Insatiable with Ali Shapiro, MSOD, CHHC

266. Dr. Stacy Sims on How "Women Are Not Small Men" (especially at midlife & with exercise)

January 24, 2024 Ali Shapiro, MSOD, CHHC Season 14 Episode 6
Insatiable with Ali Shapiro, MSOD, CHHC
266. Dr. Stacy Sims on How "Women Are Not Small Men" (especially at midlife & with exercise)
Show Notes Transcript

Get ready to dive deep into the groundbreaking insights shared by Dr. Stacy Sims in our 6th episode of season 14.  Stacy brings her wealth of knowledge and expertise to the table, shedding light on the unique physiological considerations women face, especially during phases like perimenopause and menopause. From the impact of hormones on exercise performance to the complexities of gut health and nutrient requirements, this episode is a game-changer for women seeking to optimize their fitness and wellbeing.

Guest: Stacy T. Sims, MSC, PHD, is a forward-thinking international exercise physiologist and nutrition scientist who aims to revolutionize exercise nutrition and performance for women. She has directed research programs at Stanford, AUT University, and the University of Waikato, focusing on female athlete health and performance and pushing the dogma to improve research on all women.

She wrote the science-based layperson's book (ROAR) to explain sex differences in training and nutrition across the lifespan. Both the consumer products and the book challenged the existing dogma for women in exercise, nutrition, and health. This paradigm shift is the focus of her famous "Women Are Not Small Men” TEDx talk. Dr. Sims has published over 70 peer-reviewed papers, several books and is a regularly featured speaker at professional and academic conferences. 

Mentioned in this episode:

Transcript & Show Notes: alishapiro.com/dr-stacy-sims-ex…enopause-midlife/

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Ali Shapiro [00:00:10]:
You all are in for such a treat as I have doctor Stacy Sims, A forward thinking international exercise physiologist and nutrition scientist, who aims to revolutionize Exercise nutrition and performance for women. Stacy's work is influenced by her rallying cry That women aren't small men. And this may seem obvious to all of us, but when you hear experts say, The research says, you know, what they're really saying is that what the research says about men, and this is from exercise To nutrition, to fasting. And as we talked about today, even the existing tech wearables and trackers are based on male data and thus Algorithms. Doctor Sims is working to change all of that and teach women how to exercise, train, and nourish themselves to work with the very real female sex differences across their lifespan. And this is actually incredibly complex because of how hormones affect everything from heart rate to carb intake to recovery, all while balancing if you didn't sleep well from perimenopause sleep disturbances. And one of my favorite things from this episode is how Stacy gives a super Simple and clear way to adapt your workouts based on how you're feeling that day, which can vary based on so many variables. And yet her suggestions mean you'll know when it's safe to push yourself and when it may backfire.

Ali Shapiro [00:01:42]:
Again, this is about real life not sticking to some plan. Doctor Sims has published over 70 peer reviewed papers, several books, and is she's regular featured speaker At professional and academic conferences. She's also the author of Roar, a book written to explain 6 deaf sex differences In training and nutrition across the lifespan. And most recently, she published next level, which is a book about how to exercise in perimenopause and was a lifeline for me when I didn't understand what was happening to my body and the light Stages of perimenopause. So I was kind of having a fangirl moment that I got to interview her today because I loved her book. She's directed research programs at Stanford, AUT University, and the University of Waikato. I hope I pronounced that Correctly, it's in New Zealand, and she currently holds a senior research associate position with Springs OUT University. She supervises PhD students.

Ali Shapiro [00:02:47]:
She writes academic papers, and she's on the advisory board of some really Cutting edge companies. She also has her own business where she creates and delivers online learning material Focused on women training with their physiology across the lifespan. And all the show all of her website and how to stay in touch with her will be in the show notes, So you can check that out. And she currently resides at the beach in Mount Maunganu, New Zealand, I have no idea if I'm pronouncing that right, With her husband and young daughter. So whether you're just getting started at learning how to change your exercise in perimenopause and menopause To support your new hormonal normal, or you're like me, you have a lifting routine, and yet you're still on a learning curve, You'll get so much out of today's episode, including the relief that Stacy wants you to eat carbs, She wants you to do less cardio, and if that's not enough, she offers a sane way to fast if you wanna do it. And hint, there's actually a right and wrong way for women, and most women are doing it incorrectly. And While we focus on perimenopause and menopause, if you're under 40, your menstrual cycle creates a need for varying intensities recovery as well, And what Stacy is talking about still applies to you. All this information just becomes even more important over 40, Especially for most women at 45 and over.

Ali Shapiro [00:04:17]:
And once you're done listening, please send this to all the trainers you know who are working with women at any stage of their lives. Help another woman out. Because if you and other women are putting in the time to care for their bodies through exercise and movement, I wanted to support, not sabotage all of us, and so many trainers have no idea these differences exist. Just this morning, I told my trainer at the in the group class that I was adapting for myself. He's like, you don't need to adapt with. And I was like, listen. I'm in menopause. I know what I'm doing, so you gotta push back sometimes.

Ali Shapiro [00:04:53]:
Alright. Now on to the episode. Welcome, everyone. Today, we have the doctor Stacy Sims. And, doctor Sims, I just have to thank you. Your book, Next Level, Was a lifeline to me when I discovered that I was in menopause, and I was also postpartum, so I was so confused. And I didn't know what was happening to my body, and your book was, like, the only thing that gave me guidance. So I just wanna thank you So much for your work before we get started.

Dr. Stacy Sims [00:05:23]:
Oh, thanks so much for having me. And call me Stacy because I look around, and I'm like, who's doctor Sims?

Ali Shapiro [00:05:31]:
Okay. Great. So I wanna start by unpacking your really powerful rallying cry that women are not small men. Your excellent and hilarious TED Talk Yeah. Really outlines your work and reasons, why you have that think that rallying cry is necessary. And so for listeners who may not be familiar with your work, Can you start with loving Wonder Woman as a child through the realizations that you had on the Purdue crew team and the work and the reason you're doing the work you're doing? I used

Dr. Stacy Sims [00:06:04]:
to take swim lessons and watch my own woman and Wonder Woman. And so when I was growing up, everyone's like, oh, you need to be a princess. You to act like a princess. I was like, yeah. My princesses are Wonder Woman, who's princess Diana, and princess Leia. Because they were women, you know, who Truce strong, and they didn't take shit, and they said what they thought and that kind of stuff. And so I was like, yeah. This is how women should be.

Dr. Stacy Sims [00:06:29]:
Why aren't we In, like, Cinderella land. And so growing up, I was didn't really think about if it was a boy or a girl. It was just This is what we do, and we do what we can. We say what we want even though with super shy. It's just when I did say things, it's it's what I meant. I got to university, and I was on the crew team or the rowing team. And I was also in exercise physiology and metabolism, And we are all training the same, and then we'd have these conversations in the women's boat about that time of the month, and I wasn't feeling that great. And so that was kind of the undercurrent of, Okay.

Dr. Stacy Sims [00:07:06]:
So how's the boat gonna go today? And then we were doing the same training as the men, and the men would peak for the a races and be Spot on, but we were always hit or miss. So I started asking questions like, okay. Well, do we need more recovery? Are we not as strong? And we're putting in the same kind of training. I don't get this. So I'd ask the questions in class. Like, what should we be doing? And people would look at me strangely And say, okay, so what do you mean? This is what we do. But when you're looking at the textbooks, it's never a representation of with, it's always man or they. Then when we get into the labs and the protocols are the same, and I remember being in a metabolism lab where we are trying to look at carbohydrate utilization.

Dr. Stacy Sims [00:07:50]:
So we had to standardize the same, and we had 1 test on the treadmill where we are just running with water, then a week later, we are running with, like, Gatorade. So they were looking at all the results across, like, the familiarization where you did just water, then the just water one, and then the Gatorade one, and my results were different from the 3 boys who did the same test. So they're like, what did you do wrong? I was like, I didn't do anything wrong. I'm the daughter of a Colonel in the army, I know how to follow rules, so I did everything right. And then, like, well, this this doesn't work, so we're just gonna throw them out because it's gonna skew the results. And so I was like, what what do you mean? So then hindsight, looking back, it's like, oh, okay. I was in a different phase of my menstrual cycle. So we know that you know, now we know that There's differences in baseline resting metabolism between follicular and luteal phase, and then that comes out with A greater amount of fatty added fatty acid oxidation or using fat when you're in the luteal phase versus carbohydrate, so that's what screwed up the results.

Dr. Stacy Sims [00:08:53]:
So when I'm asking why you're throwing my results out because I'm an outlier, they're like, well, that's what we often do because women's Minstrel cycle can interfere with the results. That's why we don't test women that much or we do. It's only in the low hormone phase. But often, we just exclude them because it complicates the research and makes it too long. And I kind of, like, took a step back and was sitting on that for quite a while and got very frustrated. It's like, this is not right. So, yeah, that kind of planted the seed. So as I go through my academic and sporting career, asking, well, is this really appropriate for women? And so when I got through and I got to teaching at Stanford, I would wake the undergrads up with women are not small men After lunch for a sex difference research, you know, seminar type thing, so people would kind of sit up and take notice.

Dr. Stacy Sims [00:09:43]:
And I get the question now, is it a feminist call? I'm like, no, it's not a feminist call. It's just an awareness that Women's physiology is different. We need to start looking at that differently, and men need to be involved in the conversation. Women need to be involved in the conversation Because we can look right down to things like pharmaceutical research and the infamous Ambien that came out. Right? The same dose, but women end up being still under the influence because it's too much for them, but no one really looked at that until it became a problem. So if we look early, then we don't have the problems. I love that.

Ali Shapiro [00:10:17]:
I was talking with some friends at I do, like, a it's I live in Pittsburgh. It's called Pittsburgh Fit. It's it's sim it's, like, 80% CrossFit and a bunch of my 2 girlfriends afterwards, they're talking about some of the popular, like, sports podcasts on training. And my friend, her name is Allie also, she's like, because of doctor Sims, I know to say, well, is that research on men? Because to your point or was that research done on women too? And I think that's so important for people to know because when we hear, well, the research says, the data says, we have to ask who are they studying. I mean, I I don't think people know to Ask that question, and that's why your work is so profound.

Dr. Stacy Sims [00:10:54]:
No. That's it's true because when someone goes, oh, should I be doing this or this or that, or, You know, my coach told me to do this. I mean, where did the data come from? And it's the same like with wearables and heart rate variability and all the monitoring, right? All those algorithms are based on male data. So women are I'm not recovered. I'm not training hard enough. Well, no. Actually, it's because the algorithm is reading you as an anomaly And then saying that you're outside of the bounds, so, of course, you're not in the in the bell curve of recovery.

Ali Shapiro [00:11:22]:
Oh my god. I did not know that. I don't do wearables. I'm like, I grew up in the analog world. I'm doing great that we're on Zoom. I'm like, that's enough technology for me.

Dr. Stacy Sims [00:11:31]:
You know? I have a Garmin on, but you notice it's analog.

Ali Shapiro [00:11:36]:
Oh, so you can get it on in. That's good to know. Yeah. At some point, I'm like, I'm just out. I'm too old to learn this stuff. So I'm curious because you know so much. How has your perimenopause, menopause journey been? Is it and has anything surprised you living it, let alone knowing so much? You know, like, has there been anything that surprises has surprised you?

Dr. Stacy Sims [00:12:03]:
Kind of an anomaly because when I was doing my PhD, My postdoc really at Stanford. I was working with Marsha Stefanik who was one of the principal investigators of the Women's Health Initiative. So then we were looking At different cohorts who were still coming in for follow-up and we were designing different studies, so I was very aware of the late postmenopausal and what hot flashes were Collectivity. Then I was taking some of that cohort and applying human performance research of cooling and thermoregulation. So I kind of thought everyone knew that this happened. Right? And then I realized that no one does. And then at the same time, I had the opportunity to work with one of the top Complementary alternative medicine researchers, and we are looking at black cohosh and adaptogens. So I've been using that kind of stuff forever.

Dr. Stacy Sims [00:12:49]:
When, you know, I hit my late forties, I turned 50 this year, I've just kind of been doing these things all along. So I haven't been hit with like a lot of people. So, yeah, it has I mean, I have noticed for sure that it's really hard to put on lean mass. I did have some issues sleeping early on. Lots of joint pain and soft tissue injuries, but I know how to manage it because I know that that's part of what happens and you get through the other side. So, yeah, it I don't think I've had it as difficult because I've had the education and awareness around with, But then I talk to other people who have no idea what's going on, and they think that menopause is, like, after periods stop, And then they're in menopause. It's like, no. It's the 5 to 7 or so years beforehand that you have to make these interventions So that you don't all of a sudden get hit with what's going on, belly composition or belly fat coming on, body composition changing, hot Flashes, losing lean mass, all of those things that are associated with menopause.

Ali Shapiro [00:13:49]:
I know. I thought so I had cancer as a as a teenager, so I Went through early menopause, but it was coupled with this infertility diagnosis. They're like, you're in early menopause. You can't get pregnant. But then I worked with a naturopath and an acupuncturist that got pregnant. So I was, like, they don't know what they're talking about. Like, you're a rebel. You get it.

Ali Shapiro [00:14:06]:
I'm, like, they don't know what they're talking about. So when I wasn't I didn't have hot flashes. I, But I had insomnia, and I was like, but I'm just postpartum. And but then, like, 1 year postpartum, my weight was, like, 30 pounds above my postpartum weight, and that's when I was like, wait. What's going on? Because I nothing in my diet has changed. It was during the pandemic. Like, my I walked my son all the time because that's all there was to do, And that's how I learned about it. It's like, I feel like I know a lot about the body, but I thought it was just hot flashes and not all the other stuff you're talking about, Like, joint pain and, you know, insomnia, and the body composition changes are just, like, startling.

Ali Shapiro [00:14:43]:
So I'm glad you knew. And so and it's a but it's a testament for those of people who are who our audience, you know, SKUs, like, 30 and older, To know, like, hey. You can start training for this, you know, now in a way. Yeah.

Dr. Stacy Sims [00:14:57]:
One of my friends and and coworkers here, she does a lot of stuff with me And the doctor says, she's 35, and she's already implementing everything. She's like, it's you know, you don't wait till you're 40 to start Lifting heavy and using adaptogens. You do it early. It's like prophylactic. It's a convenience.

Ali Shapiro [00:15:15]:
It is. Totally. So I listened In an interview you gave, you talked about when we're in perimenopause and menopause, we do have to switch our training. And I loved what you said is that We have to switch it so that we can almost support the physiologic changes that we're missing from our hormones now, and I just Found that so inspiring because the narrative is, especially for women, you know, over 40, you're kinda, you know, put out to pasture in this way. And by you explaining that to me, I was like, oh, we have agency in this. Like, it it of course, things may decline, but the rate that they decline, we have some control over. So Can you explain what physiologically is changing and how exercise can somewhat mimic what our hormones used to do?

Dr. Stacy Sims [00:16:03]:
Yeah. No. I always bring it up as we hear all these things about puberty. Right? We hear about all the changes that young girls go through, where their body composition changes, They're becoming very moody and sometimes a bit depressed, you know, so we see all the mood changes and then they get their period. And it's because you have the expression of estrogen progesterone. So now we're on the other end of things. And we know that through our reproductive years We see that progesterone, estrogen affect every system of the body. And so when we start having a little bit of a decline and a change in the ratio of estrogen, progesterone, we to have a a severe stress on the body.

Dr. Stacy Sims [00:16:42]:
So the body's under a lot of sympathetic drive, increased cortisol because the body's trying to figure this out. So if we look specifically at what progesterone does, it is tightly tied to what we call the vagal nerve and the vagal response. So this is why people say, oh, progesterone is calming in some regards, but it also can be very stimulatory because it's antagonized by estrogen. So when we look at estrogen, what does estrogen do? It decreases our core temperature. It's responsible for things like Vascular compliance or how our blood vessels respond to hot and cold. It's responsible for lean mass development, for power production, for nerve conduction, and, of course, brain health. So when we start having a change in our ratios, this is where we start to see a lot of the symptomology with body composition change, Feeling weaker, not as powerful, having problems sleeping. We're having problems getting into parasympathetic response, so we see a decrease in our heart rate variability.

Dr. Stacy Sims [00:17:41]:
We have lots of mood changes. We have the depression, the anxiety, the whole tired but wired. So when you put all of those symptomology together and you're a mid Forties woman, you go to the doctor and say, what the f is going on? They're like, oh, well, you're highly stressed and you just need to learn how to de stress and here's a serotonin reuptake inhibitor for mood. But then when we look at exercise and we're can use exercise as more of a tool to get through this. If we're looking at lifting heavy, which is my other tagline. Right? Lift heavy shit. We're looking for a central nervous system response. Because if we are having to lift a heavy load and we don't have estrogen that is stimulating the nerve or the muscle contraction.

Dr. Stacy Sims [00:18:26]:
And I'll take a step back and say, when we look at estrogen and what it does is it stimulates the very basal cell or satellite cell of muscle tissue to develop more muscle fibers. It's also responsible for how Strong. One of the proteins binds to another protein, myosin and actin is responsible for myosin to actually hold on to each other and create a strong contraction. And then the third thing is it is responsible for how much acetylcholine is held in and around the little gap where the nerve Fiber comes down and then the impulse jumps over that gap with acetylcholine to stimulate the muscle fibers to contract. So if we start to lose estrogen, we lose that whole kind of quagmire of power production and strength. So if we look at a central nervous system response, like I said, and the central nervous system is now, oh, gosh. We have to be able to contract heavily, Hold that contraction, have a fast nerve, and, also, we need more lean mass. That instead of relying on estrogen to do all this, we now have protein and central nervous system.

Dr. Stacy Sims [00:19:31]:
So that's that external stress and that load that's gonna create an adaptation the way estrogen used to. And then when we look at progesterone, and progesterone can be catabolic, can also be calming. So when we're looking at, okay, What do we need to do to instigate more of a parasympathetic response? We look at sprint interval training, and people go, what interval training, what are you talking about? That's really hardcore. You know, it's really uncomfortable. How is that gonna cause a calming effect? When you do sprint interval training, it's such a Wrong Truce. So I'm talking 30 seconds or less of RP of 9 or 10 on a scale of 1 to 10. You're going full gas. And we have a a subsequent Rebound effect after a set of sprint intervals where we have an increase in growth hormone, an increase in testosterone, With both decrease cortisol and increase our parasympathetic drive.

Dr. Stacy Sims [00:20:23]:
So, we're looking at SPRINT interval training not only to cause a change in our muscle morphology to increase our ability to control blood glucose but also to increase our ability to activate that parasympathetic drive. So, again, we're looking at an external stress that is much harder than what women are used to Food the most part, to create that adaptive response that these homeowners used to support.

Ali Shapiro [00:20:49]:
I just think that's so empowering. I know when I do the sits, I feel like a high after that. Yeah. Like, it's like, oh my god. This is amazing, but I didn't realize it was The rebound parasympathetic activation. That's so fast. And it's like the body's like, alright. You just, you know, chased a gazelle.

Ali Shapiro [00:21:07]:
Now it's time to relax. Yeah.

Dr. Stacy Sims [00:21:10]:
It's true. Recovery cover, and then we can go again. Yes.

Ali Shapiro [00:21:14]:
Yeah. Well, you say that, you know, most women aren't used to going that hard, and I think A lot of people hearing this may not even be super active to begin with, and then you come in in perimenopause, like, can wipe out your sleep or whatnot. When Your clients come to you, and do you ever think there's something deeper psychological going on that, like, helps That when people have trouble with consistency because I have a couple friends who are trainers, and I'm close to some of the trainers in the gym. And it's kind of they say it's kind of known in the industry that people are on and off, on and off. That and and I'm in the nutrition psychology field. Like, this is what I study. So I'm just curious. Like, do you have clients who struggle with consistency, and how do you support them in that, especially during perimenopause and menopause?

Dr. Stacy Sims [00:22:01]:
Yeah. Every yeah. Absolutely. And I always try to find out the driving factor of what and why. So it's kind of the psychological approach. Like, Why are you coming to the gym? What's your driving factor? Is it just to look good? Well, that's not gonna increase consistency. If it's to counter all of these Perimenopausal symptoms and not the not the want or the need to go on menopause hormone therapy or you're really trying to improve your sleep, well, let's Let's use that as the driving factor to get you to the gym. And I have people track.

Dr. Stacy Sims [00:22:34]:
I'm like, on the days that you do sit, how is your sleep the night After that, if you're doing really heavy lifting session, how's your afternoon fatigue? How is your appetite? How do you feel? How's your brain fog? So really taking all the symptoms that are bothering them and putting it into the scope of how do you feel after the gym or how do you feel after, you know, doing sprints up The the hill. So it's really trying to pull the symptomology that they're trying to alleviate into what they're doing, and so that gives them more buy in. So when I'm talking to someone who is not active and they're trying to, like, navigate all of this, and, unfortunately, they fall into the 150 minutes of intensity activity, which doesn't help. You know? With makes people more tired. It increases cortisol. A lot of times you see increase in body fat, and they get completely deflated. I pull them right back and say no cardio. We're not doing any cardio.

Dr. Stacy Sims [00:23:28]:
We are just lifting for 5 weeks. We're lifting and we are increasing our protein intake, And people get afraid of lifting. I was like, well, lifting is really 30 minutes 3 times a week. And what we wanna do is do good Mobility, see how you're moving, and we're just gonna work on deadlifts or squats or some other compound movement. And so they get that That parasympathetic because they're working central nervous system, they're not trashing themselves, they're starting to feel better, they're getting better sleep habits, and that's a buy in. So then we can start adding in some sprints or something like that, but it's always bringing back to the drive and always trying to understand what are the symptomology and how is it alleviated through The interventions that we're doing.

Ali Shapiro [00:24:09]:
I love that. Doctor Michelle Seeger, who is a behavioral exercise and eating you know, behavioral change, and she talks about Eating and exercise being in a unique change category because they're complex. Right? Like, you eat in so many different contexts, but she talks about how so many people have been taught in our culture. I mean, anyone, you know, our age or or older or even younger, we've kind of grown up that thinness is healthy. And and And, also, people have so many many charged emotions around their weight usually. And so she said that, like, when we're tying eating and exercise, we're always, If we're not conscious of it tying it back to weight, right, rather than what I and that's what I try to do with my clients. What you're doing is, like, how can it be about health? And my my math graduate work is in, like, adult behavior change, and adults actually need, like, really quick I call them quick fixes, which you're saying, like, Okay. If you do this sit, how are you gonna sleep tonight? And it's like, I need to know how this is gonna benefit me now.

Ali Shapiro [00:25:08]:
But I love that you're helping people take that out of the weight loss Meaning matrix and make it more about their health that isn't just about weight. So I think that's so important.

Dr. Stacy Sims [00:25:19]:
And because my daughter is 11, and I'm very conscious that some of her other friends' parents are still in that weight loss mentality, the moms. And they are like, oh, well, you have to be Skinny, and you have to look this certain way. And I'm all about having my daughter eat well, be strong. And so when she comments, I'm like, can they Can they lift the 20 kilo bar? No. They can't. Like, can you? Yes. I can. I'm much stronger.

Dr. Stacy Sims [00:25:42]:
And so she, like, brings it all back to strength. It's not about What she looks like or what clothes are popular, but about being strong and active. And I'm like, I want that mentality for every woman that's out there.

Ali Shapiro [00:25:55]:
Yes. Yes. Yes. Well and, I mean, this is kinda circling back what you were saying about strength training. And I was chatting with one of my clients who got into strength training because I gave her your book, and Oh my god. It's and we were saying, like, there's a lot of research that connects strength training to confidence, and I wonder if because our physiology influences our psychology. I wonder if part of it is what you were describing when we're strength training. Like, it really does make you feel like you know, just like, I don't know.

Dr. Stacy Sims [00:26:24]:
Well, I called you online. Yeah. Exactly.

Ali Shapiro [00:26:27]:
Yeah. I also find too I had 1 client. I have A program called Truce With Food, and she needed to start moving, and she had had some injuries. And I was you know, she's like, so I got out there for a walk, and I'm beating myself up for I Should've been moving sooner, whatever. And I like how you said, like, let's just focus with strength training. I was like, look. Your goal right now is just to show up. Like, the just Show up and see what happens versus, like, already you should be somewhere.

Ali Shapiro [00:26:52]:
And even, like, reading your book, it was so helpful to, like I started with I started with a trainer because I was injuring myself because I didn't know that that was part of menopause yet. And I was like, okay. I need to work with a trainer. But then I got into the classes, and it was like, okay. Like, I'm really loving the heavy lifting. And it wasn't until recently, I actually went I'm actually on menopause hormone therapy Food my sleep, I've been sleeping so much more deeply, and now I actually feel like it's a fun challenge to do the with versus before it felt like, Oh my god. I'm so exhausted. So I think people forget that, like, you can progress gradually.

Ali Shapiro [00:27:28]:
You don't have to start everything at once, so I love that that's your approach as well.

Dr. Stacy Sims [00:27:33]:
I want people to think about it as just a short training block. I want people to realize that you need to phase in because this is what you wanna do for the rest of your life. When I'm 90, I still wanna be doing sit training. Right? I might be going slower than someone who's walking, but I still in my head, it's hard for me, And that's that's the goal. Yeah.

Ali Shapiro [00:27:54]:
It's that time of year again. Truce with Food, trust in satisfaction, not My 6 month group program is open for registration through January 31, 2024. I only run Truce once a year, and I keep it small so that you get the best of both worlds, my individualized Group individualized attention and the benefits of an intimate supportive group. So spots do tend to fill up pretty quickly. We begin February 1st 2024. Perhaps you struggle with food for years and suspect that the solution isn't somewhere out there in some passing fad or yet another Restrictive diet. You sense that a deeper change is necessary, and midlife is a great time to address This deeper change. Over the years, I've guided hundreds of satisfied participants through this program, so you get the benefit of a refined curriculum That not only meets you where you are, but guides you to where you like to be.

Ali Shapiro [00:29:00]:
We cover a lot of ground in this comprehensive 6 month program From learning what foods are best for you now, not when you were 20 or last time something worked for a short time, to discovering the root cause of why you fall off Truce with your healthy eating, and this includes why falling off track makes sense. Not that it's the problem, But it's the thing to understand and work through. These are results that will last and require no white knuckling. No one's got energy or time for that, midlife especially. If this sounds like it might be a good fit for you, join me Food a completely free, no strings attached sneak peek in my Food your flow when it's all in flux salon series On Wednesday, December 27th, January 10th, and January 24th from 12 to 12:30 PM Eastern Standard Time, And bring any burning questions from this season so that you can get them answered on this call. Sign up for free at alleyshapero.com back Slash hello. And no worries if you're listening to this after the 3 part series has already started. Once you sign up, you'll receive access to a limited replay of what you missed.

Ali Shapiro [00:30:14]:
I hope to connect with as many of you who listen to the show as possible at this series. Once again, visit alleyshapero.com backslashflow for more details. Now back to the show. Well and can so I would love to, like, define these terms for some people. So strength training, plyometrics, and hit and sit you recommend. So when you say lift heavy shit, you know, I love that you just said, what's hard for me? So if Someone if I hadn't been reading your book and I and I hadn't locked into this great gym down the street from me, I'd probably be wondering, like, what's heavy enough? Is it 3 to 5? Is it Pilates? Is it body weight? What do you how do you define lift heavy shit?

Dr. Stacy Sims [00:31:00]:
We start with its relative. So if you don't have a history in resistance training, then it could just be body weight. But 1st and foremost, we need to know that you move well, because if you don't move well and you don't have good technique, you'll get injured. We don't want that. But the eye of it is it might take 2 weeks to learn your mobility and restrictions or it might take 3 months. So whatever it is is you have this phase in And then we start adding load. The ultimate goal is to get to being able to be comfortable at 80% or more of a one rep max, and that's always gonna be variable and changing. If you're not really up Into the gym speak of 80%, 75%, one rep max, we go on a RPE scale or sessional RPE, where if you're doing a heavy session and you're like, okay, I have to do 3 to 5, so that's 3 to 5 exercises, 3 to 5 reps at 80% or more.

Dr. Stacy Sims [00:31:55]:
Well, it's a 8, 9, or 10 on our rating of received exertion scale. Because some days you go in and you can lift more than other days. But if you're hitting that same RPE, you're gonna get the same similar training effect. So for someone who's never ever been Training and going in and doing 3 sets of 5 deadlifts with a 45 pound bar, that's super heavy for them. Someone who's been in there and knows their resistance and knows how to move well, knows how to do deadlifts, that might be a 150 Pounds instead of £45. So it is very relative to experience, comfort, confidence, and movement.

Ali Shapiro [00:32:34]:
I love that because I think for the perfectionist out there that think they should be somewhere, it's like no matter where you are, you're gonna have to be doing 8 to 10 of your Preserved, you know, rate of exertion. It's like Yeah. There's nowhere to get.

Dr. Stacy Sims [00:32:47]:
Yeah. I know. It's it's always you might go faster, but it's Still harder. You might lift heavier, but it's still hard. Right? Yeah. It never gets easier.

Ali Shapiro [00:32:57]:
Yeah. And can you I heard in another interview where you were saying Why you don't like or why you don't use variable heart rate monitors is because if people are still menstruating or in perimenopause, your hormones can alter Your perceived rate of exertion. So I love this approach because it's all relative to, did you sleep? What phase of your menstrual cycle are you in? It's like You have to be where you are in real life versus some imagined plan.

Dr. Stacy Sims [00:33:25]:
Exactly. And that's why I really like sessional or PE. So it's your rating perceived exertion in the session, and you can quantify your training load that way. Because if you're hitting all 4 or 5 of your sessions in a week at that 8, then you know that it's been a very hard training week regardless of the numbers. If you're training for something specific then that's, you know, a different story. If you're training for a race or you're training for a competition, then we look at periodization and what do those numbers mean. But for someone who's trying to get with and live life, then that rating perceived exertion is is one of the best metrics that you can use.

Ali Shapiro [00:34:01]:
Yeah. And I'm gonna have a question about that when we talk once we talk about with and sit. So can you define because, again, you said, like, the recommendation is a 150 Minutes of cardio and, you know, and then for men, it's like zone 2 training, which is like you can kinda carry on a conversation. That's how I understand zone 2, which would maybe be Presieved exertion 2, 3, 4. But you're talking about high interval training, and then there's a subset called speed interval training. So can you Define that for people.

Dr. Stacy Sims [00:34:31]:
Yeah. So when we talk about With or high intensity interval training, we're not talking about Spin classes, we're not talking about MetCon classes. We're talking about controlled intervals where we are Doing an interval that is 1 to 4 minutes long at 80% or more of your maximum. So, again, it's at 8 to 10 RPE, and the recovery between is variable. So what I mean by that is you might have a 40 minute session where you go in, you have a 10 minute warm up, And then you do 1 minute on, 3 minutes, super, super easy. 1 minute on, 2 minutes, super, super easy. So you can Alter the recovery, or you can go, okay. I'm gonna do 4 minutes at 80%, and then I'm gonna have 4 minutes recovery.

Dr. Stacy Sims [00:35:17]:
So you're fully recovered between each interval. And then you only do 4 or 5 of those and then call it. And when you start seeing that you can't maintain the same work You can't maintain the same RPE during the interval. You stop. Because we aren't after getting into That moderate intensity where it's too hard to be easy and too easy to be hard to create adaptation. The subset called sprint interval training or speed interval training is where the interval is 30 seconds or less, And the recovery can be anywhere from 2 to 5 minutes because it's essential nervous system recovery.

Ali Shapiro [00:35:56]:
Mhmm.

Dr. Stacy Sims [00:35:56]:
Because when you're going 30 seconds or less, It's not truly fuel depleting, it is ATPCP, you know, that immediate fast response. But what we want is The ability to regenerate that, but also central nervous system so that you can have that power and speed and kind of bounding part from the muscles. And It doesn't have to be running. It can be a biker. It can be swimming. It can be running. It can be walking. It could be stairs.

Dr. Stacy Sims [00:36:22]:
It could be battle reps. It could be med ball slams. Anything that's gonna get your heart rate well, no, not really heart rate because that really kinda lags behind. So we are back to your rating of perceived exertion or around a 100% of your max. So it is full gas.

Ali Shapiro [00:36:40]:
And how do you know that you're At your full gas because I find and I'm curious about some adaptation strategies for the Met Con. But sometimes I find on the Metcons, When I'm doing, like, the, you know, the CrossFit, sometimes I'm like, oh, I actually left some in the tank because I'm worried about not being to finish. So how does someone know? And is it just trial and error? Or, like, how do you know that you're really all out gas Food the sit especially.

Dr. Stacy Sims [00:37:10]:
Yeah. So when you're in a class like that and you're like, oh, it's the ego thing. Oh, I have to finish this. Right? And you have If you have someone that you're competitive with, you like, there's 3 or 4 of us in the gym, and I'm always telling them to put on the little incremental plates Just a little bit more, a little bit more, a little bit more because they always underserve themselves. And I'll put the incremental plates in between the big plates so they can't see what little sneaky things I put in there. So it's just, like, trying to be friendly competitive just to push a little bit more. But if you're if you're not that kind of person And you are okay. I wanna do this on an individual thing, and you're pushing and you're pushing and you think you're fully at that 100%.

Dr. Stacy Sims [00:37:53]:
If you can do more than 5 of those intervals, you haven't gone hard enough.

Ali Shapiro [00:37:58]:
Got it. Got it. That's so helpful. So with the sits, it's like, Just to clarify because I wanna make sure I'm doing with right. 30:30 seconds or less. Usually, I can get like, in the 1st round, I can get 30, but then the second one, I'm, like, down to 25, it starts. But you wanna take 2, like, 2 to 3 minutes in between each 32nd interval. Mhmm.

Ali Shapiro [00:38:18]:
Correct? Yep. Yep. Okay.

Dr. Stacy Sims [00:38:20]:
Like, the Salt Lake. Right? And you're, like, going as hard as you can, as hard as you can, and you're completely wasted at the end. And then people are like, okay. Every minute on the minute, let's go. No. It's every minute on the 4 minutes, let's go for 30 seconds.

Ali Shapiro [00:38:35]:
Got it. And then, like, a max of, like, 66 of those rounds?

Dr. Stacy Sims [00:38:39]:
You wanna work up to that. Yeah.

Ali Shapiro [00:38:41]:
Work up to that. Yeah. And I love that you mentioned the bike because for people one day, my gym was closed, and I was like, I'll go down to the track and run. I was sore for a week and a half. After my my running Since I was like, oh my god. I'm gonna stick to the bike.

Dr. Stacy Sims [00:38:54]:
Yeah. I find that my mechanics aren't My my heart and my lungs and my muscles are very strong from cycling and other things. And so when I go run, it's the mechanics to give out before I can actually get to that top end. Unless I'm doing hills because when you're doing hill work, your mechanics you're a little bit slower, your turnover isn't, and you don't have as long a Truce. So I can Push a little bit harder if I'm doing stairs or hills, and I check-in when I chase my husband. I'm like, hey. Come on. Let's go do some sprints.

Dr. Stacy Sims [00:39:26]:
Okay. And he's a little bit faster. So if I can keep up with him, then I know that I'm pushing hard. But if I'm lagging behind, I get mad at myself. I'm like, no. Keep going. Go. Harder.

Dr. Stacy Sims [00:39:35]:
Harder. So then I have to check-in.

Ali Shapiro [00:39:37]:
Yeah. I love that. I love that. And so I know everyone's different, and you can't, like, give a one size fits all. But if people I know you say lifting maybe, like, 2 to 3, 4 times a week, and, of course, like, checking in with your recovery. And then with the hit and sit breakdown, Like, do you think with 3 times a week or with? How do you tend to what is your, like, strategic thinking when you're working with clients on how you end up recommending what you recommend? I guess, how are you think about it?

Dr. Stacy Sims [00:40:05]:
Yeah. Anyone who's starting, I always want big rock to be lifting. So I always have them come in Minimum 2 times, preferably 3 times a week, and so we work on that. And I might have them warm up with low box jumps to get a little bit of the playa work in, Or I might have them do that towards the end, but ideally at the start when they're not fatigued. If they're not warming up with some kind of plyo work, then we do the heavy lifting, and then we finish with some sprint intervals. So it might be 2 or 3. Yes. A little bit under fatigue, but then they understand what that feeling is, and they're still hitting that top end metric.

Dr. Stacy Sims [00:40:38]:
But done and dusted within an hour with everything. Right? So then that can take care of most of your sessions in 2 to 3 in a week. If you're someone who's like, but I wanna do a little bit more, how do I separate out the sessions? It's like, okay. Well, we do 3 times of heavy lifting and then maybe two HIIT sessions in the week. So that would be specific on a separate day. I often look at it as like, okay. Monday is more your Recovery day. Tuesday, we're doing heavy lifting, followed up with a little bit of sit.

Dr. Stacy Sims [00:41:09]:
Wednesday is More of active recovery than Thursday, Friday heavy lifting. Saturday or Sunday is another hit. So you're like, okay. But if you want your weekend off, then you look how do you put that quality in during the week?

Ali Shapiro [00:41:23]:
Got it. Got it. And is should people be aiming for, like, 2 to 3 days of hit or sit or, like or does it hit or sit matter if it's you're interchanging them as long as it's 3 times of, say, like, Getting that, you know, that simulation. Yeah.

Dr. Stacy Sims [00:41:41]:
So 2 to 3 of each. 2 to 3 heavy lifting, 2 to 3 of the sit, hit combination.

Ali Shapiro [00:41:46]:
Oh, okay. Okay. Great. Hit sick combination.

Dr. Stacy Sims [00:41:49]:
Yeah.

Ali Shapiro [00:41:49]:
And so and, yeah, in your book, next level, you talk about, like, with for those people doing CrossFit because we do have people who I just love it because it just doesn't make you you don't have to think about it.

Dr. Stacy Sims [00:41:59]:
I know. It's great.

Ali Shapiro [00:42:00]:
Yeah. But you're saying the Met Con now, And my trainer wanted me to ask you this. So, like, thinking of how strategies to adapt the Met Con or and for people listening, it's In CrossFit, you usually do, like, a lifting, and then it's called metabolic conditioning, which can be 12 minutes, 8 minutes, Sometimes up to 25 minutes. How can trainers start to think about how to adapt that MetCon for women?

Dr. Stacy Sims [00:42:25]:
What we did this in the gym a couple of weeks ago. I'm like, oh my gosh. This is the ideal perimenopausal session. We did heavy lifting, so we did dead lifts first, and then we had 5 light clean and jerks every minute on the minute. And I was like, okay. So that's a bit of technique work. Then we went into sprints on the rower where you had every 2 minutes, So it ended up being 5 of a 175 to 200 meter sprint, so, you know, about 40, 45 seconds. And then you have more than a minute and a half recovery.

Dr. Stacy Sims [00:43:00]:
And then we finished with some core stuff where it was Am ramp of 5 minutes of I can't quite remember, but ended up really being 3 rounds of some real like, toes to bar and kind of stuff. I was like, okay, so we're hitting the heavy lifting, we're doing some technique, we're doing the sprint, and then we're finishing with some stability and core stuff. But if we're looking at MetCon in a CrossFit class, I like the every minute on the minute with one of those minutes of recovery minute. So you might have, you know, Let's do 5 light cleaning jerks every minute on the minute, or we're gonna go thrusters, and then we're gonna go deadlift, and then we're gonna do something else, and then we have the 4th minute off, and we have 5 rounds of that. So then you're getting that that with, but recovery. So you bring yourself back down. So it's really 4 minutes of work with variable recovery and then one real good minute off. So you might, you know so all up that's a 20 minute thing.

Dr. Stacy Sims [00:43:57]:
And when people are paying for these classes and they're trying to figure out what to do, like, okay, well, if you know that Monday, Wednesday Thursday is a heavy lifting session, and you're working on deadlift and bench press and squat. Well, those are your heavy lifting sessions, and then the met con you're working on technique. If you know that, like, Tuesday and Friday, it's not much heavy lifting, it's more working with the bar for metabolic conditioning, then those those are your met con days.

Ali Shapiro [00:44:27]:
Got it. Got it. Got it. Okay. But I like that idea that trainers should think about, and I'm gonna think about, like, doing maybe 4 like, if you're doing a 15, 16 minute MetCon, it's like 4 minutes and then take all that just take that minute off of whatever it is and then go back. So you're almost getting, like, 3 sets of hit in. You know? Exactly. Which is So

Dr. Stacy Sims [00:44:49]:
you're getting those those 4 minute intervals for you know? Those 4 minutes of work end up being, like, 1 4 minute interval because your heart rate doesn't really drop that much. And then you have that 1 minute off, which brings you down, gives you recovery, so then you can hit the next 4 minute interval pretty hard.

Ali Shapiro [00:45:07]:
I love that. And for people listening, that would be a hit. So it's, like, 8, not 10. You can't keep up 10 for 4 minutes. I just want everyone To remember

Dr. Stacy Sims [00:45:16]:
Exactly. And can

Ali Shapiro [00:45:18]:
you also talk about plyometrics? Because when I read your book, I was shocked because Having chemo, I'm, like, at more risk for osteoporosis, and I thought, oh, weight lifting will take care of that, and I eat lots of vegetables. But Can you talk about plyometrics that people need to be doing too?

Dr. Stacy Sims [00:45:33]:
Yeah. So there's 2 things to think about with plyometrics. If we're thinking about bone health, which Most of us are, especially perimenopause. The jumping is different from true plyo. So, if we think about bone health, we need to land and not bend our knees and absorb it in our muscles. We need to absorb it through our bones and joints, so it's not jumping really high. So that's why if you're doing single skips and you're not jumping really high, that's a really good bone hit. So maybe, you know, 5 to 10 minutes of jumping 3 times a week.

Dr. Stacy Sims [00:46:06]:
But if we're talking about true plyo, this is more about that Power and the muscular work and you do get some bone density from it because it's explosive movement. This is for metabolic conditioning but also muscle integrity. So we talk about battle ropes, we talk about med ball slams, we talk about box jumps, we can do, you know, jumping lunges, we can do jumping air squats. If people are concerned with hips and knees or modifications, it's all just all about that explosive quick movement. And that's what we want for epigenetic change for bone and metabolic conditioning.

Ali Shapiro [00:46:42]:
I think that's so important for peep and for people to realize I I the last time I read, it was like when people fall when they're older, it's, like, 50%, like, ends in death. And so I think people think, oh, bone health, You know, again but it's like, no. It is so important so for so you don't fall. And if you yeah. It's, like, really, really important. Like, this is a stuff I'm, like, worried about now. It's crazy how it Yeah. It changes real fast.

Dr. Stacy Sims [00:47:09]:
I know. But you're aware of it, so you'll do something about it. Right?

Ali Shapiro [00:47:12]:
So that's the thing. Totally. Well Yeah. When I was first at that gym, I saw people doing box jumps, and I was like, I'm too old for that, and now I freaking love them. It was such a challenge. Like, I was worried about physically nailing my knees on it or you know? And it's like now I'm like, Yes. I can do these. So with it feels like it's the reminder to myself to, like, don't count myself out so fast.

Ali Shapiro [00:47:33]:
Like, that's what the box stuff is for me.

Dr. Stacy Sims [00:47:37]:
So I'm still at the beginning stages, like, however many years I've been in, like, over 10 years, but I Still can't get to the 20 because the 1st time I saw people doing box jumps, a woman hit the edge and broke her fibula. And I was that 1 like, the purse the point person to be able to, like, stabilize it before the I was like, oh my god. I'm not ever doing that. And on a softbox, I can get the 20, but you get those hard boxes of Food. And I'm like, yeah. No. Cattle stop. Can't do it.

Ali Shapiro [00:48:07]:
I know because it's scary.

Dr. Stacy Sims [00:48:08]:
It is. It is.

Ali Shapiro [00:48:11]:
So you have talked about when you're traveling that you make sure you get in 12,000 steps a day, and I think people dismiss walking. And you were talking as you were talking about maybe, like, how you could train, it's like Tuesdays and Thursdays are my walking days. I mean, And I and I yeah. And I love them, but I I used to dismiss walking. I was like, walking doesn't count. You know? But so can you explain to people why You prioritize, especially when you're traveling, those 12,000 steps.

Dr. Stacy Sims [00:48:36]:
Yeah. It's movement. Right? We're looking about movement, and we see little My friends, Juliet and Kelly Starrett, they say that the snack size parts of exercise, which really help for health and conditioning. So when I'm traveling and I'm jet lagged, I'm in a new place, I'm out of my usual routine, you might have a hotel that has some dumbbells so you can't really do Proper lifting, then I really try to prioritize the walking to be, 1, outside for fresh air, 2, just to be moving, to Keep metabolic conditioning, keep clean mass, bone health, and then it's movement that you can come back and do some mobility. But it's really just Trying to accumulate those steps because it is snack sized parts of movement, and it's really important. And when people say, I'm doing all the things. I'm doing the lifting. I'm doing the sit.

Dr. Stacy Sims [00:49:28]:
I'm eating well. I'm on top of my protein. I'm doing some menopause hormone therapy, but I'm still not losing weight or I'm putting weight on. I mean, what are you doing the rest of the day? Like, are you sitting and what what's your incidental exercise? What do you mean? Are you parking right at the front of the door when you go to the grocery store, or are you parking far away and then walking in and then pushing the cart and carrying your groceries? Are you trying to, like, do drive Truce, or are you, You know, going up and using TV, like, what is your incidental movement? And they realize that they don't do much at all. So it's like, okay. Well, let's increase your incidental movement, And then that feeds forward to better metabolic health, and we start to see this the body fat budget bit.

Ali Shapiro [00:50:11]:
I love that. And I think for people listening, if they're not moving, that is, like, the most accessible way to just get started is, like and and connect It bringing your stress down. I really connected walking and incental movement to sleeping better. It's like really, really connect that. I think that's so important. So

Dr. Stacy Sims [00:50:29]:
And and being out in nature because we look at the research of, you know, how it improves parasympathetic drive and improves sleep when you are just Out walking in nature. So you just it's just something about being outside that helps with that parasympathetic and the brain activity and the serotonin, and it's Kind of like mindfulness, but you're outside walking.

Ali Shapiro [00:50:51]:
I love that you said that because I we I just got a standing treadmill for, like, when I'm coaching clients, like a walking treadmill, and it's been, like, like, 0 degrees, and it's icy. And so on Sunday, I got on the treadmill to cut as, like, actual move like, exercise. I could only do it for a half hour, and I told my husband. I'm like, oh my god. It was so boring. Even though I had a podcast on, he's like, you had you just don't have a lot of tolerance Food boredom. And I'm like, no. When I'm outside because we have a we have a big park.

Ali Shapiro [00:51:18]:
I always go to the park. And I'm like, it just there's something about it that feels So different. I'm like, because I'll walk for, you know, 75, 90 minutes outside, but I'm like, 30 minutes max on this treadmill. I just cannot do it.

Dr. Stacy Sims [00:51:33]:
True. It's yeah. Treadmills are like the death unless you really have to do it.

Ali Shapiro [00:51:40]:
So I wanna talk about fasted versus fed training, and I love that you said, you know, fasted is if you haven't eaten in 2 hours. Because this also, I learned from your book, That really changed because I work out first thing in the morning when everyone's still asleep, and it's like, he wants to think about food. But Can you talk about why we should train with like, in a fed state, meaning we've eaten within 2 hours?

Dr. Stacy Sims [00:52:03]:
That's with are different metabolically from men. Like, we need more carbohydrate. We fuel And use blood sugar first and then get into free fatty acids, where men will go right into muscle glycogen until that gets a little bit depleted, and then they'll start using free fatty acids. And because our area of our brain, our hypothalamus is very sensitive to nutrient quality and density, If we start doing some fasted training and we don't have our blood sugar elevated first thing in the morning, then the hypothalamus is like, hey, what's this stress? And it starts to perceive you as being in a low energy state and your endocrine system takes a hit. We know that within 4 days of low energy which is falling into fasted training and delaying food intake after exercise even if you do eat enough calories in the day That your thyroid starts to take a with, so you start to get a lowering of thyroid function. And then we start to see a mis Step in our luteinizing hormone pulse throughout the day over a 24 hour period, so then it decreases our ability to ovulate. And when we get into peri and postmenopause, it also affects testosterone and estrogen and some of the other, like, Conversion factors of sex hormone binding globulin into estrogen and that kind of stuff. So it's really important, Not just from being able to fuel exercise, but for endocrine health.

Dr. Stacy Sims [00:53:31]:
We're seeing also low carbohydrate Availability, meaning that a lot of women who are following lower carb intake will still have the same repercussions as if they were in low availability or relative energy deficiency in sport. So the longer term of that is we see gut issues, cardiovascular issues, Poor sleep. It looks like it's a big long list of perimenopausal symptoms, but it means you're not eating. And all it takes To kind of counter all that is about 15 grams of protein and 30 grams of carb between or before you go into your morning session, So it's not a lot. So it's just a very small, might be 180 calories worth of carbohydrate protein combination. You can get that in a drink, you can get that in a half a banana and some nuts, whatever it is that works for you. And then your blood sugar comes up, Your brain's like sweet, there's some nutrition coming in and so everything is better from an endocrine system, but you also have available blood glucose To hit the work metrics that you need to.

Ali Shapiro [00:54:37]:
That is can you say that again? Women need carbs?

Dr. Stacy Sims [00:54:41]:
Women need carbs. Do not be afraid of carbohydrate. Hydrate. Our brains need it.

Ali Shapiro [00:54:46]:
Yeah. Yeah. And and for people who are trying body composition changes and maybe even I wanna talk to you a little bit about weight loss because it's, like, nuanced, right, of, like, when sometimes people do need to do it for their health versus it being vanity. But To back up, I've read a lot of, like, if you want to lose fat, gain muscle, or lose weight, your carbs should be under your protein grams. Do you agree with that, or do you think they should be about even? Or

Dr. Stacy Sims [00:55:14]:
Yeah. It depends really on lean mass and activity level, But the biggest thing that people don't do is eat enough protein. Almost everyone is under protein. Right? So we need that protein to maintain lean mass, build lean mass, but you also need carbohydrate to help that protein work to build and maintain lean mass. So it's not about a ratio of carbohydrate to protein. We look at activity levels. So if you're highly active, then You're looking at at least 6 grams per kilogram of body weight a day. So what is with per pound? So About 14.

Dr. Stacy Sims [00:55:49]:
Oh, wait. 3?

Ali Shapiro [00:55:51]:
Well, is it 1 pound is 2.2 kilo kilograms. Is that right? So I would divide, like, Yeah. Yeah. Okay. Okay. I was multiplying.

Dr. Stacy Sims [00:56:00]:
1 1 kilo is 2.2 pounds.

Ali Shapiro [00:56:03]:
Got it. Got it. So you're right. It would be about 3 grams per pound. Okay.

Dr. Stacy Sims [00:56:07]:
Yeah. Yep. And then if you are on a recovery day, then you really wanna hit about 1 and a half to 2 grams per So when people are thinking, what is it if I'm a 150 pounds and that's at least 300 and some odd grams of carbohydrate per day? But what we have to talk about, that's kind of carbohydrate. You're looking at fruit and veg, whole grains to support gut and gut health. We're not talking about the ultra processed stuff It's so rampant in the states that I go into a grocery store and go, there are rows and rows of things here, but nothing to eat.

Ali Shapiro [00:56:40]:
I know that. There's this 1 grocery store we go to. I'm like, there's no food in here.

Dr. Stacy Sims [00:56:45]:
Yeah. It's crazy. You're like, what?

Ali Shapiro [00:56:47]:
Yeah. Well, I just I appreciate you sharing those numbers because I I find that most women are undereating. Like and then they and then they Absolutely. Then they overeat. And so, like, To have some guidelines to make people start to feel safe of, like, how they should be eating. Because I not gonna name her name, but a famous weight loss trainer I had a YouTube video, and she was like, sorry, ladies. You're gonna have to eat less than perimenopause and menopause. And I was like, but most people Are not eating enough, and then they overeat.

Ali Shapiro [00:57:18]:
And it's it's, like, it's this vicious cycle. So

Dr. Stacy Sims [00:57:22]:
Absolutely. Yeah. And I hate that narrative of calories in, calories out, eating less. You know, it's so nuanced, but The bottom line is as you get older, you need protein. And that's the like, we look at all the researches coming out When you are looking at higher doses of protein with and without exercise. We know, of course, if you're doing resistance training, you're gonna build lean mass and lose the cereal fat and subcutaneous fat a lot faster. But if you just go and hit that 1.6 to 2 grams per kilo, so around that Point 8 to 1 gram per pound of protein per day, then you can recomp your body without exercise. So it's so important, Especially when we're getting into this metabolic a little bit of metabolic dysfunction, insulin resistance, and people are so afraid to eat because they All of a sudden, I have, you know, an increase in my belly fat.

Dr. Stacy Sims [00:58:17]:
What's happened? It's like, well, increase the protein, and we carve in and around training. And you have to really take care of your gut microbiome because that's the biggest driver of body composition change. When we're looking at our gut diversity, We see specifically in the 5 years before that one point in time menopause, there's a drastic reduction in the diversity of our gut bugs. And unfortunately, an increase in the type of bugs that promote obesity. And the reason for that is our hormones, our estrogen and progesterone. Like, they are our 2nd pass is it goes to the liver, it's bound up by sex hormone binding globulin, excreted into the intestines and that's where little the gut bugs unbind it and throw it back out into circulation. So if we stop having the same ratio or we stop having the same levels of our hormones, then those gut bugs die off. And the other ones To make you crave carbohydrate because you're in such a sympathetic drive at this point in your life, the simple carbohydrate type bugs overgrow, And so you get into this whole so if you're really conscious on the carbohydrate that you're eating of being very fibrous fruit and veg and whole grains, Then that feeds that deep gut bacteria, keeps the diversity, and reduces or slows that rate of the cereal fat and subcutaneous fat gain.

Ali Shapiro [00:59:39]:
Oh my god. I love that. That adds more fuel to I'm always telling people, like, the healthiest guts the research shows that they have the most variety of food, but then When what's being marketed for gut health is just elimination diets, you know, taking everything out. It's just like, no wonder people are confused. You know? It's it's So I love that you just explained that. I did not know that. Oh, mind blown.

Dr. Stacy Sims [01:00:02]:
Yeah. There's a project going on right now in the UK called the ZOE project, And they are really looking at the microbiome, and they've done some really interesting research with Late peri, early postmenopausal women and looking at the effects of food and postprandial insulin and glucose. And, of course, it shows that there's insulin resistance. But when the they changed the diet to include more of, like, Jerusalem artichoke and that really fibrous stuff, it helped with the insulin resistance where it decreased it because of the effect of the gut diversity on metabolic and and Food glucose homeostasis. So it's not just like, let's stop the the change in body fat, but it's also it Helps with that insulin resistance that's so endemic and primarily low active peri- and postmenopausal women.

Ali Shapiro [01:00:58]:
Yeah. Amazing. Oh my god. So then what are your thoughts on intermittent fasting if women are so different and so much of the research has been done only on men Food perimenopause and menopausal women.

Dr. Stacy Sims [01:01:11]:
I hate I hate it. I'll quantify that, though. When we talk about when we talk about intermittent fasting, this is where people go off the deep end. They're like, I'm not eating until noon. I'm not breaking my fast till noon, and my eating window is 4 hours. And when we look at the population research that's coming out now Of both men and women at on intermittent fasting, we're seeing that those people who don't break their fast till noon or after Still have obesogenic profile. Like, they're not losing weight, they're not increasing telomere length, they're not getting blood glucose control, insulin sensitivity, They're doing the opposite. But for those who break their fast by 8 AM and then don't eat after 5 or 6 PM, They actually get the benefits of what we call intermittent fasting.

Dr. Stacy Sims [01:02:03]:
So I'm not a fan of intermittent fasting, But I am a fan of chronobiology and working time restricted eating. So if we look at how the body works, We need food when we're awake. We need to be able to fuel and become stress resilient by fueling our body throughout the day So that we can take on the stress, acquire it, adapt to it, and then stop eating after dinner so that we Body can completely repair and be stress resilient the next day. So, you know, if you want to hold on to the idea of intermittent fasting, then we say a 12 and 12. You know, you stop eating at 7, and you have breakfast at 7. Perfect. But a lot of people are like, well, I I'm gonna do time restricted eating. It's like, great.

Dr. Stacy Sims [01:02:49]:
Well, then Have breakfast, have snacks, have lunch, have dinner, then stop eating after dinner.

Ali Shapiro [01:02:55]:
I love that. I I just feel like Intermittent fasting is another way to say dieting, but because men are doing it, it's called intermittent fasting for biohacking.

Dr. Stacy Sims [01:03:03]:
You know? Like I know. It's crazy.

Ali Shapiro [01:03:06]:
But that's it it's like to me, it just all comes back to, like, follow nature's rhythms. Like

Dr. Stacy Sims [01:03:11]:
Yes. You

Ali Shapiro [01:03:11]:
know? It's like, you need breakfast in the morning. The sun's coming up. I love that you mentioned chronobiology because I was like, that Sounds like the emerging field of chronobiology would probably map to that too. I love that. I love that.

Dr. Stacy Sims [01:03:23]:
And we see we see seasonal changes too. It's like With the wintertime, our circadian rhythm shifts a little bit, and we see a little bit of a decrease in our metabolism and an increase in the Criving for carbohydrate because it's dark and we're cold. Yeah. And then summer right? And then summertime comes and you have more daylight exposure, you're more active, Div, your body's metabolism is a with elevated if you're not in air conditioning all the time. Right? So there are we see these seasonality changes in our metabolism and our Rhythemes. So for eating during the day when we're awake, we're still falling into those seasonal variations.

Ali Shapiro [01:04:03]:
I just I love that. I love that. So I'm curious. I said I just did wanna ask you 1 weight question is, like, how do you approach weight loss? Because, like, when I think of my experience, went into pregnancy really healthy, ate really healthy, had a really empowering birth. Right? And then I said everything kinda went off the rails. And so some of I've lost, Like, 25 pounds of fat, but 20 pounds total because I put yeah. I put on 5 pounds of muscle. But I still have, like, 10 pounds where I'm like, Okay.

Ali Shapiro [01:04:31]:
Maybe I could lose 5 more of this. I don't know. But it's like and and, I mean, that's my experience, but I feel like it it's The the tension is some women like, what is the tension of accepting that your body's gonna change a little bit versus when is it Like, I do think the weight that I lost was unhealthy. Right? Like, when I went on the decks when the InBody, it was like I had a lot of visceral fat, and I still need to get down a little bit. So how do you approach that conversation with people when it's like, when is this you're just being unrealistic versus this is a health issue? I'm just curious your Your thoughts on how you think of that.

Dr. Stacy Sims [01:05:08]:
Yeah. I I never bring up the question of weight. I'm always about fueling for performance, And then let's look at sleep hygiene. So if someone has a bit of extra visceral fat and we need to bring that down, then I focus the training on Heavy resistance training and sprints because that's what we have more crosstalk of extra kinds to help get rid of that. And then I have them decrease around a 150 or so calories from dinner. Most of the time, it's booze, like if you're having glass of wine. Right? Just so we so we bring it to the 90 10 rule instead of the 80 20 rule. So 80% of the time, you're spot on, 20% is life.

Dr. Stacy Sims [01:05:50]:
But if you're trying to lose that little bit of extra, then we switch it. 90%, you're really conscious of fueling for performance and being very stress resilient. And then the 10% is going out to dinner, having with here and there, having some dark chocolate, like living life so your whole life isn't consumed by Being fitspo. So yeah. And so then that really starts to feed forward to getting into optimal body composition and health. But if someone comes to me and is like, I need to lose 10 pounds. I'm like, why are we looking to lose 10 pounds? Was are you looking at your 1 year old weight, or are you looking at your 40 year old weight and now you're 45? If we're looking at 40 year old weight and now you're 45, okay, well, let's let's Fudge some things around the end of the day so that we have a slight calorie deficit and a higher protein intake, and we're gonna do that and do 6 week blocks. And we'll have a bit of recovery.

Dr. Stacy Sims [01:06:43]:
And so if we're doing it in a short duration of a 6 week block of really focusing, people can usually do that. 6 weeks, I can do that. I can give up my wine for 6 weeks. I can increase my protein for 6 weeks, and that's long enough for them to see an absolute change. And then they are like, do I wanna put that wine back in? Well, yeah. Maybe I do. And so then it it graduates, but they settle into an optimal weight.

Ali Shapiro [01:07:09]:
I love that. And then, also, if you do have a lot of weight to lose or even 20, 30 pounds of visceral, whatever, it also gives your body a chance to, like, adapt to The lower weight because

Dr. Stacy Sims [01:07:20]:
Yes.

Ali Shapiro [01:07:21]:
So I like that too because I've I've gone it's taken me about 2, two and a half years, I don't even remember, to To lose all that, but I've gone in and out of, like, tracking, and then I'm like, I don't wanna track anymore. I mean, I'm still doing my protein, but it's like then I just maintain, you know, and it's For a while.

Dr. Stacy Sims [01:07:46]:
Yes. Yes. And, I mean, we you look at any elite athlete, and when you're seeing them perform, they're up their optimal, But it's not necessarily healthy. You see actors and actresses Food. Right? When they're coming out for a movie, they have trained specifically to look like that for the role. But then the other times, they don't look like that. And so when we're looking especially at the elite performance, we see body weight and body composition change across the year. But for the general population, everyone has this idea that they have to look a certain way and they have to be a certain weight every day they wake up, and that's not right.

Dr. Stacy Sims [01:08:22]:
Like, you wanna put a little bit on in the winter because you need it, and then it'll come off as you get more active in the summer. And that's fine. That's fine. Your body needs that. And when I'm working with elite athletes, I'm like, I always want you to go into the beginning of competition heavier than what you want to be So you can afford to lose that weight and not get sick.

Ali Shapiro [01:08:43]:
That's so fascinating. My parents are so thin, and they're They're 80, and I'm like, I'm so afraid a virus is just gonna, like you know? They're not frail. I mean, they've they're they're healthy and active, but they're they Keep getting thinner and thinner every year, and I'm just like, oh my god. Oh, stop.

Dr. Stacy Sims [01:09:00]:
Just give you lift some weights. Let's help you lift some weights.

Ali Shapiro [01:09:04]:
Yeah. Well, they yeah. Yeah. They do, but it's still like, oh my well, probably not enough. So 2 last questions. Where do you think research on women is going. And how are you leading the charge? Because I know you're gonna be out in front. So

Dr. Stacy Sims [01:09:18]:
Trying to. I was really happy to see that there's a group of us that went to congress in September to present on women's health and Especially in the military space, like, we need to upskill because there's so many discrepancies for women in the military and you're as a As a nation, the US is having a really difficult time bringing people into the services because the men aren't fit enough. So now they wanna tap into the women. I'm like, well, if you're bringing women in, you need to pay attention. So we presented, and there were a lot of people there. And then 2 weeks later, Joe Biden's office is like, hey. We're Putting this big women's health initiative in. So now there's all these calls for proposals and research, so we're gonna see this big huge boom in women's health research.

Dr. Stacy Sims [01:10:05]:
So I'm super excited about that. In the female athlete and lifestyle medicine space, we're seeing more and more researchers who are actually gravitating to that instead of it being a subspecialty. So now we're seeing a younger generation who are like, I'm specializing in women and lifestyle medicine, so I wanna specifically look at Women in perimenopause versus late postmenopause, what are the dosages we need for exercise? What is it

Ali Shapiro [01:10:34]:
that we need for bone health. So all the things

Dr. Stacy Sims [01:10:34]:
that we're like, why hasn't this been done before are now being done. Like, there was a study that came out looking at oral contraceptive pills and Septic pills and how that can change brain morphology. So it's it it's reversible, but if we're talking about all the young girls that are being put on at 16 and their brain is still developing, it might be an issue. So these are the things that are coming out. So over the next 5 years, I'm so excited about everything that is coming out because we're seeing these pockets of really sound research and drive specifically to look at women Across the biomedical sciences and exercise sciences.

Ali Shapiro [01:11:12]:
I love this. I'm like, this is why we need diverse people in science So that people know, hey, to look at this. Hey, this, you know, this matters. So that's so exciting. Oh my god. That's That's wonderful. So you've done a lot of interviews, and, again, I'm so grateful for you coming on here. This has just been such a a highlight for me.

Ali Shapiro [01:11:31]:
Are there any questions that you're surprised no one has asked you or that you're not asked more often?

Dr. Stacy Sims [01:11:37]:
Actually, it's a good one. Question? What? That one you just asked? No. I don't think so. I think because I'm starting to get more into lifestyle medicine and people are saying, well, how do you take this into someone When a general population when you work with elite athletes so much, like, I don't really work with elite athletes so much. I work with all athletes. Like, people who want to be active or who are already active. If you're exercising on purpose, you're an athlete. But now I'm really no one's asked me about ethnic differences or multicultural differences or the sociocultural aspects of going through menopause and perimenopause.

Dr. Stacy Sims [01:12:19]:
So that's an interesting one because most of the research is done on cis with women. And we know that there are ethnic differences. We know that there are cultural differences and how it's approached. We also see that, you know, if you have something like a food desert And you're growing up and you're going through a food desert and you don't have access to all the foods that you should be eating, and how do you get increased Protein, how do you get active? Well, yeah, that is a completely different question, and we can look at playgrounds. What do playgrounds have that we can do some resistance training with? What kinds of stuff can we get when we only have a 711? Like so those are some of the questions that still need to be addressed, and I get asked. And then sometimes I put on the spot, but I'm like, okay. Well, if we take all these concepts and we put it into that person's situation, understand their cultural and sociocultural Surroundings as well as how they grow up and how they view things, we can make an impact.

Ali Shapiro [01:13:14]:
I love that you bring that up because there's a lot of, You know, articles and research about black women having worse experiences in perimenopause and menopause because of the racial weathering that they go through, You know, that that it just it's almost like menopause becomes this cauldron because you can't like you said, you become sympathetic dominant. You know? So it's like you can't handle stress the same way, so I I think that's so important. I'm I'm glad you brought that up because that's something that I think when we when we look at The people who have been, I don't I guess, marginalized even when you when you work at the margins, though, everyone benefits. You know? So it's like we need to understand that Even if you're not black or Latino, like, looking at that is gonna make it better for everybody. I think people need to understand that.

Dr. Stacy Sims [01:13:58]:
Ben and I get frustrated with menopause hormone research because it's primarily done on upper middle class white cis women, And they're all given the same dose of estrogen, like, between 15 and a 100 microgram doses, and that's not appropriate. Because if we think about women's hormones across their reproductive years, it varies. It also varies by body fat. It varies by stress. We'll see perturbations. Right? So if I'm someone who's had the low end of estrogen all the way through and then all of a sudden I'm given a 100 microgram doses, that might not be Appropriate might be too much. And it might increase, so, hyperplasia and increase my visceral fat. But no one's looking at that kind of dosage.

Dr. Stacy Sims [01:14:41]:
Right? And then when we bring in other populations and how does that synthetic estrogen work in different ethnicities, we're seeing a Big, huge disconnect on is menopause hormone therapy working or is it not? If it's not working, what are the populations? So we see it doesn't really work that well In Pacifica or African American or Asian part of it is differences in the genetic and Responses to it, but also part of it is the sociocultural aspect of why am I taking a synthetic hormone. So it's a misstep in the attrition of it too. So there needs to be a whole bunch more research done in that area.

Ali Shapiro [01:15:20]:
Oh my god. Yeah. Everything's so much more complicated than we think than We think. Right?

Dr. Stacy Sims [01:15:26]:
I know. It is. Totally.

Ali Shapiro [01:15:28]:
Well, Stacy, thank you so much for your time. I just I'm, like, on cloud 9.

Dr. Stacy Sims [01:15:34]:
It's so fun and refreshing. Thanks for having me.

Ali Shapiro [01:15:37]:
Good. Yeah. Yeah. Anything else you wanna say that I didn't get to?

Dr. Stacy Sims [01:15:43]:
No. I don't think so. Check out Next Level?

Ali Shapiro [01:15:46]:
Yes. Yes. And you had have the new release of Roar. Yeah.

Dr. Stacy Sims [01:15:50]:
It came out last week. Yep. So all that's been updated because we wrote that when my daughter was 2, and now she's 11. And there's been a lot of research has come out in the past 4 or 5 years on with, so we've upskilled it. We put imperial and metric in there because those are the questions we always got. Right? A big news section on biohacking and how sleep, sleep hygiene, Body composition changes, what is protein, how do we implement with, and we've taken it dialed it back from just elite athletes into more general pop. So, yeah, I'm pretty proud of it.

Ali Shapiro [01:16:25]:
Yeah. And I love I did wanna circle back. I love that you talked about athlete, anyone who is, like, moving. Because your cowriter, Selena Yeager, she had someone on, and they were like, you look up a definition of an athlete in the dictionary, and it's like Someone who moves. They were talking about the golfers who, like, drink and smoke, and they're considered athletes. So I I want people to know your books Apply to definitely apply to them no matter where they are. You once you start moving, you're an athlete. Right.

Dr. Stacy Sims [01:16:51]:
Your players are athletes. Right?

Ali Shapiro [01:16:53]:
Yeah. I didn't know that. Yeah. So wonderful. Yeah. Everyone next level was a lifeline. It saved my life, I swear.

Dr. Stacy Sims [01:17:04]:
Thank you. I appreciate that.

Ali Shapiro [01:17:06]:
Yeah. Yeah. And we'll put links To the books and Stacy, and can where can people find you if they wanna find more of you?

Dr. Stacy Sims [01:17:13]:
Our website is pretty inclusive where it tells, Like, you can sign up for our newsletter and get the blogs and stuff free. So I Truce to dive into the most recent science and talk about an article or 2 every couple of weeks. You can look and see what I'm up to. We have all the resources and bibliography for both books on there. But if you're like, I don't wanna go to website, you can follow me on social. So Instagram and Facebook's doctor Stacy Sims.

Ali Shapiro [01:17:39]:
Okay. Great. And, again, we'll put all the links in the show notes so people have easy access.

Dr. Stacy Sims [01:17:43]:
Thank you.

Ali Shapiro [01:17:45]:
Yeah. Thank you. Thanks so much for being here, Stacy.

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