0:00

not sure where along the lines we were taught

0:02

to fear our own hormones. We're

0:04

taught to fear estrogen because it causes

0:06

X and Y, breast cancer and

0:08

heart attacks. We're taught to fear cortisol

0:10

because with fasting or any type

0:12

of hormetic stress, things raise cortisol. Coffee

0:14

raises cortisol, therefore coffee's bad. I

0:16

think that there's this idea

0:18

that our hormones are somehow working

0:20

against us and that... There's

0:23

lack of nuance in terms of their

0:25

understanding. We've been fear -mongered around hormones

0:27

for over 20 years. Thankfully, things are

0:29

coming back around now and we're starting

0:31

to get better information. It

0:34

isn't about being perfect. It's

0:36

about being better. Hello,

0:38

my name is Dr. Stephanie Steema,

0:41

and I host expert discussions with

0:43

thought leaders in all facets of

0:45

health, including nutrition, fitness, hormones,

0:48

stress management, performance, recovery,

0:50

longevity, health span, and

0:52

energy production. On

0:54

this show, we discuss complex

0:56

science, but then we also

0:59

alchemize it into actionable, everyday

1:01

living. The ultimate goal with the

1:03

show is to assist you in making informed

1:05

decisions about your health. and to

1:07

catapult you into being the hero

1:09

in your own life. Hey

1:16

friends, welcome back to Better With

1:18

Dr. Stephanie. I am so pleased

1:20

to introduce a new feature on

1:22

the podcast. We are

1:24

calling this She Said, She Said,

1:26

and this is with my dear

1:28

friend Cynthia Thurlow. Cynthia and I

1:31

have been friends for a long

1:33

time and she's one of the

1:36

Not few people, but yeah, one of

1:38

the few people in the space that I really

1:41

respect her opinion. I love the

1:43

way that she adds context and nuance

1:45

to the topics that she's talking

1:47

about. It's not all fear porn. She

1:49

has a lot of data to

1:51

really research and she's a very, she

1:53

takes a very measured approach, which

1:55

for me is a lost art. I

1:57

also like to think about things

1:59

very deeply and think about a lot of different

2:01

sides and a lot of different contexts before

2:03

coming up with an opinion. And so Cynthia in

2:05

a way is my sister from another mister.

2:07

I really love her and I love having conversations

2:10

with her so her and I

2:12

have conversations over text. We're

2:15

always sending each other voice notes and

2:17

I sent her novels and she sends me

2:19

novels and you know we've we've been

2:21

flirting with this idea of this. the show

2:23

together. And here it is. So

2:25

we pulled some questions from our

2:27

audiences and we got together and discussed

2:29

them. So in today's episode of

2:31

She Said, She Said, you are going

2:33

to hear about why we shouldn't

2:35

be afraid of our own hormones. Is

2:38

fasted cardio versus fed cardio

2:40

better for performance and body

2:42

composition and fat loss? What

2:44

to do in menopause? All

2:47

things perimenopause, menopause,

2:49

fasting, hormones, exercise,

2:51

nutrition, You name it, it is

2:53

just two good friends getting together, gabbing,

2:55

as if we were, you know,

2:57

having coffee together. And here is our

2:59

show. She said, she said, I

3:01

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5:32

live. So good to see you.

5:34

So good to see you too. I know even just gabbing

5:36

before we got recording. I was like, all right, this

5:38

is so good. We should just start. These

5:41

are our, she said, she said episodes, which

5:43

I love the name. I love spending time

5:45

with you and I'm so happy that, that

5:47

we get to do this. Absolutely. Best way

5:49

to start a Monday. Best

5:51

way to start a Monday. I

5:53

love it. So we thought that.

5:55

We, like you and I are

5:57

always talking over text. We have

5:59

very similar audiences with very similar

6:01

concerns. It's usually a perimenopausal woman trying

6:03

to figure out intermittent fasting, perimenopause,

6:05

the hormonal change, the body composition

6:07

stuff, the sleep changes, menopause. And

6:10

we get so many questions and we

6:12

can start doing this maybe even more

6:14

formally, but so many questions come into

6:16

you and into me that are similar.

6:18

And I was like, why don't we

6:20

just, and you, you and I were

6:22

just like, why don't we just meld

6:24

our minds together on a show? or

6:26

we can actually spend the time to

6:28

really elaborate on some of these questions,

6:30

because sometimes on Instagram... I'll get these

6:33

questions on stories all the time. And

6:35

you just have like a 15 second

6:37

frame to put in like a little

6:39

bit of stuff. But this is really

6:41

where the nuance and like the real,

6:43

I think that we can really answer

6:45

these questions properly. What do you think?

6:47

I totally agree. And I think for

6:49

on so many different levels that there's

6:51

a lot of noise in the space

6:53

right now. There's a lot of good

6:55

information from, you know, well -meaning clinicians.

6:57

And then there's a lot of what

6:59

I will affectionately refer to as voices

7:01

that should be henceforth muffled because a

7:04

lot of what they're stating I think

7:06

can be harmful or can cause more

7:08

anxiety and I think we as women

7:10

put enough stress on ourselves to you

7:12

know be a great partner and be

7:14

a great mom or be a great

7:16

co -worker or be a great friend and

7:18

so I think in many ways our

7:20

viewpoints are so much in alignment in

7:22

terms of like finding the right balance

7:24

and cadence to help women navigate the

7:27

perimenopause to menopause transition in a way

7:29

where they feel empowered and they don't feel

7:31

fearful and they don't feel scared. And

7:33

I think that I feel truly

7:35

grateful for our friendship and being able

7:38

to share our perspectives with both

7:40

of our communities because, you know, we're

7:42

stronger together. You know, that's the

7:44

one thing that I can say within

7:46

this space is that we are

7:48

so much stronger and we are unified

7:50

and together and speaking out and

7:52

helping women and doing it in a

7:54

way that is sustainable and healthy

7:56

and not just healthy from a physical

7:58

perspective, but also an emotional spiritual

8:00

perspective as well. You're so

8:02

eloquent. I love to hear. I could just listen to you

8:04

talk. I'm like, just little hearts are just coming out of

8:06

my eyes as you're talking. I love that. And

8:09

actually, I just wanted to, I wanted to

8:11

just double click on something you said, which

8:13

I think is really important, which is we

8:15

are actually wired to respond to fear, right?

8:17

So you have like, let's just call it,

8:19

I'll call it out. You know, the shirtless

8:21

bro that the grocery store telling you like,

8:24

you know, this vegetable is going to

8:26

kill you. Oats are stealing minerals from

8:28

you, blah, blah, blah, blah, blah, blah.

8:30

more actually wired to listen to fear

8:32

messages like that and pay attention to

8:34

them more so than a new like

8:36

you know a scientist who's going to

8:38

say well based on the literature this

8:40

may or may not be true that

8:42

is the you know for the human

8:44

brain that is very much primary like

8:46

primarily concerned about survival something like hey

8:48

Oats are stealing from you if you

8:50

eat them they're going to run like

8:52

the you know the phytic acid is

8:54

going to steal the your minerals you're

8:56

going to listen to that more so

8:58

than hey you know what the literature

9:00

doesn't support that and in fact consumption

9:02

of oats is is related to a

9:04

healthy body composition and better performance in

9:07

the gym like you know like one

9:09

of them you're going to pay attention

9:11

to because like oh no if i'm

9:13

eating oats i'm going to you know,

9:15

die or insert negative outcome here. So

9:17

I just kind of wanted to highlight

9:19

what you said. I know you said

9:21

it in passing, but I think, you

9:23

know, just highlighting your brilliance a little

9:25

bit there in that we are very

9:27

much wired to listen to fear versus

9:29

a more maybe less energetically or emotionally

9:31

charged message that provides a bit of

9:33

nuance. So that's that's key as well.

9:35

That's such an important message. And it's

9:37

it's ironic because when I started probably

9:40

eight, nine years ago, pivoting

9:42

from traditional allopathic medicine. I

9:44

used to be the person in Whole

9:46

Foods and in Trader Joe's, and I

9:49

would identify like cleaner foods. But

9:51

actually, I feel like I have now

9:53

gotten out of the habit of being

9:55

in the grocery store and doing those

9:57

kinds of things because I think there's

9:59

so much negativity and fear in reaction

10:01

to whatever the message is. And I

10:03

think for so many people, it's all

10:06

about sustainability. And it's all

10:08

about finding things that you can

10:10

do long term. And let's be clear,

10:13

if you are trying to clean up

10:15

your diet, let's just say for as

10:17

an example, and you're trying to eat

10:19

less processed foods, it's going to

10:21

be a journey. It's not a race. And

10:23

so I think in some ways, those,

10:25

I'm sure, well -meaning influencers,

10:28

I'll just find that

10:30

reframe, those well -meaning influencers

10:32

who probably unintentionally are evoking

10:34

fear in so many

10:36

individuals. They're actually, they would actually

10:38

be more effective, but I think that they're

10:40

not looking to be more effective. I think

10:42

they're just looking to incite fear and divisiveness.

10:44

They would actually be more effective if

10:47

they change their strategies a little bit

10:49

to make it more accessible for the

10:51

average person. In fact, I think about

10:53

one individual who will remain nameless, who

10:55

for a long time only ate meat,

10:57

which is fine. I understand there can

10:59

be therapeutic benefits to eating a carnivore

11:01

diet for a period of time. But

11:03

now I'm watching this individual kind of

11:05

changing their narrative a bit and they're

11:07

incorporating more fruit and now they're eating

11:09

honey. And so I think it just

11:11

speaks to the fact that at any

11:13

stage of life, we are allowed to

11:15

change our minds and course correct, but

11:18

you are absolutely correct, especially on social

11:20

media. The algorithm loves fear driven content.

11:22

And so more often than not, that's

11:24

what gets pushed in front of us.

11:26

And so we have to be conscientious

11:28

about what we choose to view, watch,

11:30

bring into our kind of periphery of

11:32

our lives and I think that I

11:34

just I just find it fascinating if

11:36

you're on social media and you look

11:38

at what is trending more often than

11:40

not it is the social media influencer

11:42

talking about someone who had bad plastic

11:44

surgery the social media influencer who's talking

11:46

about you know some fear mongering topic

11:49

as opposed to like kittens and puppies

11:51

and like I'm the person that dives

11:53

down the rabbit hole and loves to

11:55

watch all the animal antics. I could

11:57

sit and watch that for hours because

11:59

it's pleasant but in more instances that's

12:01

not what actually drives content on social

12:03

media and is pushed in front of

12:05

us. Sorry for that tangent but I

12:07

felt like it needed to kind of

12:09

be. Yeah no it just underscores

12:11

the idea that you know It is it

12:13

is important to be mindful sometimes we can

12:15

we're going to talk about fasting today. There's

12:17

a lot of questions around fasting. I think

12:19

we'll get to but sometimes a social media

12:21

fast. That's also another you know, I have

12:23

really gone into the habit of. Unfollowing

12:26

individuals who I feel are pushing

12:28

out this. Yeah, just fear based

12:30

narrative because it's it's sort of

12:32

like I roll even honestly there's

12:34

been individuals who have had on

12:36

the show and sort of watching.

12:39

the stuff that they're putting out. I'm

12:41

like, I don't love this. I don't

12:43

love this message. It's very divisive. And

12:46

I think people, I think you sort of learn,

12:48

unfortunately, like you said, the algorithm loves, you know,

12:50

it loves fear based stuff. But I think that

12:52

us as content creators, we also learn, oh, well,

12:54

if I put up more fear -based stuff, I'm

12:56

going to get more eyeballs. So that's a good

12:58

thing. And then you just start putting out more

13:00

content like that. So don't become the algorithm. Don't

13:04

let the algorithm dictate your life. There's certainly

13:06

ways to do it ethically. But let's dive

13:08

into some of these questions. There's some really,

13:10

really good ones. These

13:13

are questions mainly from your community. And going forward,

13:15

I'll make sure to pull mine as well. Where

13:17

did you want to start? Cynthia, did you want

13:19

to start? Is there ones

13:21

that you want to jump into right

13:23

away that are speaking to you?

13:25

Well, you know, it's interesting. Life kind

13:27

of imitates art and this postmenopausal

13:29

weight gain. So women that are already

13:31

in menopause, this seems to be,

13:33

without question, the greatest

13:36

concern, complaint symptom

13:38

of this perimenopause

13:40

to menopause transition

13:43

without question. And

13:45

I think that a lot of women

13:47

are doing the right things. And this

13:49

is why I was like, let's start

13:51

the conversation there, because I think this

13:53

is a particular topic that is relevant,

13:55

timely, and also of

13:58

great concern. And I don't say this

14:00

from the perspective of the aesthetics.

14:02

I think people are frustrated and they're

14:04

trying to look for ways to

14:06

circumvent this weight gain. And this is

14:08

a question that came in from

14:10

Mary. When in, so she's

14:12

talking about, she's in menopause.

14:14

Why is a keto lifestyle and

14:16

cardio exercise not giving the

14:18

desired results? And so presumably the

14:20

results are the menopausal weight gain. And

14:22

I can't think of a better person

14:24

that I'd love to hear the response

14:26

from than you. Yeah. I

14:29

mean, I, I gotta, I gotta agree with

14:31

Mary first. It doesn't feel good. Like when we're

14:33

weight, when we're gaining weight, you know, you

14:35

don't like when your clothes don't fit. You

14:37

just, you're just miserable, right? You know, you

14:39

have this, you know, favorite jeans or favorite shirt

14:42

or favorite, whatever, when you're, you know, there's

14:44

this sort of thickening of them, of the waste

14:46

that a lot of women will complain about

14:48

us. It's like accumulation of belly fat or this

14:50

disappearance of the waste that a lot of

14:52

women think about and or experience. And so I

14:54

just want to throw some empathy there. I

14:56

totally can understand how frustrating that is. And

14:58

I think that we have to

15:01

look at keto and the intermittent

15:03

fasting. So for transparency, I wrote

15:05

a book on female centric ketogenic

15:07

diet. It's called The Betty Body.

15:10

And it's, you know, the whole book is

15:12

like menstrual cycle literacy, like ebbs

15:14

and flows of the menstrual cycle, but then how

15:16

you can sort of pair different food, you

15:18

know, diet types with where you are in your

15:20

cycle. And I gotta,

15:22

I gotta take some responsibility here because

15:25

when I wrote that book, I

15:27

still stand by the principles of that

15:29

of the diet there but what

15:31

I found happened and I didn't I

15:33

didn't put this message the messaging

15:35

wasn't clear enough so in second and

15:37

in future iterations of this book

15:40

I am going to like there's going

15:42

to be some modifications I'm going

15:44

to make and that is to say

15:46

that the diet that heals you

15:48

Okay, so if you are insulin insensitive

15:50

or you're gaining belly fat or,

15:52

you know, your clothes aren't fitting the

15:55

way that you want, a ketogenic

15:57

diet or a protocol for intermittent fasting,

15:59

let's say, is a wonderful intervention

16:01

for you to start with, right? So

16:03

the ketogenic diet's really, really good

16:05

literature on helping reverse insulin sensitivity, improving

16:07

brain fog, improving sleep, improving things

16:10

like waist circumference to hip circumference, all

16:12

this kind of stuff. The issue

16:14

is, is what, what I found after

16:16

having thousands of women, you know,

16:18

go through the book and running programs

16:20

is women started to vilify carbohydrates.

16:22

So it was like, Oh, so ketogenic

16:25

diet, low carb. So that means

16:27

that carbs are the enemy. I must

16:29

never consume carbs again. And it's

16:31

like, God, I don't know how I

16:33

miss that, you know, like as

16:35

a doctor, literally I, I beat myself

16:37

up about this truthfully because. It's

16:40

a great intervention to pull back

16:42

on the carbs temporarily. That is what

16:44

healed my prop, like my menstrual

16:46

cycle issues, my insulin sensitivity, my

16:49

estrogen dominance, and then the clients and the

16:51

patients that I cared for. Yes,

16:53

pulling back on

16:55

carbohydrates temporarily, double

16:58

underline, highlight, bold,

17:00

temporarily helps. And

17:02

then once that diet is no

17:05

longer serving you, you have to move

17:07

on from it. right? In the

17:09

same way that you might outgrow a

17:11

friendship, right? Or you might outgrow

17:13

a business relationship. It was serving

17:15

you for a while, and now you've

17:18

sort of ridden that area under

17:20

the curve, let's say. This is like

17:22

nerd speak for like you sort

17:24

of, you've exhausted the benefit of

17:26

that diet. You no longer need it.

17:28

And you now move on to

17:30

something else. Where I think

17:32

women have missed the mark. And like I

17:35

said, I'm taking some responsibility for this is

17:37

that they stayed in Keto land for too

17:39

long. And so then we start

17:41

to see denigration of thyroid function, then we

17:43

start to see insulin sensitivity actually decline.

17:45

We start to see the weight coming back.

17:47

And then what do women do instead

17:49

of saying, Hey, maybe I've like,

17:51

maybe I've passed the sell by

17:53

date, right? Like the expiration date on

17:55

this diet is done. We start

17:57

to say, Oh, I should fast longer.

18:00

I should eat even less carbs. I

18:02

should whiten, I should do keto

18:04

harder, right? So my

18:07

overall message here is

18:09

I, it is a,

18:11

In order to heal metabolism and sex

18:13

hormones and some of the things that

18:15

she's talking about, I do think a

18:17

therapeutic intervention of intermittent fasting and

18:19

the ketogenic diet is great and you

18:21

shouldn't stay there forever. And

18:23

so that's sort of the long and the

18:25

short answer. I don't know how you

18:27

feel about that. Thoughts on that? I know

18:29

obviously you're known for intermittent fasting and

18:31

millions and millions of views on it. Do

18:33

you agree with that? Disagree with it?

18:36

Any context you'd like to add? Yeah, no,

18:38

I would say that we are designed

18:40

as human beings to evolve, shift and change

18:42

throughout our lifetime. And so what

18:44

you're really speaking to is that if

18:46

there's a particular strategy or strategies that

18:48

have worked well for you at a

18:50

particular time in your life, you may

18:52

come to a point where you find

18:54

it is no longer effective. Now, I

18:56

have spoken very transparently. So I'm going

18:58

to dovetail and just say that personally,

19:00

I've worked very diligently over the last

19:02

almost year to build muscle. Well, as

19:04

you can imagine, and

19:06

menopause. Your hormones are

19:08

a little bit working against you.

19:10

And so it is much

19:13

harder to build muscle, not impossible.

19:15

But what that has looked

19:17

like for me personally is not

19:19

as much fasting, more carbohydrates.

19:21

So I can I actually do

19:23

better on a higher protein,

19:25

higher carb diet. And I was

19:28

someone that for many years

19:30

carb cycled, really tight fasting windows,

19:33

really tight rules around what I ate

19:35

in a fasted state, if anything. And

19:37

I've learned to relax that quite a

19:39

bit. And what I found very humbly that

19:42

I think is really relevant to this

19:44

conversation is that I invite you if something

19:46

is no longer working to shift gears,

19:48

maybe you need a little bit more therapeutic

19:50

carbohydrate. And when I talk about carbohydrates, It

19:53

could be more vegetables. It could be some

19:55

fruit. I do very well with fruit. I don't

19:57

do as well with grains, but I do

19:59

have some grains in my diet now. I am

20:01

dedicated, gluten -free, because I have several autoimmune conditions

20:03

that are in remission. But

20:05

what I think is important for people

20:07

to understand is that I went from a

20:09

16 -8, you know, 16 hours faster with

20:11

an 8 -hour feeding window to now having

20:14

effectively a 10 or 12 hour feeding

20:16

window to get enough protein in. I

20:18

eat more carbohydrates now. I

20:20

am leaner now than I was a

20:22

year ago, although maybe with clothes on,

20:24

I might not look any different. But,

20:26

you know, with body composition, body composition

20:28

is different. My bioimpedance scale information

20:31

has been very helpful. So when women

20:33

say, you know, this strategy is or

20:35

strategies are no longer working, it's like,

20:37

okay, your body is inviting you to

20:39

change gears. And that's the role of

20:41

hormesis, like hormetic stress in the right

20:43

amount at the right time. And it

20:45

could be that you need to adjust

20:47

your strength training. You may need to

20:49

back off on fasting. And

20:51

I think it is human nature that

20:53

when something is no longer working to

20:55

your point that you already made more

20:57

carbohydrate restriction. more exercise, more

21:00

fasting. And we think that that's the

21:02

right strategy to get us out of

21:04

it. And I think it seems counterintuitive,

21:06

but for many of us, it is

21:08

backing off on the intensity of what

21:10

we are doing and perhaps changing things

21:12

up. The other thing that I think

21:14

is interesting and relevant because the ketogenic

21:16

diet has therapeutic benefits, is

21:18

that the research demonstrates that depending

21:20

on the composition of our gut

21:23

microbiome, which we know takes a

21:25

hit in that perimenopause to menopause

21:27

transition largely from the loss of

21:29

estrogen, estrogen is very important,

21:31

very fundamentally delicate dance between that and

21:33

the immune function, the gut microbiome.

21:35

As we are navigating perimenopause and menopause,

21:37

those changes in the microbiome are

21:39

so significant that we may no longer

21:41

have the right balance of microorganisms

21:43

to facilitate a higher fat adjusted protein

21:45

intake. And so that is the

21:47

other thing that I remind women if

21:49

they say to me, oh, I

21:51

went on a ketogenic diet and they're

21:53

doing it right as they identify

21:55

what their macros are and I gained

21:58

weight on a ketogenic diet. And

22:00

the first thing I'll ask is, well,

22:02

how much fatter are you consuming?

22:04

Because a stick of butter and five

22:06

avocados a day is not going

22:08

to work for any of us, at

22:10

least not the women that I

22:12

know and I interact with, but helping

22:14

them understand that sometimes it can

22:16

be a reflection of what's going on

22:18

in the microbiome. And to kind

22:20

of bring this full circle, men

22:22

and women's microbiomes as children are very

22:24

similar until we go into puberty. And

22:27

it's puberty when we start having

22:29

these changes in sex hormones that starts

22:31

to differentiate the gut microbiome of

22:33

men and women. it comes

22:35

full circle and in menopause,

22:37

women's microbiomes more resemble men's

22:40

than in any other time

22:42

in their reproductive years. And

22:44

so just understanding that in and of

22:47

itself helps women understand like your hormones are

22:49

not per se working against you. It's

22:51

just we have to navigate things and consider

22:53

this is why I like diagnostic stool

22:55

testing. This is why I think it's so

22:57

important if you're stuck. This

22:59

is a great opportunity to shift gears,

23:01

change what you're doing, think about

23:04

some gut microbiome testing, working with a

23:06

practitioner who's knowledgeable. And

23:08

when I say knowledgeable, not someone that's done

23:10

like one, you know, 12 hour class one

23:12

day and thinks they're going to go out

23:14

and save the world. But I think for

23:16

a lot of individuals, it's understanding that shifting

23:18

gears is just part of navigating middle age

23:20

and not in a bad way in a

23:22

very proactive way. Just say, okay, this is

23:25

no longer working for me. This is no

23:27

longer serving me. but it may work

23:29

for someone else. You

23:31

know, case in point, intermittent fasting,

23:33

carbohydrate restriction, et cetera. Yeah,

23:35

that's so good. And I think just as

23:37

a, I mean, you can speak to this more

23:40

than I, but just as a function of

23:42

aging, that single cell epithelial lining of the gut

23:44

is just going to get trashed, right? It's

23:47

just going to, it's going to age, right?

23:49

If there's going to be more disorganization there.

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26:12

be a link in the show notes

26:14

for you to click on as

26:16

well. Do you take digestive enzymes

26:18

or do you like digestive enzymes? I

26:20

love digestive enzymes. They make an enormous difference.

26:22

And I think for a lot of

26:24

us, you know, not everyone needs necessarily a

26:26

support with hydrochloric acid. We know we

26:28

produce less of that as we get older,

26:31

but digestive enzymes. For a lot

26:33

of women, as an example, that they tell

26:35

me they're constipated, they struggle to have a bowel

26:37

movement every day, I'm like, girl, we just

26:39

need to get you on some good digestive enzymes.

26:41

Because for many people, it's helping

26:43

break down the carbohydrates, the fats, the

26:45

protein that'll get things moving along

26:47

and literally moving forward. I love my

26:49

digestive enzymes. I think that they

26:51

are an integral part of my supplement

26:53

regimen. And definitely one of those

26:55

things that I think can make a

26:57

big, big difference in how women

26:59

feel because so many of us deal

27:01

with bloating. Like that seems to

27:03

be a very common issue in middle

27:05

age. And digestive enzymes can be

27:08

very beneficial. Do you take any yourself?

27:10

I do. I just started actually

27:12

was interviewing Wade the Lightheart

27:15

from. He's a great interview. Yep.

27:17

Great interview. And. he basically

27:19

gave us like a masterclass on digestion.

27:21

And he was talking about, and this is

27:23

actually what made me switch. I was

27:25

like, yeah, yeah, yeah, digestive enzymes probably needed.

27:27

But then he was like, listen, you

27:29

are buying all this protein, consuming all this

27:31

protein, like make it work for you,

27:34

girl. And I was like, oh my God,

27:36

of course. So you can actually more

27:38

effectively, as we're losing some of our

27:40

own natural enzymes, you

27:42

can more effectively break down

27:44

and absorb the protein that

27:46

you are consuming. For

27:48

me, it's like, you tell me that I can

27:50

get gains in muscle mass by taking digestive enzymes

27:52

and like, I'm bought, I'm bought and I'm like,

27:54

show me where, where's the checkout? You know? So

27:57

yeah, I just started. So for me, I feel

27:59

like it's a little too early to tell, but

28:01

yeah, I'm really excited about it. Yeah. I think,

28:03

and I think that's the other thing is, you

28:05

know, we can eat really healthy food, but if

28:07

we can't break it down and assimilate it, that

28:09

becomes problematic. So I do think

28:12

digestive enzymes getting a good quality

28:14

one. for full transparency. I use

28:16

mass sims. I think that, you know, mass

28:18

sims is by bio optimizers and, you know,

28:20

they were, they were a podcast sponsor for

28:22

a while. I think I believe fervently that

28:24

that is the digestive enzyme that works really

28:26

well for me. There are other companies and

28:28

brands that are out there, but that's the

28:30

one that I personally take because that's usually

28:33

the other question I get is what do

28:35

you take? And I always say this is

28:37

what works for me, but maybe try a

28:39

couple brands out and see what you like.

28:41

Yeah. And this is the same. So I'm

28:43

taking the massimes and they do, they make

28:45

my favorite magnesium of all time. So I

28:47

love their magnesium product as well. All

28:49

right. So I think that she, that question

28:52

she got probably more than she bargained for,

28:54

but this is what these podcasts are for

28:56

is the nuance and the tangents. Where do

28:58

you want to go next, my friend? I

29:01

guess just, and this is

29:04

literally, I think we could answer

29:06

this question in one or

29:08

two sentences. Criteria for when you

29:10

have ceased your last period,

29:12

when do you become menopausal or

29:14

post -menopausal? And so I understand

29:16

the confusion because this terminology

29:18

gets used interchangeably. You're

29:21

either pre -menopausal, perimenopausal, or

29:23

menopausal, like that's it.

29:25

You don't ever get beyond

29:27

You're not never in

29:30

this post -apocalyptic menopause. Once

29:32

you're in menopause, you're there for life. You're

29:34

there. You're in the after party. You're there.

29:36

The after party. You stay there. That's

29:39

how I like to think about the nomenclature. You

29:41

know, pre menopausal would be anything under 35.

29:44

Perry menopausal would be like 35 to up

29:46

to the point where you have 12 consecutive

29:48

months without a period. And I know that

29:50

some women are going to be like, how

29:52

dare you? I'm 35. Like I am not

29:54

old, you know, cause we sort of associate

29:56

this very, yeah, we're very age sensitive, right?

29:58

So it's like Perry menopause. I'm 36. Like,

30:00

you know, do you look at me? You

30:02

know, I'm not, you know, cause

30:05

I think that there's this sort

30:07

of cultural stigma that, you know, once

30:09

you're Anything menopausal peri menopausal or menopause

30:11

you're like dried up and your you

30:13

know hair is gray and You know

30:15

you're only wearing cardigans and you know

30:17

like I don't I don't know

30:19

nothing nothing against cardigans I have some

30:21

but you know I just think that

30:23

there's this sort of like your life

30:25

is over kind of like you're not

30:28

useful anymore So yeah peri menopausal 35

30:30

to about 51 52 for most

30:32

women so it's like 15 like good

30:34

chunk of your life right like 15

30:36

ish years and then after you

30:38

know, you don't have a menstrual cycle anymore,

30:41

you're menopausal and you stay there. There's

30:43

no post menopause. There's no after

30:45

menopause. Yeah, it's interesting because when I

30:47

hear others describe menopause and after

30:49

menopause, some people say menopause is one

30:52

day in your life. I'm like,

30:54

I don't really believe that. I think

30:56

if it is, you know,

30:58

we have these buckets, your puberty. You

31:01

know, peak cycling years, then

31:03

perimenopause, then menopause, average age in

31:05

the United States is 51.

31:07

It's similar for most westernized countries.

31:09

What's interesting, though, are the people that are

31:12

in the in -between. And by

31:14

that, I mean, they're on long -acting

31:16

reproductive products like IUDs, people that

31:18

have had depoprovera or medications that are

31:20

they're not yet menopausal, but they're

31:22

not actually getting a cycle. So the

31:24

little dovetail caveat is always unless

31:26

you've had a total hysterectomy removing your

31:28

uterus and your ovaries, you know,

31:31

some people just have their uterus removed

31:33

and they're no longer getting a

31:35

cycle, but they're not yet menopausal. So

31:37

that is actually a large percentage

31:39

of women. Having said that, I think

31:41

at some point they will change

31:43

the nomenclature to incorporate, you know, this

31:45

kind of in between. I call

31:48

it the in between because they're not

31:50

yet menopausal. If you look at

31:52

lab work, They're still, you

31:54

know, they've still got, you know,

31:56

low FSH. It's not over 25.

31:58

They're maybe cyclically having symptoms throughout

32:00

their cycle. They're just not having

32:02

a menstrual flow and therefore helping

32:04

them understand like where they are.

32:06

So if you're 47 with an

32:08

IUD, you very likely are

32:10

probably not at menopause yet.

32:12

But for those of us that

32:15

have gone 12 months without a

32:17

menstrual cycle that are not part of

32:19

that long. They call it larks,

32:21

the long acting reproductive contraception in some

32:23

instances. If you're not part of

32:25

that larks community, yes, you are very

32:27

much in the peak fertile years,

32:29

perimenopause, menopause, and I call it menopause

32:31

and beyond because it's like menopause.

32:33

It's the, you know, third

32:35

of your lifetime is spent in menopause. It's

32:37

a long time. Yep. Yep. And lots of

32:39

time to make things happen. It's never too

32:41

late. You're never too old. You're never behind.

32:44

You know, you can start, you know, starting

32:46

a gut protocol. You can start, you

32:48

know, there's this woman that I follow on

32:50

Instagram. You probably know her. It's trained

32:52

with Joan. Yeah, she's amazing. She's,

32:55

I don't know how old she is, 80. I think she

32:57

might be 80. She's incredible. She's squatting,

32:59

deadlifting. And she only started a couple of

33:01

years ago. So it's like, you know, sometimes

33:03

I think I, I. wrestle with this too.

33:05

Sometimes I'm like, ah, I'm not helping enough

33:07

people. I'm not doing enough. I'm not reaching

33:09

enough people. I'm not, I'm behind. You

33:11

know, I have that sort of feeling,

33:13

this feeling of lack of time. And then

33:15

I look at Joan, who has, you

33:17

know, in the last year graced, I think

33:20

she was on Women's Health magazine and,

33:22

you know, she's this icon, at least for

33:24

me. For what's possible at any age

33:26

like any age you can start you're never

33:28

behind you're exactly like where you are

33:30

Right now is exactly where you're supposed to

33:32

be I was actually having this conversation

33:34

with my son for a separate reason But

33:36

I was saying to him like how

33:38

would you how would you be showing up?

33:40

Like he was having a situation like

33:42

an issue and I said how would you?

33:44

Show up to this situation if you

33:46

knew that everything was gonna be fine in

33:48

the end like it turned out exactly

33:50

the way that you wanted and I actually

33:52

give that advice to myself sometimes when

33:54

I feel like I'm behind the ball, I'm

33:56

not doing enough, I'm not good enough,

33:58

I'm not putting out enough content, I'm not

34:00

helping enough people. It's like, what would

34:02

it look like if it's actually, it turns

34:05

out exactly the way that you want

34:07

in the end? Like you help enough people,

34:09

you get enough women lifting weights, you

34:11

know, whatever it is, right? So

34:13

I would just offer that to any of

34:15

our listeners here as well. Like you are exactly

34:17

where you're supposed to be, you're not behind. If

34:20

you haven't started yet, that's okay.

34:22

you can start today. Your

34:24

future is still within your control.

34:26

I love that message. I think it's

34:28

important. And it's certainly, as someone

34:31

that I look to in the health

34:33

and wellness space, high integrity, great

34:35

content, positive influence, I

34:37

think we all have days like that. I

34:39

mean, I just finished a book manuscript

34:41

and I, you know, it sounds

34:43

like my publication date will be april of twenty

34:45

twenty six and in my mind i'm like

34:47

there's not enough time there's so many things i

34:49

want to do and and i finally just

34:52

told myself i needed to get out of my

34:54

head and just realize all the things will

34:56

fall into place you are a planner you have

34:58

the right resources all the things will fall

35:00

into place so i hundred percent agree with you

35:02

irrespective of where you are in life stage. You

35:05

have the ability to shift and pivot and

35:07

change throughout your lifetime. And I love that

35:09

you brought up Joan because she's someone that

35:11

I really look to as an incredible example

35:13

of what is possible. Yeah, love her. All

35:16

right, so we didn't do it in two sentences.

35:19

I don't think we ever do it in just

35:21

two sentences. We should try to

35:23

challenge ourselves, like answer this in one sentence. Be

35:26

concise. Well, I can tell you

35:28

the cardiology group that I used to

35:30

work for, they value as men because it

35:32

was almost all male cardiologists and the

35:34

NP service, they expected us to be as

35:36

concise as possible. Well, that ruined my

35:38

writing skills because I had to think about

35:40

What are the 15 things I have to put

35:42

into the sentence and make it as concise

35:44

as possible? And so I need to just reacquaint

35:46

myself with some of that, having said that. Love

35:49

it. Well, we can beat this is what pot.

35:51

I feel like Instagram is sort of like science light.

35:54

And the reason why we push people to the

35:56

podcast is where you can get the full answer, right?

35:58

Like I want, I want people listening to this

36:00

to feel like they have a seat at the table.

36:02

I want people to imagine that we're all having

36:04

coffee together and you're just sort of listening in on

36:06

a great conversation and there could be tangents and

36:08

there could be new ones and there could be details

36:10

that you just don't get on social media. Yeah,

36:13

absolutely. I've got a great

36:15

question here from Karen about

36:17

protein. As a menopausal woman,

36:19

I hear your message to be sure to

36:21

eat enough protein. I'm finding it hard to

36:23

get more than 90 grams per day while

36:25

still getting enough other micronutrients as I get

36:27

too full for meeting my veggies. I

36:29

think of my 89 -year -old mother, who

36:32

I am encouraging to eat more protein. However,

36:34

her appetite is lessened, which is so

36:36

common, and other nutrients are important too. I'm

36:38

looking for tricks to get in protein

36:40

and everything else for good health. She

36:42

asked about some other things, incomplete

36:44

protein like collagen peptides. How do

36:47

you answer this question as so

36:49

many of our listeners are dealing

36:51

with the same issues. They're watching

36:53

aging parents. We're in the sandwich

36:55

generation. They're struggling to get enough

36:57

protein in. I know that we

36:59

probably have interviewed guests that have had varying

37:01

opinions on this as well, like Mark Sisson

37:03

as an example. He talks about this very

37:05

openly. What are your thoughts?

37:07

How do you encourage women to get enough

37:09

protein in and how do you deal with older

37:12

Men and women who probably don't have

37:14

as much appetite and aren't as

37:16

physically active aren't hydrated all those things

37:19

contribute to that appetite regulation, too

37:21

Yeah, there's there's a lot of factors

37:23

here. I would say that I

37:25

would get in touch with your inner

37:27

protein shake I had one this

37:29

morning. Yeah, so I would say that

37:32

that is basically a food group

37:34

in our home is you know protein

37:36

shakes. So that is a

37:38

very easy way. Like one scoop of

37:40

most proteins, whether it's a vegetarian

37:42

or a way based protein is going

37:44

to give you somewhere between 25,

37:46

you know, 20 to 25 grams of

37:48

protein per scoop, which is really,

37:50

really easy. And when you are consuming

37:52

something in liquid form, it's not

37:54

quite as filling as let's say five

37:56

ounces of chicken. Plus

37:58

the vegetables plus the rice or whatever else

38:00

is on the plate. So it's a

38:02

little easier to get in your protein sometimes

38:04

in liquid form It's also a little

38:06

easier on the digestive tract just sort of

38:08

looping back to what we were talking

38:10

about Because the work has sort of already

38:13

been done for the digestive system, right?

38:15

You're not like the mastication and the breaking

38:17

down from a solid into like a

38:19

bolus into like liquid and extracting All that's

38:21

already kind of been done for you

38:23

with the Vitamix or whatever you're you know,

38:25

whatever mixer you're using So I would

38:27

say love shakes as a way to get

38:29

in more protein. The other thing that

38:31

I have been experimenting with lately, because I

38:33

actually get this comment, not even just

38:35

with like 89 year old moms, I get

38:37

this comment from 45 year old women

38:39

that are like, how much meat or how

38:41

much, like how much tofu do I

38:43

actually need on my plate? I'm actually having,

38:45

you know, to this person's comment, I'm

38:47

having such a hard time getting more than

38:49

90 grams of protein. I actually think

38:51

that baking with protein is my, at least

38:53

that's been like a big secret for

38:55

me and my family, because I always don't

38:58

just want to have meat. I eat

39:00

meat. I'm a meat eater. Love meat. But

39:02

I love to have dessert and I'm

39:04

not going to give up dessert. Like

39:07

that's the other, that's my hard boundary

39:09

is like, I still want to enjoy

39:11

dessert. So I have been experimenting with

39:13

protein brownies and chocolate mousses and, you

39:15

know, Cottage cheese and Greek yogurt usually

39:17

make up the bulk of those recipes,

39:19

you know, I made one just the

39:22

other day It was a protein brownie

39:24

and it was basically like Greek yogurt.

39:26

I put some collagen I put protein

39:28

powder in there put some cocoa and

39:30

I think put some sugar like mix

39:32

it all up and threw it in

39:34

the oven and it was so delicious

39:36

and it felt like I was having

39:39

a brownie. It tasted like, you know,

39:41

sometimes you bake something with protein and

39:43

you're like, oh, this tastes awful. Like

39:45

I can taste the chalkiness. It tasted

39:47

wonderful. So I would

39:49

say baking with protein. And

39:51

then liquid forms of like a protein

39:53

shake are easy ways to help the

39:56

digestive capacities of someone who doesn't have

39:58

that, you know, that, that, that digestive

40:00

faculty anymore, that maybe is having trouble

40:02

breaking things down and absorbing them. The

40:04

digestive enzymes that we've already talked about.

40:06

And then I think that the, I

40:08

think that for me, she was saying

40:11

something about like, she gets too full

40:13

to eat her veggies. I would, I

40:15

would start with if she's having a

40:17

solid meal, let's say. I

40:19

would start with the protein and then you

40:21

can move on to like the rice or the

40:23

veggie, like, you know, whatever the carbs or

40:25

the fat are, but I would eat the, I

40:27

would eat the protein first to make sure

40:29

that you're getting in the protein because your hunger

40:31

signals, it takes about 20 minutes or so

40:33

depends on the person, but about 20 to 25

40:35

minutes between the signal and the stomach. that

40:37

you're full to kind of get up to the

40:39

brain. So 20 minutes into eating, you've probably

40:41

consumed the protein, maybe you've gotten into the fat

40:43

as well. And then I would leave the,

40:45

I'd leave the carbs for, for last. So those

40:47

would be sort of my, you know, action

40:49

items, action items there. Anything that

40:52

I missed or that you'd like to

40:54

add? No, no, I love the creativity

40:56

because I think that's, that's key. What

40:58

I typically find is. giving women some

41:00

type of a sense of what 30

41:02

grams of protein looks like, because more

41:04

often than not, it is not this

41:06

massive portion of protein. They are underestimating

41:08

their protein. So tracking macros to get

41:10

a sense of how much protein you're

41:12

eating is number one, because then you

41:14

can build awareness around that. Number two,

41:16

I 100 % agree with you about the

41:18

protein shakes. And for me, that's really

41:20

how I when I went from having

41:23

a tight fasting window to two meals to

41:25

three meals. I worked it up with two

41:27

meals and then a protein shake. And now

41:29

probably I'm having a protein shake twice a

41:31

week. I really can now manage that third

41:33

meal. I think it's all

41:35

about finding what feels good to your

41:37

body. For me, I'm very much a

41:39

red meat person. I like bison. I

41:41

like beef. I like elk. I don't

41:44

love chicken. I will occasionally eat chicken.

41:46

And when I say occasionally, like maybe

41:48

twice a month, but more often than

41:50

not, I will, you know, have some

41:52

fish or some selfish It's finding what

41:54

is sustainable and easy. And I love

41:56

that you brought up having some protein

41:58

powder incorporated into some protein options. And

42:00

for me, sometimes I'm just, you know,

42:03

I train on Monday afternoons. And so by

42:05

the time I get home from the

42:07

gym, I'm not really interested in having a

42:09

big meal. Usually lunch on Mondays is

42:11

my big meal. And then I'll have something

42:13

smaller. Sometimes it's a protein pancake that's

42:15

made with, you know, whey protein, a part

42:17

of a banana mushed up. It

42:19

usually may incorporate an egg and, you

42:21

know, it ends up being like enough protein

42:23

that it's reasonable and feasible. It tastes

42:26

delicious. And it's just a different way to

42:28

eat eggs and weigh protein together and

42:30

do it in a way where the eggs

42:32

are safe. Cause I. Fervently believe

42:34

I have a teenager who will eat a

42:36

dozen eggs in a sitting. He'll just break

42:38

them open and chug them down cause he,

42:40

he's kind of a machine, but that, that's

42:42

just not the way that I like to

42:44

consume eggs. Having said that. You

42:46

know, first of all, measure what you

42:48

are consuming. So you have a sense

42:50

of how much protein you're consuming and

42:52

then start slowly increasing it. What I

42:55

can tell you about older patients is

42:57

that they've gone many years with a

42:59

lot of muscle mass loss. So their

43:01

metabolism shifts after the age of 60.

43:03

I find that they, you know, their

43:05

sense of taste is changing sometimes. You

43:08

know, they don't want to just cook

43:10

for themselves anymore. So I think sometimes

43:12

you have to find the things that

43:14

they like and enjoy and help them

43:16

capitalize on that. My mother -in -law is

43:18

both visually impaired now. Unfortunately, she's sharp

43:20

as a tack, you know, mentally, but

43:22

visually has some deficits, has some mobility

43:24

issues. And my husband and

43:26

my sister -in -law will cook for her, freeze

43:29

things for her, and then she can

43:31

defrost it. And she gets bored really

43:33

easily. And so I think when we're

43:35

talking about older adults, it's finding things that

43:37

they like and maybe helping them prep

43:39

ahead so that they don't spend a

43:41

lot of time cooking. That may also help

43:43

them be more interested in getting that

43:45

protein in. But I can tell you

43:47

from my own experiences with my mother, who

43:50

is 79 years old, she is stubborn. And

43:52

she wants to eat her one meal

43:54

a day, and that's what works for

43:56

her. And we've just kind of left

43:58

it. I've told her I'm de -obligating

44:00

myself from worrying about her protein consumption.

44:02

I just gently keep reminding her that

44:04

maybe add some collagen, maybe have

44:07

some essential amino acids, which is something

44:09

I know we didn't talk about for some

44:11

of us who are trying to buffer

44:13

that protein intake. When I travel,

44:15

sometimes I'll take essential aminos, but it's not

44:17

something I do every day. And I

44:19

only use it in very rare instances where

44:21

I'm concerned about buffering that protein intake.

44:23

But there's lots of different things you can

44:26

do. It's what is feasible and reasonable

44:28

and then working from there. And if 90

44:30

grams is what you can do consistently,

44:32

please don't beat yourself up about it. That's

44:34

a lot more than most women are

44:36

consuming. I think the averages I've looked at

44:38

have been maybe 45 to 50 grams

44:40

at best. Yeah. Yeah. I've read. I've

44:43

read 50 to 60 grams on a date and

44:45

it's like 90 grams is, you know, you're already sort

44:47

of in the top percent. Yes. You're

44:49

still winning. Yeah, you're still winning. And

44:51

maybe it's a little bit of collagen

44:53

or protein and you're blended in your morning

44:55

coffee. I know that, and your point

44:57

around the elderly being stubborn, it's like they

45:00

are just set in their ways, right? So

45:02

we also have to be, we also have to

45:04

understand that because one day too, we're going to be,

45:06

we're going to be there and our children are

45:08

going to be like, mom, the latest stuff says this

45:11

and you're like, nope. I want my protein brownies.

45:13

I don't want, I don't want nothing else. Right. There's

45:15

going to be some new science in 30 years

45:17

that I am not going to be willing to listen

45:19

to. So we also have to just, just have

45:21

to love them a little bit for where they are

45:23

too. Absolutely. Without question. A

45:25

couple more questions I'd love to try

45:27

to tackle. We know that

45:29

stress is without question. There's no stress

45:31

free existence. I'm sure even monks

45:33

in Tibet probably have some degree of

45:36

stress that they experience. Yeah. This

45:38

question is, there is a theory that

45:40

fasting puts too much stress on

45:42

the body, which isn't good for health.

45:44

What are your views on this?

45:46

This is from Zelda. Now,

45:48

we talked about hormetic stress,

45:50

beneficial stress, right amount. I'd

45:53

love to get your perspective on this

45:55

because I have no doubt that we are

45:57

very unified. When you're talking

45:59

to women online or in programs, how

46:01

do you address this type of

46:03

question? Oh

46:05

my. This is, I'm probably

46:07

gonna upset some people, but here

46:09

we go. So I think

46:11

that there's this pervasive theory. Well,

46:14

first let me back up and I'll just

46:16

say that. I'm not sure, this applies in many

46:18

different facets, but I'm not sure where along

46:21

the lines we were taught to fear our own

46:23

hormones. We're taught to fear

46:25

estrogen because it causes X and

46:27

Y, breast cancer and heart attacks. We're

46:29

taught to fear cortisol because, you

46:31

know, it does, it's, you know, with

46:33

fasting or any type of hormetic

46:35

stress, it, things raise cortisol, coffee raises

46:37

cortisol, therefore coffee's bad. I think

46:39

that there's this idea that our hormones

46:41

are somehow working against us and

46:43

that There's

46:45

lack of nuance in terms of their understanding. So

46:47

I just want to talk about cortisol specifically. We

46:49

can certainly talk about estrogen. But I

46:52

hear this a lot from women.

46:54

It's like, isn't the sauna or the

46:56

cold plunge or the fasting or

46:58

the coffee or the workouts, the intense

47:00

leg days, doesn't that raise cortisol?

47:02

And it's like, yes, it does.

47:06

You know, the reason why you wake up every morning

47:08

is because your cortisol raises in the morning, right?

47:10

It's like, should you stop sleeping?

47:12

Should you stop exercising because cortisol raises?

47:15

No, that is a normal response

47:17

to the stimulus, right? If you are

47:19

doing an intense leg day or

47:21

back day or whatever, you know, even

47:23

like a, you know, high intensity

47:25

interval training, that is going to raise

47:27

your cortisol, but that is not

47:29

necessarily a bad thing. Cortisol is working

47:31

in this instance to actually mobilize. fuel

47:34

for your muscles, right? So cortisol is

47:36

one of its jobs is to actually

47:39

make sure that the, the, let's say

47:41

it's the glucose or the amino acids doesn't

47:43

that it actually stays in the blood

47:45

so that you can preferentially throw it

47:47

to the muscles, like the, the musculoskeletal system,

47:49

right? So it's, it's a, you know,

47:51

fight or flight. This is for the

47:53

fighting or the flighting, right? This is

47:55

a good thing, right? This is

47:57

core stress in, in and of

47:59

itself is not bad, right? Acute stressors.

48:02

can be things like leg day,

48:04

can be things like a cup of

48:06

coffee, fasting. It's

48:09

just when the stress, like

48:12

if I just said, okay, you're gonna do

48:14

leg day for the next 24 hours. That's

48:17

when it becomes problematic. You can't sustain

48:19

that amount of you know, you can't

48:21

sustain that amount of stress for that

48:23

long. Or if I said, Hey, now

48:25

you're going to fast for 96 hours.

48:27

Like that's when it starts to, where

48:29

we start to get some of these

48:31

diabolical consequences, right? It's like the chronicity

48:33

is what makes the stress good or

48:35

bad, right? Exercise, obviously

48:37

short -term acute stress makes us stronger

48:39

over the long term because we

48:41

have the adaptations that happen as a

48:43

result of it. Fasting, same thing.

48:45

Coffee. Like, you're going to take coffee

48:48

out of my cold, dead hands. Like,

48:50

I am not giving up coffee. Same

48:52

with, you know, cold plunges and saunas.

48:54

These all raise cortisol. But it's

48:57

just what I find is

48:59

that people are so concerned

49:01

about raising cortisol that they're

49:03

not actually engaging in the

49:05

healthy, like they're, they're, they're

49:07

ignoring the areas where they

49:09

could have a meaningful impact

49:11

on chronic low -grade cortisol,

49:14

like being in a job

49:16

that you hate. or in

49:18

a relationship that isn't working

49:20

or enduring some kind of

49:22

toxic behavior or, you know,

49:24

malignant behavior from someone without

49:26

setting any healthy boundaries for

49:28

yourself, right? These are

49:30

areas where you can actually

49:33

meaningfully make progress in terms

49:35

of that subclinical low grade

49:37

stress or resolving, you know, residue

49:40

that resides on your nervous system from,

49:42

you know, when you were a young girl

49:44

or a young adult, you know, some

49:46

maybe maltreatment as a child or, you know,

49:48

something. We've all, you know, it's just

49:50

like part of part of life. We're gonna,

49:52

we're gonna endure things that are difficult.

49:54

So I would say working on that stuff.

49:57

is less sexy. It's

49:59

less tangible because there's no start and

50:02

stop, right? We don't know how long it's

50:04

going to actually take us to get

50:06

good at setting boundaries. So we, we turn

50:08

to things like leg day or fasting

50:10

or things where we're like, Oh, I should,

50:12

should I be fasting 16, eight anymore?

50:14

Should I, should it, should it be 12?

50:16

You know, we sort of try to

50:18

find other ways. And so I applaud the

50:20

effort, but I would say that, you

50:23

know, glad that there's awareness around. around this,

50:25

but it's the chronic stuff that's really

50:27

getting you. It's not whether or not you're

50:29

fasting for 16 hours. I mean,

50:31

maybe if you're fasting for 16 hours and

50:33

you're starving and you're denying your own hunger signals

50:35

and you've been doing that for years, okay,

50:37

now we have a chronic low grade. We have

50:39

a chronic stress that you haven't addressed. But

50:42

I would say looking at some of the

50:44

things that are messier, uglier, that's where you're

50:46

really going to get the more bang for

50:48

your buck in terms of lowering your stress

50:50

and you should never skip leg day. don't

50:52

let friends skip leg day. I'm not going

50:54

to let you skip leg day. You're

50:56

not going to get out of it, but

50:58

you shouldn't, but you shouldn't be doing high intensity

51:00

interval training like six days a week either.

51:02

Right. So you should be, you know, selectively doing

51:04

that one or two times a week. So

51:06

I know that that's a bit of a convoluted

51:08

answer, but I would say don't be afraid

51:10

of your own hormones. Cortisol is

51:13

not your enemy. There's a difference between

51:15

good stress and bad stress. You stress

51:17

distress and then acute and low like

51:19

acute and chronic stress. We have to

51:21

also differentiate between as well. I think.

51:23

There are so many good points there.

51:25

And I think just to really kind

51:27

of reaffirm this is that we can

51:30

have this very kind of duality of

51:32

good, bad. There's nothing in between. And

51:34

I always say most of us exist

51:36

in the gray, meaning that a little

51:38

bit of stress is beneficial. Too much

51:40

stress is not. And it's determining as

51:42

we are navigating this perimenopause to menopause

51:44

transition, what is right for us? Like

51:47

as an example, I will give you

51:49

an example. And I think

51:51

Sarah Gottfried even talks about this. I

51:53

don't like cold. But I

51:55

will be the first person to say

51:57

doing a little bit of cryotherapy, a

51:59

little bit of cold shower is good

52:01

for me. But sticking me in a

52:03

plunge pool would probably do detrimental for

52:05

me personally, detrimental things to me personally,

52:07

because that would be too much stress.

52:09

But to someone else that might be

52:11

great and that might be a lot

52:14

of beneficial stress. So I think for

52:16

each one of us, it's having that

52:18

conversation about how lifestyle is influencing our

52:20

stress levels. And then also,

52:22

honestly, having a conversation with

52:24

yourself that if you are not

52:27

taking a pause, so perimenopause,

52:29

menopause, pause is an important word

52:31

here. If you are not

52:33

reflecting on what is working for

52:35

you or not working for you at

52:37

this stage of life, you're missing

52:39

an opportunity. My life looks

52:41

vastly different than it did 10

52:43

years ago. I am 53. I

52:45

will be 54 this year. Ten

52:48

years ago, I was in the

52:50

midst of perimenopause. I hit a wall.

52:52

And so I openly talk about

52:54

how many changes I had to make

52:56

to be able to navigate the

52:58

rest of perimenopause into menopause in a

53:00

way that supported my hormones, some

53:02

of which were starting to falter. and

53:04

support my lifestyle. And so I

53:06

think you brought up so many good

53:08

points about the lifestyle piece, not

53:10

being fearful of hormones. We've been fear

53:12

mongered around hormones for over 20

53:14

years. Thankfully, things are coming back around

53:16

now. And we're starting to get

53:18

better information. But I think

53:20

that we have to take a very

53:23

nuanced approach to these conversations. And

53:25

then just being honest about what's working

53:27

for you, there are probably people listening

53:29

that can still do more intense exercise,

53:31

and they don't feel depleted. And then

53:33

others may feel like You know, I

53:35

went from doing, I would say, CrossFit

53:37

-ish type classes in my late 30s,

53:39

early 40s. And then afterwards, I was

53:41

like, that degree of stress and

53:43

intensity no longer works for me, but I

53:45

can lift heavy and I can do

53:47

hit or, you know, jump training twice a

53:49

week and I do it in a

53:51

short window and that works really well. So

53:53

I would just say, consider what is

53:55

serving you within your personal life and make

53:57

adjustments accordingly. Great. I

53:59

love that. Last question. This

54:01

is a question from Erica. She mentions,

54:04

I was able to lose 130

54:06

pounds in my early 40s using intermittent

54:08

fasting. At that time I was

54:10

just starting perimenopause. Now I'm hearing that it

54:12

is dangerous for menopausal women to fast this

54:14

way and that we should not work out

54:16

fast but eat before and after due to

54:18

cortisol. Is this right? I'm

54:20

still maintaining my weight loss using

54:22

intermittent fasting and fasted workouts. Great

54:25

question. Good question. First of all,

54:27

congratulations. Yes, it's amazing. God,

54:29

how many? 130

54:31

pounds. That is a

54:34

person. Yes, 130

54:36

pounds sustained. That's incredible. Good

54:38

for you. Okay, so this question

54:40

I think is getting the heart of

54:42

it is like fasted cardio or

54:44

fasted training versus not fasted cardio or

54:46

fasted training. I will say this,

54:48

if intermittent fasting is working for you

54:50

clearly, it is, you can continue

54:52

doing that. The literature is pretty clear.

54:54

It doesn't actually matter whether you

54:57

train fasted or you train fed in

54:59

terms of fat loss, right? So

55:01

if you train, let's say you do

55:03

your cardio or you're training fasted,

55:05

you burn more fat during the activity.

55:07

So let's say you're on the

55:09

treadmill or you're lifting weights or whatever,

55:11

you burn more fat during that

55:13

activity. because your body's trying to mobilize,

55:15

again, cortisol is rising, trying to

55:17

mobilize some substrate for your muscles to

55:19

be able to work. But

55:21

once the activity stops, you

55:23

actually burn less fat over the

55:25

next 24 -hour period. If

55:28

you train fed, so you

55:30

eat something beforehand, you

55:32

will burn less fat during the activity,

55:34

but your fat loss is going to

55:36

be augmented or higher after that after

55:38

that activity stops. So it's like it

55:40

evens out, right? So whether or not

55:42

you train fasted or not. In terms

55:44

of if the goal is fat loss,

55:46

there's no difference. Okay. What does seem

55:48

to matter is total protein intake. Obviously

55:50

we've talked about this. You talked about

55:52

this on your show. I talked about

55:55

this on the show in that 24

55:57

hours following the training or the activity

55:59

that you're replenishing both the protein and

56:01

the glycogen lost in the muscle in

56:03

order to do that activity, whatever the

56:05

activity was. So I would say like.

56:07

keep at it girl like if you'd

56:09

like to train fasted and that's fine

56:11

where I do think that there is

56:13

a difference with fasted versus non fasted

56:15

is performance in the gym so what

56:17

I find personally during the week like

56:19

this morning I I go to the

56:21

gym I don't have the stomach to

56:23

fully eat something. Okay. So depending on

56:25

the time, I'll either have protein and

56:28

oats, which I lovingly call prots. So

56:30

it's just like some oats go so

56:32

well together, right? So prots. So some

56:34

protein powder and oats before I find

56:36

that that is easy for me to

56:38

digest. I have it 20 minutes in.

56:40

And then by the time I get

56:42

to the gym, like I'm ready to

56:44

rock or all the other thing, if

56:46

it's, if it's super early, like there's

56:48

a couple of days in the week

56:50

where My kids have early

56:52

training, so if I don't get to

56:54

the gym at like an ungodly

56:56

hour, like 5 .30, then my

56:59

workout for that day is just not going

57:01

to happen. So I get to the

57:03

gym, and what I'll do is I'll have

57:05

ketones instead. So ketones are... just basically

57:07

like a drink, shout out to Ketone IQ,

57:09

who, one of the sponsors of my

57:11

show anyway, I absolutely love their stuff.

57:13

So they come, it comes in like Green Apple

57:15

and Peach or whatever. So I'll take a shot of

57:17

that. And that gives my muscles and my body

57:19

substrate, enough substrate for me to get through the workout

57:21

and then I'll come home and then, you know,

57:23

drop the kids off and then I eat and then

57:25

I have like a nice big breakfast. So

57:28

that would be how I would respond to

57:30

it. So if it's, it really comes down

57:32

to the goal. If the goal

57:34

is fat loss, the literature seems to be

57:36

pretty clear. It doesn't really matter. It's kind

57:38

of whatever you prefer to do. If you

57:40

are looking at performance in the gym, some

57:43

kind of substrate prior to the

57:45

workout does seem to augment. It

57:47

just seems to help with your

57:49

endurance. It seems to help with

57:51

your ability to push further. You

57:53

know, just its fuel for the nervous

57:55

system because a workout is a nervous

57:57

system endeavor. So that's how I would,

57:59

that's how I would answer that. That's

58:01

absolutely perfect. So I think for anyone

58:03

listening that feels like they are trying

58:05

to navigate this. And I had Dr.

58:07

Stacy Simpson and she was talking about

58:10

how she doesn't like fasted exercise, you

58:12

know, based on her research. And so

58:14

I encourage anyone just to do some

58:16

degree of experimentation. Like on Mondays, I

58:18

have an afternoon workout. I've had two

58:20

meals before I go to the gym.

58:22

I can push way harder than I

58:24

do at 9am on Wednesday morning, which

58:26

is my other. concerted

58:28

like dedicated time to be in the gym

58:30

and lifting. And on those

58:32

days, I will actually have a piece of fruit

58:34

in route to the gym. And sometimes I

58:36

will have a protein bar because it just depends

58:38

on how hungry I am. And yes, you

58:40

can find some protein bars. Now, I usually will

58:42

say eat beef jerky, but I don't want

58:44

anything salty in the morning. For some reason, that

58:46

is not what appeals to me. I do

58:49

find on Mondays, I can push myself way harder.

58:51

That's usually when my trainer will push me

58:53

way harder than she will on Wednesday morning. And

58:55

that has been an end of one experiment for

58:57

me personally. So I will have two

58:59

meals. I'll work out at four o 'clock, four to five.

59:01

And then I go home and I eat a small

59:03

dinner because I don't really want to eat much at

59:05

six o 'clock at night. With that

59:08

being said, I was surprised to see

59:10

how differently I could show up and

59:12

work out with more food on board.

59:15

And I still work out hard on Wednesday morning.

59:17

I just don't work out like I can't

59:19

push myself quite as hard without having a little

59:21

bit of fuel. And that doesn't mean that

59:23

my body can't access stored fuel. It's just I've

59:25

noticed that my performance, that's not the morning

59:27

I want them to try to have me do

59:29

a dead hang for a minute and a

59:31

half. I'm like, no, it's not happening. The other

59:33

thing that's actually interesting about that is. maybe

59:36

one of the reasons that you're finding

59:38

that your performance is better on the

59:40

Monday in the afternoon is your core

59:42

body temperature is also higher, right? So

59:44

you've had the two meals, like you've

59:46

said, you've probably been moving around somewhat,

59:49

joints are nice and lubricated. And also

59:51

your core body temperature is elevated. So

59:53

that also does seem to influence performance

59:55

in the gym as well. And so

59:57

I, and that doesn't mean

59:59

that if you like, if you have to

1:00:01

work at a 530, like you just got

1:00:03

to get it done, right? So. This is

1:00:05

just another comment to say, there's optimal times

1:00:08

to do things like. when Cynthia's working out

1:00:10

on Mondays, she's basically like, if there was

1:00:12

like a perfect to do, like a checklist

1:00:14

that, like she's followed it, right? So it's

1:00:16

like two meals, some gentle movement, core body

1:00:18

temperatures elevated. That's when she can push herself

1:00:20

because your nervous system has been primed. You

1:00:22

have fuel, but on the Wednesdays, let's say

1:00:24

when your workouts at nine, core body temperature

1:00:27

hasn't peaked yet. Our core body temperature peaks

1:00:29

usually around noon -ish for most, like if you're

1:00:31

based on, like you're waking up. you know,

1:00:33

assuming that you're waking up at, you know,

1:00:35

your honest circadian rhythm where you're waking up

1:00:37

when it's, waking up when it's like going

1:00:39

to sleep when it's dark. 12 to one

1:00:41

is usually when our core body temperature peaks,

1:00:43

but you're working out at nine because that's

1:00:45

the time that you have that day, right?

1:00:48

I work out some, like some days at

1:00:50

five 30 in the morning with ketones because

1:00:52

I don't have time for fuel. I haven't

1:00:54

had my core body temperature. I'm still cold.

1:00:56

So I got to make sure I really

1:00:58

do some mobility drills before I start. Really

1:01:01

pushing but the point is you're there's sometimes

1:01:03

when you're gonna get it like perfectly, right? It's

1:01:05

gonna be super optimal and then other times

1:01:07

it's going to be less than that But you're

1:01:09

just gonna find a way to get it

1:01:11

done because that's life life is not perfect Things

1:01:13

are gonna be messy, you know, it's somewhere

1:01:15

in the messy middle that we often find ourselves

1:01:17

And I think it's important, you know, there

1:01:19

were definitely many years where my kids swam in

1:01:21

the morning And then we were up at

1:01:23

four I was up at four to get them

1:01:25

to the pool at five and that was

1:01:27

my time to work out and and I look

1:01:29

back now and I cringe, but you know,

1:01:31

there's only so many years we have with our

1:01:34

kiddos before they get launched out of the

1:01:36

house. And so I think we have to work

1:01:38

with what we have. And certainly many

1:01:40

years where I had to be in the hospital

1:01:42

at 730 in the morning. So I was in

1:01:44

the gym early because that was the only time

1:01:46

I could actually get that done. So I think

1:01:48

for each one of us, it's figuring out what

1:01:50

works for us, what makes our bodies feel good

1:01:52

and actually embracing that because I think for some

1:01:54

people, When they start experimenting, whether

1:01:56

it's with different times, different types of modalities, maybe

1:01:58

working out from home versus in the gym,

1:02:01

finding out what works best for you. I now

1:02:03

have become a work, like a home, home

1:02:05

body, because I actually really prefer working out at

1:02:07

home because I don't care what I look

1:02:09

like. I don't have to match. I don't care

1:02:11

if my socks match. When I go to

1:02:13

the gym, I have to have a couple extra

1:02:15

things like, do I match today? I

1:02:18

have a puppy who likes to chew up socks. So

1:02:20

I have a lot of unmatched socks right now for

1:02:22

the gym, which is a source of never ending humor

1:02:24

slash frustration. I think for each

1:02:26

one of us, it's figuring out what

1:02:28

is what is working for us and

1:02:30

what is not. And don't be afraid

1:02:32

to, to course correct, just like this

1:02:34

entire conversation. You know, maybe working out

1:02:36

in the morning has worked for you really well, and

1:02:38

then you start figuring out you work out better

1:02:40

midday or in the afternoon. I'd be the first person

1:02:43

to say you could have knocked me over with

1:02:45

a feather. I never would have imagined that I could

1:02:47

push myself so hard in late afternoon. In fact,

1:02:49

I kind of demotivate myself sometimes. I'm

1:02:51

like, I'm going to the gym. I'm getting in

1:02:53

the car. I'm not as motivated, but I

1:02:55

always feel better after the fact, even if you're

1:02:57

not feeling particularly motivated, get the workout in.

1:02:59

Yeah. And even there's some days when I get

1:03:01

to the gym and. I feel so tired

1:03:03

and then I just end up having the best

1:03:05

workout. And then sometimes the opposite's

1:03:07

true too. I do all the right things.

1:03:10

I've slept like a beast. I've had my pre

1:03:12

-workout. I'm ready to go and I don't have

1:03:14

anything to give. And I just leave it

1:03:16

all, like whatever I have to give, I do.

1:03:18

And sometimes I have to modify. So all

1:03:20

of it is like all of it, all of

1:03:22

it counts. You know, that you showed up

1:03:24

is like 90 % of the game. So yeah.

1:03:26

Oh, I'm curious. So what pre -workout are you

1:03:29

doing? Are you doing like coffee as your pre

1:03:31

-workout or do you have like a formal pre

1:03:33

-workout? Oh, I, I do both. So coffee early

1:03:35

in the morning, I have a, I'll have

1:03:37

like a shot of espresso if it's like my

1:03:39

super early 530 morning. When I work out

1:03:41

at a bit more of a reasonable hour, like

1:03:43

today I was at the gym at about

1:03:45

630. I'll have my cappuccino. I have like my

1:03:48

cappuccino in the morning, but I do have,

1:03:50

uh, I will, sometimes I will also take like

1:03:52

a formal pre -workout, which has, you know, has

1:03:54

all the things that it has caffeine in

1:03:56

it. It has all the things. Yeah. Beta -al

1:03:58

and all the things that give you like the

1:04:00

sort of, I, I get a little bit

1:04:02

tingly. My face gets a little bit tingly. I'm

1:04:04

like, okay, so now I get to talk

1:04:07

to God. Well, I'm

1:04:09

doing my squats and my face is tingling

1:04:11

and I'm looking up for mercy. I'm like,

1:04:13

all right, I'm gonna a conversation now. So

1:04:15

yeah, so I take pre -work. I usually

1:04:17

do the pre -workout on the weekends because my

1:04:19

weekend gym schedule is a little bit more

1:04:21

lax. I typically go later in the morning

1:04:23

or if my kids have a game, then

1:04:25

I'll go after the game, which is usually

1:04:27

in the afternoon. So again, like you've had

1:04:29

a couple of meals in, I've had some

1:04:31

coffee and like I'm ready to go. So

1:04:33

the pre -workout usually comes in on the

1:04:35

weekends. Yeah. I'm always asking other women like

1:04:37

what they do and what works well for

1:04:39

them. I am not a coffee person, but. The

1:04:42

more I read the research, the more

1:04:44

I should be a coffee person. So I

1:04:46

keep trying to find ways because I

1:04:48

find it too bitter. That's my biggest issue

1:04:50

is it's I'm a hypertaster. So

1:04:52

things to extremes. I'm like, when I used

1:04:54

to eat cheese, like even eating the strong

1:04:56

cheeses never appealed to me. Probably TMI, but

1:04:58

I do drink iced green tea. That is

1:05:01

the way that I get it down. I'm

1:05:03

like, I know it's beneficial. And

1:05:05

that's what I do. But I usually

1:05:07

other than water or creatine electrolytes, that's usually

1:05:09

all I do. Okay. So the thing

1:05:11

I'm going to tell you, I put, so

1:05:13

what I love to put in my

1:05:15

cappuccino is a sugar -free syrup. It's like

1:05:17

a salted caramel. Flavor,

1:05:20

I'll send you the link. We'll put the

1:05:22

link in for the show notes for anyone who

1:05:24

wants to I forget the name It's like

1:05:26

Matthews or Mateos or something I mean I just

1:05:28

pick it up off of Amazon and it's

1:05:30

like a salted caramel Shot and I'll put the

1:05:32

coffee in it because coffee can be bitter

1:05:34

but even when I have the special shot I'll

1:05:36

put like a little bit of that salted

1:05:38

caramel and it's I mean maybe so there's like

1:05:40

they have a thousand flavors They have like

1:05:42

you know maple and they have you know English

1:05:44

toffee and hazelnut like they have all different

1:05:46

flavors But that I find makes the coffee bit

1:05:48

more palatable. There's no sugar in it. It's

1:05:51

like a sugar alcohol. So I'll, I'll share that one

1:05:53

with you and you can, you can let me know. Yeah.

1:05:56

Definitely. Definitely. I'm, I'm always open. In fact, I

1:05:58

came back from a functional med program that

1:06:00

I'm doing and I was like, dang, I gotta

1:06:02

try coffee again. I'm going to have, there's

1:06:04

just so many health benefits to it that I'm

1:06:06

like, all right, we're going to try. We're

1:06:08

going to keep trying. Well,

1:06:10

I'm gonna send you that link and then next

1:06:12

time we meet up. This is a good this is

1:06:14

a good cliffhanger next time We meet for this

1:06:16

she said she said you can tell me if you've

1:06:18

tried it and then we can we can talk

1:06:20

about coffee. Yeah, absolutely lots of benefits Awesome. It's always

1:06:22

good connecting with you my friend and till next

1:06:25

time sounds good All right,

1:06:27

all right, I hope you

1:06:29

enjoyed today's episode. And I

1:06:31

must give you the obligatory

1:06:33

legal and medical disclaimer here.

1:06:35

This podcast better with Dr.

1:06:37

Stephanie is for general information

1:06:40

only. And the advice recommendations

1:06:42

we discuss do not replace

1:06:44

medicine chiropractic or any other

1:06:46

primary health care providers advice,

1:06:48

treatment or care. In the

1:06:50

consumption of this podcast, there

1:06:52

is no doctor patient relationship

1:06:55

that has been formed and

1:06:57

the use and implementation of

1:06:59

the information discussed are at

1:07:01

the sole discretion of the

1:07:03

listener. The information and opinions

1:07:05

shared on this podcast are

1:07:07

not intended to be a substitute

1:07:10

for primary care. diagnosis or

1:07:12

treatment. In other words, guys,

1:07:14

be smart about this. Take it with

1:07:16

a grain of salt. Take this information

1:07:18

to your primary healthcare provider and have

1:07:20

a discussion with him or her to

1:07:22

make the best choice that is

1:07:24

for you. Remember, I am a doctor,

1:07:26

but I am not your doctor. And

1:07:28

these conversations are meant

1:07:30

for educational purposes only.