#137 Dr. Stacy Sims: Leading Expert on Female Physiology & Training

My guest today is exercise physiologist and nutrition scientist Dr. Stacy Sims. Through her own experience of being an elite athlete, Stacy became focused on revolutionizing exercise nutrition and performance for women. Before all my men run for the door if you have a woman in your life this is a must-listen. If you are in a relationship with a woman, your mom, a sister, a daughter, or if you are a coach, the information that Dr. Sims shares is helpful and could be life-changing for some women.

Who knew that at different times during our cycles our immune systems are weaker or stronger? Stacy shares that we should eat more calories at very specific times in our cycle and that intermittent fasting may not be a girl’s best friend even if she’s trying to change her body composition.

Her new book, Next Level is out now.

Enjoy

Listen to the episode here:

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Key Topics:

• The Menstrual Cycle [00:12:00]
• The Low Hormone Phase [00:14:37]
• Being a Female Athlete/Coach [00:18:43]
• Women and Daily Performance [00:21:59]
• Common Myths During Pre/Perimenopause Stages [00:30:27]
• Female Teenagers and Trainings [00:43:11]
• Medicinal Herbs/Adaptogens During Periods [00:47:11]
• Intermittent Fasting [00:54:37]
• Sleep Help [00:59:24]
• The Middle Group [01:04:37]
• Knowledge for Empowerment [01:08:28]

Dr. Stacy Sims: Leading Expert on Female Physiology & Training

It started as a selfless drive. As they dug in more and tried to find the answers and there weren’t many, I decided that I had to be one of the people that were able to find the answers and share those answers.

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When we look specifically at coaching protocols, we look at research design. It all comes from the male lens but if we take it from a female lens and say, “It’s normal to have a menstrual cycle,” or, “It’s normal for a woman to be on an oral contraceptive pill,” and include that in the conversations that we’re having an include that in the research that we’re doing, it’s normal. People will open and go, “It’s so much easier over here.” That’s the pushback because to other people, it seems to be that it’s more difficult than I’m creating difficulty instead of creating a new norm or pushing for a new norm.

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We’re different and in order to understand what is going on for over half the population, we have to look at how hormones influence the systems of the body or do not influence the systems of the body.

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There are lots of little things that you can do but having that basic awareness of where you are and how your hormones can affect you gives you a huge arsenal of how to show up for that.

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Welcome to the show. My guest is Dr. Stacy Sims, she has a new book out called Next Level and she had a wonderful TED Talk years ago called Women Are Not Small Men. Stacy is an exercise physiologist and nutrition scientist. She does a lot of work that is focused on performance for women. Her focus is to revolutionize exercise nutrition for women and she’s even directed programs at Stanford. Yes, it is a conversation around women, women and performance, and what’s happening during which part of their cycle during the month.

However, it’s so science-based and so practical that I would encourage you if you have a woman in your life, a female partner, a mother, a sister, or a daughter, if you are a coach, any of this is so helpful because she breaks it down in a no nonsensical matter of fact way. She’s giving us the data, “During our low hormones or parts of our cycle, this is what’s happening. During our high, this is what’s happening.” When should we be working on skills versus getting after it and going for power and even noticing there are natural things that we could take that would help us 7 to 10 days before we got into our cycle that would make that process easier.

She’s the perfect person to have these conversations with because in a way if you think about it, women in performance or in sports are underserved just because the studies are done on men and it’s easier. It makes sense. What she does is about the information. There’s not a lot of extra fluff and even though it is women’s talk, Dr. Sims does a perfect job of considering the information and the right amount of passion and support. It makes it clear, easy to understand, and helpful. I’m excited to have her. She and I crossed paths a few years ago. We were trying to do it but COVID hit and she lives in New Zealand. There’s a lot going on and so I’m happy that she is on the show. Her book is Next Level. I hope you enjoy it.

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Dr. Sims, thanks for joining us.

Thanks for having me.

Are you in New Zealand?

We escaped for a few months. I’m just outside of DC at my mom’s house because the borders were shut so tight that we couldn’t get out. I missed my family so we escaped and we’re here until the end of July 2022.

Is your mom spoiling you and making your food and stuff? Do you get babied by your mom?

No. It’s more like my daughter’s getting babied by my mom, which is good.

We’ll get started. I appreciate your work a lot. I appreciate you coming to the show. I know that we tried to get together years ago for you to come to the show. I don’t know when that was.

I think so but then COVID hit and then everything went wacky. The pre-COVID years.

Congratulations on your book, Next Level. I know how much work that is. I always appreciate it when people can complete a book. This is not your first book. Let’s start with your background a little bit and your work and how you arrived upon getting into more specifically performance and performance for females and then we can get rolling.

I’ve always been the kid that asked why and now I see that in my daughter too. When I was younger, I was always asking why and trying to find the answers. When I got to undergrad, I couldn’t find answers. I was on the rowing team and we were training as hard as the men but there were times when the women’s boat wouldn’t peak at the right moment the men did. I transferred to exercise physiology. I’m reading all these texts and I couldn’t identify with what was going on because it didn’t make sense.

The fact that they kept using the reference man and all the language and it was about, “He did this,” “He did that,” “We know this from a male,” I started asking questions about women and they’re like, “We don’t know enough about men. Why do you want to study women,” or, “We don’t study women because of the menstrual cycle but that’s okay because women are like men so we generalize.”

As I started getting more and more involved as an elite athlete racing at top levels and seeing how the recovery aspects that we were told to do weren’t quite working or some of the training protocols were making women get into more of an overtrained state. An accumulation of it was when I was racing in Kona when I first started my PhD. There was a group of us that went over to race and some of us were in the high hormone phase of our menstrual cycle and ended up in the IV tent with the need for sodium and fluid. Those in the low hormone group didn’t have an issue.

There were all these things that kept coming up as an athlete and then having the availability as an academic to go ask those questions and try to find the answers. I didn’t age out but as I decided to get out of competition, I’m working with high-level Olympians and high-level coaches that are wanting to find that extra performance for their athletes. The accumulation of it was that it started as a selfless drive. As they dug in more and tried to find the answers and there weren’t many, I decided that I had to be one of the people that were able to find the answers and share those answers.

You’re the perfect person because, a lot of times what I feel is if we’re having these opportunities to dive more specifically in support of let’s say, in this case of women, you don’t have a precious approach. It’s very a matter of fact, it’s scientific and it’s like, “It’s different,” and I appreciate it. I have found a lot of times that there gets to be this framework built around saying, “Oh,” and making it so monumental that we’re different, instead of saying, “Here’s the deal. X, X. Y, Y. We’re different. Let’s dive into the science.”

I also feel that we could pass that on to younger women. You talk a lot about teenagers dropping out of sports because they’re uncomfortable talking about their cycles. You’re talking about bringing this clinical approach. I feel that way. I feel like when women want to do something that’s perceived as a little bit on the wider parts of the lane like, “Be more high performance,” “Be a CEO,” or whatever it is, it’s like, “What are the tools that you need?” It’s not, “It’s going to be hard and really difficult.” I want to start the conversation by saying that because one of the things that gets attention and is a disservice to the actual people you’re trying to get the information to is all of this other stuff instead of, “Let’s dive into this. What can we do to support you on this quest, whatever it is?”

[bctt tweet=”The biggest thing that women are guilty of is not eating enough.”]

I still get pushback. I’ve heard so many things throughout my career. I have a specific file for emails that are pushback, or what we call the not-so-intelligent emails because people push back against it but I’m like, “This is science. Science evolves so it might change but we know the physiology. This is what it is. These are the things that we can do.” People often ask, “Do you have an agenda,” but I don’t. I just want information out for people to be empowered.

When you say push back and do you have an agenda, what type of people are asking that? What do you mean? I’m curious.

Because I’ve been in med schools, sports science, and that stuff, it’s been a male-dominated environment, to begin with. I’ve had, “Why do you want to study women? It’s too difficult. You’re going to be here forever to do your PhD.” My PhD students get that as well from clinicians even now. You’re trying to get through some research. Why don’t you do men? It’s because we’re different. In order to understand what is going on for over half the population, we have to look at how hormones influence the systems of the body or do not influence the systems of the body.

Pushback from coaches who find it too much in the too-hard basket to ask about the menstrual cycle and training according to the menstrual cycle and understand it. There are all these. It’s more from the male lens. I’m not saying, everything has come from the patriarchy but when we look specifically at coaching protocols, we look at research design.

It all comes from the male lens but if we take it from a female lens and say, “It’s normal to have a menstrual cycle,” or, “It’s normal for a woman to be on an oral contraceptive pill,” and include that in the conversations that we’re having an include that in the research that we’re doing, it’s normal. People will open and go, “It’s so much easier over here.” That’s the pushback because to other people, it seems to be that it’s more difficult than I’m creating difficulty instead of creating a new norm or pushing for a new norm.

I would think that they would be grateful because the system is so complex. My hope is maybe we can start there, which is breaking down the cycle and the different hormones like low hormone levels at times of the month, and things like that. Let’s give a brief overview of that so when we talk about this more specifically, people will have a sense of it. It’s amazing how much you can have your period for 30 years and know little about it and what’s happening with more estrogen, less progesterone, and things like that.

If we look at it as a typical textbook 28-day cycle and we know that that’s not normal. For most women anywhere from 21 to 40 days is normal. Day one is the first day of bleeding. Around day fourteen is ovulation. In that time period between day one, first day of bleeding and ovulation, we call that the Follicular Phase or the Low Hormone Phase. This is where estrogen and progesterone are baseline low. Right before ovulation, we have a surge of estrogen which helps with ovulation. After ovulation, estrogen drops off and then starts to come up again and progesterone is produced from the sack the egg was in, the corpus luteum so progesterone starts to come up.

When that sack is completely degraded, we don’t have any more progesterone so progesterone starts to drop off, estrogen starts to drop off, and then we have day one of bleeding again. We have this spirit of low hormone follicular phase, ovulation with high estrogen, and then the luteal phase, which is where estrogen and progesterone start to come up.

When we’re talking about the menstrual cycle in different lengths, it’s the follicular phase that changes because the body’s trying to prepare for a robust fertile egg to come out so that we can have pregnancy. When we’re talking about the variation within a menstrual cycle, it’s normal for women to go from a 20-day, 22-day, 20-day, 22-day all the way up to 40 days.

We can talk about this in reference to what you found for performance. Let’s assume that these right now are women that are still having a regular cycle. Let’s not say we’re talking about menopause yet or premenopausal or perimenopausal. Let’s say we’re taking this group and they’re in performance. I know it’s a little different with certain things fasting and what have you but would it be okay to assume to say that we also have women listening who have a more normal level of activity. They’re not necessarily the tip of the spear of high performance looking for these incremental things of growth and increase in strength and such. Can we assume that a lot of these rules apply across the board?

For the most part, the way I look at it is how resilient a body is to stress. When the hormones are low, we also have a greater ability to withstand stress from an immune standpoint as well as a psychological standpoint and a physiological standpoint. Because these hormones affect every system of the body so when we’re looking at that low hormone phase, this is where we want to take on stress. It’s because our bodies can overcome it. It can adapt well to it and this is where we can put in our high-intensity work, be it elite athletes or someone who’s looking for better health gains.

Around ovulation, because estrogen is anabolic in itself, then we have another good window of opportunity to push it hard, be it you’re trying to walk up a hill or set a PR or you’re in the gym lifting. Whatever it is, you have that other opportunity. After ovulation, we want to start tapering down because our entire system changes. Our immune system changes and it becomes more pro-inflammatory.

The reason for that is we don’t want the innate immune system to come and attack a potentially implanted egg so the body is like, “We need to change our immune system to be more fever-like,” so there are a lot of cytokines. Our body becomes less resilient to stress when we have this increased systemic inflammation.

As we start looking at how our metabolism changes, we have a greater reliance on fatty acids because progesterone pulls the blood sugar and glucose away from the liver and the muscle to put it into the endometrial lining. It also breaks down more muscle tissue to free amino acids to build endometrial lining. We have to be cognizant of the training and nutrition that we’re doing. If we start looking resilient, sort of resilient, and then we’re not so resilient to stress about the five days before the period starts, we can plan our training and our lives in sync with our menstrual cycle. There are nuances of course because every woman is individual so I tell women, “Track your own cycle, preferably over the course of three full cycles, because you’ll start to see patterns.” A lot of women don’t realize that.

Maybe right around ovulation, you have a flat day and then you feel bulletproof. Instead of having that negativity, and that second-guessing that you did something wrong and that’s why you feel flat, you realize that it’s the way your body responds to a surge of estrogen and a drop-off. You can be like, “I know what that is. It’s the day before ovulation.” You start to see these patterns that give you more objective data then you can still tailor these things into your own personal performance lifestyle.

When you talk about this time when we are more vulnerable, especially for younger athletes, you will encourage people that this might be a good time to work on skills and not be killing themselves. Let’s say I’m either the athlete or I’m the coach. Maybe you’ve got twelve girls. A lot of times I’ve been on teams that are totally nuts. After a few months, you start to tighten in and your cycles get pretty close to one another. Let’s say you’ve got moving parts, and you have different athletes at different parts of their cycle.

One, if I’m the athlete, how do I ask for permission, if you will, to go, “Could I do some more skill-oriented type things?” As a coach, it’s making it almost like, “No big deal. We’ve got some stuff in place for this type of scenario.” I’m curious because even if we know it, it would be hard to say, “I don’t know that I can go all out for the next three days.”

We look at that from a team perspective, for sure. When we are looking at that team environment, the biggest way we can make an impact is in the weight room where you can’t have everybody doing the same thing all at once. We often see teams that are divided up into different circuits so we can divide it up according to the lower or high hormone phase. When we’re on the field or we’re having land-based practices it’s more of the awareness both as the athlete yourself, and then having a conversation with the coach.

The way that we’ve been able to scope it so it becomes more of a comfortable language is a wellness check. We know that when you show up for practice, there’s always a brief wellness check like a scan where the coach is seeing who’s injured, who’s not, and who might be getting sick. It becomes one of those basic wellness checks where it’s like, “Who’s on their period?” “Who’s getting ready to get their period?” It doesn’t have to say, “I’m on my period.” It could be a traffic light system where when you’re green, you’re good to go. I’m on my period. Red, I need to do a little bit more skill-based stuff because I’m a few days before my period. It’s trying to take that tabooness off.

There’s also some tech out there that can help coaches navigate that conversation through app work but when we get to that playing field or the land-based work where somebody wants to do some more high-intensity work and then someone needs to pull back a bit, it’s knowing who needs to pull back so the coach isn’t going, “What’s wrong with you today? Keep pushing, keep going, keep going,” or they’re not looking at the times, sprints and the jumps to make a decision on who’s playing and who’s not. It becomes more of the awareness rather than disrupting the entire practice and it’s the skill-based stuff on the outside that a lot of people end up doing, or the gym work that we can tailor, more so, to the menstrual cycle rather than the group land-based stuff.

Stacy, you’re in business, you’re a mom, and you have a full life. What’s a simple language for these other parts? For example, let’s say, we’re at a time when we are more fatigued or tired. If we’re in one of these, low hormone cycles or high hormone cycles, depending on what’s happening, how do we start to weave that in even if it becomes our own personal thing? We don’t have to announce it to everybody in the family like, “Mom’s doing this,” or you’re at work and you’re the boss. How does it show up that we can make these tweaks where we have to get stuff done? We don’t get to check out.

It’s the same with athletes. There are going to be times where you’re like, “I feel off. I have a sense of it. I’m not going to overreact to it. I have to play. I have to compete, but maybe I’m in a place.” At least it gives you a, “It’s okay. I don’t suck all of a sudden.” For a crazy working parent or boss who’s running a business, how does that show up?

It’s having awareness and tracking and knowing where you are. When we look at what is performance versus training, we know that you can nail anything on any day because the psychological can supersede the physiological. It’s also having in your arsenal, knowing that, “I should be doing a bit of a de-load this week.” It’s coming to the day with the awareness that you’re not quite so stress-resilient. It’s making time to have a little bit more mindfulness if you can or skipping that high-intensity session that you had planned and maybe doing some actual movement instead to keep the body moving.

It falls into the whole taking care of yourself aspect as well but having that objective data to know where you are, you can show up on the day and perform at your highest. If you have the idea that, “On day 24 and day 25, I’m flat,” then you’re making those small tweaks not to put in that high-intensity work or not to show up for an intense meeting that you might not be completely prepared for.

If you do have to, there are some nutrition interventions that you can do, you can have a little bit more carbohydrates before that meeting or before that high-intensity session. You can have essential amino acids in a drink so that you have more circulating leucine to help with brain decisions and reduce brain fog. There are lots of little things that you can do but having that basic awareness of where you are and how your hormones can affect you gives you a huge arsenal of how to show up for the day.

Maybe we could slide over. Everyone is different in their needs, what they’re doing and they’re their cycles. We could talk about some of the eating during the cycles because one of the things that I thought was so interesting is I’m almost anemic. I have fought low iron the whole time. When I heard you talk about how inflammation from training can be disruptive to the gut’s ability to absorb iron I got excited. If you’re trying to do the right things, you get the IVs and all of these things but when you said that I thought, “This is more information for me to understand about the impacts of things that are good for me.”

Exercise is good but if you’ve done it forever, there might be some other byproducts. I thought that was one of the things that were interesting. Even the fact that we need, and as we get older, more protein than we think or that is measured. Everyone is different but in a broad-strokes way could you say, “Curing these types of the cycle more carbohydrates is good. Here are ways to open up your recovery windows and things like that.” We try to do it like them or the trend. It’s like, “We’re going too fast.” “We’re going to do all these things,” and that may be a complete disservice.

[bctt tweet=”Real foods first.”]

We know from research that women do better in a fed state, regardless of age just because our morphology and metabolism are different for exercise. If we look at the hormonal influences in the low hormone state, we have a more similar metabolism to men. We can look at moderating our carbohydrate intake but we have to make sure that whatever activity we do we have something to eat prior to it. It doesn’t have to be massive. It could be half a banana. It could be protein-oriented coffee or green tea. It’s something to bring blood sugar up and signal to the brain that there is nutrition available to withstand stress.

It’s after ovulation when we have that rise of estrogen-progesterone. That becomes interesting. We know that women can’t carbo-load but if we increase the total amount of carbohydrates that we’re eating in our meals, we have more available carbohydrates for cognition reaction and physical activity. It’s because our body goes through more blood sugar first and then fatty acids but we don’t tap so much into our muscle and liver glycogen, which is why we can’t store it well.

Protein is super important, especially as progesterone comes up because progesterone is catabolic. It breaks down everything. If we’re trying to build mass or recover from injury, we need to dose our protein. For women who are pre-menopausal, we are looking a good 30-gram hit of high-quality leucine-based protein within 30 to 45 minutes after exercise and regular doses of protein in every meal. We need to keep those amino acids circulating.

As we get into peri and postmenopause because we become more anabolic resistant, that post-exercise protein is closer to 40 grams. We have that 30 to 45-minute window post-exercise to take advantage of the mechanical stress and some of the other pathways for muscle protein synthesis. Women come back down to baseline within about an hour after activity but the minimum is 3 to 18 hours depending on intensity. It’s because our metabolism is different and how fast we come back down to a resting blood glucose level. If we break up the phases, in the low hormone phase, we want to focus on taking care of the gut, having a good fruit-veg mix, a good amount of protein, and making sure that we’re fueling for it and recovering from our sessions.

After ovulation, it increases the total amount of carbohydrate intake. Our metabolism goes up because we’re building tissue so this is another reason why women are craving food, especially carbohydrate-oriented food. We need to make sure that we have regular dosing of protein throughout the day at every meal and this accounts for those hormone perturbations and helps us maintain a good nitrogen balance for lean mass development. It helps reduce the risk of injury from inflammatory states as well as potential mechanical injury from a misstep. Also, having too many tight tissues because you have the availability of amino acids helps prevent the small little tears that can happen from mechanical stress.

I heard you talk about that. They tested older women and it was like, “She doesn’t need the protein anymore.” You’re like, “They didn’t give her enough of what she needed for that to have a reaction.” I’m over my fifties and I have a lot of friends that are either younger than me or older than me or when I was in my 40s everyone was always walking you to, “This is how it’s going to be when you get into middle age.” There’s no way around it and the body composition is going to change. Things change. I get it. You have different hormones.

I have seen a lot of female athletes that have paid attention or women in general that are training hard because of that 35 years of culture. Look at CrossFit. You have a lot of women much later training at a high level. We surrender the decisions we’re making to trends and what everyone thinks we should be doing instead of listening to our bodies, and doing this homework. If someone is premenopausal, menopausal, or perimenopausal, what are some of the most common mistakes that they’re doing because they get frustrated? I’m eating air and I keep gaining weight. That’s what you’re seeing most of them experience. What are you seeing most commonly if their hormones are okay? Everyone should get their blood work done and check their hormones.

The biggest thing that women are guilty of is not eating enough. We grew up in the culture of supermodels and the Jane Fonda calorie and calorie-out fat burning. That is a pervasive myth that is so ingrained in a lot of women’s psyches that they often fall into a low energy availability state. We know that over 50% of recreational active women regardless of age are in a low energy availability state. This means that they’re not eating enough to support their basic resting metabolism when they’re sitting on the couch watching Netflix and not moving all day. Let alone having nutrition available for daily life stress and exercise stress.

I have so many women who are like, “I don’t understand what’s going on. I’m getting squishy. I’m putting weight on. I’m eating less. I’m training more.” It’s like, “Let’s have a pause here. What are you eating? How much are you eating?” Most of these women are between that 1,500 and 1,800-calorie a day range but they’re exercising five times a week. That 1,500 is enough to maintain your basic metabolism. It is not enough for as soon as you get up and start doing household chores or taking the kids to school or training or going to work or whatever you’re doing.

When we look at what women are not doing appropriately is not fueling for what they’re doing, and they’re not eating enough. If you don’t eat enough, everything starts a downturn. The thyroid takes a hit, resting metabolism takes a hit. You start putting on belly fat, you can’t build lean mass, and you start losing lean mass because your body starts metabolizing it. When we start looking at the language and the words we need to use around it, it’s fueling for your activity and your stress. We need women to eat more. The other aspect regardless of hormone and age is the resistance training pace.

It’s great that CrossFit has made it apparent. You can’t get too big. If you look at Annie Thorisdottir and some of the fantastic elite CrossFit athletes, they train more than the typical CrossFit athlete would do. It’s hard to get bulky especially as we age unless you have an abundance of food, which brings us back to the fact that most women aren’t eating enough.

When we look at the resistance training piece, we know that from sex differences at birth and muscle morphology, women do better with power-based training so we’re looking at the lower rep range and the higher weights. It’s not for building bulk, but for having that neuromuscular connection, that central nervous system to muscle fiber connection to maintain strength and explosive power that we need when we get older to be able to react if we slip on a curb.

Coming from volleyball, you know the power and explosiveness you need for that but we’re looking at the lifelong aspect of what women need to do now in their premenopause, especially in perimenopause to maintain muscle integrity and muscle function. When we look at the cardiovascular aspect that is more of a nuance of age-related and time-related. Time-related nuances of how much time you have and what’s your goal. Are you training for something or not? Are you looking for a body composition change? Are you looking for all the benefits that you get with epigenetic exposure to high intensity?

You meet people, certainly more than I do but I meet people all the time that they have not been successful in many endeavors of this and you have a narrative about, “This is my sentence. This is my genetics and all that we do.” You’ve seen it enough times where when people can figure out this formula that as far as body composition, you can make the shifts. Can you make the shifts when you’re 60, when you’re 50, or when you’re 40? You can.

When we’re looking at the perimenopausal years, this is where people can get away with a lot. You can try trendy diets. You can try the exercise trends and rebound a bit but when we get into our early to mid-40s, and we start having that change over ratios of estrogen progesterone, this is where we have to have an eye on what training and nutrition are we doing because this is where we start having the biggest effect in our body composition. It’s not menopause, postmenopause, where we have all the body composition change.

It’s the years leading up to it because we starting to have a more anovulatory cycle so less progesterone is being produced so we have a longer follicular phase more estrogen dominance, more systemic inflammation, a greater baseline level of cortisol, and an incredible amount of sympathetic drive. We are always in that tired but wired state. It is because estrogen progesterone affects every system of the body.

When we start looking at what training we need to do, we need to look at the external stressors that will challenge the body and allow it to adapt as if those hormones were still supporting those adaptations. This is where we have the eye to stay out of that moderate-intensity zone. I know so many women love Peloton, Orangetheory, and F45. That’s not what they should be doing because it puts them squarely in this moderate-intensity zone, which ups cortisol and doesn’t do anything for body composition change.

We need to look at polarizing our training, and doing more focused on heavy resistance work. Phasing in doing a lot of mobility and making sure you have good mechanics before you start putting on load on the bar or the dumbbells and then looking at what is true high intensity. We have that sprint interval training so it’s twenty seconds full gas. You might do 5 or 6 of those and call it because you’re completely taxed out.

High stress causes an epigenetic change in the muscle to improve insulin sensitivity and your body’s ability to uptake blood sugar. It changes within the actin-myosin filaments, which are the key proteins for muscle contraction to keep myosin intact and to encourage lean mass development because estrogen is tightly tied to myosin.

When we look at maybe not quite so high intensity, but more of the HIIT, the high-intensity interval training, which is longer so the two minutes stuff, this is more your metabolic change where you’re working above the threshold. You’re teaching the body to use more of the carbohydrates and facilitating free fatty acid use as a resting fuel so this is where we start to impact that visceral fat telling the body, “Don’t store it. We need to use it.” It’s that idea of what training we’re doing when we start to get that perimenopausal aspect. When we hit menopause and postmenopause, we’re already attuned to the training that we want to do.

If you are already in that postmenopausal state, and you’ve missed that window in pre it doesn’t mean you can’t start now and invoke body composition change. It becomes important, the resistance training aspect, the plyometric or jump training for bone density, and then we look at that sprint interval training for that metabolic change. It doesn’t matter at what age you pick up these different ideas behind training and implement them.

You can invoke body composition change. We’re not subjected to that image that so many of the TV programs have of the slovenly man who’s aging next to a 20-year-old because they don’t want to put a 40 or 45-year-old woman on the TV. It plays into those myths and there are things that we can do to break the mold, keep empowering, changing, and achieving performance potential as we age.

An important caveat to that is that you have this practical and scientific approach because that’s your background but it’s also important that we do it with a soft hand and not because what happens is you’ll see a lot of women react to this. They are almost over. It gets too intense. They don’t miss a workout and they’re counting calories. This creates a whole other layer of stress and you talk a lot about getting your cortisol down and things like that.

I want to slide that in there as somebody who’s been around a lot of performance for a long time. That’s not the answer either because not only does it drive your stress and your hormones to a negative level or other levels, but you’re missing a whole other series of important things about being a person. You’re getting focused on weight and this and that instead of how it’s an entire practice.

Another thing that I appreciated and I feel this way, I don’t count calories. I’m aware. I know, “You blew it on the water today. You blew it on the calories.” “You ate a ton today.” I’m aware but I know that you’re not into calories. You’re into good food and the right amount of food. For you and I, we’re going to feel you might need more carbohydrates than me. Maybe I need a little less. Maybe I need more fat than you. Who knows? I would also encourage people to experiment with whole real food but then play around with how you metabolize and convert food to energy and what feels good to you.

I can’t say it enough. Real food first. There are so many cofactors within real food that allow it to work appropriately in our bodies and feed our gut. Coming back to the States from New Zealand, and looking at the plethora of choices of food and how many cheap processed calories are available online I’m like, “There’s such a miscommunication of what it means to be nourished versus what food is.” If I come back stateside, I’m always reminded of how different the food system is and how different real food context is in this country. It’s interesting.

I feel for people because it makes it harder to be more successful, especially what gets positioned as healthy and things like that. It’s real food and be mindful. A simple way to be a little more successful is to make all your own dressings and keep your oils and things very simple. Keep it olive oil or avocado oil for your dressings because at least you know what goes into them.

Can we talk about teenagers? I have three daughters and I’m always interested in resistance training. I don’t know what it’s like in New Zealand but here, everyone is nuts about sports and performance, they’re out there overtraining and they’re in one sport for the entire year. They’re not doing multiple different sports. Is there a more appropriate age? When they’re young it’s technique. You were talking about proper squatting, lunging, and things that get this base. We don’t want to start loading their bodies too early with weight. What is a zone? I’m 6’3”. I have long levers versus if I was some badass first base softball girl who was naturally more powerful or whatever. I know we’re different. What’s the approximate? Now we’re starting maybe too early.

There is a push in New Zealand to specialize as well but not as bad as here. The big misstep is around puberty when you see coed teams and then you start to diverge into female-oriented teams and body-oriented teams or male-oriented teams. The training practices and the ideas for female specificities are still the same as the boys. When we look at what happens at puberty when we have that epigenetic exposure or sex hormones, the boys will get leaner, they’ll get fitter, they’ll get faster, but for the girls, the hips widen, and the shoulder girdle widens to accommodate for that. We have a change in our center of gravity, we have a change in body composition, and of course, you get your period. There are all these things that are not addressed.

Around that age is where we want to start all those functional modalities and movements to make sure you have good mental mechanics. Often, it’s having to reteach running, throwing, jumping, and landing and landing mechanics because of the new biomechanics that girls have after they’ve entered puberty. When we look at those good mechanics, this is when we can start adding load. Prior to that, it is body weight and body weight are good because we’re looking at the changes in the biomechanics for girls. The functionality around those good mechanics is going to lead super far forward into any sport that they choose to be in.

[bctt tweet=”It’s not menopause/postmenopause where we have all the body composition change. It’s the years leading up to it.”]

What I find is when people are loading as early as 13 or 14 years old. They’re like, “Let’s get in the weight room. Let’s put weight on the bar.” What I find is the injuries in the ACL issues and the low back issues that these girls in some of the boys have by the time they’re 16 are due to the fact that these mechanics weren’t taken care of and were re-taught how to move and move functionally well before adding load.

There is lots of resistance type working due without adding that extra load of weight on the bar or heavy dumbbell work. It’s so critical for coaches to understand that during this period of time between 12 to 14 or 15, girls are going to be changing at different rates. If we keep it functional and within the sporting perspective to use bodyweight, mobility, and good mechanic work. As they get more specific in what they want to do with the eye to go into university with that sport in mind, that’s when you start adding the load.

Within that, when you have a tall athlete, the idea of an overhead snap with a squat, few athletes over a certain size do that well and safely. It’s also having coaches who have the understanding not only of how to teach it correctly but maybe certain moves would be better to do less often and less reps. For certain athletes, not at all. That’s the other thing. We get into these things like, “This is how we do it.” It’s like, “Okay.” In the end, maybe we could keep adapting.

You mentioned omegas and amino. I understand that all this is specific but a lot of us like this idea. I’ll give you an example. I take a shot of Shatavari because I was told by a friend of mine whom I respect very much that it’s a pretty supportive herb. Are there supplements or herbs that you find that can work nicely for a lot of people when it comes to their cycle and female health?

I know that it’s independent. I’m a huge fan of adaptogens and I’m a huge fan of DIM, especially for teenage girls having issues with inflammation and hormone-mediated changes to the skin, muscle, and that stuff. It’s using DIM to taper estrogen metabolism and hormone metabolism is great but then when we start looking at adaptogens, ashwagandha, and Lion’s Mane for brain function, there’s the specificity within that range of medicinal herbs and the phytochemicals in there that can make a huge impact. It depends on who the person is and what their needs are.

My belief is if we can get as informed as possible, stay in touch with how we’re feeling, be able to be willing to say, “I feel great and I’m bleeding.” “It’s the second day of my period and I know everyone thinks I’m supposed to be tired but I feel great.” “I know maybe I should feel good but I’m tapped out today,” and having the right information. One of the things is supplementation. You talked about adaptogens. I do a basic D, zinc and magnesium, and omegas. I do quercetin and a few other things but for magnesium and zinc, do you like them? Do you have to wait?

With my daughters, I give them certain things. They all started at different times. Once they’re about 15 or 16, especially if they have their cycle, I give them magnesium for sleep, D, or things like that because even if you’re in the sun all the time, not all of us can’t get enough D. I know it’s specific, but if you were going to encourage people to investigate some staples that feel important and safe, what are they?

Vitamin D, sure. That also helps with inflammation especially with anemia so it helps significantly. When we look at magnesium and zinc, I tried to get people to use it in the high hormone phase because our body goes through so much more zinc and magnesium. When you add an Omega-3 with magnesium and zinc, it counters a lot of the prostaglandin or the inflammatory responses the body goes through especially right before the period. We call it a PMS Stack where you do 1 gram of Omega-3s, 45 milligrams of zinc and 200 milligrams of magnesium 7 to 10 days before your period starts every night.

Over the course of three cycles, it lessens the PMS, it lessens the inflammation and lessens the bleeding and it works with the way your body responds to inflammation, the prostaglandins, and the COX inhibitors or the COX receptors because they work to inhibit a lot of those things your body learns. Magnesium and zinc are so important, not only for the inflammation aspect but for sleep and other regulatory aspects of the immune system.

Everyone’s so quick to be like, “I’ll take ibuprofen.” If we’re eating real food and we don’t have things checked out, there are other things to do to experiment with this. What people don’t realize is this stuff is tough on our microbiome, which then causes a series of other issues and we give it to our kids pretty young. I know that when you’re not feeling good it feels like a temporary quick and easy take care of it but it’s your suggestion that people would give that a chance. What about caffeine? Doesn’t caffeine give us a little relief?

It does. It’s more of if you’re a caffeine responder or non-responders so they’ve done quite a bit of genetic work with it. That small amount of caffeine can cause changes in blood flow and then that also helps with headaches and some of the achiness. A small amount of caffeine is great. That’s why they put in Excedrin and some of the others like Tylenol plus or whatever it is. I look at it as when you’re talking about ibuprofen and nonsteroidal, I’m allergic to them all so I’ve had to do surgeries and stuff and have turned to turmeric.

There are some case-controlled studies looking at the difference between Celebrex and turmeric and turmeric has much better outcomes with regard to inflammation and pain than Celebrex. There is some good complementary alternative medicine research that’s been done on these phytochemicals, plants, and these compounds but it’s not out there because you have big pharmaceutical giants and westernized medicine that pushes it down.

If we’re looking at things like using turmeric for inflammation, joint pain, inflammation that happens around the menstrual cycle, and then also stacking it with magnesium and zinc, you can do so much with that supplementation and looking at real food to boost it. That way, the pharmaceuticals reach for nonsteroidal and these kinds of things get pushed to the wayside.

With my kids, they get to a certain age and then they start to come back around but it’s almost like it either has to come from the outside. Let’s say one of my daughters is younger. If you said, “This is something from the drugstore for your cycle,” she’d believe me more than if I gave her curcumin or something. She’d be like, “Here we go. Don’t tell me it’s gluten-free.” You could say, “They make this to alleviate your cycle. You have to get into it.” They don’t need to learn everything but it’s like, “It’s so much better for you.” Forget it but help them out a little bit.

“A stranger down the road gave it to me and it’s perfect.” Intermittent fasting. There’s a place for that but I want to revisit this because we mentioned it. I want to talk about how it doesn’t necessarily support women in the same way that it does men. Especially as women get older, it may not be as good. Now if you’re more sedentary, let’s say you can use this as a way to work around certain things. Maybe we could talk about it for an active woman and a non-active woman and maybe get a sense of intermittent fasting because it usually gets glowing reviews and we have to be careful with that.

We see all the stuff has blown out with how it improves focus, it improves blood sugar control, it increases parasympathetic drive, but again that comes from male data. When we put it into the active woman who is exercising on a regular basis on purpose, the exercise data is way stronger for longevity, telomere length, cognitive abilities, and then intermittent fasting. We also know that calorie restriction is a better means of body composition manipulation for women. It comes down to women doing better in a fed state for exercise and stress.

A lot of times when women are trying to do intermittent fasting and exercise. They end up exercising in their fasted window, or they delay food after exercise, which keeps them in this breakdown state or this catabolic state, which the body perceives as low energy availability. When we look at the basic physiology, we know that in order for men to stay out of endocrine dysfunction, low testosterone, and other hormone imbalances, they need a minimum of fifteen calories per kilogram of fat-free mass. Women need 40 so right there, when we start looking at the differences in the thresholds before we start having dysfunction, if we add intermittent fasting, women will fall well below that threshold.

You might have had some success for the first couple of months but after that, you start to have a lot of dysfunction. It drives sympathetic aspects up. You end up having poor sleep. You don’t get the focus. You don’t get the parasympathetic responses and you have changes in blood lipids that are more of a negative scope so your LDL goes up, your total cholesterol goes up and you don’t get blood glucose control. When we start looking at the data that’s coming out specifically for women, and specific for active women, trying to get women to understand that intermittent fasting and time-restricted eating are not the way to go for longevity, health, and good fitness adaptations through the work that they’re doing.

Can you share? You have a nice little trick that you do where after you train and you’re not hungry, you extend your recovery window by maybe having a little snack with protein that buys you an extra window of time.

Women’s baseline metabolism comes back so quickly but if you have that 25 to 30 grams of protein postexercise, it opens up that recovery window for about two hours so gives you that time to put the body into the right anabolic state. Let’s rebuild this tissue. There’s nutrition coming in but I’m not hungry because it’s been hot and I’ve been doing a hard workout so let me get some of that protein in. After I fully cooled down and have a bit more time, I can have a real meal. That food still goes into reparation and adaptation so it is a good way of opening up that window and giving you a bit more leeway with the timing of your food.

Another thing is there might be a lot of parents reading and their kids are busy from morning to night with school, practices, homework, and competing. You also suggest that maybe the meal before competing is dinner and after you can have a snack so it’s also getting planning around the schedule to support them. It’s hard, especially with teenagers. You don’t control them as much. They never seem to want to eat breakfast. It’s an ongoing conversation but it’s not. They just want to eat or what have you.

If parents are looking for those kinds of tools, it’s a way. We talked about fueling and we talked about training. We all know sleep is important. I don’t know if it’s hormonal or if it’s that we’re prone to more mind-grinding. Women are more high alert. The biological will be prone to negative emotion, which doesn’t necessarily mean bad. It means you’re paying attention to a lot of different details more naturally. Do you have things that you use to support better sleep for you or even your daughter or people that come to see you for help?

It’s the basic sleep hygiene of not eating two hours before bed because we want to make sure that we get into that parasympathetic rest and digest type aspect. We want to be able to rest and not digest so no food two hours before bed. If you’re having issues sleeping because it’s hot or you’re paired menopausal with vasomotor symptoms, look at something like cold tart cherry juice 30 minutes before bed. It’s not sugar-laced so it doesn’t impact the whole rest digest and that increases your natural melatonin production and drops your core temperature so that you can get into a good sleep. It’s the no screens, the blue light filter, and all of those kinds of good sleep hygiene.

My daughter has a weighted stuffed animal. It’s a hippopotamus but she uses that and that helps her waylay some of the anxieties. As an adult, you get a weighted blanket or you can get a weighted hippo. All of those little things help but one of the big things for women is we have changes across the menstrual cycle on our sleep architecture because of the way hormones affect us.

We know that in the seven-ish days before a period starts, we have an increase in progesterone, which drives our core temperature up. We have an increase in estrogen that interferes with melatonin so it’s important to dump heat before you go to bed. It can be the tart cherry juice, it can you could be putting your hands and your feet into cold water because that dumps a lot of heat so your body can get into that lower sleeping temperature to be able to get below that oscillation of wake-up point.

The last thing that a lot of women fall into is they don’t eat enough so they become hypoglycemic when they’re sleeping at night and this is what causes a lot of disturbances and wakeups because they don’t have enough to keep them out of that hypoglycemic. We know that casing before bed can definitely help alleviate a lot of that.

Have you ever used or messed around with a glucose monitor just to see how things impact you?

I have been trialing the Supersapiens and the continuous glucose monitor and I’m not convinced of the data yet. It’s good when you’re paying attention to yourself. It gives you good information about yourself but it’s not so great as a comparison or making decisions on the fly about when you should eat. There’s a transient time between what’s happening in the blood versus what’s happening in the interstitial fluid that it’s being read from. There’s about a fifteen-minute lag time. When people are like, “Look at this. My blood sugar went way up about 30 minutes after I ate this.” It could be 45 or it could be sooner because of that lag time. If you’re looking at it from a trend’s perspective, and you start to read it as trends instead of absolutes give us good information.

We’re doing a research study right now looking at the menstrual cycle phase in ultra-runners and how they have blood glucose control. We make them run three hours fasted and not have anything so we can get a good marker of what’s happening with fatty acids versus blood sugar. We then give them a bolus of carbohydrates before they run for another hour on the treadmill to see their responses. We’re finding that women do well on a small amount of carbohydrates when they’re doing the low-intensity work so that comes into play.

We don’t know enough about fueling for women but the measurement between blood glucose and the continuous glucose monitor we’re seeing this lag time so we have to look at the trends with the CGM rather than the absolutes. It is a useful tool just like a whistle on the clipboard was a useful tool back in the day. If people are into biohacking and want to understand more about themselves, then it can be useful.

We’ve talked about younger women and older and different phases of life. If there’s a group in the middle and they’re interested and thinking they’re doing a lot of the right things, they’re getting to bed, they’re hydrated, they’re exercising, is there anything extra that we can help with? You mentioned that in your early 40s, making sure things are dialed in to take that through. Is there anything else that I missed that we could remind them to be paying attention to for the long journey of aging and feeling good?

This comes back down to the gut. There’s been a couple of papers that have been circulating off JAMA talking about the obesity epidemic and how calorie intake has been decreasing. Now they’re saying there’s been enough generational change that it comes down to gut microbiome and the way that gut microbiome has been affected by the food system. We’re looking at women who are struggling to change body composition even though they’re doing all the right things. If we look at getting a genetic sequencing of the gut microbiome to understand what the diversity is and what are phyla, they can make significant inroads and changes to their body composition by changing their gut microbiome.

That’s another far-reaching biohacking but it has a lot of robust science behind it and it’s so important because you see so many women that are constantly struggling even though they’re doing all the right things. Right, being the operative word there. They’re fitting in, they’re doing stuff for their health, they’re paying attention to what they’re eating, but they still can’t change and it comes down to what’s happening with those little bugs in your deep gut.

There are definitely ways of sequencing it through some of the different private companies. You can get a doctor’s referral subscription to get it paid for through insurance in the States but it’s so important to understand that especially as we’re starting to see what science is coming out saying, “We’ve had this generational change and it’s not about the calories and the physical activity. It’s about how our food system and our choices have affected the diversity of our gut microbiome.”

Dr. Sims, you have courses that people can come online with you. This is separate from Next Level and from some of the prior books. I want to bring this up so if people want to go down and dive deeper into this and learn from you, correct me if I’m wrong, you say, “I break this up into seven modules.” I love this expression, “Women are not small men.” It’s getting into, “We’re different. I don’t know why everyone’s afraid to talk about that. We’re different. It’s science. We’re great.” You get into the menstrual cycle and hormones.

The third is diet trends. You talked about training like a woman and having those conversations whether it’s with the people around you or coaches. Also, ways to biohack and manage the cycles of your period, dealing with the high and low hormonal days, PMS, and things like that. The last part of the module is putting that all together.

I want to tell people that if they want to dive deeper, you have a lot of opportunities for people to learn these things for themselves so they can take more control. A lot of times, it is confusing. It’s confusing to navigate. We’re inherently lazy, we say we want to feel better or make changes but it’s hard to do. That’s how I like to wrap it up with you.

Beyond being someone who is diving into this data, people are coming to you for help when you, yourself are managing a lot as a person. When you eat something and you go, “This is not going to serve me right now but I want it,” I’m curious. For you, if there’s room and forgiveness in there for yourself people think, “Once I know, I’m supposed to do everything perfectly.” This is not what this is about.

No. Not at all. It’s the empowerment of understanding but nothing’s perfect. You have the ideal theory and you have reality. I tried to go by the 80/20 rule where 80% of the time you’re on it and 20% is the life factor. Unfortunately, I have the predisposition to forget to eat when I’m highly stressed. I have to be reminded.

Often, I’ll find that I’ve gone through the day and I’ve fueled for training like I’m supposed to because I want to feel good about that but then I exist on green tea or coffee for the rest of the day. I get a lot of those things and then I have to catch myself. Even when you know, it’s hard. I don’t want people to take the word for the gospel and say, “I have to do this all the time,” and feel bad if I don’t get it done because you have life and you have reality. It’s having the knowledge and empowering yourself to make those choices but also not beating yourself up if you’re living life because that’s what we do.

I wanted to end with that because my hope for people is that they are accountable. If something isn’t working, they put the energy into learning and you’re a great person to learn from but there’s that reminder that there is not a person out there even when they’ve gotten certain parts of it figured out that has anything dialed. It’s doing the right things more often and supporting ourselves when we get that feeling. Once we feel a certain way the other stuff then almost doesn’t become worth it.

I took my youngest daughter to eat and she’s like, “Can I get ice cream?” I don’t even like ice cream but I saw the words chocolate peanut butter together in one. In a way, there’s a lot of abstinence that goes on. She’s like, “Do you want an ice cream with me?” I was like, “Yes, I do.” The thing I want to say is people are going to look at you. You’re ripped. You’re brilliant and you know a lot about this. They think I have something like, “You were an athlete.” It means nothing. We’re all doing the best we can. I want to revisit with you in a few years when your daughter starts to try to eat all that weird food that teenagers eat and see how you’re navigating that.

She already does. She already tried but she’s learned at an early age to listen to her tummy because they have this thing called cake day in New Zealand where it’s a fundraiser. She made too many mini cupcakes and felt sick. I always remind her, “Do you remember cake day?” She’s like, “I don’t want to feel that.” She learned at an early age. She eats all the things and tries to get away with weird stuff but then she’s like, “I don’t want to feel like that.” Good learning. Early major learning.

I don’t know if any of us learn except the hard way. Most of us need to know for ourselves so our children are no different.

You can say everything but until they experience it, it’s not going to go anywhere,

The book is Next Level. Dr. Stacy Sims, remind people where people can find you.

On social it’s Dr. Stacy Sims on Facebook and Instagram. The website is still easy. It’s DrStacySims.com. All the stuff is on the website and then we tried to put out good information on social to help women.

Are you having fun?

Most days.

I’m always working on the fun. Thanks for your time.

Thank you. I appreciate it.

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That wraps it up for this episode. Make sure to follow us on Spotify for free episodes and subscribe to the Gabby Reece show on Apple or wherever you get your podcasts. You can follow me at @GabbyReece on Instagram and Twitter. Aloha.

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Resources mentioned:

• Dr. Stacy Sims
• Next Level
• Women Are Not Small Men
• Peloton
• Orangetheory
• F45
• Supersapiens
• Dr. Stacy Sims
• Instagram
• Spotify
• Apple
• @GabbyReece
• Twitter

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About Dr. Stacy Sims