Michelle Mottola - She Leads Science

In this episode of She Leads Science, Dr. Liz Joy sits down with Dr. Michelle Mottola, a globally recognized leader whose work has helped transform exercise during pregnancy from a source of caution and confusion into an evidence-based standard of care. Together, they explore Dr. Mottola’s scientific journey, her leadership in advancing maternal health research, and the growing global recognition that cardiometabolic health during pregnancy can shape a woman’s future risk of cardiovascular disease and death. The conversation highlights her groundbreaking work on gestational diabetes, exercise safety, and the long-term health implications of pregnancy, as well as her success translating research into practice through the NELIP program. Dr. Mottola also shares one of her most memorable and practical messages for pregnant women: don’t eat for two, eat twice as healthy. This episode is a compelling look at the science, leadership, and global impact of exercise during pregnancy.

Transcript

Tempo: 120.0

SPEAKER_01 0:16

Welcome back to She Lead Science. I'm your host, Dr. Liz Joy, and today I am thrilled to be joined by Dr. Michelle Matola, who hails from the University of Western Ontario in London, Ontario, Canada, also known as the Kinder Chandler North America. Dr. Matola is a globally recognized leader in exercise physiology and maternal health. Her work has fundamentally shaped how we think about physical activity during pregnancy, moving it from a place of caution to one of evidence-based opportunity. She has had groundbreaking research on exercise, gestational diabetes, and cardiometabolic health, and her nutrition, exercise and lifestyle intervention program, or NELAP, has been recognized as a best practice in Canada. She is a fellow of the American College of Sports Medicine, the Canadian Society for Exercise Physiology, and the Canadian Academy of Health Sciences, and has also been repeatedly recognized for her excellence in teaching. Today we'll talk about her journey, her science, and why what happens during pregnancy may be one of the most important windows for long-term cardiovascular health. Michelle, thank you so much for joining me. Thank you very much for inviting me. So we have a lot to talk about. So we're going to get going here. When somebody asks you at a dinner party, what do you do? What's your answer these days?

SPEAKER_02 1:38

Basically, I say try and keep it simple and basically say that I investigate the impact of exercise during pregnancy on chronic disease risk and specifically looking at nutrition and physical activity.

SPEAKER_01 1:52

Awesome. Super important, right, when we talk about all the pillars of healthy lifestyle with physical activity and nutrition being right at the top. And all of those lifestyle behaviors are just as important during pregnancy as they are throughout the rest of the lifespan. Absolutely. So I have to ask, so so when you tell people what you do, do they immediately stop eating dessert or ask you more questions about whether they should even be exercising during pregnancy? Yes, they do.

SPEAKER_02 2:22

As a matter of fact, that's one of the questions I always get is well, is it safe? Is it safe for the baby or the mother to be exercising during pregnancy? And of course, we can start talking about well, how much is too much, how much is too little, those kinds of things. But yeah, I I get those questions all the time.

SPEAKER_01 2:43

Well, let's we're gonna talk a lot about your science and about your leadership, but let's start with your path. So I'm curious, you know, what first drew you into embryology, exercise physiology, you know, kind of how it all relates specifically to pregnancy.

SPEAKER_02 3:02

Interesting questions. So um a long time ago, I won't say when, but um, basically I did my undergrad uh in physical education at the time, and then moved into exercise physiology. We're specifically looking at uh physiology with exercise. And then um I just happened to meet a British gentleman that was interested, that was an embryologist uh at the University of Alberta, and basically he was interested in women's health, and as an embryologist, he kind of saw what I was doing. I was also interested in in uh women's health, but certainly not pregnancy at the time. And he basically said to me, Would you be interested in a PhD? And I went, Um, sure, yeah, that sounds interesting. So um that's kind of where it started. So then I switched over into medicine and uh did a PhD in embryology. And and of course, when you think about marrying exercise physiology and pregnancy at the time, it worked out really well. So um that was kind of where things started.

SPEAKER_01 4:09

Love that. Yeah, you know, our exposures and our experiences early on in our career definitely kind of helped to set that path forward for us. Absolutely, absolutely. And you've spent decades in this field. I mean, really long before it was widely accepted that exercise during pregnancy is even beneficial. Um, I'm curious whether or not you ever felt like you were pushing against the grain early on.

SPEAKER_02 4:34

Oh, yeah, absolutely. Yeah, like when I first started in this field, there were there were no guidelines. In fact, um, nobody really knew whether it was safe for pregnant individuals to exercise or not, what's the impact on the fetus? And so it it ended up basically when I did my PhD, I had to rely on animal work. So I was exercising pregnant rats because nobody knew what the impact was on the fetus. So that was basically my PhD dissertation was exercising pregnant rats. And and then from there, um, because from my work and some work that was going on at the time, we found that uh the fetus was fine when um the mother was exercising. And in fact, the babies were quite healthy, and so that kind of sparked my interest again. And then, of course, the best thing to do is to look at human observation rather than animal models, and so then um I did a postdoc at Loma Linda University and uh again using the animal model, but then you have to look at human observation somehow. So when I first got my job at um the University of Western Ontario, I did start with the animal model, but then I also started using that as pilot work for investigating the human. And uh so the rest is history. I haven't done any animal work since then, but um have continued to look at human observation.

SPEAKER_01 6:10

Wow. You know, uh you're the perfect example of the scientist who kind of goes lab bench to park bench, right? And everything in between. Yes. So, you know, we know that healthy behaviors during pregnancy are really important for the developing fetus. Um, we encourage women to stop smoking, stop drinking alcohol, gain some weight, but not too much, you know, all in that effort to produce a healthy baby. Um but I think, and I I think actually no, that we spend far less time thinking about the impact of pregnancy on the health of the mother. So as an exercise physiologist, can you share with us what happens physiologically during pregnancy that makes this such a critical window for the future health of the mother and how exercise influences that?

SPEAKER_02 7:03

Absolutely. I think as an embryologist, I have to do also talk about a little bit about um the maternal environment and the impact on the fetus. But um I do think that by providing a healthy environment for the fetus, the mother is also gaining benefits from being physically active and also eating healthy. And one of the things that that I've seen with uh some of our clients is that they go, Oh, thank God I'm pregnant, I can eat whatever I want. And that is not what you should be doing. And and in fact, we we encourage our pregnant clients to not eat for two, but eat twice as healthy and also to be physically active. And and I think by doing incorporating a healthy lifestyle, that will help to decrease the risk of getting gestational diabetes, that will also decrease the risk of gaining excessive weight during pregnancy, because we know that both of those things, both diabetes during pregnancy and also excessive pregnancy weight gain, can impact the future cardiometabolic risk of the mother, especially if she gains excessive weight and then gets pregnant again, and then you can see how the there could be a cycle of obesity that can happen, and that can also be the same with gestational diabetes. So the individual that has had gestational diabetes in one pregnancy, if they get pregnant again, they're more likely to continue that diabetes cycle as well. And and I know there's a myth that would suggest that once the baby is born, if you've had gestational diabetes, that you don't get diabetes ever, thank goodness pregnancy is over, but that's not true. We do know that it does affect the metabolic health of the mother. And in fact, research has shown that she can actually develop diabetes within the first year after delivery. That's type 2 diabetes, and and as she ages and as she goes through menopause, these are risk factors just based on the fact that she had diabetes during pregnancy that can certainly impact cardiometabolic health in the mother.

SPEAKER_01 9:26

Wow, there's a lot to uh there's a lot to unpack there. Um, I seem to recall, and correct me if I'm wrong, that um a pregnancy complicated by gestational diabetes increases the likelihood of developing type 2 diabetes by a factor of seven. Is that about right?

SPEAKER_02 9:44

Yes, yes, absolutely. And and it's not just 15 years later, it is certainly within that that first window, that first year after the baby is born, that that um individuals can be very susceptible to developing diabetes um after pregnancy. But the interesting thing about all of this is that no one ever gives them the test to see if they are diabetic, right? Like that's that's a problem because it because a lot of times it's the first year after delivery that is focused on the baby, but not necessarily focused on the mother. And so a person that has had gestational diabetes or a person that has gained excessive weight, this is an opportunity for physicians to actually maybe infuse an uh another way to have a healthy lifestyle in that first-year postpartum. And that will also assist in maternal infant bonding to have a healthy lifestyle. So babies are more likely to look at what their parents are doing, and they will be more likely to be physically active if they have active parents or eat healthy. So I I think there's there's a number of things that we can do potentially in that first year, is to maybe try and bisect through this cycle of obesity, either during pregnancy, so that the mother can have a healthy lifestyle, and then even in the postpartum period. So we can maybe try and mitigate some of these uh disease risk factors that can occur just because of pregnancy.

SPEAKER_01 11:31

Yeah, what you're saying is really making me think about, you know, we define prenatal care, you know, as basically from, I don't know, about eight weeks gestation until delivery. And then in the United States, women have a, you know, maybe a two-week postpartum check and generally a six to eight-week postpartum check. And then it's like, yeah, right. And um the mom may be seen in the context of health care for the baby, you know, as they come in for those well-child care checks um in the first year of life. But we don't necessarily have a system, you know, where we're doing follow-up, you know, of maternal health in that first year postpartum. I mean, I think there's a real opportunity for significant improvement in women's health care if we really start to think about pregnancy care as not being just nine months of pregnancy, but really extending it for that entire postpartum year.

SPEAKER_02 12:28

That's right. Yeah. And in fact, we talk about the first 1,000 days of life, and that brings us up to two years, um, because there's there's a lot of uh growth and development occurring with the baby, but also the influence of the parents uh is also very significant at that time as well. And of course, breastfeeding is also an important factor for all of this. And and I think this is another opportunity for us as caregivers to talk about the health of the mother through breastfeeding, uh, maybe provide her with lactation consultants to assist with that infant and maternal bond. That can we know, we know that there are many benefits for breastfeeding for both mother and infant.

SPEAKER_01 13:15

And we also know that you know, exercise does not impair breastfeeding, it does not change the quality of breast milk, nor does it change the volume of breast milk. So I think that's another worry that some women um in my 12 years of doing OB as part of my family medicine practice, um, women would express some concern there. Um, but solid research to show that exercise is perfectly compatible with breastfeeding. Absolutely. Yep.

SPEAKER_02 13:43

Yeah, and in fact, I think one of the things that we have in our society is that pregnant and postpartum individuals are not being active enough. And and I think that by not being physically active, we that's where we start to see issues with chronic disease development in both the mother and also in the baby, because uh there's something called the developmental origins of health and disease, affectionately called dohad, that indicates that the maternal environment can have a huge impact on chronic disease risk of the baby as well. And so if we can talk about being physically active during pregnancy and also into the postprimate period, we may be able to potentially stop those that cycle of obesity, cycle of diabetes that I've been talking about now.

SPEAKER_01 14:38

Yeah, wow. Um, okay, very briefly, um, can you talk a little bit about, you know, how I want to go back to the gestational diabetes piece because we've done so much work there. But could you actually explain how exercise influences glucose regulation during pregnancy, you know, so that the audience will kind of understand that pregnancy is a unique um environment for the development of diabetes.

SPEAKER_02 15:08

Right. So, what happens during pregnancy normally, normally, is that there is uh some insulin resistance occurring at the skeletal muscle level in a normal pregnancy. And that's important because glucose, maternal glucose, is saved, if you will, for fetal growth and development. And if there are risk factors for diabetes in the mother, that can maybe tip the person over the edge where diabetes could potentially develop. And when that happens, there's a a large uh there's a an increase in the amount of blood glucose that is available for fetal growth and development. And that's where it's really important that a person with gestational diabetes control their blood sugars, because if if they don't, then that blood sugar then is taken up by the fetus, and the fetus can then get very large macrosomic babies, and that can lead to issues with labor of birth, trying to give birth to a very large baby, but the baby is also born uh lethargic and with a hypoglycemia, because what the baby does, trying to be very brief here, but what the baby does when it sees all of this glucose from the mother is the baby's pancreas reacts and in order for the uh for the insulin that the baby produces to counterbalance the glucose from the mother. And so once at birth happens, that active increase of glucose is immediately cut off, but the baby doesn't know that, so it continues to secrete insulin from its pancreas, and what happens then is the baby is born very lethargic at birth with a very low blood sugar because of this uh impact of gestacional diabetes, uncontrolled gestable diabetes during pregnancy. Does that make sense?

SPEAKER_01 17:10

Yeah, that makes sense. That's a great explanation. Uh, I'm gonna shift us a little bit now into um talking about uh a little bit around um the guidelines, you know, for exercise during pregnancy. We'll talk a little bit about um safety. We've talked a lot about benefits. Um, but you know, I do remember very well the very first pregnancy uh exercise guidelines. I was in fact a medical student at the time. I was teaching aerobics because it gave me a free health club membership. Um and uh that made me the de facto expert on the topic. Um and you know, what I heard from women who were teaching my aerobics class was, you know, on some level, they were completely appalled at the recommendations and scared about others. I mean, you know, recommendations like don't exercise on a carpeted floor, uh, don't get your heart rate above 140. Um, you know, and and as you know, I know, the heart rated for advice is seemed to carry on for decades, despite really a lack of evidence. And and I know that, you know, your work and the work of your colleagues is definitely trying to change this and to make regular physical activity during pregnancy a norm rather than the exception. Um I'm curious to think, you know, uh, how are we doing?

SPEAKER_02 18:34

Well, I think we're doing better than than what I remember as well from 1985, right? Um because now with all of the evidence that we have, and we we have done a lot of work with uh 12 systematic reviews that we put out with the Canadian guidelines for physical activity during pregnancy. Um, and basically the bottom line of that is that we talk about 150 minutes per week, at least three times per week, and uh with a variety of aerobic or resistance training. Uh, but we do have target heart rates that we have produced with the Canadian guidelines for individuals that are pregnant based on fitness level and their pre-pregnancy BMI. And and these are based on pregnant people. So um we do have heart rate guidelines and again based on fitness levels. So, for example, a person who is say 25 years of age that is very fit, the target heart rate could go up to 165 beats per minute. And again, that's based on evidence and it's based on research at the time. And uh again, as long as the individual doesn't have any contraindications for being physically active. And and the other thing that we've done is we've we've got something called the get active questionnaire for pregnancy, where we were trying to empower individuals who are pregnant to complete this get active questionnaire for pregnancy so that they can take their own health into their own hands with regards to medical screening. So, for example, on the front page of this document, there's a checklist. If you answer no to any of the things on that checklist, then you can go ahead and be physically active. So we no longer need to have medical approval for an individual who is pregnant to be physically active. And I think that's a big change than what we've had in the past, in that now women are and and individuals who are pregnant are now taking their health into their own hands. So I think that's a really huge improvement than what we've done in the past.

SPEAKER_01 20:58

Yeah, I would definitely agree. Um, you know, as I mentioned, I delivered babies for about 12 years in my um family medicine clinical practice. Um, and and certainly some women specifically came to see me for prenatal color because I would let them exercise. Um and and living in Utah, that meant steam. Well, I'll I'll come back to that in just a second because I have some unique advice there coming from a colleague. Um but I had others who are not regularly active, and you know, I would counsel them to engage in regular exercise because my line was pregnancy is not a disease. It is a normal condition in women. Right. Um and interestingly, that always made people pause and kind of go, huh. Right, right, and yet, and yet, during my 10 years at both the University of Utah and and then at Intermountain Health, I spent 26 years between those two institutions and I worked also. Hard to try and get the OBs to regularly assess and advise women about exercise during burning people. But I have to admit, I was not that successful. I mean, you know, part of it is that it's a 10-minute belly check, right? Uh for prenatal care. And so time is precious and they move on to the next patient. But, you know, if you could design the ideal clinical approach, you know, what would exercise counseling during pregnancy look like? Um, and where do you think we're still falling short in implementation?

SPEAKER_02 22:34

Yeah, that's a great question. I I've been trying to solve that one for years. But I think I think the best way to do this is to say to your pregnant cli pregnant patients, every minute counts. Every minute of being physically active counts. If you can get up to 150 minutes of activity, that's great. But even if you can't, every minute of being physically active counts. And so you can think about daily living. So even if they do go to the gym for 30 minutes or whatever, the question is what do they do for the rest of the 23 and a half hours during the day? And if you if we can somehow increase their activity so that maybe they take the stairs instead of taking the elevator, um, they park farther away at the grocery store so they they can walk into the into the grocery store from farther, parking farther away. There are many things that they can do to increase the amount of activity that they do during the day. And I think the important thing, especially if we're thinking about gestational diabetes, is moving major muscle groups. Right? So walking or even doing uh resistance training is moving major muscle groups, and that's the key to helping to prevent gestational diabetes, because the the blood glucose from the mother is then being sucked into, if you will, into the working muscles of the mother that helps to regulate blood glucose values. And that I think is key in trying to prevent gestational diabetes, for example. And so even if you've got two minutes or even one minute, I think saying to your pregnant clients or pregnant patients, every minute counts for being physically active.

SPEAKER_01 24:33

Yeah, that's really similar, I think, to you know, the advice we provide to people who are not pregnant, right? That every step counts, every minute counts, that the physical activity prescription is aerobic exercise, resistance training, um, move more throughout the day and sit less. Basically the same.

SPEAKER_02 24:53

Basically the same. And walking is a great aerobic activity, and a lot of people forget that. And in fact, we've we've asked pregnant individuals what would they like to do? And and it's amazing. The the thing that comes back most often is walking. Everybody walks. So I think that's a great way to improve aerobic activity.

SPEAKER_01 25:15

Yeah, it's it's true in the United States as well that you know most adults who meet the physical activity guidelines for Americans, do so through walking. It's just so accessible and relatively low cost. You need a pair of sneakers.

SPEAKER_02 25:28

Yeah, true enough.

SPEAKER_01 25:30

Okay, so I have to go back to skiing for just a second because uh, like I said, I live in Utah. I'm staring at the mountains right now. And uh one of my very good friends, uh, past president of the American College of Sports Medicine, Dr. Bill Roberts, big skier, um, you know, his advice to me when I was pregnant was um that I could keep skiing as long as I could buckle my boots by myself. So that's become my my advice for um women who uh ask me about uh being able to ski during pregnancy. And if you are an expert skier, you know, bring the level down to advanced. If you're advanced, bring it down to an intermediate. If you're intermediate, bring it down to a beginner. And probably if you've never skied before, pregnancy is not the time to start.

SPEAKER_02 26:19

Exactly. Yeah, and I think I think um pregnant individuals have to be very careful, cautious of falling. And that may not be, they may be an expert skier, but you can't predict what's happening behind you, right? Like anybody that could knock you over or right, accidents do happen. So it's just adding that caution, cautionary note to that as well, I think.

SPEAKER_01 26:44

Yeah, exactly. So I do want to talk a little bit about, um, like I said, you've done lab bench to park bench. So let's talk a little bit about nutrition and exercise lifestyle intervention program or NELIP. Um, and and share with us a little bit more about you know what that um program is about and what's made it successful.

SPEAKER_02 27:08

I think it's uh patient-centered care that that makes it uh very successful. So we meet one-on-one with our participants every week, we walk with them every week, and then they also have motivation to come in and see us. We monitor uh weight gain and we give them the gestational diabetic meal plan. And that basically is smaller meals more often throughout the day. So, what we try and do is instead of having a big breakfast, a big lunch, a big dinner, where you see really high swings in like glucose values, we try and have it so it's it's moderated. So we have smaller meals every couple hours so that over the total day, they're still ingesting about 2,000 kilocalories per day, which is normal for what you would see with with pregnancy. But we've we split it out throughout the day so that we're trying to regulate blood glucose values in in our pregnant clients. And when you combine that with a walking program, and our program is just a walking program, that's all it is. Um, we start them at um 20 minutes, and then we add two minutes every week until they get to 40 minutes, and then they maintain that. So they're not out slogging, it is something that they can maintain, it's something to look forward to when they come in to visit with us. And we also help to counsel them with regards to either their uh culture, um, if there are cultural issues with nutrition or with uh being physically active. So we try and make it as patient focused as possible. And I think that's why it's been so successful. We we try and keep them accountable, we try and keep them motivated, and um and yes, it is a one-on-one. And we've interestingly we've found that we when we tried to do a group session, the pregnant individuals did not like being in a group. They'd rather have the one-on-one interaction. And and I mean, in a way, that kind of makes sense because it's about them, right? It's about them, each individual. And I think that might be why why it was uh very successful.

SPEAKER_01 29:28

That's cool, interesting. A little uh a little different from what we see in other populations where kind of the group dynamic is actually what helps people um you know stay together and to sustain uh regular physical activity for kind of the the social benefits of being with one another.

SPEAKER_02 29:47

Yes, absolutely. And again, I think it depends on the culture. We're also doing work with uh Arab Muslim individuals who are pregnant, and and they very much like the group setting. Um, and they look after each other and it's very community-based. And so, again, that's that's a completely different um way of doing our our null program. So again, it depends on the culture, it depends on the religion. So one size is not fit all absolutely. Um, but just from what we've seen in our population, uh, they seem to like that one-on-one better. But it's interesting though, postpartum, when we do a postpartum exercise class, they want to have to be in a group, which is interesting. Pregnancy more individualized, but in a group, uh in the general population, they like the idea of, I guess maybe other moms that may have the same issues that they do. So uh group sessions in the postpartum with us, anyways, works very well.

SPEAKER_01 30:50

Yeah, that's been my experience as well. You know, that shared learning um opportunity um and shared experience is um just so important. And uh boy, I can remember handing out a lot of advice about how to breastfeed better before I ever had a baby. And um let's just say it changed after uh I'd experienced it myself. Yes, I agree totally. Um so you know, your your leadership and innovate and innovation, you know, in this space has been remarkable. And you've you've had a very impactful career. Um was there a moment when when you realized you know you'd become the mentor or leader that others are looking to to carry on this work into the future?

SPEAKER_02 31:39

Yeah, that's a good question. I I had the opportunity to um with our stage special interest group with pregnancy and post-partner with ACSM, they um asked me to do a history of exercise during pregnancy. And so that kind of made me think about like the history of all of this, and I kind of went, oh, all right. It looks like I'm I'm kind of the last one standing, which is really sad. But I when I think about all of my mentors, they're they're either retired or unfortunately have passed away. So yeah, it's it's like when did this happen? When did this time pass? Um but yeah, like I I mean it seems now that um when I look back on it, uh there there's not a whole lot of us left, which is really sad.

SPEAKER_01 32:35

And along the way, um, you know, I think oftentimes we experience some barriers and some bumps um in our in our career paths. I'm curious what's kind of helped you navigate um leadership, you know, in this space um overall for women in science?

SPEAKER_02 32:56

Yeah, I think that's a great question. Um, you know, certainly I think it it needs a lot of perseverance. Um there's been a lot of um, like even though yes, I mean my my career has been successful, but there's been a lot of bumps along the way, like you say. Um certainly overcoming um gender bias, um, overcoming um sometimes um trying to get grants and people saying that women's health is not important, especially pregnancy is not important at this time. Um, I think we've come a long way since I started out. Um, and I think that it's really important that we continue to move forward with this field because there's still a lot of things that we haven't done yet, that we haven't looked at yet. But I do think that for the young people coming through, I think that um there there's a bright future. And I the advice that I would give them is to keep at it, keep going. You have to develop a a bit of a thick skin, um, especially when you're trying to get grants, if you're an academic. Um, but yeah, you just learn, learn from uh what's happened in the past. You learn from rejection, you learn from making it better and doing the best that you can.

SPEAKER_01 34:21

That's great advice. Um, we're coming to our the end of our time together. I have two more questions for you. Uh the first being, uh, and really tags on to what you were just talking about, but what do you think are the biggest unanswered questions in the field of exercise during pregnancy?

SPEAKER_02 34:40

That's a great question. I think there's a couple things. One of them I think is that we really need to think about how to prevent chronic disease risk. And and I think um, like when you're talking about cardiometabolic health, there is an opportunity for us to make a difference during pregnancy and postpartum. And and all I all I uh I think it's just education actually, that by educating physicians, healthcare providers, and educating uh pregnant individuals so that they can they can certainly empower themselves to look after their own health, I think is really important. So that would be one thing. And then the other thing, and it's up and coming, is looking at the elite athletes. And I think more and more individuals who are elite athletes are are continuing to train during pregnancy, are continuing to train during the postpartum period. And um we need more research, we need more evidence to find out what is safe. But um, and I think the postpartum athlete and pregnant athlete is driving that future for us. But I think that's another thing that really uh where we're going in the next several years.

SPEAKER_01 35:59

Interesting. Interesting. All right, last question. Who is a woman in science you'd love to have coffee with? I'd love to have coffee with you, Liz.

SPEAKER_02 36:08

Oh, awesome. I'll look forward to that. Um I mean, I I was thinking about that. I I you know, uh unfortunately Barbara Drinkwater has passed away. I thought that she, I thought I would love to have coffee with her and pick her brain, right? Like I think she embodies um somebody that that has spent a lifetime looking at women's health. Um, not necessarily pregnancy, of course, but certainly looking at all of the different aspects of of women's health. And it's not just pregnancy, but but um but pioneers like her, um, and she, you know, with what she has done with the American College of Sports Medicine, what what she has done over her career, I I just think that it would be a great opportunity just to pick her brain and to chat with her. But unfortunately, um we we can't do that. But yeah, it would have been nice.

SPEAKER_01 37:06

For sure. Yeah, she was she was an amazing uh scientist, um, an amazing person, um, an incredible leader and mentor, um, and definitely uh left a void uh with her passing um when she lived uh a very great long life. Thank you so much, not just for joining us today, but really for the impact your work has had on generations of women and families. And to our listeners, if you enjoyed this episode of Feeling Science, please follow it, rate it, and share it with someone who needs to hear it. Thanks so much. Bye bye. Thank you guys. Bye bye.