S3 Ep 24 Running On Empty: Understanding REDs with Dr. Renee McGregor

What if your body isn’t underperforming… it’s protecting you? We sit down with Renee McGregor, renowned sports and clinical dietitian, to unpack Relative Energy Deficiency in sport and why so many runners and active people feel flat, injured, or anxious despite training harder than ever. Renee explains how the body prioritizes movement when fuel is low and quietly turns down hormones, bone health, digestion, and immunity to keep you going—until it can’t. We walk through real-world signs to watch for, why weight often doesn’t change, and how stress from life and training compounds when recovery and nutrition timing fall short.

Together we trace the messy intersection of REDs, overtraining, and personality traits like perfectionism and control. Renee shares how assessment actually works—history, labs, behaviors—and why recovery takes time: often 18 months for the body and longer for the brain to fully recalibrate. We also address a frequent blind spot for women in their 40s and beyond: perimenopause symptoms can mimic REDs. When to consider HRT, when fueling and rest are the missing pieces, and how both can coexist. The goal is clarity, not fear, and a practical path back to stable energy, resilient bones, and consistent performance.

We challenge popular fasting trends with emerging research linking narrow eating windows to higher cardiovascular risk and explain how chronic cortisol undermines adaptation. You’ll leave with simple, athlete-proven strategies: eat before and after hard work, fuel long sessions, protect sleep, and replace rigid control with flexible choices. Share this with a training partner who needs to hear it. If the conversation helped, subscribe, leave a review, and tell us: what’s the first change you’ll make this week?

@r_mcgregor - Instagram

reneemcrgregor.com

Books by Renee McGregor:

Fuel for Thought

More Fuel You

Training Food

Orthorexia

Fast Fuel -Food  for Triathlon Success

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Transcript

Who Is Rini McGregor

SPEAKER_00 0:15

Hello and welcome back to Over the Next Tale Fitness Podcast. I'm Carla Coffee, your coach and host for the program. You can follow me on all the socials under Coffee Crew Coaching. You can reach out to me if you have any questions or if you'd like to be on the show, Carla at CoffeeCrewCoaching.com. If you're looking for a coach, a fitness coach, running coach, same thing, you can email me there at Carla at CoffeeCrewCoing.com. Today we're going to be talking to Rini McGregor. She is a dietitian from the UK, and we're going to be discussing some very life-changing information. So I hope that you'll enjoy the recording. And if you have any questions or would like to reach out to either of us, please email me and we will see what we can do to help you. So let's listen in. Hi, Rini. Thank you for being on the show. Thank you for having me, Carla. I am looking forward to our chat. Awesome. So am I. So could you tell the audience a little bit about you and what you do before I get into all my questions?

SPEAKER_01 1:33

Of course, yeah. I am what you would call a sports, exercise, and medicine dietitian. So I work in the field of sport predominantly, but I guess I have become known as somebody who has a very good knowledge and experience in working in Reds and eating disorders and just general kind of complicated presentations, I suppose, within sport around training and food and body. But that's not to say I don't also work with people who are just looking for a performance outcome. I I do a bit of everything. And I'm also an author, so I have um six books and um I do a lot of writing. I have a regular column in Runner's World in the UK. Um and I also have recently started my own Substack, which I'm really enjoying, I have to say. So yeah, that's that's me.

SPEAKER_00 2:39

Okay, and we'll put all the links to all the things in the show notes for the listeners too. Great. Um, so the reason I wanted to have you um on today was to talk about Reds and some of the other things. Um, I know for my podcast in particular, a lot of the listeners are runners, and a lot of them are women, and a lot of them are long distance runners. So what can you tell us about REDs and like what they can look for for symptoms and things?

Symptoms Across Body Systems

Intentional Vs Unintentional REDs

SPEAKER_01 3:11

Sure. So REDS stands for relative energy deficiency in sport. Um, but if I'm honest, I actually sometimes prefer the term relative energy deficiency syndrome because that's kind of what you're defining, right? So REDS is a presentation, um, and it happens based on a lot of different things, but it's underpinned by low energy availability. So low energy availability is when there's not sufficient energy being consumed to support biological processes, so that's like you know, your heart, your brain, your lungs, your endocrine function, your circulatory system, basically just being human, but also support training and movement, and and that it does include like daily movement, so you know it's not just about going for a run, it's like if you're walking your dogs, or if you're taking your kids to school, or you commute to work, like all of this counts as movement. And what happens is that um the body will always prioritize energy for movement, that's kind of how we've evolved from our hunter-gatherer ancestors, and so it will always find somehow the ability to be able to find the energy to go and to move, but actually, as a consequence of that, it will start to downregulate and sort of switch off, I suppose, what it thinks as non-essential functions for the body at that moment in time. So things like our reproductive system can get shut down, and then slowly, slowly, other things like our immune system, our bone health, um, our you know, our kind of pulmonary system. So everything can get shut down. So the thing about reds is that it there's no one fit presentation. You can't say, oh, okay, if I've got reds, I'll have this, this, and this. You might only have one symptom, you may have five symptoms, and and so it's a it's a it's what we can do is it's called a diagnosis by exclusion. So you have to look at a number of different factors. The other thing about reds is that although I said it's underpinned by low energy availability, there are other contributing factors. So, for example, under recovery. So, you know, like when we think about a lot of recreational runners, and and I'm definitely put myself in that category as well, but who are also working full-time, maybe mothers, maybe have other kind of caring um commitments, and they're trying to also train. And let's face it, everybody's trying to train like an athlete these days. No one's just happy to just go for a run, like everybody's got a training plan, or everybody's got a coach, or everybody's got, you know, like a performance goal that they're working towards. And um, I guess what can happen is when when time is squeezed and you don't give your body sufficient time to recover, whether that's between um like between competitive races, or whether that's just day-to-day, then again, that also generates stress within the body, and this stress is sort of seen by the central nervous system as threat. And again, what it does is when it when it kind of identifies threat in the body, it will start to once again down regulate the body's biological systems. And so, what we see in REDS is fundamentally a process of downregulation in that the individual, like I said, can present in so many different ways, they can present with um menstrual dysfunction, so it might be that you know their their menstrual cycle changes over time and then eventually just completely stops. Um, they might present with digestive changes, so you know we see this like increased gut permeability as a result of not having enough energy for digestion to occur. Um, and also when we deplete our bodies too much, we kind of lose the lining around our gut and around our stomach. So, again, that increases that gut permeability when we when we run. Um, we might see a lot of bone stress injuries or full-on stress fractures, so a lot of kind of, and then in addition to that, maybe some niggles around kind of connective tissue and um you might see psychological changes, so mood changes, higher anxiety. So you can see, like it's the the list is actually extensive, and it and it just it it's it depends on which system in the body has been impacted. And I guess that's the thing is that it's different for everybody. I I will never see two people that present with the same symptoms. You might see similarities, but they'll be different. Um, and the other thing to say is that reds can be intentional and it can be unintentional. So unintentional is when an individual might not appreciate just how much they need to fuel. And I think this is very common, um, and I see this with a lot of women in particular. I don't think society and um social media helps in in kind of informing us and how we should be and how we should eat, but it can also be what we call intentional reds, which is as a consequence of a more complicated condition, so that might be disordered eating, an eating disorder or exercise dependency. So, you know, that they're both they're both complicated, they both take a long time to recover from, but one probably has more um probably needs a little bit longer to to kind of recover from fully because there's often that psychological element associated with it.

unknown 9:27

Okay.

SPEAKER_00 9:27

So is red's um gender specific?

SPEAKER_01 9:32

No, it can affect anyone, and I think that's the thing. Like initially, what we were describing was the female athlete triad, which I think everybody became very familiar with, you know, that in women their their training load impacted their menstrual function, which then affected their um bone health, and so they would have this very high prevalence of bone stress injuries. But we only saw these like three points, hence the triad. But actually, once uh when they started to appreciate that actually the same physiological decline can happen in men, um, and it's not just related to three parts of the process, it's it's much more widespread, and hence why in 2014 the IOC um put together a consensus statement around REDS and what it was and the fact that it can affect both men and women, and and also any level of athlete. So, although I think people assume it's a higher prevalence in the elite and professional world, I would actually say we see we see a lot of individuals in the recreational world. And I think there was a there was a study recently that said that the prevalence of low energy availability was somewhere between 43 and 72 percent in recreational athletes. So, again, if we say that low energy availability underpins reds, then you kind of can see that it's it's really quite a big problem.

SPEAKER_00 11:08

So uh at what point do you um I don't know if uh if this is the right way to say this, but do you diagnose that it's reds rather than oh, they just have an injury? Is it having more than two symptoms? Is that what we're how you diagnose that?

Beyond Overtraining: Stress And Rest

SPEAKER_01 11:31

It's a really good question. I mean, generally speaking, what we'll do is a full assessment. So we'll look at kind of behaviors and um sort of relationships with food and and and body and training, but also look at blood test results. So we'll be looking at kind of metabolic markers, we'll be looking at stress markers, reproductive markers, um immune markers, and that gives you a pretty decent indicator of what someone is going through. So I think you can, you know, with in a with a somebody who is qualified, you can definitely sort of do this full assessment, you know, you take a very long history, and and then you can you can kind of say, yeah, okay, this individual is probably in reds. Um so you know, hypothalamic amonrhea when when menstruation stops is a is a is a potential sign. It might not be reds, but it's definitely a potential sign that that something is off and needs to be investigated further.

SPEAKER_00 12:35

I think I think we used to always just think of a person as being over-trained, but this is actually a step beyond that.

Assessment And Diagnosis Approach

SPEAKER_01 12:42

Would you agree with that? I think, yeah, I would say it I would definitely think there's an overlap with over-training, you know, like I think I think we cannot ignore the fact that insufficient rest will also generate some of these presentations. So, you know, you I've I've had somebody just um just this just today who actually, when you look at her metabolic markers and did like a history of her nutrition, actually she was eating quite well, but actually her stress markers were super high. And when you're looking at the her training load, it was it was way too much, but also she's you know, she's a junior doctor, so she's trying to do a lot and hasn't appreciated the the stress uh in her in her system, and actually that stress is being picked up in the body, and I think that's the thing, is like people often don't appreciate the our bodies are very, very clever. You know, the whole point of having a central nervous system is that it is it is monitoring for threat, and as soon as we experience a level of stress that is too high for our body to cope with, and that could be physical stress or emotional stress or a combination of the two, then it's gonna start setting off alarm bells and it's gonna start kind of saying, or hang on a minute, we need to sort this out. But again, again, because I think of the way we live these days, a lot of us just ignore and ignore and ignore and think, no, no, no, it's fine, we can keep going. And also, you know, how many of us have said, Oh, I'm really stressed, I'm gonna go for a run. And actually, sometimes probably the worst thing you can possibly do, right, is is to add another layer of stress on an already stressed-out system. So it's it's it's a really it's a it's quite a complicated process and presentation. And I think people get frustrated, like you know, I kind of see individuals that come into clinic and uh maybe they come in with a stress fracture or they come in with hypothalamic ammonia, and you you kind of start going through, okay. Well, this is what's going on for you, and this is what we need to do. And I think everybody assumes that if they just correct their eating, then it will all go back to normal. But actually, it's not really that by that point, it's almost too late to just correct your eating. You've actually got to have a complete shift and modification of all your behaviors. So that might mean, you know, it might mean a reduction in training load, it might mean a reduction in training intensity, depending on what is the presentation, you know, depending on what that person's doing. It might mean eating more, it might mean eating differently, it might mean doing all of those things, it might mean, you know, making sure you're getting more sleep. Like it's it's not a simple formula. And I think while I welcome the awareness around reds, and obviously a lot of people and a lot of athletes talking about their own experiences and symptoms and and everything else, and I I highly like I say that I absolutely welcome people talking about their lived experience. I think we also have to be very, very careful not to simplify it down to oh yeah, but if you just eat a bit more, it'll be fine because it's not as simple as that. And and every case is very different, and you know, some cases are more severe than others. All are important, all need to be rectified. But in some cases, if someone has been in a deficit and depleted for a significant period of time, it's going to take a significant period of time for the body to heal. And I think what people find most confusing is that actually in reds, you don't always lose weight, because actually, because the body is downregulating and trying to preserve energy and trying to keep you going, you don't always change from a weight point of view. You might actually even hold on to more body fat because the body's like, I need to hold on to as much energy as possible. Um, and so I think again, people can't see the damage that's being done internally, so they don't think it's a problem. So, unless you have any signs and cues, you don't do anything about it, which is why I think often when people come and see me in clinic, they've usually actually been in this place of depletion anywhere between you know a year to two years, and it's it's quite a long time before you actually start to get severe symptoms. Now, in some cases, you'll get symptoms very, very quickly, and again, it all depends on the the kind of ex the the the depth to how depleted the individual has has got.

SPEAKER_00 17:35

Wow. So that's a long time. Um, so I would think that it's also not a quick fix, it's gonna take that long or longer to get you back on track.

Recovery Timelines And Brain Changes

SPEAKER_01 17:48

100%. And I think again, it's it's it's quite it can be quite a challenging experience working in it because I think people are going, well, I've been doing everything you've said now for two months, and it's like, yeah, it's not gonna be that quick. I mean, we know that it takes a minimum of 18 months for the body to fully, fully heal. And then depending again on the depending on the kind of depletion and depending on the history. So if you've had somebody who's had an eating disorder, you know, even prior, if they've had an eating disorder in their teenage years, maybe they've had a few years of being okay or functional or whatever you want to call it, and then they go back into kind of this more um restrictive phase or over-training phase. You know, we see this a lot, right? We see a lot of individuals that have had an eating disorder as a teenager, they've never really fully recovered, and then they've moved into sport, and that's they, you know, in their mind that's saved them, but actually, all they've done is developed an exercise dependency, and and the the eating disorder and the symptoms around the eating disorder have never really been um explored properly or recovered from properly. And so, in these cases, I think what I want to highlight is that we also know that the brain and the brain structure changes. So, if you were looking at these brains on an MRI, you would actually see changes to the grey and the white matter in the brain. And what we know is that it can take up to five years having restored energy availability. So, you know, you're like, we're thinking like 18 months to kind of get back to a place where the body is functioning better and is kind of in a better place, you know, and can work. But then it's it can be another potentially up to five years for that brain structure to change. And so I think it's I always think it's really important to give that information out so people don't feel frustrated or angry at themselves that, you know, why is my thinking still like this? Why am I struggling? You know, I've done everything I've said, but I still don't, you know, I still really struggle with how my how I look or my thoughts or or whatever. And obviously, you know, it's important to do therapy alongside, but equally, I think it's important to help them to appreciate that some of it is biological, like the biological changes that have occurred are going to take time to restore. But they they do restore, but it just takes time.

SPEAKER_00 20:27

Wow, so you have the patience of that. Um, is it primarily uh people like in endurance sports, uh biking, running, um, triathlete, or can it be just your average golfer? Do you not do you know what I mean? Is it always somebody who's really pushing themselves?

Not Just Endurance: Any Sport, Any Body

SPEAKER_01 20:44

It's funny actually. I've actually I have actually had a female golfer that has had reds. So it it can happen to anyone. Um you know, like I I definitely I think I've seen it in most sports, including like uh including women's rugby, you know, like you wouldn't think that, but even in women's rugby, I have seen it. I think it's important to remember that again, just for clarification, I think a lot of people assume Reds is about trying to hit maybe a body composition or you know, kind of fit into an aesthetic that is expected in their given sport, and obviously that might be a driving influence. But I think it's also important to remember that you know a lot of the a high percentage of people who show signs of reds actually do have quite a disordered relationship with food, and often the disordered relationship with food is not really about the body, it's it's about a it's a defense mechanism that helps to protect an individual from emotions that they're unwilling to feel, right? That so I think this is why it can present in any sport, because you think about the the personality traits of people who are involved in sport, and I'm not talking necessarily about high performance sport, just in sport, full stop, they do tend to be a certain type of personality, they do tend to be, you know, high achievers, perfectionistic, compulsive, critical, sensitive, and and these are also the same traits we do see in individuals who have a high prevalence of eating disorders and disordered eating. So, you know, you put that personality type into the right psychosocial space and you generate the perfect storm for dysfunctional behaviors to happen. And I think what I always try and help people to understand is that there's usually a purpose behind that behavior of restriction or overtraining or an inability to stop. There's a purpose there, and usually that purpose is protection from a fear, you know, is protection from, again, like I said, something that they're unwilling to feel. Maybe it's a protection from a fear of being deficient or a fear of failing or a fear of rejection or a or a fear of, you know, um I don't know, not meeting expectations that they've got of themselves, but there is a fear there, you know, there's there's a there's an inner in a an inability to be vulnerable and accept that actually as humans we we often have to experience difficult emotions. And I'm not saying this is this is all conscious, but I think food and exercise are a really good way of helping people to I suppose avoid those difficult emotions. And it's not conscious, but once it happens, you become like I guess there's that familiarity of, oh, well, if I do this, I I feel better. Like we think about ourselves, we think about running. Whenever you run, you know, you're kind of really you're you're in your head, aren't you? You're kind of like you're not really thinking about some of the other stuff that's going on in your life. It's a way of sort of almost numbing everything for a short period of time. And I'm I'm not saying that that's good or bad, but I think when it becomes something addictive, when it becomes your only coping mechanism rather than learning other healthier mechanisms that can be more supportive of your health, then that's when it's likely to become dysfunctional. And that's what we have to then be mindful of.

SPEAKER_00 24:46

And that's also the the things I can control is I can control the run, I can control my food, but maybe I can't control what's going on around me. So that's seems to be that's where that happens.

SPEAKER_01 24:59

Yeah, it's definitely a false sense of security, though, right? It's a false sense of control because the reality is you're not controlling your body and you're not can controlling your food, you're being controlled, right? When we actually control, right, we have choice. We have choice in whether we go for that run or we don't go for that run. We have choice in whether we eat the pizza or we don't eat the pizza. Do you see what I mean? And I think it's it's an in- I hear you, and I absolutely agree with you. And it's it's what I hear in clinic all the time. And it's I guess it's also what I try and correct people and help them to realise they're not in control. And actually, there's so much of our life we can't be in control of, and this false sense of control, I get it, it it kind of creates this sort of neatness, this sort of this kind of tidiness. And I think what you're trying to do is avoid chaos, you know, like some people really struggle in in things not being exactly how they need them to be in order for them to move forward. And again, what I always say is that you know what, nothing in life is certain. We have to accept that things can constantly change in in the blink of an eye, right? You one minute you could be walking down the street, and the next minute you could trip over a rock. You know, you don't you don't know what's gonna happen, and and I think it it's important sometimes to bring that um just bring that kind of image into mind that you can't control how someone views you, you can't control who else you might be competing at in that race in that given moment, you can't control how other people are gonna behave, and and and like you know, if you restrict your eating or you keep on training really hard, all you're doing is taking yourself further and further and further away from the place you really want to be because it's just gonna deplete you and it's gonna make life really quite miserable, and I and I guess it's trying to get them to appreciate that and and and see that.

SPEAKER_00 27:01

Yeah, yeah, I see. So, how does um reds compare or does it not compare? Is it similar to rhabdo? I don't know the long name for rhabdo.

Control, Personality Traits, And Coping

SPEAKER_01 27:14

Yeah, rhabdomyelysis. So um rhabdo is, I mean, it's it they're kind of potentially linked, um, they are different things. Uh rhabdo is fundamentally when your muscles are put under huge amount of stress and um they they basically break down and then the it that starts to have an effect on the kidneys and the liver, and so you can be in a real mess fundamentally, and it is life-threatening. Um so it's not it's not specifically related to reds, but I guess it could be potentially as a consequence if someone you know has pushed themselves too hard. It often comes after you've actually had a period of being sedentary and then you decide to go out really hard, or if you've you know you're doing a sport for the first time, perhaps, and you just decide you're gonna go and do something crazy. And I guess that's also why we have to be careful about the the anti-inflammatories, the NSAIDs, because that already can um start to put your kidneys under pressure, and then obviously if you end up in rhabdo, you put even more pressure on your kidneys, and so again, that can also be problematic. But yeah, I don't I I I'm trying to think, I think I've never I've not seen rhabdo in clinic necessarily as a consequence of reds, maybe once in in the entire time I've worked in it, probably once I've seen it. Um, and we did question if there was something else going on that caused that, um, you know, as well as the the reds that was happening at the same time.

unknown 29:05

Okay.

SPEAKER_00 29:05

That was kind of where I what I was wondering is if you you can have either, and you don't have to have both.

SPEAKER_01 29:11

You definitely don't have to have both. You can have either, and they can be very separate, but absolutely there is a possibility that if you're in reds and your body is already compromised, potentially you could end up at slightly higher risk. But I don't want to say that is always the case. I think there's a potential there.

SPEAKER_00 29:34

Gotcha. So it's not gender specific, um, and it's not sport specific. Is it age specific at all? Or is does that run the whole gamut as well?

REDs Vs Rhabdo Clarified

Age, Perimenopause, And Overlap

SPEAKER_01 29:45

It could go any anyone, anywhere anywhere, any anytime. I guess that the the the challenge sometimes when we have slightly older women is obviously it can also hit at the same time as perimenopause and menopause. And of course, that is something we do have to keep um in mind. Like, you know, obviously, when when women go through the perimenopause or the menopause transition, we know that again there are a number of symptoms, and the symptoms can actually be very similar to reds, so you have to be kind of a little bit kind of uh mindful of that. There are also many, many, many more symptoms with perimenopause uh than there are with reds, but I think you know it it's always more challenging when you're working with somebody in their 40s onwards because you You kind of have to work out what's really going on here. So that's where the the history is even more important to kind of truly understand what's happening. Um, and the and the problem with the perimenopause is that obviously we can't you there's no there's no test, there's no like blood test, because obviously during the perimenopause, your hormones are fluctuating so much that at any given time it could be anything. And and so you know that's hence why you feel like you're on kind of on this incredible journey of unpredictability unpredictability because you just don't know how you're gonna feel it'll be different every single day because that's exactly what your hormones are doing. But what I will say, some of the similarities are obviously in reds, it can be very common for women to have low Easterine levels, and obviously in perimenopause, it can be very common for women to have fluctuating eastern levels and then eventually have very low Eastron levels. And so, again, like I said, sometimes you you have to just listen a bit more, maybe you have to try different things. So, often what we find is that one thing is you could suggest that um a woman starts hormone replacement therapy and goes on HRT, and actually what we do know is that if they are in reds, then they won't feel a significant improvement in how they're feeling because the you know the low energy availability, the overall stress in the system is not going to be counteracted by taking HRT. Whereas obviously if it's if it is perimenopause and we know that the symptoms are related to these fluctuating hormones and you kind of even out this estrogen, then often the symptoms improve, you know, even if it's temporarily, they definitely improve, and and so you can be like, okay, you know, and especially if energy levels improve and performance improves, and you just start to feel a bit better, then you can think, okay, well, this is probably this was straight perimenopause. But what I will say, you can have both. In this case, you can have both. You can have perimenopause and you can have reds at the same time, and we do see this a lot. Um, and it is it's a tough time. The perimenopause is a is a time of transition, right? And it's and it's hard because, again, like your body is unpredictable, it's not doing anything you're asking it to do. You could be somebody that has never had to worry about your body or body size, and suddenly you can feel totally uncomfortable within your body, even if your body doesn't really change, you can just feel uncomfortable because of the influence of the these hormonal changes, and that feeling can then be what triggers behaviours around doing more exercise, eating a bit less. You know, there's there's also so much noise and information about how perimenopause women shouldn't eat this and they should do this, and they should, you know, have this supplement. And so you get caught up in it because you feel so terrible, you just want to feel better. And so we definitely, I mean, we definitely see this a lot, and you know, I guess it's again step by step, you know, you you probably would start somebody on HRT, but then you would also start to look at their nutritional intake, and you would start to kind of challenge that and and in you know, kind of make change according to that. So, so it's yeah, it's not, it's not none of it's straightforward, I guess, is what I'm trying to say. Um, and it's you know, it's hard enough working in it, but I but being actually living with it is it's hard. And I and I, you know, I kind of I want people to acknowledge that I get that. It's it's really it's not a nice place to be, you know, it and it's it's often not a choice, it's just where they've ended up, and then they're a bit stuck and they need support and help.

SPEAKER_00 34:43

How um, I mean how long has the diagnosis of Reds been around? Is it fairly new? I mean, I'm sure it's always been there, but where they said this is what it is and this is what we're looking for.

SPEAKER_01 34:58

So again, it it first came on, I guess it first came into mainstream sports science in 2014. But I would say, I mean, I I've been a dietitian for over 25 years, and I used to work in in the NHS as a clinical dietitian, and actually my um my area of speciality before I left the NHS was actually working in adolescent eating disorders, and there was a lot of there's a lot of crossover between what you see in reds and what you see in eating disorders. So I would say that it's been an around for a very long time, but in terms of it being an identifiable situation within that physically active population, probably only since 2014.

SPEAKER_00 35:52

Okay. So uh speaking of eating disorders, I know um fasting isn't an eating disorder, but fasting is really on the rise, and especially with women, um, women in menopause, perimenopause. Um, is is that a a bigger trigger? Is that something that you know you should I don't know, be more careful with if you've decided to do intermittent fasting or any kind of fasting? Yeah, I mean Does that set you up for that?

SPEAKER_01 36:24

Yeah, but yeah, I mean I'm not a big fan of fasting for anyone. You know, I think there's not enough scientific evidence for all the um benefits it suggests at all. You know, I think, and actually what we do know is that if you if you create too big a fasting window and then you're also exercising during that window, you're potentially creating two effects. One is a slightly higher cortisol effect, so your stress hormone is gonna remain significantly higher and chronically high, which again, once when cortisol is high, it starts to um send a message to the hypothalamus to say, okay, hang on, there's stress here, we need to sort this out. Um, but also at the same time, um, when you create sort of in-day deficits, we know the body doesn't like that either. So again, it tends to um again react with that, it's kind of like little you know, stress monitoring, and and again, it doesn't it it doesn't really do you any good. So I think like from my point of view, there is very little evidence that anybody, particularly who's physically active, should ever do any sort of fasting at all. And in fact, you know, the most recent study that only came out a few months ago demonstrated that they've now found, it was a really big study, they've now found that um people who have done fasting, particularly the kind of intermittent fasting with the kind of window, the you know, the sort of 16-8 window, actually have a higher risk of cardiovascular disease than people that didn't. So, you know, there's something in fasting, most probably related to the cortisol, that is having a very negative effect on our cardiovascular system, and they've they've they've picked up on that. So, although, yes, it's been pushed and promoted as a you know, as a way of weight loss or weight maintenance or anti-aging, like there's so many insane reasons for doing it. Actually, the best study has shown that it's probably really not that great for you at all.

SPEAKER_00 38:40

And that would be for either gender or women.

Fasting, Cortisol, And Bone Health

SPEAKER_01 38:43

No, that was for every that was for both genders. Yeah, yeah. And and I don't I also think like, you know, like the other thing about fasting is that if you're not doing like if you're doing intermittent fasting, then I guess you have this window where you do eat and so um and you'll be again, you're kind of being contained, right? That's why people like it, because it's it's a neat way of containing a time frame that they can eat in. So it kind of gives them rules that they can live by. Um, but but but the reality is that you know we need food on a regular basis, it supports our bone health, it supports our replenishment, our recovery. And so, particularly if you're exercising in your fasting window and you're not recovering immediately after, then that can have a real detrimental effect on things like your bone health. And obviously, as we get older, that's already a problem for both men and women, right? Is that we start to loon bone density, but also women in particular, as they go through penimet, as they go through perimenopause, will have a significant drop, but it does affect men as well, the drop. So, you know, I I think it I always find it really fascinating. Like when I I look at studies and academia and you know, people testing certain hypotheses, whatever that is, whether it's about performance, whether it's about body composition, whether it's about um, you know, some sort of health metric, because they're so fixated on a spotlight on one particular outcome, what they're not doing is looking at how that, you know, that behavior or testing that hypothesis, what it might be doing to the rest of the body and how that might be affected in a different way. And I think for me, that's that's that's I don't know. I find I for me that's really important. I like to look at the person holistically and look at how all the pieces of the puzzle come together to make this person feel whole and good. And I'm I'm not sure everybody else works in the same way as me, but but that's definitely how I like to work. So, you know, if someone says to me, Oh, um, you know, I I want to do fasting, then I would like in the same way that just you know spoken through it with you, Carla, like I would explain why it wouldn't be a good idea, particularly if we're worried about bone health, or particularly if we're worried about, you know, their adaptation to their running, for example. And and so it's it's helping them to see that we're not as simple as if you do X, Y is gonna happen. Often, if you do X, Y might happen, but so will A B C and they might not be good outcomes for you, right? And I think that's that's really important to realize that humans are not machines. We are not just like, you know, we are we're often we're often compared to cars, aren't we? You put fuel in and you you you go, but we're not cars because we are living, breathing organisms that are constantly needing energy and constantly needing tending to and are constantly being monitored. We might not be monitoring ourselves, but we have homeostatic control within us that is monitoring us all the time. And so what we are is, you know, we are an incredible feat of engineering because our body keeps going, it keeps working for us, even when we put it through these very, you know, these very extreme behaviors, it still keeps working for us, hence why it turns on these compensatory behaviors in order to preserve energy and keep us moving. Like we are really quite incredible, and I I always think people take it for granted how amazing their bodies are. And you know, if we if we actually respected our bodies, if we actually learnt to nurture them and respond to them when they ask for what they need, then then actually we probably wouldn't have quite so many ailments and illnesses and and problems. But we're not taught that, are we? We're constantly being given false information, we're constantly being, you know, everything is becoming digitalized, everything is becoming um monitored by tech. And it it's I find it fascinating because I just think actually the best the best source of monitoring is ourselves. Our body knows what it needs and it knows what it wants.

SPEAKER_00 43:17

Yeah, it's just a matter of listening to it.

Listen To Your Body Over The Hype

SPEAKER_01 43:20

Yeah, and I think you know, often people say, Oh, you know, you're so lucky, you know, you you you seem to always stay the same. And I was like, I'm not lucky, I just listen to my body and it regulates, you know. Like if I'm hungry, I eat. If I'm not hungry, I don't eat. If I want something, then I allow myself to have it because I know it's gonna make my brain feel good. Like I I think it's it it's not luck, it's it's it's that internal regulatory system that I've become very good at listening to and responding to. And and yes, it takes time, but I think people who are naturally lean, as as you know, or people who are who always stay the same, whether they're lean or not, it doesn't matter. They always stay this around the same. It's not that they're lucky and they're genetically gifted in some way, it's because they listen. And I think that's often missed.

SPEAKER_00 44:16

Yeah, yeah, I would agree with that because of, especially now with social media, there's so much, and everybody wants, well, let me get on this train for a little while, let me get on this train instead of just being their own train and and just listening.

SPEAKER_01 44:31

Yeah, exactly. Yeah, totally. And I, you know, social media definitely, well, it creates all sorts of senses of unworthiness, competitiveness, like everybody, you know, everybody's got an account to a certain degree has a brand, right? And you're basically trying to promote that brand and and and sort of showcase your brand as being the best brand out there. And and I think I think that's problematic because you're always setting yourself up to compete. And I don't think that's particularly healthy.

SPEAKER_00 45:07

Yeah. Clearly, it's becoming a problem. I mean, with all of the things that we're seeing happening to people's bodies, because they're trying so many different things, and it's just becoming exhausting to our bodies.

SPEAKER_01 45:24

It's it's interesting. I read somewhere, I think I can't remember if it was, I think it was a book. Um maybe a book about psychology or something like that. And it basically was saying how if we all just stopped trying to fix ourselves, we'd actually probably be okay. But we spend so much time trying to fix ourselves, trying to be versions of ourselves we perceive we need to be to be accepted, that actually in the process of fixing ourselves, we take ourselves further and further and further away from who we truly are. And I thought that was really that was really for me, that was really poignant.

SPEAKER_00 46:02

Yeah, yes, very wow. Something for us all to think about. Is there anything, any question that I haven't asked about reds or rhabdo or any eating disorder or peramenopause or something that I've missed that you would like the audience to know?

SPEAKER_01 46:24

So I think we've done a pretty good whistle stop tour of it all, to be honest. I think um it's been it's been a really I mean, I think, you know, I don't want to scare everybody out there. I do want people to realize I do want people to know that you can recover and you can have a really healthy life. And I've worked with a lot of people where you know they now have a really healthy relationship with food and exercise and and they're living very, you know, very rich lives that they can enjoy. But I think I think the bit that most people don't appreciate is that red's is more than a physical condition. There's definitely a mindset behavior shift that also needs to happen alongside it, and I think some people are quite resistant to that. So um, yeah, it's like I said, it's it's not quite as simple as just eat more and do less, it's it's way more involved.

SPEAKER_00 47:20

Yeah. Well, hopefully um the audience will take heed of that and um you know, people will get the help they need. And um, I had the um pleasure of hearing you speak about Reds on a different podcast. So I'm glad that the word is getting out there. I want to make sure my listeners, you know, could to could get this information and kind of check themselves, you know, kind of ask some deep internal questions of do I fall into this category?

SPEAKER_01 47:48

Yes.

SPEAKER_00 47:49

I really appreciate.

SPEAKER_01 47:50

Yeah, no, thank you so much. And actually, you know, it's been interesting. Like I I've done a lot of podcasts over the years, but I have done a lot of US podcasts this year. So um obviously word is spreading across the pond, which is which is nice to know.

Hope, Mindset Shift, And Recovery

SPEAKER_00 48:08

Yes, yes, and I I really appreciate uh the the time of evening that you are joining me. And uh so I appreciate you being here and and taking time out of your busy schedule to to uh give us this information. It's very helpful.

SPEAKER_01 48:22

Oh, it's my absolute pleasure. It's lovely to to chat with you and um thank you so much for what you do.

SPEAKER_00 48:28

Yeah, my pleasure. Thank you so much for being with me. All right, bye-bye. Bye-bye. Wow, what a recording, right? Wasn't that some great information? So uh Rini's book, uh Feel for Thought, is the one that she most recently um created, and you can get it on audio as well. Uh, there will be some links uh and the list in the show notes if you want to pursue uh any of the information a little bit further. Um yeah, so I'm I hope you all enjoyed that. Again, uh please uh reach out to me at Carla at CoffeeCrewCoaching.com. Follow, share, and rate the program. If there's someone that you know needs to hear this information, please share that with them. And we'll look forward to seeing you on the next one.