Cycle Syncing, Fasted Workouts & Fitness Myths Women Are Still Falling For with Dr. Lauren Colenso-Semple, PhD

The fitness industry has made women’s health feel unnecessarily complicated. We’re told to cycle-sync our workouts, avoid training fasted, wear weighted vests, track every body-composition metric and constantly adjust our routines based on hormones, cortisol and the latest wellness trend.

In this episode, Dr. Lauren Colenso-Semple, PhD,  joins us to separate fitness fact from social media fiction. We break down whether women actually need to train differently than men, what cycle syncing gets wrong, whether walking counts as exercise, and what strength training and cardio should realistically look like.

We also get into creatine, protein needs in midlife, HRT and muscle loss, body recomposition, DEXA scans, smart scales, grip strength, weighted vests, fasted workouts and the growing and concerning-world of unregulated wellness peptides.

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DISCLAIMER: Nothing mentioned in this episode is medical advice and should not be taken as so. If you have any health concerns, please discuss these with your doctor or a licensed healthcare professional.

Transcript

SPEAKER_01 0:06

If you're doing all the right things, eating clean, taking the supplements, following the skincare routine, and you're still breaking out, bloated, burnt out, or just feeling off, you are not the problem. The problem is that the wellness world wasn't built for real women with real bodies, real stress, and real questions that deserve better than vague advice and viral wellness trends.

SPEAKER_02 0:29

Welcome to Girls Gone Wellness, the No BS podcast cutting through the noise with science, SAS, and Zero Shame. I'm Jeanette.

SPEAKER_01 0:36

And I'm Victoria, and we're naturopathic medical graduates who didn't just wake up one day and decide we were into wellness. We've spent the last decade learning the science, doing the clinical work, and graduating with a degree.

SPEAKER_02 0:48

This isn't just another influencer podcast. We're not here to sell you a greens powder or to tell you to balance your hormones with seed cycling and good vibes. We're done with fear-mongering around food, detox teas, clean beauty BS, overpriced supplements that you don't need, and the biggest lie that you are the problem when it doesn't work. No, we're flipping the script.

SPEAKER_01 1:10

This is Girls Gone Wellness. Smart, sexy, science-backed, and built for women like you.

SPEAKER_02 1:56

So today we're asking a much simpler question. Out of all of that noise, what actually matters? Today we're joined by Dr. Lauren Colenzo Semple, a researcher with a PhD focused on female physiology, exercise, and nutrition, who has become one of our favorite voices for cutting through fitness misinformation and translating the research into advice women can actually use. We are very excited to have her on as she's been a huge source of inspiration and information for us. Today we're breaking down whether women truly need to train differently than men, why cycle syncing may be getting in the way of your progress, whether weighted vests actually build muscle and bone strength, what grip strength really tells us about longevity, and whether fasted workouts are secretly destroying your hormones or are completely fine. We also get into body recomposition, protein and midlife, HRT and muscle loss, creatine, smart scales, unregulated wellness peptides, and what an evidence-based week of training should realistically look like. We are so excited for you to listen. Dr. Lauren is a wealth of knowledge. Enjoy.

SPEAKER_01 2:57

Welcome to Girls Gone Wellness, Dr. Lauren. Thank you for having me. We're so excited to have this conversation. I feel like anytime a new trend hits social media, I just wait to see what you have to say about it. And I love how you do it. I love how you put a claim up, kind of what everybody is saying, and then what the research actually says. And so we were thinking for today, that's kind of where we want to take the conversation. We're going to give you what we've seen on social media, what our patients are saying, and just have you kind of debunk or tell us what's really going on with that. So super, super excited to get started. Before we dive in, I'd love for you to tell our audience just a little bit about how you got into this space.

SPEAKER_00 3:42

Yeah, I used to work in the fitness industry. And at the time I was really interested in the science because I wanted to optimize their results. And also at the time, I felt like there was a gap, particularly in the resistance training space, uh, in the research in women. So I decided to go back to school. I got a master's degree and subsequently a PhD. And my goal was to learn more about women and muscle and resistance training. And so over the years, I've done that in various ways at kind of the very practical level and also more at the molecular level. And these days I'm kind of combining my experience in the fitness industry, working with women and my experience as a researcher, and really trying to communicate the science in a way that is really helpful and practical and actionable for people.

SPEAKER_02 4:46

And I think your social media does just that. It's very actionable and it's very practical. How did you get into social media and like posting and like building a following there? I'm always curious how people do that in that space.

SPEAKER_00 4:59

Well, I spent several years doing a study on menstrual cycle phase and how the muscle responds to exercise during these different phases and measuring hormones. And it was this really big undertaking. And when I was finally wrapping up that project, I went to kind of share my results online. And it just so happened that this concept of cycle syncing had kind of exploded on social media. And so typically, you know, you share a new paper and two people like it. Um, but this paper got so much attention because cycle syncing had become so popular and people were really passionate about it. And so I got all of this really kind of heated pushback, just sharing the science. And that kind of led me to spend a little bit more time on social media. And what I realized was how much confusion there was in the fitness and health space, particularly aimed at women. And so it kind of stemmed from there where I thought I really empathize with all of these women who are just trying to improve their health and fitness. And there's so much noise in this space, and it's creating all these barriers. And this is not what we need to be doing because so few people are even close to meeting the physical activity guidelines. We need to remove barriers, not create them. And so, time and time again, I just saw people are focusing on the wrong thing, the thing that isn't going to move the needle. And the industry as a whole is really perpetuating this because they want to sell you a gadget or they want to sell you a supplement or they want to sell you a program. And so that was really what inspired me to be a bit more active on social media.

SPEAKER_02 6:51

I love that. Well, your work is so important. So thank you so much for that because I know people that are sharing the science, a lot of times they get a lot of pushback. And I know that that can take a toll. We've talked to a lot of people on the podcast who are doing this work as well. And like some of the things that they've talked about is like actually horrifying just by sharing the science and the evidence. So thank you for doing that. Thank you for your service, that way. Um, we're just gonna jump right into it. Obviously, there's this narrative, you know, that women and men are so different. Therefore, we need entirely different approaches to health and fitness. Is there actually a different approach to building muscle in women versus men?

SPEAKER_00 7:31

So at the muscle level, no. You know, male and female muscle, if you will, is responds very similarly. It adapts very similarly, and the same tools work regardless of your sex. But of course, there's always an individual level when we talk about any kind of exercise recommendations. And so what we want is to make sure that we're creating a program or giving somebody advice that is going to fit their lifestyle, meaning I shouldn't tell you that you have to lift weights five days a week if that's completely unrealistic for you. If two days a week is realistic for you, then we need to meet you where you are. Same goes for background and injury history and preference and access to equipment. All of those things should be taken into account when we're giving someone advice at the kind of individual level. But speaking broadly, no, we don't need sex-specific recommendations in how we should be lifting weights, how we should be building muscle, all of the kind of nutrient timing nuances, rep ranges, all of that. It's there are no sex-specific guidelines when it comes to those variables.

SPEAKER_01 8:45

Do you think that the gaps in women's research are contributing to that? There's like this space now for people to be like, oh, well, we don't have the research to say that this is the case for women. So maybe women do need to cycle sync, for example, or do all these things because we don't have that research. Do you think that's contributing to that at all?

SPEAKER_00 9:04

Well, I think people continue to say that even when we do have research. And so it's sort of become this line of, well, we have no research in women, but then that's usually followed up by a very specific recommendation about what women should do. And the reality is if there's no research, then what do we do? We look for related research or we wait for the research. So in a scenario where we we actually had no idea, but we knew what worked really well in men, if it's we do what works in men or we just make something up, then I think we should probably do what works in men. But this narrative that we have no research in in women just really isn't true. Of course, there's some gaps. Of course, you know, we'll always want more research. That's the way science works. You answer one question and then you ask three more. But I don't really like the the narrative that we have no data in women because at this point, and certainly we've come a long way in the past 15 years or so, where there was a time when I would say we definitely had more research in endurance exercise in women, fat loss in women, but a little bit less about resistance training and strength and muscle. And part of that was because women didn't lift weights. So there wasn't a lot of enthusiasm for conducting or participating in that research because it was going to be very difficult to recruit for those types of studies. And now more and more and more women are lifting weights. And we have a lot of research in women of all ages looking at some of these variables like rep ranges or rest periods or gaining strength over time and all of those questions that at one point you might say, yeah, we really have a lot of data in young men here, but but not so much in older men or younger women or older women. And now we've definitely filled a lot of those gaps.

SPEAKER_01 11:08

Yeah. Okay, that's good to hear because I know people say that all the time, still to this day. There's just no research in women. So I'm glad we clarified that. Um, I want to talk about a claim that is quite common, especially right now. I was actually reading a book recently and I saw this claim in it. So I'm interested to see what your answer to this is. But there's this conversation around muscle quality as being more important or more emphasized than actual quantity of muscle mass. And uh the claim that I'm looking at is that muscle quality is like that functional capacity and metabolic health of the muscle tissue. And I'm wondering, first of all, is that a thing? What do we mean when we say muscle quality and should we care about this?

SPEAKER_00 11:52

So there's two ways that we might talk about muscle quality. One way might be when we're actually looking at the muscle itself, are we seeing fat infiltration in the muscle? The other way we might talk about quality is measured as strength relative to overall mass. So that's more of the kind of functional piece, if you will. And it when we think about intramuscular fat, that's typically in people who are not exercising. So once you start exercising, then you're you're much more likely to lose some of that intramuscular fat. Uh, we see that with weight loss in general, right? When you lose a large amount of weight, you're losing some body fat, and you're also going to lose some fat in the muscle tissue if you have fat infiltration. When we think about the functional piece, the kind of strength relative to mass, uh, yeah, I mean that that's important. But again, that just means that we want people to be resistance training. And so when we think about muscle mass and strength, they are linked. So if you are training for strength, you're going to build some muscle mass. As you start to lose muscle mass, you're going to start to lose some strength as well. And so it's yes, it's about having it, building it, maintaining it, and using it. But the way that you build and maintain it is by strength training. So I think the conversation about, oh, well, we shouldn't be worrying about mass, it's about quality. Well, it's not like we have all of these people walking around with a huge quantities of muscle that they're not using for anything. Um, so I just think it's a sort of strange way to look to look at it.

SPEAKER_02 13:46

Yeah, I agree. I feel like we were talking to Alyssa Olianek about this. She's like, there's not an issue with having more muscle. It's more so like none of us have enough muscle. So yeah, that is kind of a funny way to look at it. Obviously, weight training is taking the spotlight, which is obviously important. But how important is adding in cardio or some sort of cardio training to your weekly workout split? And like, what should this cardio look like?

SPEAKER_00 14:10

So if you're somebody who cares just about overall health and fitness, we have a lot of flexibility here. So, you know, the physical activity guidelines will typically say, oh, you should be doing, you know, this many minutes of moderate intensity or this many minutes of vigorous intensity. And the moderate versus vigorous, again, if we're just talking overall health and fitness, this is primarily about time efficiency. And so the kind of good news about the moderate intensity is that so many things count. It doesn't even have to feel like structured exercise. You could be biking with friends or playing tennis or pickleball or something that feels like a social activity, but it's also a physical activity. And then if you are really crunched for time, then we can look at more of that vigorous intensity type exercise. But I think the the real point here is what will you do consistently? And so many people start running or start going to the gym and spending a half hour on the elliptical. And they hate it so much that they do it for a couple of weeks and then they quit. So I think the the message really needs to be about that and about consistency. And certainly we can get into the nuances of if you're training for a marathon, then we might want to look at training in these different heart rate zones. But I just think that conversation sort of gets really convoluted when we're talking just about general population, about overall health and fitness, and the idea that we should be tracking our heart rate or um or doing these different kinds of intensity zones intentionally. Can you do that? Absolutely. But is it necessary? And are most people going to do that sustainably for long enough for it to really make a difference? Not in my experience. Yeah.

SPEAKER_01 16:15

It's also so overwhelming to be online and it's like, okay, you have to do hit, you have to do zone two, you have to strength train, you got to do yoga, otherwise your cortisol's too high. Like, it's like, first of all, there's not enough time in a week to get all of this done. So um, I like how you kind of position that where it's like, well, what are you going to do? I am certainly not going to do a 30-minute elliptical. Like, it's just not realistic, but you're so right. I see so many people who do it for a couple of weeks and then they're like, oh, well, now I'm just not going to go to the gym at all because I hate it so much. So it's so, so true. I want to know: is walking enough? Like, do we need to be speed walking? Do we need to hit a certain heart rate? Does that matter at all? Or is walking considered exercise?

SPEAKER_00 17:02

Well, I think overall physical activity is a major contributor to long-term health. And we've seen this with studies around the world just looking at overall kind of lifespan, health span, it's actually not the people who are doing a ton of structured exercise into their 80s and 90s. It's the people that are just leading an overall physically active life. And that can be easier depending on where you live. If you live in a city where you're taking public transportation or walking just for day-to-day activities, then it can be really easy to just have that ingrained as part of daily life. But if you're living in a more remote location or driving culture, then we need to be a lot more intentional about how we kind of get in those physical activity kind of snacks, if you will, throughout the day. And so in some cases, we can say if you're in an elevator building, can you take the stairs? Or if we're driving to the grocery store, can we park far away from the entrance? And just kind of creating some of those habits throughout the your day and week, and they kind of become slowly ingrained. So you're living a more active life.

SPEAKER_01 18:15

Okay. Um, I want to dive into the trend about weighted vests, because I know you've talked about that a little bit on your social media. And I see I'm seeing weighted vests. I'm also seeing people wearing ankle weights more now on the treadmill. So I want to talk about this because there is a claim that A, you're burning more calories when you're wearing especially a weighted vest. There's also some talk about potentially building bone density from wearing a weighted vest or even just enhancing your cardiovascular endurance. Is any of that true?

SPEAKER_00 20:23

Okay, so there are a few things to break down here. The the claims about muscle and bone density. If you are wearing the weighted vest to do a resistance training type exercise, so I'm doing lunges and this is my resistance, I'm doing squats and this is my resistance. If the vest is heavy enough that it's an appropriate stimulus, then could it be effective for muscle or for bone? Yes, it could. But walking is not the same thing because walking just isn't a suitable stimulus for muscle or for bone, with or without the weighted vest. In terms of burning more calories, this actually applies across the board with any kind of cardio type exercise, not just walking, not just the weighted vests. Uh, whenever we think about, oh, how many calories am I burning from this exercise session? Often we're looking at a wearable. Wearables are notoriously awful at actually estimating that. I mean, so off that I would discourage anyone from even looking at those numbers. Because if you're using that number to then guide decisions that you're making about caloric intake, everything can go completely haywire. So I would never focus on how many calories we're burning either in a day or in a workout because those metrics will be completely off. And the truth is that once we actually start a cardio type exercise program, we often subconsciously move less for the rest of the day and eat a little bit more for the rest of the day. And so if we are just doing the exercise and not really paying attention to the diet, the weight loss that we might calculate or anticipate is far less than than than what we would hope for or expect. And so I just think that looking at exercise as a way to drive weight loss and burn calories is really the wrong lens. If we want weight loss, we should really be focusing on changing the diet. And certainly we want the exercise along for the ride. Um, it's going to help with maintaining that weight loss. And if you are strength training, then it's going to help us maintain as much muscle as we can while we are losing weight, but it doesn't drive the weight loss.

SPEAKER_01 22:56

I almost think there's something freeing about that. Like it's nice to not have that in your mind, like, okay, I need to go to the gym to burn off whatever meal I'm gonna eat today. It's just go to the gym because of all of these other reasons. It makes it a little bit more doable and more fun, I think, for people too. So I like that kind of perspective on the conversation. What about jumping for bone health? I see a lot like in perimenopause, menopause, people are talking about doing more like jumping based exercises. Is that true?

SPEAKER_00 23:29

So you can do that, but we don't have evidence to suggest that it's better than the Kind of stimulus that you get for a bone from lifting weights. So if you enjoy jumping, then you certainly can. But if you're somebody who has a previous risk of fracture, current osteopenia or osteoporosis diagnosis, or you're dealing with urinary incontinence, then it's might not be a good fit. So I don't think we should all assume that we have to do jumping type exercises. The other thing that's important to acknowledge is there's a study that is commonly cited when we talk about bone. It's called the lift more trial. And the women in this in this trial were lifting very heavy barbell weights and doing these straight landing jumps, meaning they were hanging from a pull-up bar and dropping to the floor as hard as possible with their legs as straight as possible. It was effective, but that's not the way that people are typically performing jumping exercises. Frankly, it sounds quite risky to me, and that's not an exercise that I would do myself or suggest that others do. But it was more of a proof of concept of concept. And the point is they were trying to put as maximal force as possible on the bone. When we think about traditional plio-type exercises, often we're landing in a deep squat. When we land in a deep squat, a lot of that force is absorbed by the muscle and the connective tissue and not so much the bone. So when we think about that type of exercise and how we should actually structure it and if the bone is really absorbing maximal impact, it gets a little bit more convoluted. The other thing I'll say is when we think about bone, we're often thinking about bone density, right? So our bone mass peaks in mid-20s, let's say. And then we're trying to kind of maintain what we've got for the rest of adulthood. And exercise, whether it's impact or lifting weights, certainly can help with maintaining that bone density. But as we get into midlife and beyond, we also care about bone density as a proxy for fracture risk. So then we need to think about fall prevention. And so one of the best things we can do when it comes to fall prevention is some sort of a balance component to our training, which if you are doing strength training, you can incorporate that with a single leg exercise or something like a walking lunge where you are moving through a full range of motion under load and you are also needing to balance yourself. And so I would prioritize that more so than the jumping. Okay.

SPEAKER_01 26:10

I love that you said that. I feel like that's not talked about a whole lot. And then I think when we talk about balance, I almost think more of like the whole like Pilates and core idea. But are you saying so it would be more like the single-leg lunges, like that sort of thing, part of your resistance training?

SPEAKER_00 26:28

Yeah, I mean, there's various ways to do it. But but remember, what we want to think about is if we were, you know, going up or down the stairs and we we just kind of misstep. And can you catch yourself? Um and or, you know, if you slip, can you catch yourself? So it's really about being able to kind of be reactive and land on one foot and and have a good kind of overall sense of kinesthetic awareness. Where is my body in space? And having the the strength and the range of motion that you would get from strength training really allows for that in a kind of quote unquote functional way, if you will.

SPEAKER_01 27:09

Okay, I like it. The last thing on this topic that I want to address is grip strength. Um, I saw a claim, and I don't, I do not know the evidence of this at all, um, saying that grip strength is often a better predictor of lifespan than even blood pressure. I don't know if that's true. That sounds pretty wild. Wow.

SPEAKER_00 27:34

Yeah, so I mean, this is the longevity is such a buzzword these days. We have this data on grip strength and lifespan or length of life or mortality, because the way you measure grip strength is with just a little kind of handheld thing that people can squeeze. So you don't need any sort of skill the way that you might to if we were to say do a squat or um if we were to do a running test or some kind of other exercise test. So you can do it if you are hospitalized, you can do it if you are on bed rest, you can do it if you are at the very end stages of life, you can do a grip strength test. So we have it and it's portable, and you can do it literally anywhere. So that's why we have a wealth of grip strength data, because it's easy to measure and you can do it in people who are ill and there's there's no sort of learning curve in order to get a valid test. But really, it's a kind of proxy for overall strength. And so just because we have this association between grip strength and longevity, all that means is that we want to be prioritizing muscle mass and strength. And the way that we optimize that is by lifting weights, making sure it's challenging, progressing over time, staying consistent with that, being overall uh physically active. There's no reason to actually train your grip strength. And so I feel like that's where there's a disconnect with this messaging. The again, we we have that data because it's it's easy to get. And so we have a lot of it. And that's why you're able to kind of make those associations. But there's nothing actually magical about grip strength in and of itself. You'll have a stronger grip if you're a stronger person.

SPEAKER_02 29:23

I was gonna say, like, you can kind of just infer that, like, if you have a better grip strength, you probably have more muscle. You're probably someone that does resistance training, right? Okay. Yeah, that's what I thought. Awesome. I know you're probably asked this on every single podcast you go on, but you're truly the expert in this field. So we have to ask you your thoughts on cycle syncing. Obviously, does the cycle impact training on any level? I think we've talked about this a lot with our audience, but I would just love to hear this from you because you have the perfect answer.

SPEAKER_00 29:54

Well, when we look at the cycle syncing recommendations that you often see online, they're kind of cookie cutter, this is your follicular phase, or because estradiol is high in this week or this couple of days, then we should be doing this. All of those recommendations are not evidence-based. So, any kind of pre-planned change to the type of exercise you're doing, or the intensity of the exercise you're doing, let's not, let's not implement any of those types of pre-planned changes because a lot of those programs really encourage inconsistency because they're saying, oh, for this week, you should be switching everything up. At the most extreme level, they'll say, for this whole week, you should just do yoga and light stretching. Or for this week, you, you know, this is when you should be lifting weights. And when we're changing things up so frequently, then we aren't getting adaptation. We need consistency in order to adapt. So that is actually kind of delaying your progress if you're just constantly switching what you're doing. Now, are there times during the cycle where some women might feel weaker or feel worse due to menstrual symptoms? Yes. Typically it's one or two days at the very beginning of your cycle. So when you start your period, or at the very end of the cycle before you get your period. And if you want to skip the gym or switch out and exercise or adjust the intensity for that workout, that's completely fine. You also might find that even though you weren't feeling great, but you showed up to the gym anyway, and you're actually able to get through that workout just fine, and you might even feel better for it. So I would keep it completely open and you'll, and also not don't expect that it's going to be a terrible workout because you're in one phase or the other. I think one of the most harmful aspects of this type of messaging is that you have these what these women who are looking at their cycle tracking app, and then you know, they're saying, oh, well, it's week three or week four, or this is my luteal phase, and therefore I it should anticipate worse performance. I need to be resting. And there's no evidence to suggest that's true. And certainly in what I've heard from many, many, many women is there's some women who feel the strongest on day one of their period. And there's other women who feel like they can barely do anything physically active on day one of their period, and there's everything in between. So we really need to individualize this and not set any sort of expectations for when you should or shouldn't push. We need to allow for pushing through on rough days if that works for you, backing off on rough days so you have that option. And frankly, I think I would say this in general across the board, because there is a variety of reasons outside the menstrual cycle why we might not feel our best or be as motivated to train. And that's completely fine. So having some kind of component of auto-regulation is completely a valid approach, but also being okay with saying, I'm gonna show up today, and it doesn't have to be a 10 out of 10 workout because an eight out of 10 workout is still a very productive use of my time.

SPEAKER_02 33:31

I love that. I know I always find it so interesting, like in the week three or week four, when people are like, oh, like you should just be lying down or doing yoga. But it's like if you feel fine and you can go to the gym and you could maybe even do a 10 out of 10 workout, but you're like, oh, like if I do that, my hormones are gonna be all over the place. Like that's really putting us at a disadvantage, especially when we know for women, bone density, muscle strength, all this is so important. And if we're only lifting weights one, maybe a few days out of the month, really, if you look at it, like how are we even gonna build muscle, right? I would think that's pretty impossible to do.

SPEAKER_00 34:04

But yeah. The other thing that it's really important for people to understand is a lot of these cycle syncing programs or messages will say, on day 12, your estradiol peaks. And when we look at what you might see in a medical textbook, or if you just Google menstrual cycle hormone fluctuations, you'll see this very kind of pretty picture. The cycle is 28 days. It's divided neatly into these two phases because ovulation is right in the middle. And I can tell you, having measured hormones in so many women across so many cycles, I've only ever seen something that looks like that image once in one person, ever. So you can be you might be a woman who ovulates on day 10 or on day 20. Maybe a 21-day cycle is normal for you. Maybe a 37-day cycle is normal for you. There is so much more variability than anyone acknowledges when they're having these conversations about cycle sinking.

SPEAKER_02 35:01

Wow, that's so funny. To be that one woman, that's so funny. Is there any truth to being able to actually spot and reduce fat? I would also love you just kind of to break down the terms like toning, increasing lean muscle. Are these kind of the same things as well?

SPEAKER_00 35:21

Yeah. So when we think about changing, changing body composition, right? When the term toning is typically used to describe somebody who wants to gain a little bit of muscle and lose a little bit of fat. So you have those kind of visible lines a little bit. You can kind of see the shape of the muscle. And so those require those two separate goals. And a muscle-building goal, we're going to want sufficient calories. So probably maintaining our body weight and making sure that we are getting that consistent, challenging resistance training. For fat loss, then we'll want to adjust our diet so that we're in a calorie deficit. And when we're in a calorie deficit, then we're really trying to just maintain the muscle that we already built. So what I would say for somebody who has both goals, it's let's prioritize one at a time. So I'd love if you would try to just maintain your body weight. Don't worry about fat loss right now. Really focus on that progress in the gym. Do it for months because that's how long it'll take. Muscle growth is slow. And then once you've built that muscle, then let's go into the fat loss phase and really focus on maintaining what we've built. And that's the way that you'll actually see real changes and visible results. But it takes patience.

SPEAKER_01 36:42

That's good to know because I feel like, I mean, Jeanette and I have always talked about that. Like, is it physiologically possible to recomp in the way of like building muscle and also losing fat at the same time? I think is it physiologically possible? It's just not necessarily recommended.

SPEAKER_00 36:59

It's possible, but it's highly so it's possible if you are someone who A is brand new to lifting weights. Right. So you haven't trained before. And B, you have quite a bit of fat to lose. So that is the scenario where yes, we would anticipate that. And we might see it for, let's say, three months. And then you're going to be kind of trained enough that we wouldn't expect to see a lot of that moving forward. And then the flip side of that is if you're somebody who doesn't have a lot of fat to lose, then we're we're probably not going to see too much of that either. So it is possible, but if you've been training for quite a while and you you don't have a ton of weight to lose, then I would really focus on what I recommended before. Like let's prioritize one and then prioritize the other.

SPEAKER_01 37:53

Okay. Now these recommendations when it comes to strength training and protein and all the things that we talk about, does that continue into midlife with perimenopause or menopause? Or does the approach need to change? We hear things like protein resistance that happens in perimenopause, menopause, where you have to consume more protein. Um, does the strength training prescription need to change? What's kind of happening at midlife?

SPEAKER_00 38:22

So the principles still apply. So we need a calorie deficit for fat loss. We need effective progressive resistance training for muscle growth. And the most important things here is that is that we are continuing to be consistent and goal-oriented. So I know there's so many distractions about, oh, now that you're in midlife, you have to lift three to five reps. Like that's not true. You can do a hard set of 15 or a hard set of 10 or a hard set of five. It's all effective. We just need to be training hard enough, meaning each set we're getting close enough to failure. So it's an adequate stimulus for muscle. What we see in older people is if they're consuming, let's say, 0.8 grams per kilogram of body weight of protein per day, if we bump it up to 1.2 grams per kilo, we do see a meaningful benefit of that bump. But now on online, there's a lot of conversation about 1.6, 1.8, even 2.2 grams per kilo or one gram per pound. And the the evidence is pretty clear that regardless of sex or age, once we get beyond the 1.6 grams per kilogram body weight of protein, there's really diminishing returns. So if you just really like eating a high protein diet, then that's fine. But we want to also make sure that we're looking across the board at the diet as a whole. And so I think that the hyper focus on protein is sometimes coming at a cost because now we're forgetting about fiber. And so, especially when you have somebody who's on a GLP1, for example, and you're eating far fewer calories, you need to be really intentional about how you're filling those calories. And if we're all we're thinking about is protein, then we can end up with some micronutrient deficiencies.

SPEAKER_02 40:17

Absolutely. I love that approach. There is this claim, uh, it's a pretty big claim that in menopause, premenopause, you need HRT to prevent muscle loss. So is there any research on like adding in hormone therapy and it being able to maintain muscle mass or even for people to like gain further muscle mass?

SPEAKER_00 40:38

Yes, there is there is research on this. And I'll say, no, hormone therapy is a definitely viable evidence-based option for symptom management. And symptom management is something that we should all really be mindful of, or if if anyone is working with perimenopausal women, that's the big challenge. So it's not about we need to eat differently or train differently. It's if you're somebody who's really struggling with symptoms and those are affecting your sleep on a chronic basis, then the downstream effects of that can be really meaningful in terms of our adherence to a diet or a regular exercise program. So we definitely want to try to address symptoms if we can, and that hormone therapy is certainly a viable option for that. Now, when we think about these other claims around hormone therapy, and muscle mass is definitely one of them, that a lot of these are really overblown. So people are worried that if they're not on taking hormone therapy, that they're somehow missing out on health benefits. And I see messaging around around, oh, you know, this is good for um decreasing cardiovascular disease risk or dementia risk. And we don't have that data. And certainly when we look at muscle, whether you are on hormone therapy or not, the age-related decline in muscle mass happens. And so the only way, the tried and true way to attenuate that loss is to make sure that you're lifting weights.

SPEAKER_02 42:07

So it comes back just to making sure that you're doing resistance training and lifting weights.

SPEAKER_00 42:11

Yeah. And the other thing I'll say typically when we're talking about the hormone therapy, it's an estrogen-based hormone therapy. Yeah. But now there's a booming interest in testosterone for women. Yes. And that is, depending on where you are in the world, it's it's typically approved in some locations for low sexual desire in post-menopausal women. But now there's a lot of perimenopausal women who are thinking that they should be taking testosterone for muscle benefits. The key point is that when we think about how you might even want to use testosterone in the context of sexual health, it's about very, very low levels because we actually don't want to exceed what would be kind of normal physiological levels of testosterone. When we exceed that, can we get muscle benefits? Yes, we can. And that's what you see in bodybuilders using testosterone. However, when women do that, we end up with some unwanted side effects, hair growth where you don't want it, deepening to the deepening voice, um, clitoral enlargement. And some of these are irreversible. And so we don't want to be using testosterone um in a way at doses that would end up helping us grow or maintain muscle because it it comes with these undesirable side effects.

SPEAKER_02 43:41

That's the big problem with social media, especially like any sort of hormone replacement or hormone conversation, a lot of this nuance and the side effects gets lost. So I'm I'm glad that you touched on that. How important is it for us to track our muscle mass, like and our bone density, I guess? Like, should we all be getting DEXA scans? Is there another way to track it? What do you like to tell your clients?

SPEAKER_00 44:05

Well, for bone, I think it it sort of depends on how you see your risk. So some people will say, Oh, you know, I want to just get it, I want to get a DEXA just in case. And you you can do that, but is it necessary? It depends. You know, do you have a family history of osteoporosis? Do you have, did your mom have some fractures? Do you have a previous fracture? Are you a smoker? Um, are you a heavy drinker? Do you have a low body weight? Those are kind of risk factors that we might say for low bone density. And so you might want to keep those in mind when you're thinking about, oh, should I get a scan? Should I not? But the the thing about tracking that over time is sometimes people will think, oh, well, if my if my bone mineral density score, my that T score, if it didn't change, then I'm a failure. And I even though I just I started lifting weights, I've been doing everything right, but it didn't change. And that's the wrong way to look at it because we aren't, we shouldn't anticipate gaining bone in midlife, even with exercise. You can with exercise and medication, that's a lot more realistic, but it's really about slowing bone loss. So if it's not changing, then that should be viewed as a win. I don't recommend ADEXA scan for tracking muscle size or muscle growth. Um, ADEXA. It is quite good for bone, but what it does is measure bone, fat, and everything else. And so, yes, muscle is included in everything else, but so are your organs and total body water. And so when you're thinking about tracking it for one person, there's a lot of variables that can make it not very reliable for tracking changes over time. And so when I think about how what the metric that I'd prefer you to use, it's really progress in the gym. So if you're getting stronger, that's a very good indication that we're moving in the right direction from a muscle perspective.

SPEAKER_02 46:16

Okay, I like that. Me and Vic actually got DEXA scans last year. And I'm glad that you touched on that because when they went through our report, for me it was like, oh, you have like a hundred pounds of muscle. And I was like, yes, like I got a hundred pounds of muscle. And now I'm thinking, oh, it's probably was just like my organs. So it's fine.

SPEAKER_00 46:32

And the other thing, while we're while we're on that topic, people will use those smart scales too. And those smart scales will spit out numbers about lean mass and things like that. But they are only measuring, like basically it's sending a current up through one leg and down through the other. And so it's not even really accounting for a full body. And so those are even worse at tracking changes over time. And so use the scale, but ignore those other numbers. They're they're they're not great at tracking changes over time. So highly influenced by hydration as well. So you can get on one of those scales, you can get off, you can drink a bunch of water, you can get back on, and you just gained muscle. Oh gosh. Okay.

SPEAKER_02 47:15

So not recommended for patients. Okay.

SPEAKER_01 47:19

I have one of those smart scales, and it's funny, it's like said my bone density was so good. And like I don't know how it's tracking that, but okay. And then it said that my body fat percentage was like a certain amount. And then when we did the DEXA, all those numbers were completely different. Like, okay, so what is the point of spending more money on these smart scales when clearly they are not accurate?

SPEAKER_00 47:41

Yeah, and I think sometimes we get so bogged down in these numbers that then you're kind of focusing on the wrong things because like, you know, who cares what your body fat percentage is? And then certainly to your point, depending on the tool you use to assess it, it could be widely different. Like, but but ultimately it's not really about the number, the same way that it's not about scale weight when it comes to a number. If if what we care about is, you know, just overall body composition, how we look in the mirror, how our clothes fit, then that is a much more productive conversation around changing body than I think really being hyper-focused on the numbers.

SPEAKER_01 48:21

Definitely. Um, okay, so this is a question I've been excited to ask you because when I was prepping this episode, I did a little search on fasted training on Instagram to see what people were talking about. And I found a couple of claims about fasted training that I want to address. So one of them is that fasting training, fasted training just does not work for women, uh women specifically, that fasted training can raise your cortisol, which contributes to fat gain around the middle. And that fasted training negatively affects reproductive health. So I want to talk about fasted training because I know a lot of people prefer training fasted, whether it's because they think that it's helping them with their body set, their comp body composition, or whether it's because, in my case, I feel sick if I eat something and then I go work out. Um, and then we hear things about like you should be fed before you train. So I'd love for you to just kind of break this down for us.

SPEAKER_00 49:19

So it used to be that everyone wanted to train fasted because when you exercise fasted, you're typically using more fat as fuel. So you're burning more fat. That doesn't mean you're losing fat because when we tap into our energy stores, we we have energy stores in our fat tissue, and then we also have stored glycogen in the muscle. And so, regardless of which fuel source we are using, that actually has nothing to do with long-term fat loss. So I'd kind of get away from any conversation around like short-term fat burning. It's not relevant. Now, the idea that fasted training would be detrimental to performance, it could be if you were doing some really high-intensity long-form exercise type program, or maybe you're training two or three times a day, something like that, where we'd say, okay, you know, given the nature of this exercise session or training program, it's probably better that you are fueled. For the vast majority of people, this is not important because if we're just talking about going to the gym for 45 minutes or an hour, general health and fitness goals, we're not talking about going for a 15-mile run, we're not training multiple times a day, then it really comes down to personal preference. Because as you said, there are some people who don't feel well. They get GI issues if they eat too close to a workout. And there are other people who experiment with both and then they decide, oh, you know, this is what feels best for me. And that might be eating something that might not be. And both are equally fine because what we see long term is if you train fasted regularly, you gain the same amount of muscle as the people who trained Fed regularly. When you train fasted regularly, you lose the same amount of fat provided you're in a calorie deficit as the people who were training fed provided you're in a calorie deficit. So I think a lot of the conversation around the potential harm or this idea that it would interfere with reproductive function is actually confusing fasted training with being in a state of low energy availability. And low energy availability is uh is an issue for especially female athletes who are trying to maintain a low body weight, who are doing a lot of exercise, and ultimately they are not kind of consuming enough to fuel all of the exercise energy expenditure. So that is a real problem for those athletes. But this is a completely different scenario. What we're talking about is waking up in the morning, you already have stored glycogen. You ate dinner last night, we have fuel to perform this morning's workout, regardless of whether we eat before the workout. So we're not like waking up resetting and the tanks on empty. It doesn't work like that. And so presumably you're gonna go to the gym and then you'll eat at some point after the workout. And so provided you're consuming sufficient calories, protein, fiber for the rest of the day, then all of these nuances around nutrient timing are pretty irrelevant for the vast majority of people.

SPEAKER_02 52:42

Okay, I'm glad that you touched on that. There's this whole conversation online about peptides. I haven't even gone through this rabbit hole because I feel like it's just gonna irritate me a bit. So I haven't even gone through it to be honest. But we all know like GLP ones are obviously peptide medication. So, but there's all these other ones that are coming out with all these acronyms and all of that. Is there any research on them? Like, is there any ones that you've seen that pop up that are maybe used for recovery or building muscle or anything like that? What are your thoughts?

SPEAKER_00 53:13

This is the scariest part of fitness and wellness for me right now. Because you have people marketing something as natural because we make peptides in the body, right? There are natural peptides. They act as these chemical signals and then they're broken down. So they send a message and then they get broken down by enzymes and then they go away. Now, GLP1 is an example of that. We make GLP1, but it lasts for about a minute and then it gets broken down by enzymes. So the reason why the GLP1 drugs are so effective is because they are tweaked in a very complex way in the lab to make it so that the body doesn't recognize it as our GLP1, the GLP1 we make. It needs to be foreign enough that it doesn't get broken down by those enzymes and that it can last for several days. And that's why people can get the weekly injections. Now, those drugs went underwent many, many clinical trials. So they started with animal models and then moved into small groups of people and then larger groups of people. And after you get all of that data, you know what are the short and long-term side effects? Can you be on this in combination with other medications? Are there any contraindications for this? Can you take it long term? All of those types of questions are teased out with years and years of clinical trials. These new kind of wellness peptides, your BPC 157, CJC 1295. Um the claims around these, I mean, it seems like they do everything. It's muscle growth, it's fat loss, it's skin, libido, mood, recovery, all of it. And the shocking thing about a lot of these drugs is they've either never ever been studied in humans, they've only ever been studied in rodents, or they've been studied sort of in a clinical population, meaning, okay, we're going to see if this works for HIV patients with lipodystrophy. Now that's problematic because if all we know is the rodent stuff, then we have no idea if it's safe or effective for humans, and we have no idea how to dose it in humans. So you're making all of these assumptions about how we should use it. And if you're basing your plan off of the results of a clinical population like HIV patients, those people are going to have dysregulated growth hormone. And so that's not the same as using a drug in someone who has normal functioning growth hormone release. So there are so many aspects of these drugs that we really don't know. And there's just a lot of kind of mechanistic theater going on in the comment section because they're saying, well, if it could increase, you know, your own stimulation of growth hormone, for example, then due to this downstream effect and that downstream effect, then it could increase muscle mass and promote fat loss. That's a lot of leaps to say that it would even work, and certainly that it would work and there would be no side effects. And for BPC157, for example, it seems to work in in rodents to improve recovery from injury and surgery, but that is not without downsides because when you are creating new blood vessels, when you're increasing blood supply, is that good for healing? Yes, it is, but it can also feed a very small tumor and all of a sudden you know you have an issue with cancer. And so we need to tease that out before we promote these in a widespread way. And because they haven't been studied and they aren't approved, the manufacturing of these drugs is completely unregulated. Meaning, even if there's nothing wrong with the drug itself, it could be contaminated, it could be mislabeled, and you just have no idea. So this is the wild, wild west, and I fear that things are going to go pretty poorly as they just blow up in the wellness community. Crazy.

SPEAKER_01 57:28

It always amazes me, and I wonder the psychology behind people who are so against the things that have been well studied vaccinations, GLP1 medications, but they're willing to try these. Like it just doesn't make any sense. And yet, most people who are promoting these online, I've seen them talk badly about GLP1s, vaccinations, all the things. So it's really fascinating. Um on the topic of unregulated, I would love to talk about supplements a little bit. Um, we are in naturopathic medicine. So supplements are something that people ask us about all the time. And I think something I've noticed in our field is that we'll take something that's like, yeah, maybe this has some benefit and just like extrapolate that to be like, this is the miracle and the cure for all. Um and so I'd love to talk about first of all, are there any supplements from a fitness training perspective that you think maybe do have some benefit? Um and then we'll get into kind of the nuance of like, especially things like creatine and all of that.

SPEAKER_00 58:34

Yeah, of all of the kind of fitness-related supplements, I would say creatine definitely has the most data for efficacy and also for safety. But if we put it in context, meaning out of a sea of supplements that do absolutely nothing, creatine does a little something. And so I think sometimes the conversation's like that no one mentions that part. Like it works, but what do we mean by work? We're so excited that there's this one supplement that literally does anything at all, and that's creatine.

SPEAKER_01 59:10

Yeah. Oh my goodness. So when it comes to creatine, because of course, like you said, this is the big one. This is what everybody will ask about. Do you see it being something that is actually worth spending, let's say, 30, 40 bucks on every few months? Or is it something that we we should skip?

SPEAKER_00 59:30

Well, it depends on how you are exercising. So the way that creatine works, we talked before how we can tap into our fat stores for fuel. We can tap into stored glycogen for fuel. Now, as we ramp up the intensity of the exercise, the body needs to generate more ATP. So this is our kind of energy currency in the body. And so at lower intensities, we can use fat because we don't need it generated so rapidly because we're not doing a lower intensity exercise. As we start ramping up the intensity, then we tap into glycogen because that can generate ATP a little bit faster. When we get into these really high intensity, all-out sprint or the last couple reps of a heavy set, then we tap into the phosphocreatine system. So we have these stores in the muscle, and that allows us to generate ATP as rapidly as possible. And it's it only lasts for a really, really short amount of time because these stores are minimal. So we'll only use them when absolutely necessary, and then they get depleted pretty quickly. Supplementing with creatine tops up those stores. So if you're not getting to that type of intensity, it's not really doing anything for you from an exercise point of view. You need to be lifting weights and getting close to failure or doing some sort of really intense, vigorous sprint work type exercise.

SPEAKER_02 1:01:08

Okay, I love it. There's so much conflicting advice online about how women should train. So, for someone that's listening who maybe wants to build muscle, what does like an evidence-based week of training actually look like? So, like rep ranges, weights, cardio, how many days a week, what would you what would you say?

SPEAKER_00 1:01:30

Well, we see the biggest benefit when we go from doing nothing to doing something. So if you go from doing nothing to lifting weights twice a week, for example, that's when we see a huge amount of benefit, all sorts of benefits from a health perspective, you know, decreasing risk of cancer, respiratory disease, type 2 diabetes, dementia, and also from a muscle building and kind of quality of life, right? Because we want to maintain the muscle that we have, because that allows us to be more functionally independent as we age. So as we start to lose muscle, as we start to become more and more sedentary, then that starts to take away our ability to perform all those activities of daily living. So that's why it matters. But you don't need to be in the gym six days a week in order to get those benefits. We really do. If you did two full body exercise, full body training sessions per week, then you're getting a lot of that benefit. Is three a little bit better than two? Yes. But again, we're getting we're seeing the most benefit when we go from doing nothing to doing about two. And so if you're if you're going to lift weights two or three days a week, I'd always do a full body uh exercise session and prioritize movements that work multiple muscle groups. So that would be something like a squat or a lunge where we're working the quads and the glutes. And then I'd want some kind of a hinging movement pattern. So we're working the hamstrings and the glutes. That could be any kind of a deadlift or good morning, or if you're not comfortable doing that, then something like a cable pull-through or even a glute bridge or a hip thrust would be a great option. And then for the upper body, I'd want some kind of pushing movement. So um a push-up, a chest press, an overhead press, and some kind of a pulling movement. So a row or a pull down, and that's going to work in from a pushing perspective, you're getting the chest, the shoulders, and the triceps. And then when you're doing a pulling movement, you're getting all the muscles of the back and also the biceps. So that's the most kind of efficient way to set up a full body workout. And if you want to add some leg extensions or bicep curls or any lateral raises at the end, then that's completely fine. But the bread and butter of that program should be those compound movements where we're working multiple muscle groups.

SPEAKER_01 1:03:58

I love it. Super doable. What is the big message you want our audience to take home from this conversation?

SPEAKER_00 1:04:07

It's very challenging to make sure that we're focusing on what really matters, what really moves the needle, because there's so much noise online. And I think that women are targeted because we are likely to be kind of distracted by the next thing. And so often you'll start this new group fitness class and you'll do it for six weeks, and then you won't see results. And so you'll move on to something else. And that cycle kind of continues. And so then you get really frustrated because you're thinking, well, you know, why aren't I seeing results when I'm putting in the work? And so what I wish more women would do is stick to a program that is effective and goal-oriented for long enough to really see those adaptations and understand that that if you want to improve your body composition, which is the goal of so many women, then we really want to focus on the muscle growth. And so a lot of the group fitness classes just aren't providing the right stimulus for the goal. All physical activity is good. If you enjoy it, then do that. But if your goal is to really see these visible changes in body composition, then we need to make sure that we're lifting weights. It doesn't have to be complicated. You can use free weights, you can use machines, you can train in any rep range, but it needs to be challenging and you need to do it consistently. I love it.

SPEAKER_02 1:05:41

Amazing. Thank you so much for coming on today. This was an incredible episode. I'm deleting my body composition skill from my Amazon cart right now. Can you let our listeners know where they can find you? All of your information. You do a ton of podcasts. Just give us all the info.

SPEAKER_00 1:05:58

Yeah, you can follow me on Instagram, Dr. LaurenCS1. I have a Substack. I co-own a research review called Mass with three other PhDs, and we talk about all sorts of things health, wellness, fitness, nutrition.

SPEAKER_02 1:06:12

And if you have any questions, you can send me a DM. Awesome. Okay, thank you so much. We'll link everything in the show notes. Thank you so much again for coming on. Thank you. Thank you. Thanks for listening to Girls Gone Wellness. If this episode made you feel seen, smarter, or just a little less alone on your wellness journey, send it to a friend or tag us on Instagram at Girls Gone Wellness Podcast.

SPEAKER_01 1:06:40

Before you go, take a second to leave us a review. It helps more than you know, and it helps more women like you find their way to wellness that actually works. Want more? Head to Girls Gone Wellness Podcast.com to be the first to know about new episodes, exclusive merch drops, and everything we're building behind the scenes. Because feeling good in your body shouldn't feel like a full-time job. It should feel grounded, confident, and maybe even a little sexy too.

SPEAKER_02 1:07:04

We'll see you next week. Until then, trust your body, question the noise, and don't let anyone tell you you need fixing. This is wellness on your terms.