313: Optimal Training and Nutrition Strategies for Women with Dr. Stacy Sims

Introduction 

You're listening to Biceps After Babies Radio Episode 313.

Hello and welcome to Biceps After Babies Radio. A podcast for ladies who know that fitness is about so much more than pounds lost or PR's. It's about feeling confident in your skin and empowered in your life. I'm your host Amber Brueseke, a registered nurse, personal trainer, wife and mom of four. Each week my guests and I will excite and motivate you to take action in your own personal fitness as we talk about nutrition, exercise, mindset, personal development and executing life with conscious intention. If your goal is to look, feel and be strong and experience transformation from the inside out, you my friend are in the right place. Thank you for tuning in. Now, let's jump into today's episode.

Hey, hey, hey! Welcome back to another episode of Biceps After Babies Radio. I'm your host, Amber Brueseke, and today is a very exciting episode because I'm interviewing Dr. Stacy Sims, who is an exercise physiologist and a nutrition scientist, who is all about making sure that we are working with the female body when it comes to training, when it comes to nutrition, it's really important to understand that for decades, if not centuries, all research, medicine, education has been based on the male body and I don't have to tell you that the female body is not the same as male body. And so, what Stacy has done is a lot of research and education around the differences in training a female body. What should we be doing pre and post work out with our nutrition? How should we be fueling ourselves? How much carbohydrate should we eat? How much protein? What is our rest and recovery need? What are our Zone 2 cardio needs? We talked about that in the episode. And So what you're going to hear over the next hour is a lot of science, which, you know, I love. But a lot of really practical recommendations, when it comes to thinking about training, thinking about nutrition, and thinking about how do we optimize those things specifically for the female body. So, I cannot wait for you to hear this episode with Dr. Stacy Sims.  

Amber B 02:10 

All right, I am so excited to welcome Dr. Stacy Sims to the podcast. Thanks so much for being here. 

Dr. Stacy Sims 02:17 

Thanks for having me. I'm looking forward to chatting. It'll be fun. 

Amber B 02:20 

Yes, I was just telling Dr. Stacy before I hit record that I'm just excited to like, be able to nerd out a little bit on some of the sciency stuff cause you guys know I love, I love the science. I love the research. And there's nobody better to talk about this stuff and describe it to us than Dr. Sims. So, thank you for being here. If somebody doesn't know you or they haven't been introduced to you and your platform and your work and your research, can you just give us a little bit of background on you and specifically how you got into the research side of nutrition and fitness and exercise? 

Dr. Stacy Sims 02:56 

Yeah, so I am technically a female athlete performance physiologist. 

Amber B 03:00 

Nice! 

Dr. Stacy Sims 03:01 

So, there's a big, loud, like long word to say I'm a physiologist that specializes in women, sex differences, specifically exercise and nutrition, because I'm an exercise physiologist. So really got frustrated with looking at guidelines and all the recommendations and seeing that there was no representation of women, so it's always they, them or him, especially in textbooks and early education. And then as you're going through journal articles, it's the same thing you're looking. You're saying what population is this? It's always men. So being a continuous curious person and asking why all the time, sure my mother will be very apt to say yes, she was that kid that was annoying, that always asked why still am wanted to know why women weren't represented, and so that's been the platform for my entire career, academic and sporting career is to really dig in and understand sex differences, menstrual cycle, oral contraceptive pill, menopause, hormone therapy. How will all of these things affect your Physiology and how that yet again is different than what we see in the general biomedical research, which is all done in a male population. 

Amber B 04:14 

Yeah, I mean. This I, I love this topic. So, Stacy before we hit record, I told you that my husband is a physician. What I didn't tell you is that he is an urogynecologist. So, he is basically a female urologist. And one of his things has been, you know, kind of the, some of the same stuff, where urology has been a field of medicine for eons, right, we've had male urologists dealing with male, you know, urethra and bladder and all those issues for a long, long time. Female urogynecology has only been a board certified specialty for like 15 years because for so long for so long, like we just kind of it's like the male is the default. And the female is the afterthought. And so, you know, a lot of what he does in his work is like trying to get the research and the you know, care of women up to the standard of where men have been for a very long time, so this is like a passion of mine as well. 

Dr. Stacy Sims 05:11 

Yeah, like my head automatically went to like wait, there are anatomical and pelvic floor differences between men and women. So why is it assumed that women would be the same as men. 

Amber B 05:22 

That’s exactly. I mean right, like and they're so. And, you know, females carrying pregnancy. And I mean, there's just so many differences. And yeah, I mean it has not been a board certified especially for that long. It's just, it's, it's nutso.  

Dr. Stacy Sims 05:35 

Crazy.  

Amber B 05:36 

Yeah. So in case anybody needs any persuading, why, why can't we generalize male data to females? Why can't we do that extrapolation? 

Dr. Stacy Sims 05:49 

Well, when we look, there's sex differences in utero. So we see differences in the development of a male versus a female uterus. I mean. Yeah. Yeah, fetus. Here we are. So when we're looking specifically like stress and nutrition, if the mother is highly stressed and under nourished, a female fetus is gonna survive or a male fetus most likely will not just because we look at chromosomal links to stress and resilience. And we see that the XX is much more resilient to stress than the XY. And that's just one like really well-known documentation in the literature. So when we're looking at after birth and we're seeing this progression, we see that boys and girls are relatively similar until we hit puberty. And then there's this huge change from an epigenetic exposure of our sex hormones. So we see boys get taller, leaner, stronger, fitter, faster. Just by the nature of the testosterone and the nature of having XY, we see greater hemoglobin, oxygen carrying capacity, stronger bones, different musculature, different muscle morphology or men will have more glycolytic and type 2 and fast twitch fibers, women by the nature of being XX will change center of gravity. Their biomechanics change because their hips widen, their shoulder girdle widens. They, you know, putting on more body fat, they have more slow twitch and oxidative fibers. And then we look at mood and brain and neurotransmitters. Those are also affected not only through sex differences from like the chromosomal aspect. But also the epigenetic exposure of our sex hormones. So as we go forward, we're looking OK, well, we see all of these things, but we haven't really acknowledged the fact that how does nutrition and how does exercise affect us directly when we're looking across the board at sex differences and hormone exposures, so it it it's really interesting that all this stuff is taking place on the outside, but no one's really disseminating it down to even like the rat model, right, we see a lot of research is still done on male rats, and it comes from that historic aspect of who designed medicine, who designed sciences, who was in the room when those were designed? It wasn't women. So, the default has always been male, and so it's now this continuous fight to have female representation. 

Amber B 08:17 

Mm-hmm. Yeah. And it's, I mean, as this has started to become more of a thing. And as you really have been, you know, somewhat of a pioneer in at least getting the word out of how important it is. You know, your tagline is Females Are Not Small Men. And you've done such a great job of even just like publicizing that this is a problem and it needs to be fixed. And we need to have more research. What are some of the biggest things that have come out as we have sort of to take a closer look and look at what are some of the differences in things that would be recommended for women that wouldn't be recommended for men? Or what is the research starting to clue us into of like, oh man, we've been getting this wrong for a really long time. 

Dr. Stacy Sims  08:56 

From a from a high touch perspective, drug and drug metabolism. So but if we pull it into my bread and butter of Exercise Physiology, current recommendations of Zone 2 training not appropriate for women. Because if we're looking at what are the benefits of Zone 2, so there is this layer, right? And we hear about it all the time. You need zone 2 to increase on no respiration, right. 

Amber B 09:18 

Yeah, Yes. 

Dr. Stacy Sims 09:19 

Mitochondrial function to increase our NCT One, pulling lactate in to be able to recycle it and use it by the nature of being XX, we already have all of those things. We have a higher proportion of oxidative fibers. We have a higher and more a higher proportion of mitochondria, better mitochondrial respiration, better aspects of being able to use free fatty acids, different proteins within the mitochondria to pull in and utilize free fatty acids. We also have a greater ability of using lactate because women are very metabolically flexible because of a reproductive aspect that we have to consider.  

But what we need to do for feeding forward for like brain health, because we see a sex difference in Alzheimer's and there's a higher incidence of women with plaques that that lead to Alzheimer's in the brain, right. So we're looking at how do we actually kind of level the playing field. And it's about lactate metal realism. So women, by the nature of having less glycolytic fibers, less ability to produce lactate need to work on that side, so that our body can understand what is lactate, what and how do we produce it? How do we get rid of it and stimulate the brain to use more lactate?  

So when we're talking about all this stuff about Zone 2, it's based on male physiology. And right now, with that big buzz about everyone due Zone 2, it's like, hey, hold on a second. Let's look and see what is this population that this research was based upon. And we're looking at cancer prevention. We're looking at lactate metabolism. There are sex differences within that genre as well. So that's just one like, current example that is very frustrating when I hear all these people talking about new zones zoned. Zone 2. I'm like, no, no, no, no. Not if you are a woman. If you're trying to guard benefits. 

Amber B 11:14 

Yeah. So what is the recommendation or what should women be doing when it comes to their cardio? 

Dr. Stacy Sims 11:21 

High intensity work like Sprint interval training. We see it across the board now and it doesn't really matter if you're pre menopausal, postmenopausal. We're seeing that high intensity work feeds back to a woman's body to increase glucose homeostasis to have an epigenetic change within the muscle to be able to be more metabolically flexible. We're seeing that it's better for brain health. We're seeing it's better for gut health, we're seeing it's better for vascular compliance, so all of these things that we're that we've typically put in the category of long slow distance, let's do like the long, slow stuff for increasing our ability to lose weight and is fat that works for men, but when we look for women, it's resistance training and high intensity work. 

Amber B 12:09 

That's awesome. Can you speak a little bit too, I know that there are some differences when it comes to intermittent fasting and you know the drawbacks that are associated with a female body in terms of intermittent fasting. Can you kind of speak to that, and what should people be aware of if they are wanting to try out intermittent fasting or play around with it from a you know a female Physiology standpoint. 

Dr. Stacy Sims 12:34 

Yeah. So I'll, I'll have to quantify what, what it is, right. So we talked about intermittent fasting and this is where you have long periods of time where you're not eating. So you have like the warrior where it's 20 hours of no eating, 4 hour eating window or the 16 and eight and. And so those are our aspects where we look at and go OK well for the female Physiology. Long times of the day when we're not eating is not beneficial. We have long periods of fast it's not beneficial for the fact that in a woman's brain we have two areas of what we call kisspeptin neurons. Now Kisspeptin is responsible for two key factors in the women's body, one is endocrine function. So we're looking at luteinizing hormone pulse, menstrual cycle function. The correct feedback for having menstrual cycle and thyroid function and then the other is appetite, appetite control. And when we have long periods where we don't have food, the body gets into a breakdown state first thing to go is lean mass. And we also see that there is a perturbance in kisspeptin and it downregulates these kisspeptin neurons. We start to have endocrine dysfunction and we start to have appetite dysregulation.  

And then it doesn't happen and then we see a greater aspect of lean mass development, body fat loss. We see parasympathetic drive, we see better blood glucose control. But for women we have the opposite. If we talk about time restricted eating. So that is not eating after dinner and then eating breakfast. You're still going to get some of those benefits if you are someone who is on the cusp of diabetes. So you're pre diabetic or you're worried about your homocysteine. If you're worried about trying to lose a little bit of extra body fat, and you're also having lots of issues sleeping, then that kind of restriction is great. We normally call it just normal eating. Right. Yeah, we back and talk. 

Amber B 14:36 

Go eat dinner and then eat breakfast. 

Dr. Stacy Sims 14:39 

And then we also see some more of the population research that's coming out for those who delay food intake till afternoon. So noon onwards have a greater obesogenic profile than those who break the fast early and then stop eating. You know, earlier in the evening. So it works with chronobiology and we're seeing a bigger effect in women than we are in men. And then when we add training into it, a lot of women who are doing intermittent fasting will delay their food intake and do morning training still delay afterwards, because you'll have a perturbed in your appetite. You won't feel that hungry if you've done a hard session and then they'll break their fast, maybe two hours after a morning training session. And when I hear something like that, I'm like, well, why are you training for one? You aren't promoting lean mass development because the first thing to go when you are doing exercise in a fasted state is lean mass, because lean mass is very metabolically hungry and very metabolically active. And your body's like, wait, I'm gonna break this tissue down because I need fuel for one and two, I don't have energy coming in to support the growth and development of this. And then you stay in this catabolic state until you eat. And when you're in this catabolic state, the hypothalamus is like, wait, there's not enough nutrition coming in just to support daily life, let alone all these other things. So it starts to downregulate and we see only four days of low energy availability or this delayed food intake starts to really play with thyroid and thyroid function. So there's more outcomes that are negative for women who are playing around with time restricted eating and intermittent fasting then there are with men who do this. 

Amber B 16:24 

So let's like go to the example that you talked about, cause I think it is a very common example of women who get up early and go to the gym and you know, maybe don't eat before they do. And like you said, they're in this catabolic state until they go and eat. And maybe that could be hours after the gym. If somebody is trying to optimize for muscle growth, optimize for recovery, optimize for you know, hormone production for the female body, what would their food consumption look like? You know pre and post workout. 

Dr. Stacy Sims 16:54 

So it doesn't have to be a lot before. So say you're someone who gets up at 5:30 or 5 and is in the gym by 6 or 6:30. Like, I'm not gonna eat. I have to get up. I have to get dressed. I have to sneak out of the house before the kids get up.  

Amber B 17:07 

Right. 

Dr. Stacy Sims 17:08 

I need to do my session and get home and then deal with getting the kids up out the door.  You know, all of the morning stuff that we all deal with, it's when you get up and as you're driving to the gym, maybe it is a protein fortified coffee where you know your caffeine. It's gonna help you through your workout, but you're having one or two tablespoons of a whey protein added to it with some unsweetened or milk alternative, right? So it's just like a power boost where you're getting 15 to 20 grams of protein, maybe 20 or 30 grams of carbohydrate. You're good to go, and then you need to eat within 30 to 45 minutes after your session. So is that a protein shake? Not ideal, but it's going to do something for you. Or is it overnight oats that you've pulled out of the fridge to have with you in the car as you're driving home, or is it OK, breakfast. I prepared mostly the night before so I can pull it out and have breakfast with kids, it's not really, a huge like extra step. It's a little bit of planning, but the benefits are so far better than if you were just to go through the whole thing and try to do your training, be highly stressed, increase the catabolic state, increase the cortisol, not be able to like, take a breath and a pause until you get everyone out the door and you get to shower and then you get to eat. 

Amber B 18:33 

Yeah, that's really good. I want to talk a little bit about cortisol because I think a lot of people don't understand that. You know, exercising is a stressor on your body, right? It does is going to increase cortisol. Also an increase cortisol isn't always a bad thing. It's just the way our body deals with stress, but you know cortisol is linked to weight gain. And so what are some ways that we can work with our body to have productive stress in our life, right the gym weight lifting have those productive stress but be able to manage it in a way that it's not contributing to unwanted weight gain. 

Dr. Stacy Sims 19:06 

Yeah, cortisol is a funny one. I had a conversation yesterday with one of my friends is a GP, and we're talking about endurance athletes and cortisol and cortisol baselines and body comp that comes out of that and association with Addison's disease and that it was really interesting as you're going down that path. But the thing about a general woman who stays in that tired but wired, in that sympathetic state, that a lot of people end up falling to, we have to really be conscious that we're fueling for our activity. So we're, you know like fueling for the gym or fueling for our run. We're recovering from it. Yes, quarters all goes up. But as soon as you have some food that comes in and you're breaking that catabolic state quarters all comes down if you're doing high intensity work, yes people talk about cortisol coming up, but what they don't talk about is the follow through that you have a growth hormone spike and a testosterone boost post high intensity work which also helps drop cortisol. Especially with food. So it's understanding what modality of exercise you're doing and definitely fueling for the work at hand.  

The other thing we think about is during the day, these big pockets of stress where you are in a meeting or you're stuck in traffic and you're like, how do I deal with this massive amount of stress right now that I can feel my heart rate going up, my breathing rate going up and it's looking into a little bit of like the box breathing or the mindfulness breathing and it doesn't take a lot. It could be 5 minutes of just a couple of inhalations, exhalations cause then again helps reduce that sympathetic drive so anytime we have the opportunity to just taper and reduce that sympathetic drive, overall decreases cortisol so that we can still have stress points in our day. But we know how to manage it. 

Amber B 20:52 

Yeah, because stress isn't going anywhere. Like we're all experiencing stress is really about managing, like you said with it.  

Dr. Stacy Sims 21:00 

Yeah, exactly.  

Amber B 21:01 

Yeah. That's really good. You said something about making sure that we're fueling for the work that we're doing and I have to imagine, I'm sure you probably see it as well. I see a lot of women who are under fueling for the work that they're doing right, expecting their body to do a lot of heavy lifting, heavy workouts and then under fueling for that, how does one know or how could someone go about self diagnosing if they perhaps need more fuel for the workouts they're doing? What are some indications that we could be looking for that say, hey, you're under fueling for the work you're requiring of your body. 

Dr. Stacy Sims 21:32 

Yeah, it's kind of a hard one because we have a lot of appetite dysregulation. 

Amber B 21:37 

Sure. Yeah. 

Dr. Stacy Sims 21:38 

When we're not fueling appropriately and when someone does something hard or the weather changes or appetites a bit muted and if you're not used to eating a lot, then you're going to feel full before you actually get what you need. So when we're looking from objective point of view, we're looking at our recovery metrics like you do a hard workout. How long does it take for your heart rate to come back down? What is your heart rate variability doing? What are the trends in there? If you are still naturally cycling, what is your menstrual cycle doing? Is it shortening or lengthening? Is there a change in the bleed pattern but from a day-to-day perspective? We really look at how fatigued you are and how are you sleeping because if you are under fueled, it's being under recovered.  

And so we're looking at, OK, what are we doing? How is our recovery going? And then over the course of weeks, you can look at body comp like if you're in the gym and you're lifting heavy and you're trying to build a muscle, are you actually building muscle or are you staying the same? Same with body composition change. Are you putting on belly fat or not? You know, so we're looking at that because if we're not fueling and we stay in this breakdown state, you're not gonna build lean mass. It's just not possible, you need an abundance of nutrition to come in to signal that lean mass development and to maintain that lean mass. If we don't, then we don't build or maintain the lean mass and we put on more body fat.  

So it's just being very cognitively aware that, OK, I'm going to initially fuel for what I'm doing. So that is making sure that I'm having at least 15 grams of protein for resistance training, 15 grams of protein with 30 grams of carbohydrate before more cardiovascular work and then having my breakfast as soon as possible after that session, if it's in the morning or my lunch as soon as possible after that session. And not having a delay of 90 minutes or more. But I'm saying as soon as possible, within that 45 minute post exercise window, if you do that and then the rest of it, you're still not sure of, just work on that part right there about fueling and recovering from the exercise that you were doing. 

And remember that you cannot out exercise a bad diet or bad diet choices. And if you're trying to budge body composition, it's not about calories burned. It's about supporting that work and supporting the hormone responses around that work to mitigate signals for maintaining body fat. So, this is the especially right now when we're looking at the holidays coming up and all this stupid women's magazines are like you ate 3 cookies, you have to spend 30 minutes running on the treadmill like, no, that's not what we're talking about. You fuel for the work so your brain goes, Yes, I have enough nutrition coming in, I can do this work, I can adapt to it, I can get stronger. So then the next time you go in, your body is primed and ready to go. 

Amber B 24:34 

Yeah, yeah, I think it's just a damaging cycle that so many women get into where they think that the solution is to eat less and to under fuel and that that's what's gonna get them the lean body that they want. And, you know, kind of what you're saying is like, that's actually backwards, it's like when we can fuel our body well, when we can give it the things that it needs, it feels safe enough to be able to make those changes rather than hold on to the fat and so for anybody who's listening, who feels. It feels like the solution is just to eat less. Like, really listen to what she's saying it's like that's actually, what's keeping you stuck, it's keeping you in a place of not being able to see results. 

Dr. Stacy Sims 25:12 

Exactly. Eat more and lose body fat, and that's a very hard concept for women to crash.  

Amber B 25:18 

It's so hard, but you know, like some of the best, some of my most fun conversations are with women who take that to heart and they come back to me and they're like Amber. I have never trained, fully fueled, and it feels completely different. You know, like for a woman who has never shown up to the gym, fully fueled with enough energy in her, and then you do that and you realize what you've been missing and how much more you can push and how much better you feel in the gym like it's like night and day for what you're capable of achieving. What about carbohydrates? So we talked a little bit about intermittent fasting. We talked a little about pre and post workout nutrition, but what about carbohydrates? Or are there any differences in how women metabolize carbohydrates or carbohydrate needs for, you know, males versus females? 

Dr. Stacy Sims 26:03 

Yeah, women need more carbohydrate than men, and we look at basic metabolic aspects of fueling for exercise, women go through blood sugar first. And then they'll get into free fatty acid use, whereas men will a little bit of blood sugar fully into liver, muscle glycogen and then into free fatty acid use. And women need more carbohydrate. Just have more carb available to maintain blood glucose homeostasis, and we can't get into fat burning if we don't have carbohydrate available because the liver and some other feedback mechanisms will be like, hey, wait a second. Nope, we're not getting into that fat because we might need it to survive. So we need carbohydrate and unfortunately, women are under carbon under protein and that's the big problem. And when we're talking about carbohydrates as well, we're not talking about ultra process stuff, don't go with the sport nutrition, the goos and all that kind of stuff, that marketing to say, hey, yeah, yeah, use this. No, that's not I'm talking about. I’m talking about like real food, use it and carbohydrates super super important. Yes, we can vary the amount of carb that we're having in a day, depending on what our activity levels are, but don't have that carb phobia. That's so pervasive throughout the fitness world at the moment.  

Amber B 27:17 

Yeah, that's really, really good. I want to talk a little bit about going back to what you're talking about. Training, you know hard and something that I keep hearing people say in the industry is like you know HIIT is like too. It's too hard on your body. It's too much stress on your body. It's too much cortisol on your body and I have heard you say that you know physiologically women are able to have as many back-to-back to back-to-back hard training days that we do need that rest of recovery. So can you kind of talk a little bit about just some general recommendations for women when they're talking about putting together a training plan and they want as optimal of a training plan that has enough rest but not too much rest, cause it pushes enough in the gym and they're getting enough of each of the aspects to be able to put on muscle. What are we looking at as in terms of like a training split or number of days that we can go hard, how many recovery days do we need and I mean obviously this is general recommendations but  curious about HIIT. 

Dr. Stacy Sims 28:10 

So women, by the nature of being women, are less fatigable, so we need less recovery between our sets. But from a day-to-day perspective, this is where we start to see these nuances. If you're pre menopausal, then you can probably get away with more intense days than when you're peri and postmenopausal, but we also have to very be very aware of what we quantify as HIIT. So a lot of women will go to the gym and they'll take a boot camp class or they might do F45 or they might do some other functional fitness class that is not true HIIT. What that does is it puts you squarely in modern intensity, where it's too hard to actually be hard enough to invoke change. I mean, yeah, it's too hard for it to be no, I'll backtrack that we're talking about HIIT. It's too easy to be hard enough to invoke the change that we're wanting, but it's too hard to be easy enough to be a recovery day with that. So that puts us squarely, like in that modern intensity. 

Amber B 29:12 

Got it. Yeah, yeah. 

Dr. Stacy Sims 29:17 

Where you feel completely wrecked, but it hasn't actually been beneficial. So this is where HIIT gets that bad, bad, bad, bad reputation of increasing cortisol and causing issues. If we're looking at true HIIT, this is where it is one to maybe 4 minutes at 80% or more of your max with variable recovery we get into sprint interval training which is part of HIIT, that's 30 seconds or less that a rating of perceived exertion of nine or 10 on a scale of one to 10. And then you're having at least two to three minutes recovery between those 30 seconds. So it's a full central nervous system recovery.  

When you put those in to your session and not the moderate intensity HIIT gym classes you see actual results because again, you'll have a growth hormone response post exercise which then feeds forward to better parasympathetic, reducing cortisol. And then when we look across the wheat, what do we do? We say OK, we have two to three days of HIIT, of that HIIT, one should be a Sprint interval session. If you're peri post menopause 2 should be Sprint interval session and one could be a little bit longer of those intervals and at least three days of heavy resistance training.  

And then if you're looking at being a runner, you're like, what about my long, slow stuff? Yes, there is definitely time and place for that, but it's not your bread and butter, so I schedule it. It's like, OK, so we'll do heavy lifting session followed by some Sprint intervals either on a hill or on a treadmill. If you're in the gym. And you can do another session similar to that the next day, but then on the third day it might be active recovery or it might be an embarrassingly slow 30 to 45 minute run or whatever modality you're training for. So there's definitely scope for that soul food and that low intensity work. But if we're looking at the quality, it has to be quality over volume. And people freak out cause like I have to train for a marathon. I'm like, yes, for sure. You have to train for an Ironman. Yes, for sure. But it is about less volume, more quality, more strength. 

Amber B 31:27 

That's awesome. That's really, really helpful. And you're not doing any zone 2 Cardio, which so you know, it's like again, it's like I just feel like that is just like being thrown at us as women. And on the Internet, it's like Zone 2, Zone 2, Zone 2, and it's like, again, wait, hold on a minute. Like that research that's saying Zone 2 has been done on men, and women may need something a little bit different. It's really good. I want to talk a little bit about, you know, you mentioned pre, peri and then post menopausal. And you mentioned, you know. And we need to change that split a little bit as we get into that peri menopausal time. Is there anything else major that changes or that, you know, women who are entering that stage should be aware of when it comes to training and nutrition that is going to change during that perimenopausal time? 

Dr. Stacy Sims 32:14 

Yes, you need to put an emphasis on resistance training and protein. Like, yeah, we look at, there is a saying it's like you'd rather be the oldest person in the gym than the youngest person in the nursing home starts in perimenopause. You need to look to build as much muscle as possible because it becomes incredibly difficult. 

Amber B 32:27 

Well, that, yeah. 

Dr. Stacy Sims 32:36 

To put lean mass on and the first thing to go is strength and power because when we start having perturbations with estrogen then we start having changes in the way our body is getting feedback for building lean mass for having a strong muscle contraction and having a very fast nerve conduction to the muscle. So we want to put an emphasis on power based resistance training. So that's your, you know, three to six, maybe 7 reps and you're doing 80% or more, one Rep Max, maybe you're doing some pyramids, some cluster sets, but it's really a focus on that resistance training and then you're complementing with some high intensity work. And this is where you we see this upsurge of women who are getting into ultra runs, you're getting into ultra endurance stuff because that's where a woman's body slower and we become very, very adept at using fat and storing fat.  

So we need to do the opposite. We need to find an external stress that's going to signal our body to invoke change the way our hormones used to. When we get to late peri early post menopause, super important to do that high intensity work and to do resistance training for gut and brain health because we want to keep cognition, we want to invoke new neural pathways and we need to make sure that we are increasing the diversity of our gut microbiome, so we see in the four to five years before that one point in time called menopause, a very significant decrease in the diversity of our gut bugs, which increases visceral fat and obesity. So really cognate on the fact that you need protein and resistance training and of course fibrous fruit and veg to feed that gut, which then feeds forward to better brain health, and we know neural pathways are invoked with resistance training. When you get into later post menopause, so this is about six years after the onset of menopause, we see that there's a greater need for more frequent doses of high intensity work and significantly less volume. So this is where we would look at for maybe 5 days of sit training. And so it's very short sharp and maybe 15, 20 minutes total. Because we need to have a different stimulus almost everyday to keep vascular health, brain health and ability to invoke parasympathetic responses. 

Amber B 35:11 

It's fascinating. It's really interesting. You talked a little bit about gut health. I feel like that's kind of an emerging field. We're just kind of starting to really understand gut health. What are some recommendations for, I know you mentioned like fruit and veggies, fiber obviously. Is there anything else that we are aware of now that can help women support their gut health, as you know, we go through our life? 

Dr. Stacy Sims 35:36 

Yeah. So as many fibrous fruit and veg that you can. And so that's also your complex grains and we also are looking at like how do we protect the the mucosal lining of the gut. So we see a greater incidence of IBS and gut issues as we get older too. And that has to do with the erosion of the mucosal lining. So creatine is really important for women, for maintaining gut health. And so it's 3 grams a day. If that creatine monohydrate. And then for women who are having significant issues with immunity and gut perturbance. And we look at at putting in some more glutamine. But for a basic general factor, it's, you want to eat a wide variety of colorful fruit and veg and complex carbs to really create and invoke that diversity. And then you're also complementing with probiotics from food. So you're fermented foods don't take the over the counter stuff because we don't have enough longitudinal research and most of the bugs that are coming from over the counter probiotics and prebiotics come from one or two factories, so there's a whole bunch of bacteria out there that comes from the same factory and that does not increase the diversity. 

Amber B 36:55 

And did you hear what she said about creatine? Feel like that's something I like I have to like talk women into, like, supplementing with creatine. But you know. So this is my like plug for anybody who isn't taking creatine now. Not only is it gonna help you with generating muscle, but it also apparently helps with, you know, effects of menopause and that help as well. 

Dr. Stacy Sims 37:16 

Yeah. So I talked about creatine, not necessarily like the muscle performance factor of creatine is the bonus. But when we look at creatine overall, because of all the fast energetics that our body needs creatine for, and the fact that women aren't designed as well as men for fast energetics, we need more creatine. When I say designed as well, it's because we have around 70% of the stores the creatine phosphate is essential for everything. That's super fast so that's your brain. It's your heart. It's your gut. It's all of those functions that need really quick energy. So for supplementing we see better mood. We see better heart responses, better vascular responses, better gut motility, gut responses. And then, of course, that are muscular. 

Amber B 38:04 

So if you aren't taking creatine yet, hopefully Dr Sims just talked to you into supplementing with creatine. I love it. What does science currently say about healthy body fat percentage for women? Obviously this is one where everybody knows that there's a difference for men and women in terms of like healthy body fat percentage for men is a lot lower than healthy body that percentage for women, but what should women be aiming for in terms of having a healthy body fat percentage? 

Dr. Stacy Sims 38:31 

Yeah. And this is really interesting. Because when we look at all the body fat percentage scales and everything, they're all based on a white population.  

Amber B 38:39 

Sure.  Yeah. 

Dr. Stacy Sims 38:40 

So we have to be very aware that there are ethnic differences in body composition and body fat ranges. So if we're looking at the typical Caucasian woman, then they say up to 25% is still within healthy range, when we're looking at Pacifica and African American populations is up to 30. We're looking at Asian populations, is up to 22. So there's that range that you know, I generally say there's this range based on ethnicity, but if we hit that around that 25 mark, then we're good enough to be healthy and we have leeway either way preferably to try to get down into the early 20s rather than the upper 20s. 

Amber B 39:27 

Well, and I mean it's such an important point that you make here is like we're talking about how so much research has not been done on women and how it's been standardized to men. We can have that same conversation with how it's been standardized to Caucasian versus all the other ethnic groups. I mean, it's the same conversation of like, do we have enough research to support this for black women? Do we have enough research to support this for Asian men, right. You know, there's so many of these like differences that we have physiologically that just for years and decades, centuries even, have not even been in the consciousness when we're designing research studies or medicine or anything like that, right? So important. 

Dr. Stacy Sims 39:59 

Right, exactly. So it's, it's that you know that precision medicine, which is the buzzword where general recommendations, sure kind of question, I go, what was that population? Will it work for me? Does it feel right for me? So it is definitely having that educated eye to just what lens was this research produced? 

Amber B 40:20 

This is just kind of a fun question. I'm just curious of like where, if you're just imagining where we're going to be in 10, 20 years from now in terms of precision medicine, in terms of our understanding. Like, where do you see the field going when it comes to individualization of medicine, individualization of training protocols, individualization of nutrition. Where do you think that will be? 

Dr. Stacy Sims 40:46 

I think there's gonna be two splits. Really. We're gonna we see all these people that are embracing technology and jumping ahead of the gun by going, oh, we had this one city that showed this happen in technology. So we're going to run with that. So we're seeing it all the way through, like continuous glucose monitors, through heart rate variability, all the way up through different AI generated things. And then we have this other stream that's like, wait, wait. Let's go back to the basics. Let's look at proteomics. Let's see what's in menstrual fluid. Let's see what's in blood. Let's see what ethnic differences exist and what regional differences exist in gut microbiome. And we really get down to the molecular. But then we want to bring that up to the whole person. So it's more of a stepwise approach. So I think there's gonna be this huge like, divergent of people who are very data oriented and data hungry and they're gonna go through that analogical. And be like. Yeah, I'm gonna do this because technology says this is great and they may or may not be successful depending on what happens. And then you're gonna have this other stream that's very cautious and very succinct about what works for them and what doesn't, so I think there's not going to be much in the middle. I think there's going to be those two extremes because so far we've just been so generalized in the middle and everyone is like, wait, wait, what about me? What about me? What about me? So yeah, watch this space. 

Amber B 42:08 

Yeah. So in terms of health metrics, what I mean, there's so many health metrics we could track, you know from body fat percentage, how we variability to blood pressure to how long it takes heart rate to come down. I mean, there's just like and you were talking about with the people who are really interested in technology have all these wearables now that we can know our heart rate at anytime and we can track our glucose continually and you know all of these things. What if, which metrics do you pay attention to? What are ones that you look at consistently that help you to know, hey, I'm moving in the right direction. Hey, my body is responding the way I wanted to respond. I'm becoming healthier right where I want to become healthier, but what metric even tells us we're becoming healthier? 

Dr. Stacy Sims 42:52 

I don't. I hate to say this, but I don't pay attention to anything except how I feel. 

Amber B 42:57 

OK, that's awesome. That's super helpful. 

Dr. Stacy Sims 42:59 

Yeah. So I mean, I do research for technology companies, but I'm not bought into the algorithms because again, they're based on men and simple things like heart rate variability changes. According to if you ovulate or not, so it's, you can have a trend and you can use them just like a coach uses a clipboard and a whistle as a tool for what you're actually after, but I think the biggest thing that women have forgotten how to do because we've been bombarded with so much stuff is being intuitive of how you feel, how did you sleep, were you awake because there was a school alarm across the street for five hours while you were trying to sleep or the baby got you up. Well, maybe it's not a good idea to try to force yourself to do a high intensity work out. Maybe we do more central nervous system while we're lifting, and so we're not completely depleting ourselves, and that's fine, that is OK.  

And the other thing is like, OK, well over trends are you lifting more, how is your form, how's your technique, how are your clothes fitting? Don't pay attention to the scale, look and assess how are your clothes fitting? How are you feeling? Do you have more energy? How is cognition? So there's all these intuitive things that we need to pay attention to because we are bombarded by noise and sound. And messages all day, every day that I think most of us have forgotten how we feel intuitively and how we make decisions for ourselves based on how our bodies are responding. 

Amber B 44:18 

That's so good and I do think there's this pressure to go outside of us to find the answer. Right. Like if I just like can look at my heart rate variability or I can just look at my sleep trends or I can just look at my blood pressure or glucose or whatever it is. And I just love that reminder to go inside and say how do I feel? Yeah, like we forget that that it's like as simple as just asking ourselves that question of how do I feel and what makes me feel better, what makes me feel more rested. What makes me feel stronger? What makes me feel more alive? Like that is a question I think we probably don't ask ourselves enough, so I love that reminder to go inside again and ask yourself that question. 

Dr. Stacy Sims 44:58 

Because we could have a whole podcast on why continuous glucose monitors and heart rate variability and that kind of stuff are just not appropriate because of the feedback that that. It gives you, right? Sure and. Yeah. And so like I said, you can use it as a trend but of course if you eat something, you're gonna have a spike in your blood sugar. That doesn't mean you shouldn't eat it. It's just a normal response. But the messaging that we've gotten from CGMS is that no you should never have a blood glucose spike. 

Amber B 45:22 

Right. Yeah. 

Dr. Stacy Sims 45:23 

So, yeah, there's the misinformation that comes with the technology. That's why I said, like, you're gonna have this huge divergences. One is going to have with education as technology is maybe getting better, but a lot of people are gonna come intrinsically and be like, hmm, I don't feel that great. What's going on? Let me see. And so it's gonna be the stack wise. 

Amber B 45:40 

Yeah. Yeah, that's really good. OK, last question around kind of wrap this up around sleep, because I think it's a great, great one to end the conversation is around maximizing sleep quality, sleep duration. I think for a lot of people sleep is really hard for as simple as it seems like it should be, it can be really hard to get enough sleep, getting enough quality of sleep and we talked about earlier how important that is for recovery and for, you know, rebuilding. So any strategies or exercises or things that you have that are able to help women to be able to sleep better? 

Dr. Stacy Sims 46:14 

Yeah, I was discussing the same thing with a family member that's been having massive issues sleeping. And I said you have to go back to the basics of sleep hygiene, and so let's review what basic sleep hygiene is no screens two hours before bed. Put your phone in a different room. You are not looking at your phone. You don't want to eat within two to three hours before bed. If that means rearranging some meal time times and feeling kind of guilty you're not eating with your family, think about for your general health. This is a short period of time where we're trying to reestablish parasympathetic drive and what good sleep hygiene is. We want to sleep in a cool room. We want it to be dark. We don't want to you to be doing anything except maybe reading with a low light, a book, not a Kindle, to help you fall asleep. 

If you're someone who wakes up periodically throughout the night and you're like, I just can't go back to sleep, my mind is reeling. Then we look at, OK, what about non sleep deep breaths, which I know Huberman has coined, but it's originally yoga nidra where it is a series of progressive steps that you can learn to let your body relax and get into a parasympathetic state. So that when you wake up in the middle of night, you know to queue yourself to do these certain steps, which allows you to fall back to sleep. So if we're looking exactly at sleep hygiene first and then what kind of strategies we can to help us fall asleep quickly and let our mind set. Then we start to get into a better pattern of sleep. We get into a better pattern of sleep than we naturally fall into good sleep.  

The caveat of host’s pre, peri and post menopause. When we start having lots of disruption in our sympathetic drive and our parasympathetic drive and inability to activate parasympathetic, that's when we can look at using something like L theanine, which is a, you know a non protein amino acid that's used specifically to enhance parasympathetic response brain and it's used by tactical athletes. It's used for resetting circadian rhythm. It's something your body naturally produces, but we're not going to go for something like melatonin because we don't know the dose response that's good enough to allow women to get enough melatonin to fall into a good sleep architecture and wake up without the hangover. So we don't want to look at something that is additive. We want to look at something our body uses. 

Amber B 48:31 

I love that. Like I ask you a question about techniques or strategies or things and you're like, let's just come back to the basics. I think that it is such like human nature to look for the shiny new, you know, thing. And it's such a good reminder for all of us. So like if you're not sleeping well like, let's go back to the basics of sleep hygiene. We don't need anything fancy. We don't need anything special, it's like, are you doing all of these basics and for most of us, we'll probably look at that list and be like well, I'm not actually doing all those, all those things yet so what a good reminder. To go back to the basics, that's fantastic. 

Dr. Stacy Sims 49:06 

And don't like I had some actually it was my mom. She's like, I have lots of problems and I wake up in the middle of night so I listen to the podcast like no.  

Amber B 19:14 

Don't do that. 

Dr. Stacy Sims 49:15 

She's like, helps me fall back asleep. No, it doesn't. Because what's it's doing, it's waking your brain up because now it's assimilating and listening. And sure made me fall back asleep. But you're not actually getting you're just in a light sleep, you have to do something like the. Honestly, deep breast protocol to actually activate parasympathetic and not let your brain start thinking about something. And she's like, oh. OK, I got it. 

Amber B 49:37 

And that deep breast protocol? I don't know that I've ever heard is that like a box breathing is like A is it a cycle breathing. What is it like? 

Dr. Stacy Sims 49:44 

So you can do box breathing, but when we're looking at the non sleep deep breast protocol, it's more about progressive relaxation and learning how to progressively relax, get a little bit deeper, a little bit deeper. It starts off with breathing work and breath work like box breathing and then it gets more into the contract relax of musculature and then it's the mindfulness of OK, allow yourself to feel like you're falling into, you know, being wrapped up and falling into a deep, dark hole that's protective. So I know that Hoverman has quite a few things, but you can put in a Google search for NSDR non sleep deep rest and there's some really good vocal guided 5 to 10 minute things that allow you to learn how to do this. 

Amber B 50:37 

Oh, that's awesome. That's really great. What a good resource for people who are struggling with that. This has been fantastic. I have learned so much and I just really appreciate your wisdom. I appreciate your science mindedness and really helping to spread the the message that women are not small men and that we need our own research. And we need to make sure that the we're following has to do with our own Physiology. So if people are wanting to find you, read your book, listen to you. What, like, where should they go to do that? 

Dr. Stacy Sims 51:10 

So social media Dr Stacy Sims, we’re Insta, we’re Facebook and then our website drstacysims, d-r-s-t-a-c-y-s-i-m-s has all of the courses, it has links to all the media. It has blogs, membership, resources, all that kind of stuff. And then our second edition updated version of Roar, comes out on the 9th of January, so you know it's like when we first wrote the book, my daughter was two, and now she's 11. Science has evolved and we've updated all the science in the book and made it less about the elite athlete and more about the everyday. 

Amber B 51:36 

Ohh awesome. Yes, OK. And we will definitely link all of that up in the show notes so that you can go on. I'm really excited that ROAR is being updated. That's that's awesome. So yeah. 

Dr. Stacy Sims 52:00 

Me too. Yay! Finally. 

Amber B 52:02 

Yeah, I'm sure. I mean, I'm. I can't only imagine that that is just like a big deal to go and update something and that you wrote so many years ago but with like new stuff. Yeah, it's great. Well, thank you. This has been fantastic. I really appreciate you coming and sharing with my audience. 

Dr. Stacy Sims 52:18 

Yeah. Thanks for having me. It's been fun. 

Amber B 52:20 

Is your mind blown as much as mine is? I learned a ton on that episode and I'm really grateful for Dr. Stacy Sims for coming on to the podcast and sharing her knowledge and expertise. I love her tagline that women are not small men, and I think it is really important that we are really basing what we are doing off of research and data specifically around the female body, and I think hopefully you're coming away from this episode with maybe some things you're gonna change in your training. I know that I'm going to be doing a whole lot more of hiit and sit type of workouts than I am zone 2 cardio and that's something I'm really excited to explore and play around with. That wraps up this episode of Biceps After Babies Radio. I'm Amber, now go out and be strong because remember my friend, you can do anything.  

Outro

Hey friend, have you heard the news? We have a Biceps After Babies Radio insider list. If you love Biceps After Babies Radio, you don't want to miss a thing head to bicepsafterbabies.com/insider to join the group. You'll be the first to know all things about the podcast. See some behind-the-scenes and get special messages from yours truly. We want to make this a special community for those who are fans of the podcast. And last, did this episode particularly resonate with you? If so, will you please share it? Either send the link to someone who would find it valuable, or take a screenshot and post it to your social media and tell your family and friends why they should listen. Make sure you tag me @bicepsafterbabies so I can hear feedback and give you a little love. And you know, if you aren't already following me on Instagram or Facebook, that's the perfect time to hit that follow button. Thank you for being here and listening to Biceps After Babies Radio.