086
00:52:51.000 --> 00:52:53.000
But it's entrusting the process

1087
00:52:53.000 --> 00:52:55.000
but it's entrusting the process

1088
00:52:55.000 --> 00:52:57.000
that out in general sociocultural concepts

1089
00:52:57.000 --> 00:53:01.000
is just not acceptable for so many women right now.

1090
00:53:01.000 --> 00:53:03.000
And with that exercise regime,

1091
00:53:03.000 --> 00:53:05.000
I asked you to make for a woman

1092
00:53:05.000 --> 00:53:07.000
that's pre pre-menopause.

1093
00:53:07.000 --> 00:53:09.000
Was there anything left off there?

1094
00:53:09.000 --> 00:53:11.000
We had day one, which is mobility works,

1095
00:53:11.000 --> 00:53:13.000
strength, training.

1096
00:53:13.000 --> 00:53:15.000
So, if you were to do three days a week in gym,

1097
00:53:15.000 --> 00:53:17.000
that would be pretty similar

1098
00:53:17.000 --> 00:53:19.000
except for the compound movement.

1099
00:53:19.000 --> 00:53:21.000
What are we doing for each of those compound movements?

1100
00:53:21.000 --> 00:53:23.000
So, it would be the knee forward squat motion one day,

1101
00:53:23.000 --> 00:53:25.000
push pull, upper body,

1102
00:53:25.000 --> 00:53:27.000
and then posterior.

1103
00:53:27.000 --> 00:53:29.000
So, you're hip thrust,

1104
00:53:29.000 --> 00:53:31.000
you're dead left, that kind of stuff.

1105
00:53:31.000 --> 00:53:33.000
Because women are quad dominant.

1106
00:53:33.000 --> 00:53:35.000
To prevent injury, we really need to build

1107
00:53:35.000 --> 00:53:37.000
the posterior chain.

1108
00:53:37.000 --> 00:53:39.000
And this is your glutes, your hamstrings,

1109
00:53:39.000 --> 00:53:41.000
your dead left.

1110
00:53:41.000 --> 00:53:43.000
Yeah, so you're getting really strong

1111
00:53:43.000 --> 00:53:45.000
around the knee joints, the hip joints

1112
00:53:45.000 --> 00:53:47.000
because again, that feeds forward

1113
00:53:47.000 --> 00:53:49.000
to better movement, movement economy

1114
00:53:49.000 --> 00:53:53.000
and prevention of a misstep for a hip fracture later down.

1115
00:53:53.000 --> 00:53:55.000
What about cardio?

1116
00:53:55.000 --> 00:53:57.000
So, that's where, like,

1117
00:53:57.000 --> 00:53:59.000
if we're looking at those three days a week

1118
00:53:59.000 --> 00:54:01.000
and we're finishing with plios or some sprint work,

1119
00:54:01.000 --> 00:54:03.000
then the other days,

1120
00:54:03.000 --> 00:54:05.000
just walking low level intensity walking,

1121
00:54:05.000 --> 00:54:07.000
or maybe you have soul food.

1122
00:54:07.000 --> 00:54:09.000
You want to go for a bike ride,

1123
00:54:09.000 --> 00:54:11.000
you want to go for a run.

1124
00:54:11.000 --> 00:54:13.000
If you're not training specifically for something,

1125
00:54:13.000 --> 00:54:15.000
then those three strength training days

1126
00:54:15.000 --> 00:54:17.000
are your key workouts.

1127
00:54:17.000 --> 00:54:19.000
That's the things that you like to do.

1128
00:54:19.000 --> 00:54:21.000
I hear a lot about VO2 maxes,

1129
00:54:21.000 --> 00:54:23.000
so I thought,

1130
00:54:23.000 --> 00:54:25.000
but we should all be driving our cardiovascular performance up

1131
00:54:25.000 --> 00:54:27.000
to get a high VO2 max.

1132
00:54:27.000 --> 00:54:29.000
Well, that's where the intensity is.

1133
00:54:29.000 --> 00:54:31.000
Yeah, I think it's the only one.

1134
00:54:31.000 --> 00:54:33.000
Correct me if I'm wrong,

1135
00:54:33.000 --> 00:54:35.000
but my understanding after reading and watching

1136
00:54:35.000 --> 00:54:37.000
everything doesn't take that much to build VO2 max.

1137
00:54:37.000 --> 00:54:39.000
It's that high intensity that's a little bit uncomfortable

1138
00:54:39.000 --> 00:54:41.000
where you're pushing at that max

1139
00:54:41.000 --> 00:54:43.000
for, you know, about four minutes

1140
00:54:43.000 --> 00:54:45.000
to build that VO2

1141
00:54:45.000 --> 00:54:47.000
with the sport science world.

1142
00:54:47.000 --> 00:54:49.000
It's always been the four by four,

1143
00:54:49.000 --> 00:54:51.000
then the more weight you're in.

1144
00:54:51.000 --> 00:54:53.000
Four minutes on, four minutes off,

1145
00:54:53.000 --> 00:54:55.000
four minutes off, four minutes off,

1146
00:54:55.000 --> 00:54:57.000
four minutes off.

1147
00:54:57.000 --> 00:54:59.000
But that's not three days a week.

1148
00:54:59.000 --> 00:55:01.000
No, no, no.

1149
00:55:01.000 --> 00:55:03.000
We should protocols once a week.

1150
00:55:03.000 --> 00:55:05.000
Once a week at the most.

1151
00:55:05.000 --> 00:55:07.000
Right.

1152
00:55:07.000 --> 00:55:09.000
And the other sprints,

1153
00:55:09.000 --> 00:55:11.000
just to give you,

1154
00:55:11.000 --> 00:55:13.000
I tend to give my examples,

1155
00:55:13.000 --> 00:55:17.000
30 seconds, I'm taking my heart rate as high as I can get it.

1156
00:55:17.000 --> 00:55:19.000
And then I'll completely recover,

1157
00:55:19.000 --> 00:55:21.000
which takes me two to three minutes.

1158
00:55:21.000 --> 00:55:23.000
I just happen to do it on a treadmill,

1159
00:55:23.000 --> 00:55:25.000
but the reality is you can do it on anything.

1160
00:55:25.000 --> 00:55:27.000
It's a heart rate function,

1161
00:55:27.000 --> 00:55:29.000
not an apparatus function.

1162
00:55:29.000 --> 00:55:31.000
So for me,

1163
00:55:31.000 --> 00:55:33.000
on a treadmill,

1164
00:55:33.000 --> 00:55:35.000
after I'm done warming up,

1165
00:55:35.000 --> 00:55:37.000
you can't do it cold or you hurt something.

1166
00:55:37.000 --> 00:55:39.000
Exactly.

1167
00:55:39.000 --> 00:55:41.000
After I'm done warming up,

1168
00:55:41.000 --> 00:55:43.000
I'm a really short person.

1169
00:55:43.000 --> 00:55:45.000
I punch the treadmill up to 11,

1170
00:55:45.000 --> 00:55:47.000
and I am just working so hard,

1171
00:55:47.000 --> 00:55:49.000
I don't fly off the back.

1172
00:55:49.000 --> 00:55:51.000
But that gets my heart rate up really high,

1173
00:55:51.000 --> 00:55:53.000
about 186.

1174
00:55:53.000 --> 00:55:55.000
Everybody's top heart rate is different.

1175
00:55:55.000 --> 00:55:57.000
And then I completely recover.

1176
00:55:57.000 --> 00:55:59.000
And I do that four times.

1177
00:55:59.000 --> 00:56:01.000
It doesn't take that long.

1178
00:56:01.000 --> 00:56:03.000
And you feel so good when you're done.

1179
00:56:03.000 --> 00:56:05.000
So I can't run at the moments.

1180
00:56:05.000 --> 00:56:07.000
This morning I did explosive kettlebell swings.

1181
00:56:07.000 --> 00:56:09.000
What kind of you run at the moment?

1182
00:56:09.000 --> 00:56:11.000
Torn, hamstring, and meniscus.

1183
00:56:11.000 --> 00:56:13.000
So I can't run at the moment.

1184
00:56:13.000 --> 00:56:15.000
Running is in.

1185
00:56:15.000 --> 00:56:17.000
Run clubs have come in strong.

1186
00:56:17.000 --> 00:56:19.000
It's back in.

1187
00:56:19.000 --> 00:56:23.000
Are you at all concerned with the fact that

1188
00:56:23.000 --> 00:56:25.000
people are running all the time

1189
00:56:25.000 --> 00:56:27.000
and doing resistance training less?

1190
00:56:27.000 --> 00:56:29.000
Because running is cool now.

1191
00:56:29.000 --> 00:56:31.000
It's how people date.

1192
00:56:31.000 --> 00:56:33.000
They're not going to night clubs.

1193
00:56:33.000 --> 00:56:35.000
It's a sacrifice of other things.

1194
00:56:35.000 --> 00:56:37.000
We said about Pilates.

1195
00:56:37.000 --> 00:56:39.000
You know, if all you do is running,

1196
00:56:39.000 --> 00:56:41.000
then that is definitely not the best way to be.

1197
00:56:41.000 --> 00:56:43.000
It's not the healthiest for your whole body.

1198
00:56:43.000 --> 00:56:45.000
It's not that you're unhealthy.

1199
00:56:45.000 --> 00:56:47.000
But we're really talking about how are we optimizing

1200
00:56:47.000 --> 00:56:49.000
your body and your hormonal health

1201
00:56:49.000 --> 00:56:51.000
for a variety of different goals.

1202
00:56:51.000 --> 00:56:55.000
But also if we look very micro at running.

1203
00:56:55.000 --> 00:56:57.000
58% of runners have a ludial phase defect.

1204
00:56:57.000 --> 00:56:59.000
That means that the second half of their menstrual cycle

1205
00:56:59.000 --> 00:57:03.000
is not going to be able to last as long as we want it to.

1206
00:57:03.000 --> 00:57:06.000
Likely due to what Stacey was talking about earlier.

1207
00:57:06.000 --> 00:57:10.000
This relative energy deficiency coming back to the brain.

1208
00:57:10.000 --> 00:57:12.000
The brain signals.

1209
00:57:12.000 --> 00:57:14.000
It's not as strong to keep that corpus ludium

1210
00:57:14.000 --> 00:57:16.000
where happens after the follicle alive.

1211
00:57:16.000 --> 00:57:18.000
And a lot of women, I still have my period.

1212
00:57:18.000 --> 00:57:20.000
So I'm okay.

1213
00:57:20.000 --> 00:57:22.000
But if we're using our cycle as a vital sign,

1214
00:57:22.000 --> 00:57:26.000
we can actually say the ratio of energy balance is not great.

1215
00:57:26.000 --> 00:57:30.000
And it's often because we're doing it at sacrifice of other things.

1216
00:57:30.000 --> 00:57:34.000
So if you're doing the strength training three times a week.

1217
00:57:34.000 --> 00:57:37.000
And you're running however you're spacing out your other days.

1218
00:57:37.000 --> 00:57:39.000
That's such a healthy balance.

1219
00:57:39.000 --> 00:57:41.000
It's hard that you're going to be in a bad position with that.

1220
00:57:41.000 --> 00:57:43.000
And you'll actually improve your running more so

1221
00:57:43.000 --> 00:57:46.000
than if you're to run every day or every other day.

1222
00:57:46.000 --> 00:57:48.000
Because if you're getting strong through full range of motion,

1223
00:57:48.000 --> 00:57:51.000
then that feeds forward to better running economy.

1224
00:57:51.000 --> 00:57:54.000
Then you can vary your pace without getting injured.

1225
00:57:54.000 --> 00:57:56.000
But for people who are running every day,

1226
00:57:56.000 --> 00:57:58.000
and they're shuffling and they're getting stronger

1227
00:57:58.000 --> 00:58:01.000
in their strong muscles and weaker in their weak muscles,

1228
00:58:01.000 --> 00:58:03.000
then it perpetuates this problem.

1229
00:58:03.000 --> 00:58:08.000
People are very keen on doing marathons and half marathons at the moment.

1230
00:58:08.000 --> 00:58:11.000
And a couple of friends that are doing a lot of marathons at the moment

1231
00:58:11.000 --> 00:58:13.000
and they're very, very, very skinny.

1232
00:58:13.000 --> 00:58:15.000
Oh, welcome to my world of Dexas.

1233
00:58:15.000 --> 00:58:18.000
Yeah, is that healthy?

1234
00:58:18.000 --> 00:58:20.000
I'm not even sure if that's the right question.

1235
00:58:20.000 --> 00:58:22.000
One can judge from just looking.

1236
00:58:22.000 --> 00:58:24.000
But being extremely skinny in that regard,

1237
00:58:24.000 --> 00:58:26.000
being that's what a marathon runner physique.

1238
00:58:26.000 --> 00:58:29.000
There are some that are naturally predisposed to that.

1239
00:58:29.000 --> 00:58:30.000
All right.

1240
00:58:30.000 --> 00:58:33.000
So naturally predisposed to having really good running economy,

1241
00:58:33.000 --> 00:58:36.000
running biomechanics, having a leaner body.

1242
00:58:36.000 --> 00:58:38.000
And this is what we were talking about the Olympics earlier,

1243
00:58:38.000 --> 00:58:42.000
where you can see the ideal body type for that particular sport.

1244
00:58:42.000 --> 00:58:45.000
And then there are those like me who build muscle naturally.

1245
00:58:45.000 --> 00:58:46.000
It's pretty easy.

1246
00:58:46.000 --> 00:58:48.000
So I'd never be a skinny little runner.

1247
00:58:48.000 --> 00:58:51.000
And my running economy is a little bit off

1248
00:58:51.000 --> 00:58:54.000
because of where I build muscle versus not.

1249
00:58:54.000 --> 00:58:57.000
So not everyone is meant to be a long distance runner.

1250
00:58:57.000 --> 00:59:00.000
And there are some that are meant to be long distance runners.

1251
00:59:00.000 --> 00:59:03.000
So if we're talking about your friends who are like super skinny,

1252
00:59:03.000 --> 00:59:07.000
are they economically viable for being a long distance runner?

1253
00:59:07.000 --> 00:59:08.000
Possibly.

1254
00:59:08.000 --> 00:59:11.000
But we also have to look, are they male or female?

1255
00:59:11.000 --> 00:59:13.000
What is their injury rate?

1256
00:59:13.000 --> 00:59:14.000
What is their fueling?

1257
00:59:14.000 --> 00:59:17.000
And then for me, I'd want to see the Dexas of the women

1258
00:59:17.000 --> 00:59:20.000
that are just training long distance and super skinny.

1259
00:59:20.000 --> 00:59:25.000
Because most of the time we see a higher visceral fat

1260
00:59:25.000 --> 00:59:28.000
in and around the organs as we're talking about,

1261
00:59:28.000 --> 00:59:30.000
even though on the outside, they're super lean.

1262
00:59:30.000 --> 00:59:33.000
But they have a really high percentage of visceral fat

1263
00:59:33.000 --> 00:59:37.000
because of the inflammation, the low energy intake.

1264
00:59:37.000 --> 00:59:40.000
And most likely, estradiol suppression.

1265
00:59:40.000 --> 00:59:43.000
And that's the skinny fat thing you talk about earlier.

1266
00:59:43.000 --> 00:59:45.000
Is there an evolutionary lens on this?

1267
00:59:45.000 --> 00:59:47.000
I always think about this when we're having these conversations.

1268
00:59:47.000 --> 00:59:49.000
What used to happen thousands of years ago?

1269
00:59:49.000 --> 00:59:52.000
We talk about the evolutionary biological theories.

1270
00:59:52.000 --> 00:59:55.000
And there are a lot of sociologists that go counter

1271
00:59:55.000 --> 00:59:58.000
when I'm getting ready to say so I'll apologize in advance.

1272
00:59:58.000 --> 01:00:02.000
When we look at original hunter-gatherer type communities,

1273
01:00:02.000 --> 01:00:06.000
the male body was designed to go out to find the calories.

1274
01:00:06.000 --> 01:00:10.000
The woman body was designed to stay and take care of the offspring

1275
01:00:10.000 --> 01:00:12.000
and make sure that home was set.

1276
01:00:12.000 --> 01:00:15.000
If it was low calorie, menstrual cycle would stop

1277
01:00:15.000 --> 01:00:18.000
because you didn't want to reproduce in a time of low calories.

1278
01:00:18.000 --> 01:00:21.000
Body fat would come on because there weren't a lot of calories.

1279
01:00:21.000 --> 01:00:24.000
And so the equivocal in the time now is that I'm not eating enough

1280
01:00:24.000 --> 01:00:26.000
or I'm burning more than I'm consuming.

1281
01:00:26.000 --> 01:00:27.000
Exactly.

1282
01:00:27.000 --> 01:00:29.000
So I'm going to calorie deficit in some way.

1283
01:00:29.000 --> 01:00:30.000
Exactly.

1284
01:00:30.000 --> 01:00:31.000
And energy deficit.

1285
01:00:31.000 --> 01:00:33.000
So with the male body, and we see this,

1286
01:00:33.000 --> 01:00:37.000
their brain and hypothalamus is not as sensitive

1287
01:00:37.000 --> 01:00:42.000
to those nutrient deficits as much as a woman's body

1288
01:00:42.000 --> 01:00:45.000
because we have menstrual cycle or menstrual cycle function.

1289
01:00:45.000 --> 01:00:49.000
A man will lean up and get more cognitively focused

1290
01:00:49.000 --> 01:00:51.000
in times of low calorie intake.

1291
01:00:51.000 --> 01:00:53.000
So this is what we see with fasting data

1292
01:00:53.000 --> 01:00:56.000
and we see with restrictive diets.

1293
01:00:56.000 --> 01:00:59.000
And that was when you bring it back to that biological lens,

1294
01:00:59.000 --> 01:01:01.000
low calorie, I have to go find a calories.

1295
01:01:01.000 --> 01:01:03.000
I have to be fit to go find a calories.

1296
01:01:03.000 --> 01:01:06.000
Low calories, I need to not have to eat as much,

1297
01:01:06.000 --> 01:01:08.000
so I need to store fat.

1298
01:01:08.000 --> 01:01:10.000
And I can't have a baby because we don't have enough calories.

1299
01:01:10.000 --> 01:01:12.000
And then stress?

1300
01:01:12.000 --> 01:01:14.000
When we add modern stress onto that,

1301
01:01:14.000 --> 01:01:17.000
that's a comprehensive addition of cortisol

1302
01:01:18.000 --> 01:01:20.000
and addition of inflammation

1303
01:01:20.000 --> 01:01:22.000
and that also perpetuates body fat.

1304
01:01:22.000 --> 01:01:24.000
I mean, like stress 10,000 years ago

1305
01:01:24.000 --> 01:01:25.000
would have been like a lion.

1306
01:01:25.000 --> 01:01:26.000
Oh, yeah.

1307
01:01:26.000 --> 01:01:27.000
It's a lion's exotic.

1308
01:01:27.000 --> 01:01:28.000
Yeah.

1309
01:01:28.000 --> 01:01:29.000
Right?

1310
01:01:29.000 --> 01:01:31.000
We had stress in that this is a natural stress response.

1311
01:01:31.000 --> 01:01:32.000
We have to have them to survive.

1312
01:01:32.000 --> 01:01:33.000
Right?

1313
01:01:33.000 --> 01:01:35.000
These were episodic stresses.

1314
01:01:35.000 --> 01:01:37.000
Well, and your hormones would change

1315
01:01:37.000 --> 01:01:39.000
for a very specific purpose that you would then go do.

1316
01:01:39.000 --> 01:01:42.000
Your body would free up glucose from your liver,

1317
01:01:42.000 --> 01:01:44.000
you're getting it ready in your bloodstream

1318
01:01:44.000 --> 01:01:46.000
so you can go run from the lion.

1319
01:01:46.000 --> 01:01:48.000
And then things would shift back to normal.

1320
01:01:48.000 --> 01:01:50.000
And what's happening with chronic stress

1321
01:01:50.000 --> 01:01:51.000
is you're getting all the hormone shifts

1322
01:01:51.000 --> 01:01:53.000
because your body's really getting ready for the lion,

1323
01:01:53.000 --> 01:01:55.000
except it's just that bad meeting you had.

1324
01:01:55.000 --> 01:01:56.000
Yeah.

1325
01:01:56.000 --> 01:01:57.000
And then you're just sitting there longer

1326
01:01:57.000 --> 01:01:59.000
and you're not using that glucose up.

1327
01:01:59.000 --> 01:02:00.000
Exactly.

1328
01:02:00.000 --> 01:02:01.000
Exactly.

1329
01:02:01.000 --> 01:02:03.000
All women increasingly overtraining.

1330
01:02:03.000 --> 01:02:06.000
I think the problem in this country is not

1331
01:02:07.000 --> 01:02:11.000
maybe in the women who are really intentional,

1332
01:02:11.000 --> 01:02:13.000
maybe there are some that are overexonizing,

1333
01:02:13.000 --> 01:02:15.000
but if we look at a population,

1334
01:02:15.000 --> 01:02:17.000
nobody is exercising enough.

1335
01:02:17.000 --> 01:02:18.000
Exactly.

1336
01:02:18.000 --> 01:02:20.000
I mean, people ask me all the time.

1337
01:02:20.000 --> 01:02:22.000
Tell me the first thing people need to do.

1338
01:02:22.000 --> 01:02:24.000
I'm like, I'll take anything.

1339
01:02:24.000 --> 01:02:26.000
I mean, I'll take getting off the couch

1340
01:02:26.000 --> 01:02:28.000
with any method, whatever makes you happy.

1341
01:02:28.000 --> 01:02:30.000
I'll say, get off the couch and do 10 air squats.

1342
01:02:30.000 --> 01:02:31.000
Thank you.

1343
01:02:31.000 --> 01:02:32.000
That's enough.

1344
01:02:32.000 --> 01:02:33.000
That's enough.

1345
01:02:33.000 --> 01:02:34.000
That's enough.

1346
01:02:34.000 --> 01:02:35.000
So in the crowd,

1347
01:02:35.000 --> 01:02:38.000
it's like, I'm going to invest in my health every day.

1348
01:02:38.000 --> 01:02:41.000
That is not the majority of people.

1349
01:02:41.000 --> 01:02:42.000
Yeah.

1350
01:02:42.000 --> 01:02:43.000
That's my bubble.

1351
01:02:43.000 --> 01:02:45.000
And the people who listen to your show, though,

1352
01:02:45.000 --> 01:02:47.000
might be a different demographic.

1353
01:02:47.000 --> 01:02:48.000
We have to acknowledge, right?

1354
01:02:48.000 --> 01:02:51.000
Then population of America.

1355
01:02:51.000 --> 01:02:53.000
I mean, like a lot of people who listen to your show, Stephen,

1356
01:02:53.000 --> 01:02:56.000
are interested in health and their body

1357
01:02:56.000 --> 01:02:58.000
and achieving minds and goals.

1358
01:02:58.000 --> 01:03:02.000
And so certainly, you know, I have practiced fertility

1359
01:03:02.000 --> 01:03:04.000
in North Carolina and in Austin.

1360
01:03:04.000 --> 01:03:07.000
And I see a completely different patient population,

1361
01:03:07.000 --> 01:03:08.000
you know, in Austin, Texas,

1362
01:03:08.000 --> 01:03:10.000
which is a very fit area.

1363
01:03:10.000 --> 01:03:13.000
Women are constantly overtraining.

1364
01:03:13.000 --> 01:03:15.000
But to Stacey's point earlier about this,

1365
01:03:15.000 --> 01:03:18.000
maybe evolutionary, what happens.

1366
01:03:18.000 --> 01:03:21.000
Women go into this hypothalamic dysfunction.

1367
01:03:21.000 --> 01:03:23.000
Even before it's what we call like amenorea.

1368
01:03:23.000 --> 01:03:25.000
Hypothalamic amenorea is essentially where the brain,

1369
01:03:25.000 --> 01:03:28.000
where the hypothalamicis shuts off,

1370
01:03:28.000 --> 01:03:30.000
says, can't reproduce right now.

1371
01:03:30.000 --> 01:03:31.000
XYZ reason.

1372
01:03:31.000 --> 01:03:33.000
No FSH and LH are coming out.

1373
01:03:33.000 --> 01:03:34.000
You're not ovulating.

1374
01:03:34.000 --> 01:03:35.000
You're not making estrogen.

1375
01:03:35.000 --> 01:03:37.000
You're not going to get pregnant.

1376
01:03:37.000 --> 01:03:38.000
So you're more likely to survive?

1377
01:03:38.000 --> 01:03:40.000
Yeah, so it's a sort of viable mechanism.

1378
01:03:40.000 --> 01:03:43.000
Pregnancy is dangerous in hunter-gatherers.

1379
01:03:43.000 --> 01:03:47.000
But there's state modern medicine acts like you're perfect

1380
01:03:47.000 --> 01:03:48.000
or it's turned off.

1381
01:03:48.000 --> 01:03:51.000
And the reality is there's all these shades of gray in between

1382
01:03:51.000 --> 01:03:53.000
where these different chronic stressors

1383
01:03:53.000 --> 01:03:55.000
and your insulin resistance and your inflammation

1384
01:03:55.000 --> 01:03:58.000
and your overexercising and your underfueling

1385
01:03:58.000 --> 01:04:00.000
come in and make it so the hypothalamicis

1386
01:04:00.000 --> 01:04:02.000
is not responding correctly.

1387
01:04:02.000 --> 01:04:05.000
And that's what we're trying to get people to intervene there

1388
01:04:05.000 --> 01:04:07.000
before it gets too bad.

1389
01:04:07.000 --> 01:04:11.000
And I see a large number of women who do fall into that zone

1390
01:04:11.000 --> 01:04:15.000
where they are trying their hardest to be healthy

1391
01:04:15.000 --> 01:04:19.000
but what they are choosing to do is actually having a negative impact

1392
01:04:19.000 --> 01:04:22.000
on their hormonal health and how their brain is interpreting

1393
01:04:22.000 --> 01:04:23.000
their hormones.

1394
01:04:23.000 --> 01:04:25.000
And it's very rare to see that in a man.

1395
01:04:25.000 --> 01:04:28.000
The number one reason why I will see low testosterone

1396
01:04:28.000 --> 01:04:31.000
is purely because many men are taking testosterone

1397
01:04:31.000 --> 01:04:34.000
or because of other exogenous factors like marijuana use.

1398
01:04:34.000 --> 01:04:38.000
It is very rarely my brain is not sending out the signals

1399
01:04:38.000 --> 01:04:41.000
to cause my testicles to make testosterone.

1400
01:04:41.000 --> 01:04:44.000
I like to frame it where women are under recovering,

1401
01:04:44.000 --> 01:04:45.000
not overtrain.

1402
01:04:45.000 --> 01:04:49.000
So if we're under recovery, then it makes it more acceptable

1403
01:04:49.000 --> 01:04:50.000
to fuel.

1404
01:04:50.000 --> 01:04:52.000
And I always want to bring it back to,

1405
01:04:52.000 --> 01:04:55.000
it doesn't matter because I come from high performance,

1406
01:04:55.000 --> 01:04:59.000
I'm going to use those words where it's like you're not recovering enough.

1407
01:04:59.000 --> 01:05:01.000
We want to focus on recovery on these days.

1408
01:05:01.000 --> 01:05:04.000
We want to make sure that you're eating and fueling around.

1409
01:05:04.000 --> 01:05:06.000
So it's never overtraining.

1410
01:05:06.000 --> 01:05:07.000
It's always under recovery.

1411
01:05:07.000 --> 01:05:08.000
It's like a balance as well.

1412
01:05:08.000 --> 01:05:11.000
So what do you say to all the voices on social media

1413
01:05:11.000 --> 01:05:15.000
that are just yelling at mostly women and telling them

1414
01:05:15.000 --> 01:05:17.000
it's just a matter of well power?

1415
01:05:17.000 --> 01:05:20.000
And you don't have the body composition you deserve.

1416
01:05:20.000 --> 01:05:22.000
Well, you swipe left and don't talk to them.

1417
01:05:22.000 --> 01:05:23.000
Yeah.

1418
01:05:23.000 --> 01:05:25.000
But that's me, right?

1419
01:05:25.000 --> 01:05:27.000
I'm talking to the woman on Ohio who's feeling defeated

1420
01:05:27.000 --> 01:05:30.000
and stumbles across someone screaming at her on the internet.

1421
01:05:31.000 --> 01:05:35.000
That her body composition that she's not happy with is her fault.

1422
01:05:35.000 --> 01:05:40.000
I hate that because it's a construct of society, right?

1423
01:05:40.000 --> 01:05:42.000
Especially Western society.

1424
01:05:42.000 --> 01:05:44.000
This is where we have to educate.

1425
01:05:44.000 --> 01:05:45.000
It's not your fault.

1426
01:05:45.000 --> 01:05:48.000
These are the things that have come in to play and lined up

1427
01:05:48.000 --> 01:05:50.000
to create the situation.

1428
01:05:50.000 --> 01:05:55.000
But now we have tools to offer you to take one step out of that situation.

1429
01:05:55.000 --> 01:05:58.000
And let's see how many more steps we can get you away

1430
01:05:58.000 --> 01:06:01.000
from the situation to improve your health.

1431
01:06:01.000 --> 01:06:04.000
And are the rules of exercise slightly different

1432
01:06:04.000 --> 01:06:06.000
once you've entered perimenopause?

1433
01:06:06.000 --> 01:06:09.000
So this is where we really need to look at how

1434
01:06:09.000 --> 01:06:13.000
we can use exercise and some environmental stress

1435
01:06:13.000 --> 01:06:16.000
to create a really strong adaptive stress

1436
01:06:16.000 --> 01:06:18.000
and a really strong recovery stress.

1437
01:06:18.000 --> 01:06:20.000
Can you explain adaptive stress?

1438
01:06:20.000 --> 01:06:22.000
Yes, I'm thinking of the 10,000 people who follow me

1439
01:06:22.000 --> 01:06:25.000
who have no idea what adaptive stress is.

1440
01:06:25.000 --> 01:06:30.000
If I go and I do some resistance training, some heavy lifting,

1441
01:06:30.000 --> 01:06:33.000
I want to create a stress on my body

1442
01:06:33.000 --> 01:06:37.000
that's going to then have a signaling cascade

1443
01:06:37.000 --> 01:06:41.000
to repair the muscle in a stronger way than when I first went.

1444
01:06:41.000 --> 01:06:43.000
Because lifting the muscle damages the muscle?

1445
01:06:43.000 --> 01:06:46.000
Yes, and it creates a series of feedback mechanisms

1446
01:06:46.000 --> 01:06:50.000
that make it repair stronger than when you first went in.

1447
01:06:50.000 --> 01:06:52.000
So that's an adaptive stress.

1448
01:06:52.000 --> 01:06:57.000
And we're looking at what levels of stress we can put,

1449
01:06:57.000 --> 01:07:00.000
so it's a training stress or what levels of stress we can use

1450
01:07:00.000 --> 01:07:05.000
through exercise to really, really create an environment

1451
01:07:05.000 --> 01:07:07.000
that improves our health.

1452
01:07:07.000 --> 01:07:09.000
So if we talk about sprint interval training,

1453
01:07:09.000 --> 01:07:12.000
the 30 seconds on and the two to three minute recovery,

1454
01:07:12.000 --> 01:07:16.000
the reason why we want that super high end stress

1455
01:07:16.000 --> 01:07:19.000
of our heart rate is it then creates

1456
01:07:19.000 --> 01:07:22.000
a eventual epigenetic change.

1457
01:07:22.000 --> 01:07:24.000
So it's that environment that's going to create a change

1458
01:07:24.000 --> 01:07:28.000
within the muscle that's going to allow that glute 4 protein

1459
01:07:28.000 --> 01:07:31.000
that I mentioned earlier to open up and have glucose come in

1460
01:07:31.000 --> 01:07:33.000
reducing insulin resistance.

1461
01:07:33.000 --> 01:07:36.000
Also, with that really high, high heart rate,

1462
01:07:36.000 --> 01:07:38.000
we're having a lot of stress on the muscle that's going

1463
01:07:38.000 --> 01:07:42.000
to really some myocons, which are little hormone signals

1464
01:07:42.000 --> 01:07:44.000
that then will go to the liver and say,

1465
01:07:44.000 --> 01:07:47.000
wait a second, we don't need to store visceral fat.

1466
01:07:47.000 --> 01:07:51.000
We need to create non-estrified fatty acids,

1467
01:07:51.000 --> 01:07:54.000
which can then go into our skeletal muscle

1468
01:07:54.000 --> 01:07:56.000
to be used in the mitochondria as fuel.

1469
01:07:56.000 --> 01:07:59.000
So we want to have the stress that's strong enough

1470
01:07:59.000 --> 01:08:02.000
to create these cascade of feedback mechanisms

1471
01:08:02.000 --> 01:08:04.000
to improve our overall health.

1472
01:08:04.000 --> 01:08:07.000
If we stay in that moderate intensity zone,

1473
01:08:07.000 --> 01:08:11.000
we aren't creating a strong enough stress to create that signaling.

1474
01:08:11.000 --> 01:08:12.000
What are we doing?

1475
01:08:12.000 --> 01:08:17.000
We are exacerbating inflammation or exacerbating cortisol.

1476
01:08:17.000 --> 01:08:19.000
Now cortisol isn't the demon,

1477
01:08:19.000 --> 01:08:21.000
but when we have an elevation of it,

1478
01:08:21.000 --> 01:08:23.000
and especially in perimenopause,

1479
01:08:23.000 --> 01:08:25.000
when we're sympathetically driven,

1480
01:08:25.000 --> 01:08:27.000
and we already have a higher level of baseline cortisol,

1481
01:08:27.000 --> 01:08:30.000
if we are continuously in this modern intensity zone,

1482
01:08:30.000 --> 01:08:34.000
we never get a signal to allow that to drop.

1483
01:08:34.000 --> 01:08:36.000
So if we're looking at polarizing,

1484
01:08:36.000 --> 01:08:40.000
which is top-top end and low recovery end,

1485
01:08:40.000 --> 01:08:43.000
then with the top end, we get the signal cascade

1486
01:08:43.000 --> 01:08:45.000
of improving body comp,

1487
01:08:45.000 --> 01:08:48.000
improving insulin sensitivity,

1488
01:08:48.000 --> 01:08:50.000
as well as getting growth hormone

1489
01:08:50.000 --> 01:08:52.000
and testosterone responses,

1490
01:08:52.000 --> 01:08:54.000
which then feed back to drop cortisol.

1491
01:08:54.000 --> 01:08:56.000
So am I right in thinking the solution?

1492
01:08:56.000 --> 01:08:57.000
If I'm a perimenopausal,

1493
01:08:57.000 --> 01:08:59.000
is to do high-intensity interval training

1494
01:08:59.000 --> 01:09:01.000
for short periods of time?

1495
01:09:01.000 --> 01:09:04.000
So we look at the quality of the training,

1496
01:09:04.000 --> 01:09:05.000
not the volume of the training.

1497
01:09:05.000 --> 01:09:07.000
So if we're in our reproductive years,

1498
01:09:07.000 --> 01:09:09.000
then yes, you can do the modern intensity stuff

1499
01:09:09.000 --> 01:09:11.000
because you have estrogen

1500
01:09:11.000 --> 01:09:13.000
and some of our other hormone feedback signals

1501
01:09:13.000 --> 01:09:16.000
that are going to drop cortisol,

1502
01:09:16.000 --> 01:09:19.000
it's going to allow your body to recover and repair.

1503
01:09:19.000 --> 01:09:21.000
And what makes quality training?

1504
01:09:21.000 --> 01:09:22.000
What is quality training?

1505
01:09:22.000 --> 01:09:23.000
So this is your polar.

1506
01:09:23.000 --> 01:09:25.000
So you have a very specific session

1507
01:09:25.000 --> 01:09:26.000
that you're going to do.

1508
01:09:26.000 --> 01:09:27.000
So from Vonda,

1509
01:09:27.000 --> 01:09:28.000
it's your 30 seconds on,

1510
01:09:28.000 --> 01:09:29.000
as hard as possible,

1511
01:09:29.000 --> 01:09:31.000
two to three minutes recovery,

1512
01:09:31.000 --> 01:09:33.000
do that four times at your session.

1513
01:09:33.000 --> 01:09:35.000
Okay, I'm going to try and summarize this.

1514
01:09:35.000 --> 01:09:37.000
Let's see if this is a test.

1515
01:09:37.000 --> 01:09:39.000
See if I understood all of this stuff.

1516
01:09:39.000 --> 01:09:42.000
So if I do a lot of volume,

1517
01:09:42.000 --> 01:09:46.000
but I play in that sort of medium intensity range,

1518
01:09:46.000 --> 01:09:48.000
I'm basically just like stressing out my body

1519
01:09:48.000 --> 01:09:49.000
in all the worst ways.

1520
01:09:49.000 --> 01:09:50.000
Exactly.

1521
01:09:50.000 --> 01:09:51.000
Like the inflammation,

1522
01:09:51.000 --> 01:09:52.000
it's just not good for my body necessarily.

1523
01:09:52.000 --> 01:09:55.000
If I don't do vigorous enough exercise,

1524
01:09:55.000 --> 01:09:57.000
then that's also bad

1525
01:09:57.000 --> 01:10:00.000
because nothing's going to break in there for built.

1526
01:10:00.000 --> 01:10:01.000
It's nothing's going to adapt.

1527
01:10:01.000 --> 01:10:03.000
Nothing's going to grow.

1528
01:10:03.000 --> 01:10:06.000
If I do it for long periods of time,

1529
01:10:06.000 --> 01:10:07.000
really anything for long periods of time,

1530
01:10:07.000 --> 01:10:08.000
that's also stress.

1531
01:10:08.000 --> 01:10:13.000
But the key thing to do is to do shorter,

1532
01:10:13.000 --> 01:10:16.000
higher intensity exercise

1533
01:10:16.000 --> 01:10:18.000
that will cause my body to adapt

1534
01:10:18.000 --> 01:10:22.000
but won't put it into that inflamed stressful state.

1535
01:10:22.000 --> 01:10:25.000
And you also have to pepper in some lower intensity work.

1536
01:10:25.000 --> 01:10:28.000
So this is your flexibility.

1537
01:10:28.000 --> 01:10:30.000
So that you have recovery.

1538
01:10:30.000 --> 01:10:32.000
You're getting blood flow circulating.

1539
01:10:32.000 --> 01:10:35.000
You're tapping into some mitochondrial work.

1540
01:10:35.000 --> 01:10:38.000
So that you are still getting benefit of exercise

1541
01:10:38.000 --> 01:10:40.000
but it's not in that modern intensity.

1542
01:10:40.000 --> 01:10:42.000
So that's what we mean by polarizing.

1543
01:10:42.000 --> 01:10:46.000
So if we were to talk in like the zone talk

1544
01:10:46.000 --> 01:10:48.000
that everyone talks is out there, right?

1545
01:10:48.000 --> 01:10:49.000
We're looking at it.

1546
01:10:49.000 --> 01:10:51.000
So if we're talking about heart rate

1547
01:10:51.000 --> 01:10:53.000
and the way that your body works,

1548
01:10:53.000 --> 01:10:54.000
we have zone one,

1549
01:10:54.000 --> 01:10:55.000
which is just sitting around.

1550
01:10:55.000 --> 01:10:56.000
Yeah, like you're.

1551
01:10:56.000 --> 01:10:57.000
Yeah.

1552
01:10:57.000 --> 01:10:58.000
We're in zone one.

1553
01:10:58.000 --> 01:10:59.000
We're in zone one.

1554
01:10:59.000 --> 01:11:02.000
Zone two is the broscience kind of thing

1555
01:11:02.000 --> 01:11:03.000
where you're like,

1556
01:11:03.000 --> 01:11:05.000
let's work in the zone two area

1557
01:11:05.000 --> 01:11:07.000
where we're working.

1558
01:11:07.000 --> 01:11:09.000
I was in zone two when you were talking about menstrual cycle.

1559
01:11:09.000 --> 01:11:10.000
Yeah, there you go.

1560
01:11:10.000 --> 01:11:11.000
That's it.

1561
01:11:11.000 --> 01:11:13.000
Your heart rate is elevated.

1562
01:11:13.000 --> 01:11:15.000
Still a little bit have a conversation.

1563
01:11:15.000 --> 01:11:19.000
For women, it's good for recovery stress release.

1564
01:11:19.000 --> 01:11:22.000
For men, it's good to improve metabolic flexibility.

1565
01:11:22.000 --> 01:11:25.000
We're looking at zone three, four.

1566
01:11:25.000 --> 01:11:27.000
That's the area you want to stay out of.

1567
01:11:27.000 --> 01:11:29.000
Unless you're specifically training for something

1568
01:11:29.000 --> 01:11:31.000
that requires you to be there.

1569
01:11:31.000 --> 01:11:33.000
That would be your half marathons,

1570
01:11:33.000 --> 01:11:35.000
your endurance races, that kind of stuff.

1571
01:11:35.000 --> 01:11:37.000
Everyone wants to stay out of zone.

1572
01:11:37.000 --> 01:11:39.000
Three, four.

1573
01:11:39.000 --> 01:11:41.000
They're in training.

1574
01:11:41.000 --> 01:11:43.000
They're in training.

1575
01:11:43.000 --> 01:11:44.000
That's the medium range, right?

1576
01:11:44.000 --> 01:11:45.000
Yeah, that's medium range.

1577
01:11:45.000 --> 01:11:47.000
So you want to jump into zone five,

1578
01:11:47.000 --> 01:11:48.000
hang around for.

1579
01:11:48.000 --> 01:11:49.000
Five, six.

1580
01:11:49.000 --> 01:11:50.000
Okay, a couple of minutes and then get out of there.

1581
01:11:50.000 --> 01:11:51.000
Yeah.

1582
01:11:51.000 --> 01:11:52.000
But in a week.

1583
01:11:52.000 --> 01:11:53.000
This is what.

1584
01:11:53.000 --> 01:11:54.000
Yeah, it's crystal clear.

1585
01:11:54.000 --> 01:11:56.000
So two to four days a week,

1586
01:11:56.000 --> 01:12:00.000
you should be lifting progressively to lift heavy,

1587
01:12:00.000 --> 01:12:05.000
meaning have your weights fewer reps, right?

1588
01:12:05.000 --> 01:12:07.000
One compound lift a day,

1589
01:12:07.000 --> 01:12:10.000
plus the augmentive lifts that go behind it, right?

1590
01:12:10.000 --> 01:12:12.000
So you're warming up first,

1591
01:12:12.000 --> 01:12:14.000
then you're going to do one lift,

1592
01:12:14.000 --> 01:12:16.000
and then you're going to do your jumping

1593
01:12:16.000 --> 01:12:18.000
or your balance work.

1594
01:12:18.000 --> 01:12:20.000
The other days of the week,

1595
01:12:20.000 --> 01:12:24.000
you will do preferably low intensity doing anything,

1596
01:12:24.000 --> 01:12:28.000
walking briskly down the New York street could count as that.

1597
01:12:28.000 --> 01:12:30.000
It's continuous motion.

1598
01:12:30.000 --> 01:12:33.000
And then a couple days a week,

1599
01:12:33.000 --> 01:12:35.000
add in your sprint intervals.

1600
01:12:35.000 --> 01:12:40.000
You're really high zone five, six, high intensity.

1601
01:12:40.000 --> 01:12:43.000
And then when you've got that,

1602
01:12:43.000 --> 01:12:47.000
you can add in your four by four VO2 max

1603
01:12:49.000 --> 01:12:50.000
on one of the other days,

1604
01:12:50.000 --> 01:12:52.000
because it sounds like a lot.

1605
01:12:52.000 --> 01:12:54.000
But when I work with non-pro athletes,

1606
01:12:54.000 --> 01:12:56.000
I layer on behaviors.

1607
01:12:56.000 --> 01:12:57.000
Absolutely.

1608
01:12:57.000 --> 01:13:00.000
Because if I say all of this nuance,

1609
01:13:00.000 --> 01:13:02.000
nobody's going to do anything.

1610
01:13:02.000 --> 01:13:05.000
Always describe it as we have these pillars, right?

1611
01:13:05.000 --> 01:13:06.000
First, we have to nail sleep.

1612
01:13:06.000 --> 01:13:07.000
It doesn't matter who you are.

1613
01:13:07.000 --> 01:13:08.000
You have to.

1614
01:13:08.000 --> 01:13:09.000
Because you cannot.

1615
01:13:09.000 --> 01:13:10.000
It's not negotiable.

1616
01:13:10.000 --> 01:13:12.000
Yeah, you cannot invoke any kind of metabolic

1617
01:13:12.000 --> 01:13:15.000
or body composition change without adequate sleep.

1618
01:13:15.000 --> 01:13:17.000
Also improves stress resilience.

1619
01:13:17.000 --> 01:13:20.000
Then we look at nutrition and physical activity.

1620
01:13:20.000 --> 01:13:22.000
The behaviors that go with both of those

1621
01:13:22.000 --> 01:13:23.000
are somewhat independent.

1622
01:13:23.000 --> 01:13:25.000
You have some people that are more motivated

1623
01:13:25.000 --> 01:13:26.000
to do physical activity.

1624
01:13:26.000 --> 01:13:28.000
And some people are more motivated

1625
01:13:28.000 --> 01:13:30.000
to change nutritional habits.

1626
01:13:30.000 --> 01:13:31.000
Most of the time,

1627
01:13:31.000 --> 01:13:33.000
there are two different personalities.

1628
01:13:33.000 --> 01:13:35.000
So we have to look at what comes next.

1629
01:13:35.000 --> 01:13:36.000
And then we also have,

1630
01:13:36.000 --> 01:13:37.000
which isn't lesser importance,

1631
01:13:37.000 --> 01:13:38.000
but often neglected,

1632
01:13:38.000 --> 01:13:40.000
is the mindfulness and community.

1633
01:13:40.000 --> 01:13:41.000
So this is being out in nature.

1634
01:13:41.000 --> 01:13:43.000
It's connecting with friends.

1635
01:13:43.000 --> 01:13:45.000
It might be going to group exercise class.

1636
01:13:45.000 --> 01:13:47.000
It might be just having coffee.

1637
01:13:47.000 --> 01:13:49.000
But that is really, really important

1638
01:13:49.000 --> 01:13:51.000
for parasympathetic and whole,

1639
01:13:51.000 --> 01:13:53.000
like, whole beings response.

1640
01:13:53.000 --> 01:13:54.000
Exactly.

1641
01:13:54.000 --> 01:13:57.000
So there's a new book out coming out called Joy Span.

1642
01:13:57.000 --> 01:13:59.000
I don't know if you've spoken with her.

1643
01:13:59.000 --> 01:14:00.000
So she's a geriatric entologist

1644
01:14:00.000 --> 01:14:02.000
and works with the very elderly.

1645
01:14:02.000 --> 01:14:04.000
And she has a very specific,

1646
01:14:04.000 --> 01:14:06.000
you know, what determines

1647
01:14:06.000 --> 01:14:09.000
who's going to kill it in that last decade of life?

1648
01:14:09.000 --> 01:14:11.000
And that community part,

1649
01:14:11.000 --> 01:14:13.000
using your brain,

1650
01:14:13.000 --> 01:14:15.000
you know, having interactions with human beings

1651
01:14:15.000 --> 01:14:17.000
seems to be the key.

1652
01:14:17.000 --> 01:14:19.000
And if you don't keep that going

1653
01:14:19.000 --> 01:14:21.000
through this 40s, 50s, 60s,

1654
01:14:21.000 --> 01:14:23.000
when you get to 70 and 80,

1655
01:14:23.000 --> 01:14:26.000
you're not going to have a great end of your life.

1656
01:14:26.000 --> 01:14:27.000
And what about the last phase then?

1657
01:14:27.000 --> 01:14:29.000
So someone's post-menopausal.

1658
01:14:29.000 --> 01:14:33.000
Does their exercise recommendations change at all?

1659
01:14:33.000 --> 01:14:35.000
We like to start the habits early

1660
01:14:35.000 --> 01:14:37.000
and continue them through.

1661
01:14:37.000 --> 01:14:38.000
If you haven't started,

1662
01:14:38.000 --> 01:14:39.000
it's not too late.

1663
01:14:39.000 --> 01:14:40.000
As we're seeing, like,

1664
01:14:40.000 --> 01:14:41.000
with lift more and some other

1665
01:14:41.000 --> 01:14:44.000
of the older age resources coming out,

1666
01:14:44.000 --> 01:14:45.000
it's never too late to start.

1667
01:14:45.000 --> 01:14:47.000
We just have to be very careful

1668
01:14:47.000 --> 01:14:49.000
of how you start to have support

1669
01:14:49.000 --> 01:14:52.000
and phase you into these different exercise modalities.

1670
01:14:52.000 --> 01:14:55.000
Is it the same exercises there?

1671
01:14:55.000 --> 01:14:56.000
Meaning.

1672
01:14:56.000 --> 01:14:58.000
You know, the three days a week,

1673
01:14:58.000 --> 01:14:59.000
the mobility, the strength.

1674
01:14:59.000 --> 01:15:01.000
I am firmly post-menopausal

1675
01:15:01.000 --> 01:15:03.000
and I am doing all these things.

1676
01:15:03.000 --> 01:15:04.000
But it's different.

1677
01:15:04.000 --> 01:15:06.000
Different people always ask me,

1678
01:15:06.000 --> 01:15:07.000
what does heavy lifting mean?

1679
01:15:07.000 --> 01:15:08.000
Right. It's relative.

1680
01:15:08.000 --> 01:15:10.000
It's relative. My heavy

1681
01:15:10.000 --> 01:15:12.000
is not going to be Stacey's heavy

1682
01:15:12.000 --> 01:15:14.000
or I should say the other way.

1683
01:15:14.000 --> 01:15:16.000
Stacey's very heavy is not going to be my heavy.

1684
01:15:16.000 --> 01:15:17.000
In lift more,

1685
01:15:17.000 --> 01:15:19.000
they just, the authors described the one,

1686
01:15:19.000 --> 01:15:20.000
the one rep max.

1687
01:15:20.000 --> 01:15:22.000
And so one rep max is like,

1688
01:15:22.000 --> 01:15:23.000
safely.

1689
01:15:23.000 --> 01:15:25.000
What is the heaviest you can do?

1690
01:15:25.000 --> 01:15:26.000
One rep, you know.

1691
01:15:26.000 --> 01:15:27.000
So far by a step curl,

1692
01:15:27.000 --> 01:15:29.000
what is the heaviest weight I can do?

1693
01:15:29.000 --> 01:15:30.000
One to fail, you know,

1694
01:15:30.000 --> 01:15:32.000
I'm going to fail after this one.

1695
01:15:32.000 --> 01:15:34.000
And for me, that was about 20 pounds.

1696
01:15:34.000 --> 01:15:35.000
With good form.

1697
01:15:35.000 --> 01:15:36.000
Exactly.

1698
01:15:36.000 --> 01:15:37.000
Safely with good form.

1699
01:15:37.000 --> 01:15:39.000
And so I could nail 20.

1700
01:15:39.000 --> 01:15:41.000
And so then they took them down to

1701
01:15:41.000 --> 01:15:44.000
about 70, 80% of that,

1702
01:15:44.000 --> 01:15:47.000
which for me was about 15, 16 pounds.

1703
01:15:47.000 --> 01:15:50.000
So that you can usually do about five reps

1704
01:15:50.000 --> 01:15:51.000
before you hit failure.

1705
01:15:51.000 --> 01:15:54.000
And that is what they consider lifting heavy.

1706
01:15:54.000 --> 01:15:56.000
And that seemed to really resonate with my followers

1707
01:15:56.000 --> 01:15:58.000
to understand what that meant.

1708
01:15:58.000 --> 01:16:01.000
And there's so many women that underestimate their strength.

1709
01:16:01.000 --> 01:16:02.000
See them?

1710
01:16:02.000 --> 01:16:05.000
And they gravitate towards the 10 pound dumbbells.

1711
01:16:05.000 --> 01:16:07.000
It's like, put that away.

1712
01:16:07.000 --> 01:16:09.000
Go to the next one.

1713
01:16:09.000 --> 01:16:11.000
Do a couple of lifts with that.

1714
01:16:11.000 --> 01:16:13.000
And then ideally, I want you to put that away

1715
01:16:13.000 --> 01:16:14.000
and pick up the next one.

1716
01:16:14.000 --> 01:16:16.000
Because that's going to challenge you.

1717
01:16:16.000 --> 01:16:20.000
Because women have been so conditioned to do 10 to 15 reps

1718
01:16:20.000 --> 01:16:23.000
to get, quote, toned and not really put in the work

1719
01:16:23.000 --> 01:16:25.000
they need to build muscle

1720
01:16:25.000 --> 01:16:27.000
and to get the benefit out of strength training.

1721
01:16:27.000 --> 01:16:30.000
And I'm always telling them you're underestimating yourself

1722
01:16:30.000 --> 01:16:32.000
and so many facets don't cheat yourself

1723
01:16:32.000 --> 01:16:34.000
with the strength training as well.

1724
01:16:34.000 --> 01:16:36.000
Because people have to remember

1725
01:16:36.000 --> 01:16:38.000
what we're what we're training for now.

1726
01:16:38.000 --> 01:16:41.000
It's different than I had a woman recently say,

1727
01:16:41.000 --> 01:16:45.000
I was taught to do biceps curls, five pounds, 30 times.

1728
01:16:45.000 --> 01:16:48.000
Well, after 30 times, not only are you bored,

1729
01:16:48.000 --> 01:16:51.000
but you probably could be at failure 30 times.

1730
01:16:51.000 --> 01:16:53.000
That will build endurance.

1731
01:16:53.000 --> 01:16:55.000
I am training to be as strong as possible.

1732
01:16:55.000 --> 01:16:59.000
And when I have strength down,

1733
01:16:59.000 --> 01:17:01.000
then I start playing with tempos

1734
01:17:01.000 --> 01:17:05.000
so that I could replace some of the explosive muscle fibers

1735
01:17:05.000 --> 01:17:07.000
that I'm going to lose over time.

1736
01:17:07.000 --> 01:17:10.000
To your point, Ronda, I just been writing my book

1737
01:17:10.000 --> 01:17:12.000
in Cape Town as I was told you before we started recording.

1738
01:17:12.000 --> 01:17:14.000
And one of the studies that I read about

1739
01:17:14.000 --> 01:17:18.000
while I was writing the book was a study done by a guy

1740
01:17:18.000 --> 01:17:21.000
called How Hershfield and his colleagues

1741
01:17:21.000 --> 01:17:24.000
where they asked, they put people in these MRI scanners

1742
01:17:24.000 --> 01:17:27.000
and they asked them to think about a famous celebrity.

1743
01:17:27.000 --> 01:17:29.000
And then they asked them to think about themselves today

1744
01:17:29.000 --> 01:17:31.000
and then they asked them to think about themselves

1745
01:17:31.000 --> 01:17:32.000
in 10 years time.

1746
01:17:32.000 --> 01:17:35.000
And in 10 years time, the same brain regions lit up

1747
01:17:35.000 --> 01:17:37.000
as if they were thinking about the celebrity,

1748
01:17:37.000 --> 01:17:41.000
which kind of led them to conclude that in our brain,

1749
01:17:41.000 --> 01:17:44.000
we almost see our future selves as a bit of a stranger.

1750
01:17:44.000 --> 01:17:45.000
Yes, that's right.

1751
01:17:45.000 --> 01:17:47.000
And so when we think about long-term planning,

1752
01:17:47.000 --> 01:17:50.000
this is in part why a lot of this advice

1753
01:17:50.000 --> 01:17:52.000
is often most effective when it's put in the context

1754
01:17:52.000 --> 01:17:55.000
of short-term performance or cognitive benefits.

1755
01:17:55.000 --> 01:17:59.000
Because we really do struggle to care about ourselves at 90.

1756
01:17:59.000 --> 01:18:02.000
And I think we all kind of think we can figure it out later.

1757
01:18:03.000 --> 01:18:06.000
I think what's different for women, especially in menopause

1758
01:18:06.000 --> 01:18:10.000
is because we're also taking care of our parents in so many ways.

1759
01:18:10.000 --> 01:18:14.000
We're in this raising kids going through our own hormonal upheaval

1760
01:18:14.000 --> 01:18:17.000
and then watching our mothers, our grandmothers, our aunt's age.

1761
01:18:17.000 --> 01:18:21.000
And the way society is set up, women become the caretakers

1762
01:18:21.000 --> 01:18:23.000
of their parents, generally the oldest daughter.

1763
01:18:23.000 --> 01:18:25.000
And I have to give full credit to my sister

1764
01:18:25.000 --> 01:18:28.000
who lives in the same town as my mom and as a nurse.

1765
01:18:28.000 --> 01:18:30.000
So she really is bearing the brunt of taking care of mama

1766
01:18:30.000 --> 01:18:32.000
because I'm living this life.

1767
01:18:32.000 --> 01:18:34.000
So thank you, Lee, if you're watching.

1768
01:18:34.000 --> 01:18:36.000
It is such a tremendous stress.

1769
01:18:36.000 --> 01:18:39.000
And so our motivation, my sister and I,

1770
01:18:39.000 --> 01:18:42.000
is like, we don't want to do this to our daughters.

1771
01:18:42.000 --> 01:18:43.000
Exactly.

1772
01:18:43.000 --> 01:18:47.000
The other thing I want to bring in is the brain health component.

1773
01:18:47.000 --> 01:18:49.000
We talk about Alzheimer's and dementia.

1774
01:18:49.000 --> 01:18:54.000
And one of the reasons I really preface doing high-intensity work

1775
01:18:54.000 --> 01:18:55.000
is to lactate production.

1776
01:18:55.000 --> 01:18:58.000
Because we're finding more and more research coming out

1777
01:18:58.000 --> 01:19:02.000
of this showing that part of the development of dementia

1778
01:19:02.000 --> 01:19:05.000
and Alzheimer in the plaque is a misstep in brain metabolism.

1779
01:19:05.000 --> 01:19:07.000
So when we're looking at brain metabolism

1780
01:19:07.000 --> 01:19:09.000
and the brain uses a lot of glucose,

1781
01:19:09.000 --> 01:19:10.000
it also uses lactate.

1782
01:19:10.000 --> 01:19:15.000
Now for women, we have less of the glycolytic or lactate producing fibers

1783
01:19:15.000 --> 01:19:17.000
and we tend to lose those with age.

1784
01:19:17.000 --> 01:19:21.000
Men are born with more, tend to hold on to them more.

1785
01:19:21.000 --> 01:19:25.000
So it's not necessarily as big an issue for lactate production.

1786
01:19:25.000 --> 01:19:28.000
We then need to spend more time in the low-intensity

1787
01:19:28.000 --> 01:19:32.000
being able to produce more of our fat-burning capacity.

1788
01:19:32.000 --> 01:19:34.000
But for women doing that high-intensity work

1789
01:19:34.000 --> 01:19:36.000
and being able to produce lactate

1790
01:19:36.000 --> 01:19:38.000
to then allow the heart and the brain

1791
01:19:38.000 --> 01:19:41.000
to use that preferential fuel feeds forward

1792
01:19:41.000 --> 01:19:47.000
to reducing the misstep in this brain metabolism component

1793
01:19:47.000 --> 01:19:50.000
that occurs and it's such a sex difference.

1794
01:19:50.000 --> 01:19:53.000
When we're seeing a change in glucose metabolism

1795
01:19:53.000 --> 01:19:56.000
in and around perimenopause and to menopause.

1796
01:19:56.000 --> 01:19:58.000
So it's that lactate production that I

1797
01:19:58.000 --> 01:20:01.000
is kind of the offshoot of the high-intensity work

1798
01:20:01.000 --> 01:20:05.000
that's super important for brain health as well.

1799
01:20:05.000 --> 01:20:07.000
When you look at glucose metabolism in the brain,

1800
01:20:07.000 --> 01:20:10.000
I'm talking specifically coming out of Arizona

1801
01:20:10.000 --> 01:20:12.000
and from Lisa Muscone's work

1802
01:20:12.000 --> 01:20:15.000
and they looked at glucose utilization in the brain,

1803
01:20:15.000 --> 01:20:18.000
especially the forebrain through the transition,

1804
01:20:18.000 --> 01:20:22.000
it's wildly different based on what phase

1805
01:20:22.000 --> 01:20:25.000
of perimenopause, menopause, and postmenopause

1806
01:20:25.000 --> 01:20:28.000
that they're in and it's absolutely astounding

1807
01:20:28.000 --> 01:20:30.000
and they're seeing patterns that can give clues

1808
01:20:30.000 --> 01:20:32.000
that may be the women who are headed towards

1809
01:20:32.000 --> 01:20:35.000
the dementia route versus those who aren't.

1810
01:20:35.000 --> 01:20:37.000
And women are significantly more likely than men

1811
01:20:37.000 --> 01:20:39.000
to develop dementia and Alzheimer's,

1812
01:20:39.000 --> 01:20:42.000
because they have certain unique biological risk factors

1813
01:20:42.000 --> 01:20:44.000
and also because they live longer.

1814
01:20:44.000 --> 01:20:46.000
And the sociocultural component,

1815
01:20:46.000 --> 01:20:48.000
I keep bringing it up because I stress.

1816
01:20:48.000 --> 01:20:51.000
Yeah, but also if we're looking at women who are

1817
01:20:51.000 --> 01:20:53.000
89 years old now,

1818
01:20:53.000 --> 01:20:56.000
they're upbringing to this point

1819
01:20:56.000 --> 01:20:57.000
is completely different than ours,

1820
01:20:57.000 --> 01:20:59.000
meaning that the job availability

1821
01:20:59.000 --> 01:21:01.000
and the brain stimulation they had

1822
01:21:01.000 --> 01:21:04.000
when they were in their 30s, 40s, 50s,

1823
01:21:04.000 --> 01:21:06.000
completely different than what we have now.

1824
01:21:06.000 --> 01:21:07.000
Better of Fort West.

1825
01:21:07.000 --> 01:21:09.000
Of course. So they didn't have necessarily

1826
01:21:09.000 --> 01:21:12.000
opportunity to be scientists, lawyers, medical doctors.

1827
01:21:12.000 --> 01:21:15.000
So they didn't have as much stimulation of brain

1828
01:21:15.000 --> 01:21:17.000
and implications on that neuroplasticity.

1829
01:21:17.000 --> 01:21:22.000
So we're seeing a higher episodic issue

1830
01:21:22.000 --> 01:21:26.000
of dementia and Alzheimer's and older women now

1831
01:21:26.000 --> 01:21:29.000
because they didn't have the same lay-down effect

1832
01:21:29.000 --> 01:21:32.000
that we have now as 50-year-olds,

1833
01:21:32.000 --> 01:21:33.000
40-50-year-olds,

1834
01:21:33.000 --> 01:21:36.000
and the stimulus we have for neuroplasticity.

1835
01:21:36.000 --> 01:21:37.000
Oh, so okay.

1836
01:21:37.000 --> 01:21:40.000
Like you're laying down brain pathways and neurofibers.

1837
01:21:40.000 --> 01:21:41.000
So neuroplasticity.

1838
01:21:41.000 --> 01:21:42.000
Think about it like the bone,

1839
01:21:42.000 --> 01:21:44.000
but you're creating pathways in your brain

1840
01:21:44.000 --> 01:21:45.000
to make you healthier,

1841
01:21:45.000 --> 01:21:48.000
but more resilient to dementia.

1842
01:21:48.000 --> 01:21:51.000
But they're also going to have a stronger brain younger.

1843
01:21:51.000 --> 01:21:53.000
Are they not going to have more stress

1844
01:21:53.000 --> 01:21:55.000
if they're working in more hours?

1845
01:21:55.000 --> 01:21:56.000
And fascinating study,

1846
01:21:56.000 --> 01:21:59.000
and this one shot me out of a cannon emotionally,

1847
01:21:59.000 --> 01:22:03.000
was if you choose to become a caretaker of a parent

1848
01:22:03.000 --> 01:22:04.000
with dementia,

1849
01:22:04.000 --> 01:22:06.000
you have a 60% increased risk.

1850
01:22:06.000 --> 01:22:08.000
Now there's a genetic component,

1851
01:22:08.000 --> 01:22:10.000
but when they took the genetics out of it,

1852
01:22:10.000 --> 01:22:13.000
and they feel like it's the stress of caregiving

1853
01:22:13.000 --> 01:22:14.000
for that parent,

1854
01:22:14.000 --> 01:22:16.000
you are signing your own death warrant,

1855
01:22:16.000 --> 01:22:18.000
because now you are increasing your risk of death.

1856
01:22:18.000 --> 01:22:19.000
Because, yeah,

1857
01:22:19.000 --> 01:22:20.000
because I'm right in thinking

1858
01:22:20.000 --> 01:22:22.000
that women are still both caregiver

1859
01:22:22.000 --> 01:22:24.000
and now in the corporate world.

1860
01:22:24.000 --> 01:22:27.000
Yes, yes, that's right.

1861
01:22:27.000 --> 01:22:28.000
So it's both.

1862
01:22:28.000 --> 01:22:29.000
Yeah.

1863
01:22:29.000 --> 01:22:31.000
Stress from both ends.

1864
01:22:31.000 --> 01:22:33.000
Lactate production for the win.

1865
01:22:33.000 --> 01:22:37.000
But you also have an active plan to combat this, right?

1866
01:22:37.000 --> 01:22:38.000
Yes.

1867
01:22:38.000 --> 01:22:39.000
We're not going to live in a world that is stress-free.

1868
01:22:39.000 --> 01:22:41.000
If you're a woman in the world,

1869
01:22:41.000 --> 01:22:45.000
you are likely to have a caretaking role in some fashion.

1870
01:22:45.000 --> 01:22:48.000
Even if you are chasing other dreams

1871
01:22:48.000 --> 01:22:50.000
when it comes to professionally,

1872
01:22:50.000 --> 01:22:52.000
building good brain pathways

1873
01:22:52.000 --> 01:22:55.000
is wonderful as far as a way to help start

1874
01:22:55.000 --> 01:22:59.000
from a higher standpoint before you have brain loss.

1875
01:22:59.000 --> 01:23:01.000
However, we've just like we've said on these other standards,

1876
01:23:01.000 --> 01:23:03.000
the brain is that too.

1877
01:23:03.000 --> 01:23:05.000
We need to think about active ways.

1878
01:23:05.000 --> 01:23:07.000
We're going to combat what is happening

1879
01:23:07.000 --> 01:23:09.000
in today's world naturally.

1880
01:23:09.000 --> 01:23:11.000
And some of the factors are modern society

1881
01:23:11.000 --> 01:23:15.000
that put us into this pro-inflammatory state.

1882
01:23:15.000 --> 01:23:17.000
But we need to think about making lactate,

1883
01:23:17.000 --> 01:23:19.000
what's important for us.

1884
01:23:19.000 --> 01:23:21.000
And it really is a plan.

1885
01:23:21.000 --> 01:23:23.000
I'm going to figure it out when I'm 90

1886
01:23:23.000 --> 01:23:25.000
and the problems in front of me is too late

1887
01:23:25.000 --> 01:23:27.000
for these medical problems.

1888
01:23:27.000 --> 01:23:29.000
So in back to your point about neuroplasticity,

1889
01:23:29.000 --> 01:23:31.000
we're not reading as much.

1890
01:23:31.000 --> 01:23:32.000
We're on our phones.

1891
01:23:32.000 --> 01:23:34.000
And so...

1892
01:23:34.000 --> 01:23:35.000
In my house?

1893
01:23:35.000 --> 01:23:36.000
Yeah.

1894
01:23:36.000 --> 01:23:38.000
And so, as a culture,

1895
01:23:38.000 --> 01:23:41.000
there's this worry that all this time on the phone

1896
01:23:41.000 --> 01:23:42.000
and these dopamine hits,

1897
01:23:42.000 --> 01:23:44.000
but not creating stories in your head

1898
01:23:44.000 --> 01:23:47.000
and reading for pleasure at night,

1899
01:23:47.000 --> 01:23:50.000
a lot of women are on their phones now before bed,

1900
01:23:50.000 --> 01:23:53.000
rather than developing that neuroplasticity

1901
01:23:53.000 --> 01:23:56.000
that we get from storytelling.

1902
01:23:56.000 --> 01:23:58.000
I did something at 24 years old

1903
01:23:58.000 --> 01:24:00.000
that has had a profound impact on my life.

1904
01:24:00.000 --> 01:24:02.000
I set myself the challenge of posting

1905
01:24:02.000 --> 01:24:04.000
every single day on my social media channels.

1906
01:24:04.000 --> 01:24:05.000
And at the time,

1907
01:24:05.000 --> 01:24:07.000
I was doing it to grow my following.

1908
01:24:07.000 --> 01:24:09.000
But it had this profound impact on my life

1909
01:24:09.000 --> 01:24:11.000
and two remarkable things happened when I did that.

1910
01:24:11.000 --> 01:24:13.000
I managed to learn faster

1911
01:24:13.000 --> 01:24:15.000
because every single day I'm capturing what is happening to me

1912
01:24:15.000 --> 01:24:17.000
and trying to distill it down into something

1913
01:24:17.000 --> 01:24:19.000
that I can share with the world.

1914
01:24:19.000 --> 01:24:20.000
But more remarkably,

1915
01:24:20.000 --> 01:24:22.000
it led me to building a following

1916
01:24:22.000 --> 01:24:23.000
of many millions of people

1917
01:24:23.000 --> 01:24:26.000
and that's the basis that I used to launch the diorevascio.

1918
01:24:26.000 --> 01:24:28.000
And that's why I want to tell you about our sponsor today

1919
01:24:28.000 --> 01:24:29.000
Adobe Express.

1920
01:24:29.000 --> 01:24:31.000
They are the platform that I use

1921
01:24:31.000 --> 01:24:32.000
to make all the posts across my LinkedIn

1922
01:24:32.000 --> 01:24:34.000
and across my Instagram.

1923
01:24:34.000 --> 01:24:35.000
It's a couple of clicks

1924
01:24:35.000 --> 01:24:37.000
and you don't need to be an expert.

1925
01:24:37.000 --> 01:24:38.000
And that is why I love using it

1926
01:24:38.000 --> 01:24:40.000
because I'm not an expert in graphic design.

1927
01:24:40.000 --> 01:24:42.000
It's accessible to use for all of us,

1928
01:24:42.000 --> 01:24:44.000
even if we don't have the technical prowess

1929
01:24:44.000 --> 01:24:45.000
to design great things.

1930
01:24:45.000 --> 01:24:46.000
So if you want to start compounding

1931
01:24:46.000 --> 01:24:47.000
both your reach and your knowledge

1932
01:24:47.000 --> 01:24:49.000
like I did at 24 years old,

1933
01:24:49.000 --> 01:24:53.000
then head to Adobe.ly-steven

1934
01:24:53.000 --> 01:24:55.000
and get started with Adobe Express.

1935
01:24:55.000 --> 01:24:59.000
That's Adobe.ly-steven.

1936
01:24:59.000 --> 01:25:01.000
The next question that came in from the audience,

1937
01:25:01.000 --> 01:25:04.000
we asked 1,000 women to submit their questions.

1938
01:25:04.000 --> 01:25:06.000
The next one is, what's the best

1939
01:25:06.000 --> 01:25:09.000
and healthiest way for a woman to lose weight?

1940
01:25:09.000 --> 01:25:10.000
Lift weights.

1941
01:25:10.000 --> 01:25:11.000
And eat.

1942
01:25:11.000 --> 01:25:12.000
And eat.

1943
01:25:12.000 --> 01:25:13.000
And eat.

1944
01:25:13.000 --> 01:25:14.000
Yes, absolutely.

1945
01:25:14.000 --> 01:25:17.000
And you could have a very slight calorie deficit

1946
01:25:17.000 --> 01:25:19.000
towards the end of the evening.

1947
01:25:19.000 --> 01:25:20.000
Running?

1948
01:25:22.000 --> 01:25:24.000
As a way of burning calories,

1949
01:25:24.000 --> 01:25:26.000
the problem is people think that they can

1950
01:25:26.000 --> 01:25:28.000
out-exercise a bad diet.

1951
01:25:28.000 --> 01:25:29.000
And you can't.

1952
01:25:29.000 --> 01:25:31.000
Composition of your diet matters immensely.

1953
01:25:31.000 --> 01:25:33.000
And I hate calling it lose weight.

1954
01:25:33.000 --> 01:25:35.000
I now call it recomposition.

1955
01:25:35.000 --> 01:25:36.000
Yeah.

1956
01:25:36.000 --> 01:25:37.000
But let me put it in context.

1957
01:25:37.000 --> 01:25:38.000
Yeah, go run.

1958
01:25:38.000 --> 01:25:41.000
You're going to burn 100 calories a mile.

1959
01:25:41.000 --> 01:25:43.000
Three girls scout cookies,

1960
01:25:43.000 --> 01:25:44.000
three thin mints,

1961
01:25:44.000 --> 01:25:45.000
U.S. favorites,

1962
01:25:45.000 --> 01:25:47.000
is 180 calories.

1963
01:25:47.000 --> 01:25:50.000
So you have to run two miles

1964
01:25:50.000 --> 01:25:52.000
to eat three cookies.

1965
01:25:52.000 --> 01:25:53.000
Most of us,

1966
01:25:53.000 --> 01:25:55.000
if you're going to eat cookies,

1967
01:25:55.000 --> 01:25:57.000
don't eat three thin mints.

1968
01:25:57.000 --> 01:25:58.000
You eat the whole sleeve.

1969
01:25:58.000 --> 01:25:59.000
Right.

1970
01:25:59.000 --> 01:26:00.000
To your point,

1971
01:26:00.000 --> 01:26:03.000
it is impossible to out-exercise food

1972
01:26:03.000 --> 01:26:05.000
unless you're a high-level athlete.

1973
01:26:05.000 --> 01:26:06.000
And even then, no.

1974
01:26:06.000 --> 01:26:07.000
Thousand calories.

1975
01:26:07.000 --> 01:26:08.000
And then, no.

1976
01:26:08.000 --> 01:26:10.000
Because we look at diet composition.

1977
01:26:10.000 --> 01:26:12.000
And we see that endurance athletes

1978
01:26:12.000 --> 01:26:14.000
who use a lot of high sugary,

1979
01:26:14.000 --> 01:26:15.000
time carbohydrate,

1980
01:26:15.000 --> 01:26:17.000
like did gels and the sports stuff,

1981
01:26:17.000 --> 01:26:19.000
they've interrupted their gut microbiome

1982
01:26:19.000 --> 01:26:21.000
so much that they have sugarapples.

1983
01:26:21.000 --> 01:26:22.000
Yeah.

1984
01:26:22.000 --> 01:26:23.000
Well, it's not even that.

1985
01:26:23.000 --> 01:26:25.000
It's the phylochange.

1986
01:26:25.000 --> 01:26:27.000
We're seeing a decrease in the diversity,

1987
01:26:27.000 --> 01:26:28.000
but we're exercising.

1988
01:26:28.000 --> 01:26:30.000
And we see that exercise increases

1989
01:26:30.000 --> 01:26:32.000
the diversity of the gut microbiome,

1990
01:26:32.000 --> 01:26:34.000
is what they're eating during the training

1991
01:26:34.000 --> 01:26:36.000
with the heat and hypoxic stress.

1992
01:26:36.000 --> 01:26:37.000
Wow.

1993
01:26:37.000 --> 01:26:39.000
That is creating the growth of the,

1994
01:26:39.000 --> 01:26:41.000
from a kudis phylo,

1995
01:26:41.000 --> 01:26:43.000
that's associated with obese outcomes.

1996
01:26:43.000 --> 01:26:44.000
So that's,

1997
01:26:44.000 --> 01:26:45.000
it changes the gut.

1998
01:26:45.000 --> 01:26:46.000
The gut bacteria.

1999
01:26:46.000 --> 01:26:47.000
Yeah.

2000
01:26:47.000 --> 01:26:48.000
Yeah.

2001
01:26:48.000 --> 01:26:50.000
So we have this,

2002
01:26:50.000 --> 01:26:52.000
yeah, we have this misconception

2003
01:26:52.000 --> 01:26:54.000
that if you're an elite athlete

2004
01:26:54.000 --> 01:26:55.000
and you're burning all these calories,

2005
01:26:55.000 --> 01:26:57.000
then you're just eating a fuel, right?

2006
01:26:57.000 --> 01:26:58.000
But it's not.

2007
01:26:58.000 --> 01:27:00.000
It's the quality of the diet.

2008
01:27:00.000 --> 01:27:01.000
If we want to perform well,

2009
01:27:01.000 --> 01:27:03.000
whatever performance means,

2010
01:27:03.000 --> 01:27:05.000
if you're Olympic athlete,

2011
01:27:05.000 --> 01:27:06.000
down to recreational person,

2012
01:27:06.000 --> 01:27:08.000
who just wants to accomplish a 5k,

2013
01:27:08.000 --> 01:27:10.000
the composition of your diet

2014
01:27:10.000 --> 01:27:12.000
is immensely important.

2015
01:27:12.000 --> 01:27:13.000
What about a Zempac?

2016
01:27:13.000 --> 01:27:15.000
Everybody seems to be on a Zempac,

2017
01:27:15.000 --> 01:27:16.000
JLP ones.

2018
01:27:16.000 --> 01:27:17.000
I prescribe it.

2019
01:27:17.000 --> 01:27:19.000
And our clinic is all perimenopause and menopause.

2020
01:27:19.000 --> 01:27:21.000
And so we always start with,

2021
01:27:21.000 --> 01:27:23.000
let's see how you do

2022
01:27:23.000 --> 01:27:25.000
with lifestyle changes first.

2023
01:27:25.000 --> 01:27:27.000
So we give that three to six months.

2024
01:27:27.000 --> 01:27:28.000
When they come back,

2025
01:27:28.000 --> 01:27:29.000
every time they come back,

2026
01:27:29.000 --> 01:27:31.000
we're doing another body composition chain

2027
01:27:31.000 --> 01:27:34.000
for probably 50% of the patients,

2028
01:27:34.000 --> 01:27:36.000
lifestyle plus or minus HRT,

2029
01:27:36.000 --> 01:27:38.000
their body composition changes,

2030
01:27:38.000 --> 01:27:39.000
they're happy,

2031
01:27:39.000 --> 01:27:40.000
they're health, you know,

2032
01:27:40.000 --> 01:27:41.000
they're much healthier,

2033
01:27:41.000 --> 01:27:42.000
everything's moving in the right direction.

2034
01:27:42.000 --> 01:27:44.000
So now we're left with the people

2035
01:27:44.000 --> 01:27:45.000
who are doing all the things.

2036
01:27:45.000 --> 01:27:47.000
This isn't the typical story of people

2037
01:27:47.000 --> 01:27:48.000
that start at Zempac.

2038
01:27:48.000 --> 01:27:50.000
They see it on the Instagram

2039
01:27:50.000 --> 01:27:52.000
and then a week after I'll be at their house

2040
01:27:52.000 --> 01:27:53.000
and they'll tell me,

2041
01:27:53.000 --> 01:27:54.000
yeah, I'm on a Zempac.

2042
01:27:54.000 --> 01:27:55.000
And it's really,

2043
01:27:55.000 --> 01:27:57.000
it's usually just someone sees it online.

2044
01:27:57.000 --> 01:27:58.000
They hear it on a podcast

2045
01:27:58.000 --> 01:28:00.000
and they're on it within a couple of days.

2046
01:28:00.000 --> 01:28:02.000
The access is getting easier.

2047
01:28:02.000 --> 01:28:03.000
The price is coming down.

2048
01:28:03.000 --> 01:28:05.000
And there is for any medication,

2049
01:28:05.000 --> 01:28:06.000
there are risks,

2050
01:28:06.000 --> 01:28:07.000
there are benefits.

2051
01:28:07.000 --> 01:28:11.000
And there's ways that will promote health.

2052
01:28:11.000 --> 01:28:12.000
And with any medication,

2053
01:28:12.000 --> 01:28:14.000
you can not promote health if you give.

2054
01:28:14.000 --> 01:28:17.000
I mean, JLP ones can be revolutionary

2055
01:28:17.000 --> 01:28:18.000
for certain people.

2056
01:28:18.000 --> 01:28:19.000
A lot of people are not training

2057
01:28:19.000 --> 01:28:20.000
for a 5K,

2058
01:28:20.000 --> 01:28:21.000
let alone anything else.

2059
01:28:21.000 --> 01:28:23.000
And we know if we go very simply,

2060
01:28:23.000 --> 01:28:24.000
that sells, right?

2061
01:28:24.000 --> 01:28:26.000
They make a different type of estrogen.

2062
01:28:26.000 --> 01:28:27.000
They're inflammatory.

2063
01:28:27.000 --> 01:28:28.000
You have insulin resistance.

2064
01:28:28.000 --> 01:28:31.000
And all of this sets you up at a deficit

2065
01:28:31.000 --> 01:28:33.000
to say, I want to get healthier.

2066
01:28:33.000 --> 01:28:35.000
For women, we'll say you have PCOS,

2067
01:28:35.000 --> 01:28:37.000
who already have a predisposition

2068
01:28:37.000 --> 01:28:38.000
for insulin resistance.

2069
01:28:38.000 --> 01:28:40.000
They have a harder time losing weight

2070
01:28:40.000 --> 01:28:42.000
because now they're also storing visceral fat.

2071
01:28:42.000 --> 01:28:44.000
We know they get on this cycle

2072
01:28:44.000 --> 01:28:45.000
with hormonal change.

2073
01:28:45.000 --> 01:28:47.000
You know, being on a Zempac

2074
01:28:47.000 --> 01:28:49.000
allows them to lose weight

2075
01:28:49.000 --> 01:28:51.000
and combat insulin resistance

2076
01:28:51.000 --> 01:28:53.000
in a faster way

2077
01:28:53.000 --> 01:28:55.000
than they've ever been able to do before.

2078
01:28:55.000 --> 01:28:57.000
And especially when it comes to fertility

2079
01:28:57.000 --> 01:28:58.000
and you're on a timeline,

2080
01:28:58.000 --> 01:29:00.000
that can be really revolutionary.

2081
01:29:00.000 --> 01:29:01.000
When you lose weight

2082
01:29:01.000 --> 01:29:03.000
because that estrogen decreases,

2083
01:29:03.000 --> 01:29:05.000
many women with PCOS,

2084
01:29:05.000 --> 01:29:06.000
if they were overweight,

2085
01:29:06.000 --> 01:29:07.000
will start ovulating again

2086
01:29:07.000 --> 01:29:08.000
because that suppression

2087
01:29:08.000 --> 01:29:11.000
from the additional estrogen is gone.

2088
01:29:11.000 --> 01:29:14.000
And their inflammation markers go down,

2089
01:29:14.000 --> 01:29:16.000
their insulin resistance decreases.

2090
01:29:16.000 --> 01:29:17.000
So there's a subset of people

2091
01:29:17.000 --> 01:29:20.000
who have found their life changed by them.

2092
01:29:20.000 --> 01:29:21.000
And we never want to discredit that.

2093
01:29:21.000 --> 01:29:24.000
Many people have a difficulty losing weight,

2094
01:29:24.000 --> 01:29:26.000
chronic medical conditions,

2095
01:29:26.000 --> 01:29:28.000
have been able to reverse them,

2096
01:29:28.000 --> 01:29:30.000
and this has been a tool in the toolbox.

2097
01:29:30.000 --> 01:29:32.000
Because about 70% of Americans

2098
01:29:32.000 --> 01:29:35.000
would fit in that category of chronic health conditions,

2099
01:29:35.000 --> 01:29:36.000
difficulty losing weight.

2100
01:29:36.000 --> 01:29:38.000
They're 73% right now

2101
01:29:38.000 --> 01:29:40.000
or overweight or obese in the US.

2102
01:29:40.000 --> 01:29:42.000
So should 73% of Americans be on GLP once?

2103
01:29:42.000 --> 01:29:43.000
And it was higher in women.

2104
01:29:43.000 --> 01:29:44.000
Well, we always...

2105
01:29:44.000 --> 01:29:46.000
One common thing is

2106
01:29:46.000 --> 01:29:48.000
having tools in the toolbox

2107
01:29:48.000 --> 01:29:49.000
and being able to know when to use them,

2108
01:29:49.000 --> 01:29:50.000
when to offer them.

2109
01:29:50.000 --> 01:29:53.000
Just like when we have the HRT discussion,

2110
01:29:53.000 --> 01:29:55.000
we don't want to see people

2111
01:29:55.000 --> 01:29:56.000
say women for this discussion,

2112
01:29:56.000 --> 01:29:59.000
not being offered a therapeutic option

2113
01:29:59.000 --> 01:30:01.000
or not choosing it out of fear.

2114
01:30:01.000 --> 01:30:02.000
Well, when I hear that,

2115
01:30:02.000 --> 01:30:04.000
it's going to help me lose weight.

2116
01:30:04.000 --> 01:30:06.000
And I've got two options.

2117
01:30:06.000 --> 01:30:08.000
I can go out and lift all these weights,

2118
01:30:08.000 --> 01:30:09.000
they see, and I can...

2119
01:30:09.000 --> 01:30:11.000
Which, you know, one day, I don't...

2120
01:30:11.000 --> 01:30:12.000
Yeah, it's hard, isn't it?

2121
01:30:12.000 --> 01:30:13.000
Go to the gym after what my shoes are,

2122
01:30:13.000 --> 01:30:15.000
and all these things.

2123
01:30:15.000 --> 01:30:17.000
Or I can take this injection.

2124
01:30:17.000 --> 01:30:20.000
And lose all your muscle and lose your bone

2125
01:30:20.000 --> 01:30:22.000
and end up like the little floating figure

2126
01:30:22.000 --> 01:30:25.000
in Wally movie that I've talked about before, right?

2127
01:30:25.000 --> 01:30:29.000
And that's my fear of just blanket people use you.

2128
01:30:29.000 --> 01:30:30.000
You're also...

2129
01:30:30.000 --> 01:30:32.000
Whether you mean to or not,

2130
01:30:32.000 --> 01:30:34.000
giving the illusion that, you know,

2131
01:30:34.000 --> 01:30:37.000
willpower is all you need to lose weight

2132
01:30:37.000 --> 01:30:38.000
by what you said.

2133
01:30:38.000 --> 01:30:40.000
I can either do these hard things

2134
01:30:40.000 --> 01:30:42.000
or I can choose this medication

2135
01:30:42.000 --> 01:30:44.000
which appears to be the easier way out.

2136
01:30:44.000 --> 01:30:46.000
And two things can be true at once.

2137
01:30:46.000 --> 01:30:47.000
People can work extremely hard.

2138
01:30:47.000 --> 01:30:49.000
Maybe they don't understand exactly

2139
01:30:49.000 --> 01:30:50.000
what they should be doing.

2140
01:30:50.000 --> 01:30:53.000
And that's part of what we're trying to change the discussion on.

2141
01:30:53.000 --> 01:30:55.000
But reversing some metabolic change,

2142
01:30:55.000 --> 01:30:58.000
even initially, can make a big difference in their game plan.

2143
01:30:58.000 --> 01:31:03.000
But you will lose body weight on these medications.

2144
01:31:03.000 --> 01:31:06.000
And so you have to have somebody guiding the ship.

2145
01:31:06.000 --> 01:31:11.000
I think what we all don't love is the access without oversight.

2146
01:31:11.000 --> 01:31:13.000
I mean, nobody's helping you say,

2147
01:31:13.000 --> 01:31:15.000
how are you not using muscle?

2148
01:31:15.000 --> 01:31:17.000
How are you doing this in a safe fashion?

2149
01:31:17.000 --> 01:31:19.000
You can just text somebody on an app

2150
01:31:19.000 --> 01:31:22.000
and suddenly get medication to your house.

2151
01:31:22.000 --> 01:31:23.000
You know, in our clinic,

2152
01:31:23.000 --> 01:31:24.000
it is an hour long.

2153
01:31:24.000 --> 01:31:27.000
Now they're coming in to discuss the GOP one option.

2154
01:31:27.000 --> 01:31:31.000
It is an hour long visit of risk benefits, side effects,

2155
01:31:31.000 --> 01:31:34.000
protein intake, resistance training, mandatory.

2156
01:31:34.000 --> 01:31:36.000
We will follow your bone density.

2157
01:31:36.000 --> 01:31:38.000
We will follow your bone mass.

2158
01:31:38.000 --> 01:31:39.000
I mean, your muscle mass here.

2159
01:31:39.000 --> 01:31:40.000
We have these scanners.

2160
01:31:40.000 --> 01:31:41.000
These are great.

2161
01:31:41.000 --> 01:31:42.000
Available.

2162
01:31:42.000 --> 01:31:44.000
And we're not going to get to a number on the scale

2163
01:31:44.000 --> 01:31:46.000
and sacrifice your long-term health.

2164
01:31:46.000 --> 01:31:48.000
And my patients are drinking the Kool-Aid.

2165
01:31:48.000 --> 01:31:49.000
They're coming in.

2166
01:31:49.000 --> 01:31:50.000
They've found, you know, they...

2167
01:31:50.000 --> 01:31:51.000
They're coming to you for a reason.

2168
01:31:51.000 --> 01:31:52.000
Yeah.

2169
01:31:52.000 --> 01:31:54.000
And so I'm a little bit unique in my clinic.

2170
01:31:54.000 --> 01:31:56.000
And now I have a social media following

2171
01:31:56.000 --> 01:31:58.000
and people kind of watch a few things before they come see me.

2172
01:31:58.000 --> 01:31:59.000
So they know my...

2173
01:31:59.000 --> 01:32:01.000
They're not shocked by me giving this advice.

2174
01:32:01.000 --> 01:32:03.000
Because I give it all day on social media.

2175
01:32:03.000 --> 01:32:04.000
So if you give them the...

2176
01:32:04.000 --> 01:32:05.000
Is MPEG?

2177
01:32:05.000 --> 01:32:07.000
But they still don't go to the gym.

2178
01:32:07.000 --> 01:32:08.000
They still don't do anything else.

2179
01:32:08.000 --> 01:32:09.000
Then we'll stop giving it to them.

2180
01:32:09.000 --> 01:32:10.000
They won't be healthy.

2181
01:32:10.000 --> 01:32:11.000
And they know that.

2182
01:32:11.000 --> 01:32:12.000
We've talked to them about that.

2183
01:32:12.000 --> 01:32:14.000
We've explained it on the front end.

2184
01:32:14.000 --> 01:32:16.000
That this is a tool in your toolkit.

2185
01:32:16.000 --> 01:32:18.000
Because we can see their muscle mass.

2186
01:32:18.000 --> 01:32:21.000
We won't renew the prescription if they've lost the muscle mass.

2187
01:32:21.000 --> 01:32:23.000
So if you are losing weight

2188
01:32:23.000 --> 01:32:26.000
and not lifting and eating enough protein,

2189
01:32:26.000 --> 01:32:28.000
on ozemic or any way else,

2190
01:32:28.000 --> 01:32:30.000
and you do a body composition,

2191
01:32:30.000 --> 01:32:33.000
you may see total weight lost.

2192
01:32:33.000 --> 01:32:37.000
You will see pounds of muscle loss.

2193
01:32:38.000 --> 01:32:40.000
You may see body fat percentage loss.

2194
01:32:40.000 --> 01:32:42.000
But if you do this correctly

2195
01:32:42.000 --> 01:32:45.000
with enough protein in your diet and lifting weights,

2196
01:32:45.000 --> 01:32:49.000
the amount of muscle loss will be very small

2197
01:32:49.000 --> 01:32:51.000
versus amount of fat loss.

2198
01:32:51.000 --> 01:32:55.000
So we know we are going to lose a little muscle

2199
01:32:55.000 --> 01:32:57.000
but you can't lose eight pounds of muscle.

2200
01:32:57.000 --> 01:32:58.000
Right.

2201
01:32:58.000 --> 01:32:59.000
So we can tell.

2202
01:32:59.000 --> 01:33:01.000
And I give them the hard numbers.

2203
01:33:01.000 --> 01:33:03.000
Like 10% is acceptable.

2204
01:33:03.000 --> 01:33:04.000
We're going over that.

2205
01:33:04.000 --> 01:33:05.000
We're getting into the danger zone.

2206
01:33:06.000 --> 01:33:07.000
We're going to cut back on your dose.

2207
01:33:07.000 --> 01:33:08.000
We're going to, you know,

2208
01:33:08.000 --> 01:33:12.000
but they commit to the work on the front end.

2209
01:33:12.000 --> 01:33:15.000
I think that's the important point is that these job

2210
01:33:15.000 --> 01:33:18.000
who are antagonists don't burn your fat.

2211
01:33:18.000 --> 01:33:19.000
They burn.

2212
01:33:19.000 --> 01:33:20.000
They stop you eating as much.

2213
01:33:20.000 --> 01:33:21.000
They stop.

2214
01:33:21.000 --> 01:33:22.000
They stay tight.

2215
01:33:22.000 --> 01:33:23.000
Which is going to mess them,

2216
01:33:23.000 --> 01:33:24.000
which is going to reduce everything.

2217
01:33:24.000 --> 01:33:25.000
Because I was thinking about myself.

2218
01:33:25.000 --> 01:33:26.000
I was thinking, well,

2219
01:33:26.000 --> 01:33:27.000
I go to the gym every day.

2220
01:33:27.000 --> 01:33:28.000
I'm going to keep going.

2221
01:33:28.000 --> 01:33:30.000
So maybe if I had a little bit of a Zampek

2222
01:33:30.000 --> 01:33:31.000
or whatever it's called,

2223
01:33:31.000 --> 01:33:32.000
then it would burn my fat.

2224
01:33:32.000 --> 01:33:33.000
But actually, that's not what it is.

2225
01:33:33.000 --> 01:33:34.000
It's not no.

2226
01:33:34.000 --> 01:33:35.000
I'm going to stop me eating,

2227
01:33:35.000 --> 01:33:37.000
which is going to reduce my muscle, my burn.

2228
01:33:37.000 --> 01:33:38.000
That's right.

2229
01:33:38.000 --> 01:33:39.000
Goodbye, biceps.

2230
01:33:39.000 --> 01:33:40.000
That's the thing.

2231
01:33:40.000 --> 01:33:41.000
It's like,

2232
01:33:41.000 --> 01:33:42.000
No, these are my subscribers.

2233
01:33:42.000 --> 01:33:43.000
Yeah.

2234
01:33:43.000 --> 01:33:44.000
Exactly.

2235
01:33:44.000 --> 01:33:45.000
Exactly.

2236
01:33:45.000 --> 01:33:46.000
Exactly.

2237
01:33:46.000 --> 01:33:47.000
Yeah.

2238
01:33:47.000 --> 01:33:48.000
Okay.

2239
01:33:48.000 --> 01:33:49.000
That makes sense.

2240
01:33:49.000 --> 01:33:51.000
So to this person asking what's the best and healthiest way

2241
01:33:51.000 --> 01:33:52.000
to lose weight,

2242
01:33:52.000 --> 01:33:54.000
the response is stop eating the cookies

2243
01:33:54.000 --> 01:33:56.000
and start lifting some ways.

2244
01:33:56.000 --> 01:33:57.000
The 80-20 rule.

2245
01:33:57.000 --> 01:33:58.000
Right.

2246
01:33:58.000 --> 01:34:00.000
So 80% of the time you're on it, right?

2247
01:34:00.000 --> 01:34:02.000
You're paying attention to

2248
01:34:02.000 --> 01:34:04.000
a high-quality diet.

2249
01:34:04.000 --> 01:34:05.000
You are eating,

2250
01:34:05.000 --> 01:34:07.000
according to circadian rhythm.

2251
01:34:07.000 --> 01:34:09.000
You are doing this strength training,

2252
01:34:09.000 --> 01:34:10.000
you're getting the good sleep,

2253
01:34:10.000 --> 01:34:12.000
and then 20% is life.

2254
01:34:12.000 --> 01:34:13.000
Where I'm going to stay up late.

2255
01:34:13.000 --> 01:34:15.000
I'm going to have some wine or whiskey.

2256
01:34:15.000 --> 01:34:16.000
I'm going to go out.

2257
01:34:16.000 --> 01:34:17.000
I'm going to be on vacation.

2258
01:34:17.000 --> 01:34:20.000
So you're not excluding all the fun things in life.

2259
01:34:20.000 --> 01:34:22.000
If it comes to a point where you're like,

2260
01:34:22.000 --> 01:34:23.000
I'm still not budging the needle.

2261
01:34:23.000 --> 01:34:25.000
Then maybe it's a 90-10 rule.

2262
01:34:25.000 --> 01:34:27.000
Or 90% of the time you're on it.

2263
01:34:27.000 --> 01:34:29.000
And 10% is the life factor.

2264
01:34:30.000 --> 01:34:32.000
There's these hard and fast rules

2265
01:34:32.000 --> 01:34:33.000
I've been accused of giving.

2266
01:34:33.000 --> 01:34:34.000
I don't give rules.

2267
01:34:34.000 --> 01:34:36.000
I give optimization ideas.

2268
01:34:36.000 --> 01:34:40.000
So it's not following strict 80-20 or 90-10.

2269
01:34:40.000 --> 01:34:42.000
It's what fits in your life.

2270
01:34:42.000 --> 01:34:45.000
And if you're really motivated on losing weight,

2271
01:34:45.000 --> 01:34:48.000
the first thing I tell people to do is ditch alcohol.

2272
01:34:48.000 --> 01:34:51.000
Everyone wants to lose the part on the belly.

2273
01:34:51.000 --> 01:34:52.000
Yeah, sure.

2274
01:34:52.000 --> 01:34:54.000
Is there not like an exercise I can do just by the partner?

2275
01:34:54.000 --> 01:34:56.000
No, there's no exercise.

2276
01:34:57.000 --> 01:34:59.000
So visceral fat's a little bit different.

2277
01:34:59.000 --> 01:35:01.000
It's like a whole different organ.

2278
01:35:01.000 --> 01:35:03.000
So when we talk about visceral fat,

2279
01:35:03.000 --> 01:35:06.000
it has different drivers.

2280
01:35:06.000 --> 01:35:08.000
We drive fat to the intral abdominal cavity.

2281
01:35:08.000 --> 01:35:10.000
It creates a different cytokine.

2282
01:35:10.000 --> 01:35:12.000
Subcutaneous fat is a storage facility.

2283
01:35:12.000 --> 01:35:14.000
It is when we overeat calories.

2284
01:35:14.000 --> 01:35:16.000
We will drive fat under the skin.

2285
01:35:16.000 --> 01:35:18.000
And it's kind of genetically determined.

2286
01:35:18.000 --> 01:35:20.000
Females tend to gain about their hips and thighs.

2287
01:35:20.000 --> 01:35:22.000
And actually that hip and thigh fat

2288
01:35:22.000 --> 01:35:25.000
is protective for cardiovascular disease

2289
01:35:25.000 --> 01:35:27.000
and the pre-medipausal women.

2290
01:35:27.000 --> 01:35:29.000
Not in men, but in women.

2291
01:35:29.000 --> 01:35:34.000
But when that fat shifts to the intral abdominal cavity,

2292
01:35:34.000 --> 01:35:35.000
it starts.

2293
01:35:35.000 --> 01:35:37.000
That fat is metabot much more metabolically active

2294
01:35:37.000 --> 01:35:39.000
than the fat under our skin.

2295
01:35:39.000 --> 01:35:41.000
And it creates these pro-inflammatory cytokines.

2296
01:35:41.000 --> 01:35:44.000
And then you end up in this negative feedback cycle.

2297
01:35:44.000 --> 01:35:47.000
Your liver starts becoming dysfunctional.

2298
01:35:47.000 --> 01:35:48.000
Insulin resistance increases.

2299
01:35:48.000 --> 01:35:51.000
That drives more fat to the visceral cavity.

2300
01:35:51.000 --> 01:35:52.000
Increases inflammation.

2301
01:35:52.000 --> 01:35:53.000
And it just goes on.

2302
01:35:53.000 --> 01:35:54.000
So get liposuction.

2303
01:35:54.000 --> 01:35:55.000
No, no, no.

2304
01:35:55.000 --> 01:35:56.000
You can't lipose this way.

2305
01:35:56.000 --> 01:35:58.000
They're inside the fat.

2306
01:35:58.000 --> 01:36:00.000
That's really inside the abdominal cavities

2307
01:36:00.000 --> 01:36:01.000
that we're talking about.

2308
01:36:01.000 --> 01:36:03.000
That visceral fat, which is the worst kind.

2309
01:36:03.000 --> 01:36:04.000
Well, what about liposuction?

2310
01:36:04.000 --> 01:36:05.000
Can I just suck it out?

2311
01:36:05.000 --> 01:36:06.000
People are doing all kinds with that fat.

2312
01:36:06.000 --> 01:36:07.000
Under the skin.

2313
01:36:07.000 --> 01:36:08.000
Under the skin you can.

2314
01:36:08.000 --> 01:36:09.000
That's an aesthetic decision.

2315
01:36:09.000 --> 01:36:11.000
The stuff under the skin.

2316
01:36:11.000 --> 01:36:12.000
Oh.

2317
01:36:12.000 --> 01:36:13.000
Liposuction it out.

2318
01:36:13.000 --> 01:36:15.000
Is that a good idea or bad idea?

2319
01:36:15.000 --> 01:36:16.000
No, it'll come back.

2320
01:36:16.000 --> 01:36:17.000
All these things we're talking about.

2321
01:36:17.000 --> 01:36:19.000
It sounds like a lot of instructions.

2322
01:36:19.000 --> 01:36:21.000
And it is, actually.

2323
01:36:21.000 --> 01:36:25.000
But when you layer them on, it becomes your lifestyle.

2324
01:36:25.000 --> 01:36:26.000
Yes.

2325
01:36:26.000 --> 01:36:27.000
It's not a diet.

2326
01:36:27.000 --> 01:36:29.000
It's not an exercise program.

2327
01:36:29.000 --> 01:36:31.000
It's just how I live.

2328
01:36:31.000 --> 01:36:32.000
You're right.

2329
01:36:32.000 --> 01:36:34.000
Which brings me to my next question from the audience,

2330
01:36:34.000 --> 01:36:38.000
which is, what is the best diet for a woman who is perimenopausal?

2331
01:36:38.000 --> 01:36:39.000
Plant forward.

2332
01:36:39.000 --> 01:36:40.000
Plant heavy.

2333
01:36:40.000 --> 01:36:41.000
Yeah.

2334
01:36:41.000 --> 01:36:45.000
Because you're getting, you're getting, so when I'm talking to patients,

2335
01:36:45.000 --> 01:36:48.000
we talk about the quality of their nutrition.

2336
01:36:48.000 --> 01:36:50.000
So is your pattern of eating?

2337
01:36:50.000 --> 01:36:53.000
I hate to call it diet because it's for a little word now.

2338
01:36:53.000 --> 01:36:57.000
But is the pattern that you're eating pro-inflammatory or anti-inflammatory?

2339
01:36:57.000 --> 01:36:59.000
What's pro-inflammatory?

2340
01:36:59.000 --> 01:37:02.000
So meaning, the things that you put in your body are they likely to cause inflammation.

2341
01:37:02.000 --> 01:37:07.000
And we know there are certain things that do that, like heavily ultra-process foods,

2342
01:37:07.000 --> 01:37:09.000
you know, in large amounts.

2343
01:37:09.000 --> 01:37:11.000
Everybody can tolerate a little bit of everything.

2344
01:37:11.000 --> 01:37:13.000
But if the majority of your diet and for most Americans,

2345
01:37:13.000 --> 01:37:17.000
the majority of their diet is 60% as ultra-process foods.

2346
01:37:17.000 --> 01:37:18.000
Okay.

2347
01:37:18.000 --> 01:37:20.000
Those are by and large pro-inflammatory.

2348
01:37:20.000 --> 01:37:22.000
What about red meat?

2349
01:37:22.000 --> 01:37:25.000
Red meat and moderation, and especially leaner,

2350
01:37:25.000 --> 01:37:28.000
one seems to be a very reliable source of protein.

2351
01:37:28.000 --> 01:37:32.000
As far as inflammation goes, it seems to be neutral in small amounts.

2352
01:37:32.000 --> 01:37:35.000
Not heavily, like high fat meals or processed meats,

2353
01:37:35.000 --> 01:37:37.000
then you're flipping over into pro-inflammatory.

2354
01:37:37.000 --> 01:37:39.000
Is there a diet for fatality?

2355
01:37:39.000 --> 01:37:41.000
It's very much what we're saying right here,

2356
01:37:41.000 --> 01:37:44.000
that plants have fiber that's going to feed your gut microbiome,

2357
01:37:44.000 --> 01:37:46.000
that's going to decrease inflammation.

2358
01:37:46.000 --> 01:37:48.000
So fruits and vegetables, getting enough fiber,

2359
01:37:48.000 --> 01:37:51.000
is the number one change that most people need to make.

2360
01:37:51.000 --> 01:37:55.000
From there, we want to, of course, decrease all your ultra-process foods.

2361
01:37:55.000 --> 01:37:56.000
Healthy fats.

2362
01:37:56.000 --> 01:37:59.000
Fat is the backbone of cholesterol.

2363
01:37:59.000 --> 01:38:01.000
Is the backbone of your steroid hormone.

2364
01:38:01.000 --> 01:38:04.000
So if you want to make hormones, we've got to have some cholesterol,

2365
01:38:04.000 --> 01:38:07.000
some healthy fats coming in to provide the backbone for that.

2366
01:38:07.000 --> 01:38:08.000
That's essential.

2367
01:38:08.000 --> 01:38:12.000
So things like olive oil, nuts, your avocados, seeds.

2368
01:38:13.000 --> 01:38:15.000
These are going to provide some of those healthier fats

2369
01:38:15.000 --> 01:38:17.000
that are easier to use for you.

2370
01:38:17.000 --> 01:38:20.000
And when it comes to protein, there's a lot of different protein sources.

2371
01:38:20.000 --> 01:38:23.000
We know that the data is so hard on nutrition,

2372
01:38:23.000 --> 01:38:26.000
because I can quote a study that says for every serving of plant protein

2373
01:38:26.000 --> 01:38:28.000
that you take over animal protein,

2374
01:38:28.000 --> 01:38:30.000
you have a higher chance of ovulating regularly.

2375
01:38:30.000 --> 01:38:31.000
And that's true.

2376
01:38:31.000 --> 01:38:33.000
A lot of that, though, is nuanced by the fact

2377
01:38:33.000 --> 01:38:35.000
that people who eat plant-based sources of proteins

2378
01:38:35.000 --> 01:38:39.000
tend to eat other plants in general and less ultra-process foods

2379
01:38:39.000 --> 01:38:42.000
than people who have the highest quartile of meat and take.

2380
01:38:42.000 --> 01:38:44.000
If we go to a micro-level, though, not all meat,

2381
01:38:44.000 --> 01:38:46.000
animal meat is created equal.

2382
01:38:46.000 --> 01:38:48.000
Animal meat does not have fiber in it.

2383
01:38:48.000 --> 01:38:51.000
So we know it's not feeding our gut microbiome.

2384
01:38:51.000 --> 01:38:54.000
So if we want to talk about carnivore diet,

2385
01:38:54.000 --> 01:38:58.000
things like that is definitely not microbiome friendly for you

2386
01:38:58.000 --> 01:39:00.000
and not hormonally healthy.

2387
01:39:00.000 --> 01:39:02.000
So we really want to really have those whole foods,

2388
01:39:02.000 --> 01:39:05.000
the fruits, vegetables, the healthy fats,

2389
01:39:05.000 --> 01:39:07.000
the proteins that are going to be good sources.

2390
01:39:07.000 --> 01:39:09.000
And just like we talked about other things,

2391
01:39:09.000 --> 01:39:10.000
it's not all or nothing.

2392
01:39:10.000 --> 01:39:13.000
Red meat every day is probably going to be inflammatory.

2393
01:39:13.000 --> 01:39:16.000
Having it on the weekend is probably okay.

2394
01:39:16.000 --> 01:39:18.000
And the way I describe this to patients is,

2395
01:39:18.000 --> 01:39:21.000
let's imagine a scale where every decision you make

2396
01:39:21.000 --> 01:39:23.000
can kind of tick up the inflammatory marker

2397
01:39:23.000 --> 01:39:24.000
or bring it back down.

2398
01:39:24.000 --> 01:39:28.000
If you are making active decisions that are more anti-inflammatory,

2399
01:39:28.000 --> 01:39:32.000
you can tolerate the glass of champagne, the birthday cake,

2400
01:39:32.000 --> 01:39:35.000
these little things that we know will cause inflammation in your body,

2401
01:39:35.000 --> 01:39:39.000
but your body is meant to respond to inflammation and get back to normal.

2402
01:39:39.000 --> 01:39:42.000
The problem is when it's constantly challenged,

2403
01:39:42.000 --> 01:39:47.000
when 70% of the things that you eat cause this chronic inflammation inside of you,

2404
01:39:47.000 --> 01:39:51.000
your body can no longer respond appropriately when it's challenged again.

2405
01:39:51.000 --> 01:39:55.000
Things that are pro-inflammatory tend to also disrupt the gut microbiome,

2406
01:39:55.000 --> 01:39:58.000
tend to like it all makes sense when you think about it.

2407
01:39:58.000 --> 01:40:00.000
And there's quite a few studies that are coming out

2408
01:40:01.000 --> 01:40:06.000
in the four to five years before the one-point time called menopause.

2409
01:40:07.000 --> 01:40:09.000
So in late perimenopause,

2410
01:40:09.000 --> 01:40:12.000
that there's a significant decrease in gut microbiome diabetes.

2411
01:40:12.000 --> 01:40:14.000
Oh, Zoe, did that work?

2412
01:40:14.000 --> 01:40:15.000
Yes, yeah.

2413
01:40:15.000 --> 01:40:18.000
And it's really interesting because of the second pass

2414
01:40:18.000 --> 01:40:20.000
and the way that hormones are metabolized.

2415
01:40:20.000 --> 01:40:24.000
When we have our natural cycle,

2416
01:40:24.000 --> 01:40:28.000
and we have an exposure of our sex hormones,

2417
01:40:28.000 --> 01:40:30.000
the common cycle,

2418
01:40:30.000 --> 01:40:32.000
then we have more of diversity

2419
01:40:32.000 --> 01:40:36.000
because the gut bugs help unwind, I guess, as a...

2420
01:40:36.000 --> 01:40:39.000
So we metabolize estrogen into inactive metabolite,

2421
01:40:39.000 --> 01:40:41.000
and then they get excreted in the feces.

2422
01:40:41.000 --> 01:40:44.000
So it goes through the liver and then dumped into the bile.

2423
01:40:44.000 --> 01:40:48.000
Does that mean that if my microbiome is likely to be less diverse as I age,

2424
01:40:48.000 --> 01:40:50.000
I need to be thinking more about...

2425
01:40:50.000 --> 01:40:52.000
The diversity of your plant foods.

2426
01:40:52.000 --> 01:40:53.000
And this is what's really...

2427
01:40:53.000 --> 01:40:55.000
Artex, probiotics, etc.

2428
01:40:55.000 --> 01:40:56.000
Not over the counter.

2429
01:40:56.000 --> 01:40:57.000
Okay.

2430
01:40:57.000 --> 01:40:58.000
We want to...

2431
01:40:58.000 --> 01:40:59.000
You first start with food.

2432
01:40:59.000 --> 01:41:00.000
Yes.

2433
01:41:00.000 --> 01:41:01.000
But not a pill that you're trying to take.

2434
01:41:01.000 --> 01:41:02.000
Right.

2435
01:41:02.000 --> 01:41:04.000
Actually, the food that you're putting into your body

2436
01:41:04.000 --> 01:41:07.000
is the best source for all the microbiomes as fiber.

2437
01:41:07.000 --> 01:41:09.000
What about protein?

2438
01:41:09.000 --> 01:41:10.000
Bonda.

2439
01:41:10.000 --> 01:41:12.000
The way I like to approach nutrition for people

2440
01:41:12.000 --> 01:41:15.000
is first having people notice what they're eating.

2441
01:41:15.000 --> 01:41:18.000
And then from that, break it down into,

2442
01:41:18.000 --> 01:41:20.000
well, how much of it is protein?

2443
01:41:20.000 --> 01:41:21.000
How much it is fat?

2444
01:41:21.000 --> 01:41:22.000
How much just carbs?

2445
01:41:22.000 --> 01:41:24.000
Without that kind of education,

2446
01:41:24.000 --> 01:41:25.000
it's almost meaningless.

2447
01:41:25.000 --> 01:41:27.000
So when we've done that,

2448
01:41:27.000 --> 01:41:31.000
and I'm making recadent mandations for protein,

2449
01:41:31.000 --> 01:41:36.000
we will not build the muscle we need to build.

2450
01:41:36.000 --> 01:41:39.000
We will not get stronger the way we're capable of getting stronger.

2451
01:41:39.000 --> 01:41:41.000
A, if we're not eating enough,

2452
01:41:41.000 --> 01:41:44.000
and B, if we're not taking enough protein.

2453
01:41:44.000 --> 01:41:49.000
So the RDA recommendations of 0.8 grams per kilogram

2454
01:41:49.000 --> 01:41:52.000
is survival doses of protein,

2455
01:41:52.000 --> 01:41:54.000
like sitting on a chair like a mushroom.

2456
01:41:54.000 --> 01:41:56.000
Providing malnutrition is the goal of it.

2457
01:41:56.000 --> 01:41:57.000
It's just too horrible.

2458
01:41:57.000 --> 01:41:59.000
It is not for active people.

2459
01:41:59.000 --> 01:42:01.000
It is not for living your best life people.

2460
01:42:01.000 --> 01:42:02.000
0.8.

2461
01:42:02.000 --> 01:42:07.000
The recommended daily intake is 0.8 grams per kilogram

2462
01:42:07.000 --> 01:42:08.000
of lean body mass.

2463
01:42:08.000 --> 01:42:09.000
So it's low.

2464
01:42:09.000 --> 01:42:10.000
It's very low.

2465
01:42:10.000 --> 01:42:17.000
So the research supports easily supports,

2466
01:42:17.000 --> 01:42:19.000
let's use pounds,

2467
01:42:19.000 --> 01:42:22.000
0.86 grams per pound

2468
01:42:22.000 --> 01:42:24.000
for lifting people.

2469
01:42:24.000 --> 01:42:26.000
I recommend over a gram,

2470
01:42:26.000 --> 01:42:29.000
a gram for ideal pound

2471
01:42:29.000 --> 01:42:33.000
because I'm presuming

2472
01:42:33.000 --> 01:42:35.000
that the people I'm taking care of

2473
01:42:35.000 --> 01:42:37.000
are going to start being active,

2474
01:42:37.000 --> 01:42:38.000
that we're trying to build muscle,

2475
01:42:38.000 --> 01:42:41.000
that we're not in starvation mode.

2476
01:42:41.000 --> 01:42:46.000
So 0.8 grams per pound.

2477
01:42:46.000 --> 01:42:51.000
I recommend one gram per ideal pound.

2478
01:42:52.000 --> 01:42:54.000
So there's some other resources

2479
01:42:54.000 --> 01:42:56.000
come out looking at skinny fat.

2480
01:42:56.000 --> 01:42:58.000
So that's normal weight obesity.

2481
01:42:58.000 --> 01:43:01.000
So as we're talking, normal VMI,

2482
01:43:01.000 --> 01:43:03.000
normal VMI, but internal...

2483
01:43:03.000 --> 01:43:05.000
5 body fat.

2484
01:43:05.000 --> 01:43:08.000
And then what happens is they have low muscle mass.

2485
01:43:08.000 --> 01:43:09.000
Low muscle mass.

2486
01:43:09.000 --> 01:43:12.000
So they took a group of women split them up

2487
01:43:12.000 --> 01:43:14.000
so you had a control group.

2488
01:43:14.000 --> 01:43:16.000
And then you had this intervention group

2489
01:43:16.000 --> 01:43:18.000
and the only change they made,

2490
01:43:18.000 --> 01:43:19.000
there's no exercise

2491
01:43:19.000 --> 01:43:21.000
and they only changed they made,

2492
01:43:21.000 --> 01:43:23.000
was they brought the intervention group

2493
01:43:23.000 --> 01:43:26.000
up to 1.6 grams of protein per kilogram.

2494
01:43:26.000 --> 01:43:29.000
So this is 0.8 per pound.

2495
01:43:29.000 --> 01:43:31.000
And over the course of 12 weeks

2496
01:43:31.000 --> 01:43:33.000
of eating that protein intake,

2497
01:43:33.000 --> 01:43:35.000
this intervention group

2498
01:43:35.000 --> 01:43:37.000
completely recomp their body.

2499
01:43:37.000 --> 01:43:39.000
So their muscle quality came up,

2500
01:43:39.000 --> 01:43:40.000
body fat went down.

2501
01:43:40.000 --> 01:43:42.000
Control group, of course, nothing happened.

2502
01:43:42.000 --> 01:43:43.000
So it just shows the importance

2503
01:43:43.000 --> 01:43:45.000
of having that higher protein intake

2504
01:43:45.000 --> 01:43:49.000
just to support basic muscle function.

2505
01:43:49.000 --> 01:43:51.000
And the frailty data out of the WHO,

2506
01:43:51.000 --> 01:43:52.000
so the Women's Health Initiative

2507
01:43:52.000 --> 01:43:53.000
looked at multiple things,

2508
01:43:53.000 --> 01:43:55.000
not just breast cancer and heart disease,

2509
01:43:55.000 --> 01:43:57.000
but they followed these women

2510
01:43:57.000 --> 01:43:59.000
even off of HRT for decades.

2511
01:43:59.000 --> 01:44:02.000
And when they looked at frailty scores

2512
01:44:02.000 --> 01:44:05.000
in the elderly and protein intake

2513
01:44:05.000 --> 01:44:09.000
above 1.6 grams per kilogram,

2514
01:44:09.000 --> 01:44:11.000
had the lowest frailty scores

2515
01:44:11.000 --> 01:44:14.000
just based on protein intake alone.

2516
01:44:14.000 --> 01:44:16.000
Yep.

2517
01:44:16.000 --> 01:44:18.000
What about fasting?

2518
01:44:18.000 --> 01:44:20.000
I know so many people that are doing

2519
01:44:20.000 --> 01:44:22.000
water fasts and juice fasts.

2520
01:44:22.000 --> 01:44:24.000
So they told you why?

2521
01:44:24.000 --> 01:44:26.000
I've had an evolution with the way I think about fasting.

2522
01:44:26.000 --> 01:44:28.000
When I first kind of, you know,

2523
01:44:28.000 --> 01:44:30.000
was stepping out of the box

2524
01:44:30.000 --> 01:44:32.000
and what's happening in menopause

2525
01:44:32.000 --> 01:44:34.000
and why was my body composition?

2526
01:44:34.000 --> 01:44:36.000
I didn't know what to call it back then,

2527
01:44:36.000 --> 01:44:38.000
but what was all this going on that was new

2528
01:44:38.000 --> 01:44:40.000
and all my patients were having it as well.

2529
01:44:40.000 --> 01:44:42.000
And these were my girlfriends.

2530
01:44:42.000 --> 01:44:44.000
And these were PhDs.

2531
01:44:44.000 --> 01:44:46.000
And we're running marathons.

2532
01:44:46.000 --> 01:44:48.000
We're doing all this stuff.

2533
01:44:48.000 --> 01:44:50.000
And everyone's kind of complaining of the same thing.

2534
01:44:50.000 --> 01:44:52.000
And so fasting seemed to be helpful.

2535
01:44:52.000 --> 01:44:54.000
And my girlfriends were trying,

2536
01:44:54.000 --> 01:44:56.000
we all kind of did this fasting thing.

2537
01:44:56.000 --> 01:44:58.000
And I was like, super excited about it.

2538
01:44:58.000 --> 01:45:00.000
Everybody felt better.

2539
01:45:00.000 --> 01:45:02.000
Blah, blah, blah, blah.

2540
01:45:02.000 --> 01:45:04.000
Okay. So fast forward.

2541
01:45:04.000 --> 01:45:06.000
I'm learning more about hormones,

2542
01:45:06.000 --> 01:45:08.000
body composition, protein intake,

2543
01:45:08.000 --> 01:45:10.000
all of these needs.

2544
01:45:10.000 --> 01:45:12.000
And I quickly realized,

2545
01:45:12.000 --> 01:45:14.000
if we're looking at health span,

2546
01:45:14.000 --> 01:45:16.000
if we're looking at body composition,

2547
01:45:16.000 --> 01:45:18.000
there may not be a lot of room for fasting

2548
01:45:18.000 --> 01:45:20.000
for these patients, you know,

2549
01:45:20.000 --> 01:45:22.000
or for my girlfriends, you know.

2550
01:45:22.000 --> 01:45:24.000
And it is really difficult for my patients

2551
01:45:24.000 --> 01:45:26.000
to reach their nutrition goals,

2552
01:45:26.000 --> 01:45:28.000
so never at the expense of meeting

2553
01:45:28.000 --> 01:45:30.000
your basic nutrition goals

2554
01:45:30.000 --> 01:45:32.000
and your calorie needs.

2555
01:45:32.000 --> 01:45:34.000
And it is really, really hard to do while fasting.

2556
01:45:34.000 --> 01:45:36.000
So you may get a short-term benefit with weight loss,

2557
01:45:36.000 --> 01:45:38.000
but there really doesn't now.

2558
01:45:38.000 --> 01:45:40.000
Distressions can get into the nitty gritty.

2559
01:45:40.000 --> 01:45:42.000
All, you know.

2560
01:45:42.000 --> 01:45:44.000
But the basic idea of fasting,

2561
01:45:44.000 --> 01:45:46.000
if we want to use the term fasting,

2562
01:45:46.000 --> 01:45:48.000
we have to look at it as,

2563
01:45:48.000 --> 01:45:50.000
are we talking about intermittent fasting

2564
01:45:50.000 --> 01:45:52.000
or time restricted eating?

2565
01:45:52.000 --> 01:45:54.000
So intermittent fasting is kind of like,

2566
01:45:54.000 --> 01:45:56.000
you know, your water fast,

2567
01:45:56.000 --> 01:45:58.000
your five day, two day,

2568
01:45:58.000 --> 01:46:00.000
all that kind of crazy stuff,

2569
01:46:00.000 --> 01:46:02.000
which for the most part,

2570
01:46:02.000 --> 01:46:04.000
men can get away with,

2571
01:46:04.000 --> 01:46:06.000
and have a positive impact on body composition,

2572
01:46:06.000 --> 01:46:08.000
restricted eating,

2573
01:46:08.000 --> 01:46:10.000
and working with their circadian rhythm,

2574
01:46:10.000 --> 01:46:12.000
which is optimal,

2575
01:46:12.000 --> 01:46:14.000
then you have breakfast within a food

2576
01:46:14.000 --> 01:46:16.000
within a half an hour of waking up

2577
01:46:16.000 --> 01:46:18.000
that helps dampen that

2578
01:46:18.000 --> 01:46:20.000
Gareland and cortisol response

2579
01:46:20.000 --> 01:46:22.000
I talked about before,

2580
01:46:22.000 --> 01:46:24.000
so that everything is coming down,

2581
01:46:24.000 --> 01:46:26.000
your hormones are starting to work properly,

2582
01:46:26.000 --> 01:46:28.000
and your body is like, great,

2583
01:46:28.000 --> 01:46:30.000
I'm ready to go.

2584
01:46:30.000 --> 01:46:32.000
I can handle this.

2585
01:46:32.000 --> 01:46:34.000
And then you're eating at regular intervals,

2586
01:46:34.000 --> 01:46:36.000
and protein and fiber intake.

2587
01:46:36.000 --> 01:46:38.000
Then you have dinner,

2588
01:46:38.000 --> 01:46:40.000
and then you don't eat after dinner.

2589
01:46:40.000 --> 01:46:42.000
Every eating interval.

2590
01:46:42.000 --> 01:46:44.000
So breakfast, maybe you have a snack

2591
01:46:44.000 --> 01:46:46.000
before looking at training

2592
01:46:46.000 --> 01:46:48.000
or exercise.

2593
01:46:48.000 --> 01:46:50.000
If you're splitting your breakfast,

2594
01:46:50.000 --> 01:46:52.000
then you're having some protein

2595
01:46:52.000 --> 01:46:54.000
and carb before,

2596
01:46:54.000 --> 01:46:56.000
you're having the rest of your protein

2597
01:46:56.000 --> 01:46:58.000
or more protein afterwards,

2598
01:46:58.000 --> 01:47:00.000
and then you're having

2599
01:47:00.000 --> 01:47:02.000
some protein and some fiber at lunch,

2600
01:47:02.000 --> 01:47:04.000
so every time you're eating,

2601
01:47:04.000 --> 01:47:06.000
you have a protein and fiber focus.

2602
01:47:06.000 --> 01:47:08.000
So time restricted eating is

2603
01:47:08.000 --> 01:47:10.000
within a 24 hour period?

2604
01:47:10.000 --> 01:47:12.000
So you're looking at,

2605
01:47:12.000 --> 01:47:14.000
I'm going to eat during the day

2606
01:47:14.000 --> 01:47:16.000
when my body needs it,

2607
01:47:16.000 --> 01:47:18.000
and I'm going to stop eating

2608
01:47:18.000 --> 01:47:20.000
when I finish dinner,

2609
01:47:20.000 --> 01:47:22.000
so I have about a two, maybe three hour break

2610
01:47:22.000 --> 01:47:24.000
before I go to bed.

2611
01:47:24.000 --> 01:47:26.000
So that when I go to bed,

2612
01:47:26.000 --> 01:47:28.000
I'm not trying to digest food.

2613
01:47:28.000 --> 01:47:30.000
My body can get into the parasympathetic responses

2614
01:47:30.000 --> 01:47:32.000
about 12 hours of eating and 12 hours of not.

2615
01:47:32.000 --> 01:47:34.000
So you're trying to follow that circadian rhythm

2616
01:47:34.000 --> 01:47:36.000
and work with your hormones.

2617
01:47:36.000 --> 01:47:38.000
It can also, when we do have that period of time,

2618
01:47:38.000 --> 01:47:40.000
which maybe that sounds very intuitive,

2619
01:47:40.000 --> 01:47:42.000
but a lot of people are eating at 10 p.m.,

2620
01:47:42.000 --> 01:47:44.000
they're snacking on food,

2621
01:47:44.000 --> 01:47:46.000
then they're trying to go to bed,

2622
01:47:46.000 --> 01:47:48.000
and then they're getting up.

2623
01:47:48.000 --> 01:47:50.000
When you give your body a little bit longer,

2624
01:47:50.000 --> 01:47:52.000
so at 12 hours time,

2625
01:47:52.000 --> 01:47:54.000
is when your body will really

2626
01:47:54.000 --> 01:47:56.000
efficiently be using up all your glucose,

2627
01:47:56.000 --> 01:47:58.000
really dropping some of those insulin levels,

2628
01:47:58.000 --> 01:48:00.000
so much that it's stressful,

2629
01:48:00.000 --> 01:48:02.000
and we're using stress very generically here,

2630
01:48:02.000 --> 01:48:04.000
but on a cellular level,

2631
01:48:04.000 --> 01:48:06.000
long periods of fasting for women,

2632
01:48:06.000 --> 01:48:08.000
specifically, can be very stressful to the body.

2633
01:48:08.000 --> 01:48:10.000
And that's why, if you think about

2634
01:48:10.000 --> 01:48:12.000
Stacy's example of what happened

2635
01:48:12.000 --> 01:48:16.000
in two fasting periods to a man and a woman,

2636
01:48:16.000 --> 01:48:18.000
different things are going to happen to your body

2637
01:48:18.000 --> 01:48:20.000
if it thinks it's being an starvation.

2638
01:48:20.000 --> 01:48:22.000
So we don't want to put your body in a starved state.

2639
01:48:22.000 --> 01:48:26.000
We're just trying to give it a time period without food,

2640
01:48:26.000 --> 01:48:52.000
so that it can start to process the energy

2641
01:48:56.000 --> 01:49:06.000
of the diet.

2642
01:49:06.000 --> 01:49:28.000
We're just trying to give it a time period

2643
01:49:58.000 --> 01:50:00.000
to a good sleep because your body is like,

2644
01:50:00.000 --> 01:50:02.000
it's not time to go to sleep.

2645
01:50:02.000 --> 01:50:04.000
Your melatonin peak in women usually peaks around 9 o'clock,

2646
01:50:04.000 --> 01:50:06.000
so you start to get sleepy.

2647
01:50:06.000 --> 01:50:08.000
That gets shifted to 11, 12,

2648
01:50:08.000 --> 01:50:10.000
so you're not actually going to get good sleep

2649
01:50:10.000 --> 01:50:14.000
because you now have reset your melatonin responses.

2650
01:50:14.000 --> 01:50:18.000
So we want women to understand that time restricted eating

2651
01:50:18.000 --> 01:50:22.000
when you're not eating in the dark is really beneficial.

2652
01:50:22.000 --> 01:50:24.000
That is way to say it.

2653
01:50:24.000 --> 01:50:26.000
Easiest way to say it.

2654
01:50:26.000 --> 01:50:48.000
We're just trying to give it a time period

2655
01:51:18.000 --> 01:51:40.000
because we're just trying to give it a time period

2656
01:51:40.000 --> 01:52:02.000
because we're just trying to give it a time period

2657
01:52:02.000 --> 01:52:24.000
because we're just trying to give it a time period

2658
01:52:24.000 --> 01:52:46.000
because we're just trying to give it a time period

2659
01:52:46.000 --> 01:53:08.000
to give it a time period

2660
01:53:08.000 --> 01:53:30.000
to give it a time period

2661
01:53:30.000 --> 01:53:52.000
to give it a time period

2662
01:53:52.000 --> 01:54:14.000
to give it a time period

2663
01:54:14.000 --> 01:54:36.000
to give it a time period

2664
01:54:36.000 --> 01:54:58.000
to give it a time period

2665
01:54:58.000 --> 01:55:20.000
to give it a time period

2666
01:55:20.000 --> 01:55:42.000
to give it a time period

2667
01:55:42.000 --> 01:56:04.000
to give it a time period

2668
01:56:04.000 --> 01:56:26.000
to give it a time period

2669
01:56:26.000 --> 01:56:48.000
to give it a time period

2670
01:56:48.000 --> 01:57:10.000
to give it a time period

2671
01:57:10.000 --> 01:57:32.000
to give it a time period

2672
01:57:32.000 --> 01:57:54.000
to give it a time period

2673
01:57:54.000 --> 01:58:16.000
to give it a time period

2674
01:58:16.000 --> 01:58:38.000
to give it a time period

2675
01:58:38.000 --> 01:59:00.000
to give it a time period

2676
01:59:00.000 --> 01:59:22.000
to give it a time period

2677
01:59:22.000 --> 01:59:44.000
to give it a time period

2678
01:59:44.000 --> 02:00:06.000
to give it a time period

2679
02:00:06.000 --> 02:00:28.000
to give it a time period

2680
02:00:28.000 --> 02:00:50.000
to give it a time period

2681
02:00:50.000 --> 02:01:12.000
to give it a time period

2682
02:01:12.000 --> 02:01:34.000
to give it a time period

2683
02:01:42.000 --> 02:02:04.000
to give it a time period

2684
02:02:04.000 --> 02:02:26.000
to give it a time period

2685
02:02:26.000 --> 02:02:48.000
to give it a time period

2686
02:02:48.000 --> 02:03:10.000
to give it a time period

2687
02:03:10.000 --> 02:03:32.000
to give it a time period

2688
02:03:32.000 --> 02:03:54.000
to give it a time period

2689
02:03:54.000 --> 02:04:16.000
to give it a time period

2690
02:04:16.000 --> 02:04:38.000
to give it a time period

2691
02:04:38.000 --> 02:05:00.000
to give it a time period

2692
02:05:00.000 --> 02:05:22.000
to give it a time period

2693
02:05:22.000 --> 02:05:44.000
to give it a time period

2694
02:05:44.000 --> 02:06:06.000
to give it a time period

2695
02:06:06.000 --> 02:06:28.000
to give it a time period

2696
02:06:28.000 --> 02:06:50.000
to give it a time period

2697
02:06:50.000 --> 02:07:12.000
to give it a time period

2698
02:07:12.000 --> 02:07:34.000
to give it a time period

2699
02:07:34.000 --> 02:07:56.000
to give it a time period

2700
02:07:56.000 --> 02:08:18.000
to give it a time period

2701
02:08:18.000 --> 02:08:40.000
to give it a time period

2702
02:08:40.000 --> 02:09:02.000
to give it a time period

2703
02:09:02.000 --> 02:09:24.000
to give it a time period

2704
02:09:24.000 --> 02:09:46.000
to give it a time period

2705
02:09:46.000 --> 02:10:08.000
to give it a time period

2706
02:10:08.000 --> 02:10:30.000
to give it a time period

2707
02:10:30.000 --> 02:10:52.000
to give it a time period

2708
02:10:52.000 --> 02:11:14.000
to give it a time period

2709
02:11:14.000 --> 02:11:36.000
to give it a time period

2710
02:11:36.000 --> 02:11:58.000
to give it a time period

2711
02:11:58.000 --> 02:12:20.000
to give it a time period

2712
02:12:20.000 --> 02:12:42.000
to give it a time period

2713
02:12:42.000 --> 02:13:04.000
to give it a time period

2714
02:13:04.000 --> 02:13:26.000
to give it a time period

2715
02:13:26.000 --> 02:13:48.000
to give it a time period

2716
02:13:48.000 --> 02:14:10.000
to give it a time period

2717
02:14:10.000 --> 02:14:32.000
to give it a time period

2718
02:14:32.000 --> 02:14:54.000
to give it a time period

2719
02:14:54.000 --> 02:15:16.000
to give it a time period

2720
02:15:16.000 --> 02:15:38.000
to give it a time period

2721
02:15:38.000 --> 02:16:00.000
to give it a time period

2722
02:16:00.000 --> 02:16:22.000
to give it a time period

2723
02:16:22.000 --> 02:16:44.000
to give it a time period

2724
02:16:44.000 --> 02:17:06.000
to give it a time period

2725
02:17:06.000 --> 02:17:28.000
to give it a time period

2726
02:17:28.000 --> 02:17:50.000
to give it a time period

2727
02:17:50.000 --> 02:18:12.000
to give it a time period

2728
02:18:12.000 --> 02:18:34.000
to give it a time period

2729
02:18:34.000 --> 02:18:56.000
to give it a time period

2730
02:18:56.000 --> 02:19:18.000
to give it a time period

2731
02:19:18.000 --> 02:19:40.000
to give it a time period

2732
02:19:40.000 --> 02:20:02.000
to give it a time period

2733
02:20:02.000 --> 02:20:24.000
to give it a time period

2734
02:20:24.000 --> 02:20:46.000
to give it a time period

2735
02:20:46.000 --> 02:21:08.000
to give it a time period

2736
02:21:08.000 --> 02:21:30.000
to give it a time period

2737
02:21:30.000 --> 02:21:52.000
to give it a time period

2738
02:21:52.000 --> 02:22:14.000
to give it a time period

2739
02:22:14.000 --> 02:22:36.000
to give it a time period

2740
02:22:36.000 --> 02:22:58.000
to give it a time period

2741
02:22:58.000 --> 02:23:20.000
to give it a time period

2742
02:23:20.000 --> 02:23:42.000
to give it a time period

2743
02:23:42.000 --> 02:24:04.000
to give it a time period

2744
02:24:04.000 --> 02:24:26.000
to give it a time period

2745
02:24:26.000 --> 02:24:48.000
to give it a time period

2746
02:24:48.000 --> 02:25:10.000
to give it a time period

2747
02:25:10.000 --> 02:25:32.000
to give it a time period

2748
02:25:32.000 --> 02:25:54.000
to give it a time period

2749
02:25:54.000 --> 02:26:16.000
to give it a time period

2750
02:26:16.000 --> 02:26:38.000
to give it a time period

2751
02:26:38.000 --> 02:27:00.000
to give it a time period

2752
02:27:00.000 --> 02:27:22.000
to give it a time period

2753
02:27:22.000 --> 02:27:44.000
to give it a time period

2754
02:27:44.000 --> 02:28:06.000
to give it a time period

2755
02:28:06.000 --> 02:28:28.000
to give it a time period

2756
02:28:28.000 --> 02:28:50.000
to give it a time period

2757
02:28:50.000 --> 02:29:12.000
to give it a time period

2758
02:29:12.000 --> 02:29:34.000
to give it a time period

2759
02:29:34.000 --> 02:29:56.000
to give it a time period

2760
02:29:56.000 --> 02:30:18.000
to give it a time period

2761
02:30:18.000 --> 02:30:40.000
to give it a time period

2762
02:30:40.000 --> 02:31:02.000
to give it a time period

2763
02:31:02.000 --> 02:31:24.000
to give it a time period

2764
02:31:24.000 --> 02:31:46.000
to give it a time period

2765
02:31:46.000 --> 02:32:08.000
to give it a time period

2766
02:32:08.000 --> 02:32:30.000
to give it a time period

2767
02:32:30.000 --> 02:32:52.000
to give it a time period

2768
02:32:52.000 --> 02:33:14.000
to give it a time period

2769
02:33:14.000 --> 02:33:36.000
to give it a time period

2770
02:33:36.000 --> 02:33:58.000
to give it a time period

2771
02:33:58.000 --> 02:34:20.000
to give it a time period

2772
02:34:20.000 --> 02:34:42.000
to give it a time period

2773
02:34:42.000 --> 02:35:04.000
to give it a time period

2774
02:35:04.000 --> 02:35:26.000
to give it a time period

2775
02:35:26.000 --> 02:35:48.000
to give it a time period

2776
02:35:48.000 --> 02:36:10.000
to give it a time period

2777
02:36:10.000 --> 02:36:32.000
to give it a time period