Lift Heavy, Protect Your Brain: Strength, Creatine, and Sauna for Women with Dr. Stacy Sims

In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with exercise physiologist and nutrition scientist Dr. Stacy Sims, moving from what does not work to what actually does for women in perimenopause and menopause. They cover why strength training, not endless cardio, is one of the most powerful tools women have for protecting muscle, bone, and brain health at midlife, and Dr. Sims walks through exactly how to structure a 20 minute strength session for maximum benefit. The conversation turns to creatine, including why women between 18 and 65 see some of the strongest benefits for brain and heart health, proper dosing, and why timing and mixing matter for bioavailability. Dr. Sims and Dr. Haver also discuss why distance runners can still develop osteoporosis despite years of training, and how chronic under fueling and calcium loss play a role. Guest links: Dr. Stacy Sims https://www.drstacysims.com/ Dr. Stacy Sims https://www.facebook.com/drstacysims/ (Facebook) Dr. Stacy Sims https://www.youtube.com/channel/UCPD55VPa1ZWx1a_nzWC2VJA (YouTube) Dr. Stacy Sims https://www.instagram.com/drstacysims/?hl=en (Instagram) Stacy T. Sims, PhD https://www.linkedin.com/in/stacy-t-sims-phd/ (LinkedIn) Dr. Stacy Sims Newsletter https://www.drstacysims.com/generic_optin?utm_source=linktree&utm_medium=social&utm_campaign= Dr. Stacy Sims Microlearning Course https://www.drstacysims.com/microlearning Books “The New Perimenopause,” https://thepauselife.com/pages/the-new-perimenopause-book?srsltid=AfmBOoqkbc2_wmfEQSfuf1fMT3s-ImuwNhUak8wC4KsEiYhHyNtQgSy5 by Dr. Mary Claire Haver “The New Menopause"⁠ https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z/ref=sr_1_3?crid=10GNBSGVPDFJZ&dib=eyJ2IjoiMSJ9.djG88jtefTqLpTg36Li8QIefDxRPHA-WKVyCC9DQ7X71Ad734j96bPWX-yewnsv9Pqm7WCali5P5-h2eixUH_yHkbz1DHy2rQFoQSh7O92HNwttIL_ZBgXVor81D-Z3sbsfBh7JOJXDQwUuhWNnA5LHbsuI1CyhIyjtRm6_DXYJFaWrkYTjJeqJyFBnBZfgTprhlgJe_RZoWH9pOY6S9XzRapnMjnZgOq7PBA7Wy2KM. ZfI9WXwN58225D-i3qDhw4ZlXZO4pt8rPX1nAKiBNHM&dib_tag=se&keywords=perimenopause+book+mary+claire&qid=1775810714&sprefix=perimenopause+book+mary+claire%2Caps%2C511&sr=8-3 by Dr. Mary Claire Haver “Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond,” https://www.amazon.com/Next-Level-Kicking-Crushing-Menopause/dp/0593233158 by Dr. Stacy Sims “ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life,” https://www.amazon.com/ROAR-Fitness-Physiology-Optimum-Performance/dp/1623366860 by Dr. Stacy Sims

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:02Dr. Mary Claire Haver?

  In part one of my conversation with Dr. Stacy Sims, exercise physiologist, nutrition scientist, and author of Next Level and Roar, we challenged some of the biggest assumptions women have been taught about exercise and nutrition. We talked about why fasted workouts, endless cardio, and eating less often work against us. Not because we're doing something wrong, but because so much of the advice that we've inherited was never designed for female physiology. Today, we're taking that conversation one step further. If we know what doesn't work, what should we be doing instead? We dive into the kind of exercise that actually protects our brains and bodies as we age, including our muscles,

• 0:48Dr. Mary Claire Haver?

  our bones, and our metabolism. We talk about why strength, not endless endurance, is one of the most powerful tools women have, and exactly how just 20 minutes in the gym can make a meaningful difference. We also tackle wellness trends dominating social media and separate what the evidence actually says from what marketing wants us to believe. We cover creatine, sauna, cold plunges, GLP-1 medications, and peptides. If you've wondered where to focus your limited time and energy, this episode will give you a plan grounded in science and designed for women's bodies. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist

• 1:31Dr. Mary Claire Haver?

  and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to UnPaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.

• 2:00Dr. Mary Claire Haver?

  The views and opinions expressed on UnPaused are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.

• 2:25Dr. Mary Claire Haver?

  How do you feel about GLP-1s?

• 2:28Speaker 01

  Ah, interesting. It's a time and a place thing again. I love them for what they're doing for the OBCD epidemic. Not necessarily excited with the uninformed practitioner who is not pushing lifestyle. So we see that loss of lean mass. Because I can always, I think I told you this before, the Wally movie, where they're floating around, right? And he falls off. Yeah. And he can't stand up. I'm like, that's where we're going. What I don't like, and I did an Instagram rant on this after the Grammys. And for me, it's not like, okay, maybe you have health reasons for using it. But for me, as the mother of a teenage daughter who's very impressionable, and for so long, we have been really pushing strong, be strong,

• 3:11Speaker 01

  eat food, skinny is not good. Now, all of a sudden, you see all these Hollywood people who are backlashing, and now, super skinny is in. And the mental health damage that it's doing to all the young people out there is astronomical. Because there's now putting women back in that box to be very small and demure and not take up space. And that's what frustrates me. Because there's no real reason to be microdosing, or to get super skinny. We don't know what the long-term outcomes are if you don't need it for

• 3:42Dr. Mary Claire Haver?

  For normal weight.

• 3:43Speaker 01

  Right.

• 3:44Dr. Mary Claire Haver?

  For healthy people.

• 3:44Speaker 01

  You're right. And so it's more like the Wild Wild West. And I feel like you can get GLP-1s anywhere.

• 3:50Dr. Mary Claire Haver?

  Anywhere. Well, on that topic, you know, GLP-1 is an FDA-approved peptide, but what do you feel about the whole peptide movement right now?

• 3:58Speaker 01

  We're talking like BP?

• 4:00Dr. Mary Claire Haver?

  I'm talking about the gray market.

• 4:01Speaker 01

  Oh, yeah.

• 4:01Dr. Mary Claire Haver?

  Not, not Smorlan, and not things that are FDA-approved. I mean, for our listeners, insulin is a peptide. Like peptides are just chains of amino acids that bind to receptors and do things in the body. And but I'm talking about the gray market, you know.

• 4:14Speaker 01

  Yep.

• 4:14Dr. Mary Claire Haver?

  And some of them are gonna be fast tracked, I think, under this administration, good or bad. But how do you feel? Is this helping? Is this hurting? Do you have an opinion?

• 4:23Speaker 01

  And they

• 4:24Dr. Mary Claire Haver?

  Are they in New Zealand?

• 4:25Speaker 01

  They are in New Zealand. They're not legal, though. You have to, like, I'm gonna say anyway.

• 4:30Dr. Mary Claire Haver?

  Black market.

• 4:30Speaker 01

  You circumnavigate to order from Australia and say it's for research only. You cannot get someone to compound it for you in New Zealand. And they're very tight on that because they're like, well, there's no real demonstrative evidence to show that they work and it's banned by WADA. So we're not letting you have it. Some of our professional athletes came back in with it and they got arrested and put on probation because they're bringing illegal substance in. So it's not legal in New Zealand, but very aware of it because I have a lot of injured professional athletes who are like, maybe I should get on these. These are gonna help. Even when I tore my meniscus and hamstring, I was considering it and I was like, oh, maybe I'll give it a go. So I have tried them and didn't see much. What worries me is now that we are in this mass longevity market and everyone's clamoring

• 5:14Speaker 01

  to be in there, that they're overselling. They're overselling results and there's not science to back it up. We see stuff in rodent studies that may or may not be promising. We don't know yet. We don't have any real human trials. If you want to experiment on yourself, maybe, but probably not because we don't have enough evidence. And that's where I see, like, every time you go open up something with longevity and precision medicine is IV therapy, peptide therapy, all this stuff.

• 5:42Dr. Mary Claire Haver?

  I went to a longevity conference for women and it was in New York and, you know, very excited to go and learn because, you know, I'm now treating patients in those last few decades of life and what is the science saying what's out there? And it was basically a menopause conference and people trying to sell gray market peptides. Like, there was no longevity science, like, at least as far as what I was hoping for.

• 6:07Speaker 01

  Right.

• 6:08Dr. Mary Claire Haver?

  And I'm like, is this what women's health? In our last three decades has become,

• 6:13Speaker 01

  Yeah.

• 6:13Dr. Mary Claire Haver?

  You know,

• 6:14Speaker 01

  And it's not just the peptides either. Now people are pushing rapamycin and methylene blue and mTOR blockers and all these kinds of things. It's like, where's the evidence? And why do we need it? Let's first take care of all the basics here.

• 6:26Dr. Mary Claire Haver?

  Yeah.

• 6:27Speaker 01

  And then let's go to the traditional route. Maybe we're going more holistic. We're doing acupuncture and dry needling and we're looking at how are we improving tendon health? Let's listen to Keith Barr where he's talking about how do we improve tendon health if we're doing isometric work from the researcher who's doing the research. But no, this is a case where marketing is louder than science.

• 6:47Dr. Mary Claire Haver?

  Now, let's talk about what works.

• 6:49Speaker 01

  Creatine.

• 6:50Dr. Mary Claire Haver?

  Creatine works.

• 6:51Speaker 01

  Why?

• 6:52Dr. Mary Claire Haver?

  Why? Should all women be taking creatine?

• 6:54Speaker 01

  Yes, and I read an article.

• 6:56Dr. Mary Claire Haver?

  Why? Are you sure? You said yes so fast.

• 6:59Speaker 01

  So fast, I know. I'm gonna say because I.

• 7:01Dr. Mary Claire Haver?

  I take creatine, full disclosure.

• 7:03Speaker 01

  Me too. Because I read an article this morning that just came across and it was a systematic review that was looking at the benefits of creatine and the people that benefit the most for using creatine are women specifically ages 18 to 65. And this is not for athletic performance, it's for brain and heart health. And I'm like, finally, the research is catching up.

• 7:25Dr. Mary Claire Haver?

  I know Abby's trying.

• 7:26Speaker 01

  I know Abby's doing such a great job on that. Yeah.

• 7:29Dr. Mary Claire Haver?

  So what is creatine? How does it work? How much should we take? Explain it to the listener. And it's cheap.

• 7:34Speaker 01

  It is very inexpensive when you get a really good one, which you have.

• 7:38Dr. Mary Claire Haver?

  I have.

• 7:38Speaker 01

  Yeah. So we look at creatine, as we were talking about glycolitics and glycolytic fibers and fast twitch, the very first energetic that happens is the breakdown of ATP to CP. So that's adenosine triphosphate and creatine phosphate. Creatine is part of that. So when you break it down, we need more creatine available to keep doing the ATP, CP and recreating it so that we have that fast energetics. Most people are not fully saturated. Our liver produces one to three grams a day, not a whole lot for all of our fast energetics. People aren't necessarily eating all of the creatine containing foods. And we see that women, by the nature of the way they eat and the fact that.

• 8:20Speaker 01

  We don't have as much muscle mass as men typically, then we don't have as much creatine available. So if we are slowly increasing creatine by supplementing, so maybe three to five grams a day, very low dose. Over the course of two to three weeks, we fully saturate all of our tissues. So what does that mean? That means that we have increased all the stores of our creatine. So our brain works better. We see that there have been some RTCs that look at creatine.

• 8:46Dr. Mary Claire Haver?

  Randomized control trials.

• 8:48Speaker 01

  Yes, thank you. That look at creatine and depression and it helps people get out of a significant depressive state a lot faster. They're looking at CBT, which is cognitive behavior therapy with creatine versus a serotonin reuptake inhibitor. And the CBT and creatine works better.

• 9:05Dr. Mary Claire Haver?

  Wow.

• 9:05Speaker 01

  So there's lots of efficacy for using creatine and the research just keeps flowing. And it's really exciting to see, you know, the effects of fatigue and jet lag. Like I am in the jet lag stage, so I'm dosing 20 grams a day.

• 9:21Dr. Mary Claire Haver?

  For those of you don't know, Dr. Sims lives in New Zealand and flew here to San Francisco this week. So she is in the jet lag phase.

• 9:27Speaker 01

  So yeah, we're five hours behind, but a day ahead, but it's okay. So when we look, and I use this in my shift workers too, it's like, we want to help the brain eliminate that fatigue and the feeling that it is so fatigued, it goes through a lot of glucose and it alters our carbohydrate metabolism, which is one of the problems that we see with shift work. So if we're looking at dosing creatine specifically point three eight grams per kilogram, which.

• 9:54Dr. Mary Claire Haver?

  Math.

• 9:55Speaker 01

  I know.

• 9:55Dr. Mary Claire Haver?

  Just tell me a number.

• 9:56Speaker 01

  About 20 grams.

• 9:57Dr. Mary Claire Haver?

  Oof.

• 9:57Speaker 01

  Yeah. And we take it over the course of the day. So it's the old bodybuilding idea of.

• 10:03Dr. Mary Claire Haver?

  This for shift workers?

• 10:04Speaker 01

  Yep. Five grams, four times a day, but also with jet lag because it increases brain energetics. It's fuel for the brain. So it reduces the fatigue, cognition comes up, reaction time is better. It helps with overall metabolism because now the brain is not being, it doesn't have the perception of being overly fatigued. So it is really incredible for brain and brain metabolism, brain health.

• 10:28Dr. Mary Claire Haver?

  How much? So if you're not a shift worker. Just, you know, Jane in Ohio on the couch right now.

• 10:33Speaker 01

  Yeah.

• 10:33Dr. Mary Claire Haver?

  How much does she be taking?

• 10:34Speaker 01

  Three to five grams a day.

• 10:36Dr. Mary Claire Haver?

  When? Does timing matter?

• 10:38Speaker 01

  Does not matter. We do know that if you mix it in, then it loses its bioavailability within three hours.

• 10:45Dr. Mary Claire Haver?

  So you don't- Mix in with food or mix in?

• 10:47Speaker 01

  Water.

• 10:47Dr. Mary Claire Haver?

  Oh.

• 10:48Speaker 01

  Or whatever liquid it is. Once you mix it in with something liquid, then it loses its bioavailability within three, sometimes five hours, depending on-

• 10:57Dr. Mary Claire Haver?

  So you need to drink it within three to five hours, is what you're saying?

• 10:59Speaker 01

  Exactly.

• 11:00Dr. Mary Claire Haver?

  Okay. Good to know.

• 11:01Speaker 01

  So don't mix it in the night before and then drink it-

• 11:03Dr. Mary Claire Haver?

  The next day. So I walk on a treadmill-

• 11:06Speaker 01

  Yeah.

• 11:06Dr. Mary Claire Haver?

  In my garage.

• 11:07Speaker 01

  Yep.

• 11:07Dr. Mary Claire Haver?

  I cannot see the outside because I live in Galveston, Texas, and it's usually 95 degrees or higher with 100% humidity, so it makes it doable.

• 11:14Speaker 01

  Mm-hmm.

• 11:15Dr. Mary Claire Haver?

  But what is the difference between walking outside versus walking on a treadmill?

• 11:19Speaker 01

  From an energetic standpoint, not much. But from a mental health standpoint, a significant difference. We see so much research now coming about green space and nature and how beneficial it is just to take a walk in nature for mental health. We see it releases more of the dopamine and we have more of a relaxation. We're able to get into more parasympathetic responses, which is great for sleep. And a lot of times when we are out in green space and just being in a park and there are other people around, we don't feel isolated. And isolation is another really big killer as we get older. So it's just being out in nature connects you to the environment, to the community, as well as being

• 12:03Speaker 01

  out in nature really does improve mental health status.

• 12:06Dr. Mary Claire Haver?

  So along the mental health line, we see, on my end, a doubling of mental health, depression, anxiety, rage, new things like misophonia and just a lot of disruption of your normal day-to-day ability to cope with things.

• 12:21Speaker 01

  Mm-hmm.

• 12:22Dr. Mary Claire Haver?

  Resilience, I call it. From your area of research now, of course, menopause hormone therapy, we're learning leaps and bounds in perimenopause-

• 12:28Speaker 01

  Yeah.

• 12:28Dr. Mary Claire Haver?

  How beneficial it can be for mental health specifically.

• 12:31Speaker 01

  Yes.

• 12:32Dr. Mary Claire Haver?

  But what are you seeing in your research around exercise and nutrition that we're missing?

• 12:36Speaker 01

  I get this question quite a bit because like one of the newsletters we just- Put out was about brain health and I didn't want to get into the whole M H T conversation. Follow Lisa's work quite closely and we know there still isn't enough definitive research to say yay or nay.

• 12:51Dr. Mary Claire Haver?

  Yeah.

• 12:52Speaker 01

  But when we look at exercise and nutrition, we know there's definitive research that will help change systems. So when I'm talking to people like menopause hormone therapy, we see there's so many benefits, especially in perimenopause. But it's also in addition to the lifestyle and what is the lifestyle? We see women who are so focused from our generation on volume, volume, volume, volume. I want to be an ultra runner. I want to do this, this, this, this, this, this, marathons, Ironman. It's like, why? Why are you driving for endurance? Oh, because I have extra time or you really disseminate it down and it comes down to aesthetics. And it's like, no, we want quality. Like if you want to do Ironman, great, but let's look at your training.

• 13:35Speaker 01

  Because the long, slow volume of stuff is not going to be beneficial for body, brain, bone, mass, any of that.

• 13:42Dr. Mary Claire Haver?

  Talk about the rates of osteoporosis with distance runners.

• 13:46Speaker 01

  I know. Funny.

• 13:47Dr. Mary Claire Haver?

  It's really shocking.

• 13:49Speaker 01

  I know. I shouldn't say funny as in haha, funny in the irony.

• 13:52Dr. Mary Claire Haver?

  The irony of it. Yeah.

• 13:53Speaker 01

  Because people think that running is so protective, but it's not.

• 13:56Dr. Mary Claire Haver?

  In many ways.

• 13:57Speaker 01

  Right.

• 13:57Dr. Mary Claire Haver?

  But not for bone.

• 13:59Speaker 01

  Not for bone.

• 13:59Dr. Mary Claire Haver?

  I dug into it a little bit because this happened to a very good friend who's a, who wants to do more, more ultra stuff. And she's got osteoporosis and not, she's not 50. From what I could find, there's probably chronic under fueling because you just can't keep up with calories when you're moving that much constantly. There's not enough time.

• 14:16Speaker 01

  Right.

• 14:17Dr. Mary Claire Haver?

  You know?

• 14:17Speaker 01

  Exactly.

• 14:17Dr. Mary Claire Haver?

  So maybe that's one of the reasons.

• 14:19Speaker 01

  Yeah. And the calcium loss that you have with the impact of running. We saw this a lot in our younger runners who were just coming out of red S, relative energy deficiency in sport, low energy availability. They're taking Tums before running helped with the calcium loss because then it was circulating. So there are things that you could do, but for the most part, people don't realize it because they've been told, oh, you know, running is protective, but it's not. It's not multidirectional. It's not enough to invoke a, a challenge to the bone. That's going to create the signal to make it stronger and more resilient. And again, it's the fueling factor. And so when I'm working with people who are doing long distance, it's like, we need to pull you right back. I know that this is your end game here.

• 15:03Speaker 01

  This, but if we want to get you there, we have to change up your training. We have to make sure you're fueling. We want you to be lifting. We want to pepper in high intensity. Yes, volume is important because you're doing endurance. I've had so many women who have PB'd in their endurance events have, there's a, a race down in New Zealand called God Zone. So it's a five day, multi-day race out in the woods, multi-sport, all things. And this woman's like, I have just been rucking with a heavy backpack. I've been lifting. I've been doing some intensity. I was worried because I didn't have a lot of time on my feet and volume, but we PB'd by day. And I was like, fantastic. Amazing. So there's so many things that come into play when you start talking to people about what's your end game and how are we going to get there?

• 15:47Speaker 01

  But we have to look at the signaling that your body is getting across the way in order to maintain your health.

• 15:57Dr. Mary Claire Haver?

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• 17:10Dr. Mary Claire Haver?

  Are women more fatigue resistant than men?

• 17:13Speaker 01

  They are.

• 17:13Dr. Mary Claire Haver?

  Why?

• 17:14Speaker 01

  Yeah. So this is really interesting research that comes out from like in utero. We know that when a mother who is pregnant with an XY fetus, who's under a lot of

• 17:24Dr. Mary Claire Haver?

  That would be a boy.

• 17:25Speaker 01

  Right. I'm trying to be PC. Versus a woman who is under a lot of environmental and mental and physical stress as pregnant with a girl, that she'll most likely miscarry with an XY. So we see this.

• 17:39Dr. Mary Claire Haver?

  And I did not know that.

• 17:40Speaker 01

  Oh, you didn't?

• 17:41Dr. Mary Claire Haver?

  I'm an obstetrician and no one ever told me.

• 17:43Speaker 01

  I'm going to send you the research. It's really cool. And we see that there is an epigenetic change that's happening within the XX fetus because of the dosing of the X chromosome that increases the resilience to stress. So when we take the baby out and the baby is born and we have a XX woman, the resilience to stress is greater than the resilience of XY. So when we start looking at fatigue and fatigue resistance, yes, from a physiological and biological, we can look at things like pain tolerance. We can look at muscle fiber factors, but it really comes down to the epigenetic

• 18:27Speaker 01

  change that we have with stress that makes women more fatigue resistant and more resilient. So I found that fascinating.

• 18:35Dr. Mary Claire Haver?

  That is amazing. What is the difference, you know, you touched on this, but for our listeners, between oxidative muscle fibers and glycolic and like how, you know, a lot of, a lot of women don't understand the difference here.

• 18:49Speaker 01

  Right. And I think it's because people just think that the body is more of an algorithm. Right? So if we're looking at the way the body fuels itself, we think about glycolytic fibers and this is our very fast energetics. This is anything that is from zero to 30 seconds, sometimes up to two minutes. And the body hasn't quite gotten up to speed enough to use oxygen. So when we're looking at the fuel for it, it's primary glucose. It's ATP, which is adenosine triphosphate and you break it and you have adenosine.

• 19:22Dr. Mary Claire Haver?

  The Krebs cycle.

• 19:23Speaker 01

  Right. The Krebs cycle. Right? This is why we need creatine to boost.

• 19:27Dr. Mary Claire Haver?

  We'll talk about creatine later.

• 19:28Speaker 01

  Yeah. And so that's our glycolytic. It's not using oxygen. It's primarily using glucose. And we're looking at breaking down glucose. This is also how we produce lactate when we're in high intensity. Oxidative is when we're at a lower intensity, we've had some time and it might be four minutes onwards and oxygen can come into play. So oxygen is really important when we talk about the Krebs cycle, right? For using fat metabolism and burning free fatty acids to use that as a fuel. So there isn't this automatic switch because they work in conjunction, right? And so when we're talking about glycolytic fast twitch, women have less of that and we need to work on that. We talk about oxidative women are by the nature of XX

• 20:09Speaker 01

  have a lot of that and are really good at that. But for men, they have a lot of glycolytic and not a lot of oxidative. So when we talk about the bro data and the male data, it's really

• 20:19Dr. Mary Claire Haver?

  Why it's so hard to apply to women?

• 20:21Speaker 01

  Exactly. Exactly.

• 20:23Dr. Mary Claire Haver?

  What is power-based training?

• 20:24Speaker 01

  Power-based training, there's two aspects. When we're thinking about in the gym, power-based training, this is lifting under speed and working tempo. So you might go in your squat, really one, two, three, four, pause, and then explode out. So that's power-based. Plyometrics, jump training, anything that's fast explosive type stuff.

• 20:45Dr. Mary Claire Haver?

  Why is that important?

• 20:46Speaker 01

  That's all fast twitch. And it's also really good for maintaining proprioception, neural connections, good metabolism. We think met ball slams, all that kind of stuff is just really accelerate and relieve pass. Powerful. And we need that because not only are we seeing that having power and strength is a good indicator of how you're going to live year later years, but it's also really beneficial for our brain metabolism, for signaling to get rid of visceral fat, to allow us to not fall, to improve our balance and proprioception.

• 21:21Dr. Mary Claire Haver?

  So I go down to the gym and I have 20 minutes.

• 21:25Speaker 01

  Yep.

• 21:26Dr. Mary Claire Haver?

  What should I do?

• 21:27Speaker 01

  Well, I know that you have a history of strength training.

• 21:30Dr. Mary Claire Haver?

  Yeah, I do.

• 21:30Speaker 01

  Right? And high intensity work. So if I were to take you for 20 minutes and you're in your, your home gym, I would warm up five minutes with mobilization because this is part of the conversation.

• 21:41Dr. Mary Claire Haver?

  So bad at that, Stacy. I just want to get right to it.

• 21:43Speaker 01

  I know, but it's so important. We have to be able to move well. If we neglect mobilization, then we don't move so well.

• 21:50Dr. Mary Claire Haver?

  So what is mobilization?

• 21:51Speaker 01

  So this isn't stretching. This is like using resistance bands to what we call voodoo floss, the hamstring. So you have it attached to the rig so you can bend over and pull and distract the hip capsule, get into the hamstring. So it's not stretching, but it's opening up everything for a full range of motion. You start to have a little bit of shoulder impingement. You can use the resistance band, pull back it in and pull the shoulder back. It helps prevent shoulder impingement, all sorts of things. So then if we say, okay, now we have 15 minutes left, I want you to do one compound movement. So are we working on our squats today? Then our mobilization is going to get in that full range of motion, opening up our hips or knees or ankles. And then we're going to build up our squats and then maybe I'm going

• 22:34Speaker 01

  to have you do some pause squats. So you're going to tempo down two, three, four, pause at the bottom, explode out. And we might, depending on where you are in your program, maybe you're doing four sets of that, maybe you're doing five sets of that on a heavier load, but we're trying to move with intent and some explosiveness. And then I'm going to have you finish with a little bit more mobilization because you've done some really hard explosive work in your squat. If we're not doing the explosive work and we're just doing our typical squats, then I'd have you finish with some battle rope work or maybe some sprints on your treadmill, just for a little bit more high intensity. Done and dusted in 20 minutes.

• 23:13Dr. Mary Claire Haver?

  Wow. Okay. Most women, when I looked at the research, have never lifted a weight. I, there's been really fun memes going around about women being the first in their generation to ever work on strength training. And I'm, I'm very certain.

• 23:26Speaker 01

  It's my mother.

• 23:27Dr. Mary Claire Haver?

  Jogged and jogged so much. She's had three bladder lifts.

• 23:31Speaker 01

  Oh, wow.

• 23:31Dr. Mary Claire Haver?

  And eight children. So that was definitely a part of it. But like she swam a little bit and but they had one of those machines that had the band that went around her waist.

• 23:43Speaker 01

  Oh, yeah.

• 23:44Dr. Mary Claire Haver?

  And would shake. And then my dad would get on it and like my sister and I would sit there and watch them like shake their bellies.

• 23:50Speaker 01

  Yeah.

• 23:51Dr. Mary Claire Haver?

  And like that was their gym.

• 23:52Speaker 01

  Yeah.

• 23:53Dr. Mary Claire Haver?

  So.

• 23:53Speaker 01

  The vibration.

• 23:54Dr. Mary Claire Haver?

  The vibration.

• 23:55Speaker 01

  Similar. My parents both jogged. My dad was push up stuff because of the army. You know, had to do calisthenics. We ended up with the Nordic track and I think we had one of the Chuck Norris, you know, like wrote police assistance at some point. And then when I was a teenager, I found the firm aerobic workouts with weights.

• 24:14Dr. Mary Claire Haver?

  Oh, yeah.

• 24:14Speaker 01

  Remember the firm?

• 24:15Dr. Mary Claire Haver?

  The firm.

• 24:15Speaker 01

  Yep. So I think I was the first one. And then I got into going to the gym with my friend at 16 because her brother was a bodybuilder and we had to go meet him at the gym. So instead of hanging out, we're like, okay, we're gonna lift. And then I introduced my mom to the firm aerobic workout with weights.

• 24:31Dr. Mary Claire Haver?

  Amazing.

• 24:32Speaker 01

  She started doing small weights and she's been doing small handheld weights, but trying to get her to build that weight stuff up is hard.

• 24:38Dr. Mary Claire Haver?

  A lot of resistance.

• 24:39Speaker 01

  Because it's not in, yeah, because it's not in the culture.

• 24:41Dr. Mary Claire Haver?

  How do you know, you know, for an absolute beginner, if she's like listening to this podcast, where does she start?

• 24:46Speaker 01

  Where does she start? I tell people, if you're just starting your journey, that you want to have a wellness meeting with yourself 10 minutes, three times a week. We don't break wellness meetings. Well, we don't break meetings and we definitely don't break wellness meetings with ourselves. If at first it's just the consistency of those 10 minutes, three times a week and you're going outside with your cup of coffee and having time in nature to improve mental health, fantastic. But over the course of maybe two weeks, then I want you to start adding in some body weight stuff.

• 25:17Dr. Mary Claire Haver?

  Mm hmm.

• 25:17Speaker 01

  That could be doing some air squats, could be doing some single leg lunges, maybe you're doing balance on one leg, tree pose.

• 25:25Dr. Mary Claire Haver?

  Mm hmm.

• 25:26Speaker 01

  Pushups against the wall, anything that's going to be resistance push pull for you as you start your journey and you're going to find what you really like. And if you're like, ah, I really enjoy working out at home and I want to be outside, then maybe you get an app, maybe you get into something like P volv, maybe you get into like Haley Happens stuff, like there are lots of different really good programs that you can do at home, but ideally you get a friend and you meet your friend and you have 20 minutes together where you can catch up, but you're also working out.

• 26:02Dr. Mary Claire Haver?

  Isn't there mental health benefits? I mean, working out with a friend is better on multiple levels.

• 26:06Speaker 01

  Absolutely, absolutely.

• 26:08Dr. Mary Claire Haver?

  I do miss that, you know, I used to go to classes with my girlfriends and there was a lot of dancing and fun involved and some weights and stuff, but it wasn't enough. And I got out of the habit and the classes got really, really busy and it was hard to find a spot and so, but I do miss working out with friends, you know, just for that social aspect.

• 26:26Speaker 01

  Exactly. And sometimes you can push yourself a little bit more when you're with your friends. Yeah. So that's how I tell women to start. And then if you're already on a journey and you have a consistent like cardiovascular program, let's try to, to take out one or two of those days and make it a circuit program. So you already have it in your calendar, what you're doing and you get up and maybe you walk every day, but let's go, we walk one day, the next day we're going to go on your walking route, but we're going to pepper it up with some body weight stuff so that we can get some circuit work in there. Just start changing it a little bit because the body really likes to adapt to change and that's how we get improvements.

• 27:14Dr. Mary Claire Haver?

  I've heard you talk about this and I think our audience will find it interesting about core work and situps.

• 27:20Speaker 01

  Yeah.

• 27:20Dr. Mary Claire Haver?

  Do we need to do situps?

• 27:22Speaker 01

  No, you don't need to do situps.

• 27:24Dr. Mary Claire Haver?

  Thank God.

• 27:26Dr. Mary Claire Haver?

  Why?

• 27:26Speaker 01

  I like to tell people, sit-ups is like the lid on the box. And sometimes you get presents and there's no lid. And that's great. And that's kind of what we want, because all the stuff in the, in the box is what you're after. So core is your spine and it's your abs and it's your posture. And when people think about core work, they're like, oh, I have to dedicate X amount of minutes to core. And it's not really that functional.

• 27:50Dr. Mary Claire Haver?

  Mm-hmm.

• 27:51Speaker 01

  If we're doing compound movements, like our deadlifts, our squats, our push press, our bench press, we end up using our core stabilization. And you'll find over the time of doing that, that your core becomes very strong. And you're like, who needs sit-ups? Because the idea of doing sit-ups is you're just working the very top part. And you're not actually invoking any change. You might build some more muscle there. And some people are like, yeah, I lose weight rapidly in my midsection. So now I have six pack abs. But functionally, where in life do you do this? Right?

• 28:24Dr. Mary Claire Haver?

  True. When you get out of bed.

• 28:25Speaker 01

  Right. Exactly. When you get out of bed. So when we look at what is core, we want to look at stabilize our obliques, our spine, our lower abs, so that we're not hinging all the time. So we sit upright, we open up our chest. And you want to be like the bamboo straw, not the bendy straw.

• 28:42Dr. Mary Claire Haver?

  Mm-hmm. So in general, is cardio good or bad for women?

• 28:47Speaker 01

  Well, it depends. Right? It depends on what you're wanting. So cardio, yes, good. But extensive and not planned, not so much.

• 28:55Dr. Mary Claire Haver?

  Okay.

• 28:55Speaker 01

  So if we're in our younger years, we can get away with anything, right? We know this. This is great. As we get older, we want to optimize. So if we're looking at optimizing our health, then yes, we need to pepper in some high intensity work. If you're looking for cardiovascular benefits only, then you can also get that from strength training. If I have someone who's like, I want cardiovascular benefits and I am very short on time and I don't really like to run, I don't want to walk, I hate the bike. It's like, okay, well, let's do strength training.

• 29:24Dr. Mary Claire Haver?

  Why?

• 29:25Speaker 01

  Because when we're looking at strength training and the capillarization or how your muscles are getting blood, you are improving capillarization as you're building your muscle. You're also having a different blood flow diversion when you're strength training. And all of that increases the way that the heart is working, which improves cardiovascular health. And we also see that people who are doing lots and lots and lots and lots and lots of cardio, they have remodeling of their heart. And for women, it's different than men. And so I've had a lot of women recently who have been told by their doctors that they have a heart arrhythmia and they have to stop exercising. And these are endurance athletes and they're like, what's going on? It's like, okay, well, let's look at the heart arrhythmia. And when you look, you're like, it's not an arrhythmia.

• 30:08Speaker 01

  This is an indication that your heart has remodeled as an endurance athlete, as a female endurance athlete. Because women who do lifelong endurance exercise, so we see that from our generation, our chambers get bigger and the muscle around the chambers get stronger. But we don't have a risk for things like VT or ventricular tachycardia. For men who are lifelong exercisers, their heart remodels where the muscle gets super strong and the chamber doesn't get bigger. So they end up with dual innervation and they end up with these arrhythmias and VTAC and stuff. But because the woman's heart hasn't remodeled like a man's heart, then she's deemed as the anomaly and the arrhythmia.

• 30:51Speaker 01

  So when we're looking at cardio, we have to say, okay, what's the purpose? What are we doing? A lot of people, myself included, is like, it's mental health. I need to get outside. I want to ride my bike. I want to go for a run. I want to do all of these things that are more cardio intensive because it's for me, mental health. Great, do it. But if you're looking for aesthetic outcomes or you're looking for cardiovascular outcomes, you're looking for brain health, there are different things that we can do. Cardio is part of it, but it's not the be all end all.

• 31:19Dr. Mary Claire Haver?

  Okay, let's move on to some of the esoteric things. What is cold plunging? I see it trending everywhere on social media and I hate to be cold. Like there's nothing worse in my mind than sitting in an ice bath. So I've never done it.

• 31:33Speaker 01

  Okay, good. I think Wim Hof actually hit back on me about it, but whatever. So we look at ice bath or cold plunging. It's the idea of getting into very cold water, zero to four degrees Celsius. So, you know, around that thirty two to forty degree Fahrenheit mark. And you're in there for 30 seconds to a minute and invokes a very strong response. When we look at the male data, that strong response is an endocrine shift. So we have better endocrine health. We have, meaning better hormone health.

• 32:03Dr. Mary Claire Haver?

  Metabolic.

• 32:03Speaker 01

  Yeah, metabolic health. Get a better parasympathetic in that focus. But for women, it's such a strong sympathetic drive. It goes the opposite. So we're looking at that really cold water and cold plunge for women. It's not ideal. Our body does not respond the same. We look at maybe 55 degrees Fahrenheit, which is around that 14 degree mark Celsius. Women will start to get the same benefit. They don't need that ice water to get the same benefit. Cause we have different sex differences in thermoregulation. But those responses are not as robust as we see in male data. So the cold plunge thing, I'm like, what are we doing? Oh, it's male centric again, and we're pushing. And it's a, it's a billion dollar industry now.

• 32:47Dr. Mary Claire Haver?

  All right, let's talk about saunas.

• 32:48Speaker 01

  Saunas are great.

• 32:49Dr. Mary Claire Haver?

  Go to the other end.

• 32:50Speaker 01

  Go to the other end. So saunas are great for men and women. And again, we're.

• 32:54Dr. Mary Claire Haver?

  Why?

• 32:55Speaker 01

  We're looking at an environmental heat stress. And when we have any kind of stress on the body, we have responses that improve health and health outcomes. So one of the factors that happens with hot or heat exposure, particularly the dry sauna, not the infrared sauna, is we have skin responses first. Skin gets heated up. We have vasodilation, skin comes to the surface, which means that our muscles and our heart and everything is like, oh, wait, I need more blood. So one of the factors, our heart rate increases, but that's a signal to improve all of our blood volume. So we end up producing more red cells. We end up producing more plasma volume. We end up with better blood pressure. We end up with better endocrine responses, metabolic health.

• 33:39Speaker 01

  We see that you can use it 10 minutes after training to extend the training stress. You've had a very short session and you're like, I need to extend that for cardiovascular or whatever reasons. Then you get in the sauna and extend it. And for women, it's a stronger stress because throughout our reproductive life, our menstrual cycle in the second half, we have an increase in our core temperature because of progesterone.

• 34:00Dr. Mary Claire Haver?

  Right.

• 34:00Speaker 01

  So our body's used to thermoregulatory shifts on a monthly basis. So if we go into the heat, we can sit there for a longer period of time.

• 34:08Dr. Mary Claire Haver?

  And how long do you need? To see benefit.

• 34:11Speaker 01

  Yeah. So when we're looking for health benefits, it could be 10 minutes, three or four times a week at the most. If you're looking for adaptive benefits, where we're looking to go someplace hot and be okay, then we're looking at nine days in a row, 30 minutes in. And a lot of people are like, I just want health benefits. Great. Pepper it up. If you only hit it once a week, great. That's still a heat stress that your body's going to respond to.

• 34:33Dr. Mary Claire Haver?

  So I was gifted with a sauna blanket. It's like a giant sleeping bag that gets really, really hot inside. And I think it has infrared too. Am I fooling myself?

• 34:44Speaker 01

  Yes.

• 34:44Dr. Mary Claire Haver?

  Yes.

• 34:44Speaker 01

  Because your head is not in it.

• 34:46Dr. Mary Claire Haver?

  My head is not in it. Or my arms, because I breathe.

• 34:50Speaker 01

  Yeah, no. But there is also benefit for being in a spa up to your neck. It's heat exposure and it takes longer to get the benefits because you have the circulation of water, which is not the same as being in a very hot environment and your head is not getting heated. But heat exposure is beneficial for all aspects of health for both men and women. And the responses for women are more robust than they are men. So cold, men have more robust responses. Heat, women have more robust responses.

• 35:19Dr. Mary Claire Haver?

  Is there any low cost version of a sauna that, you know, I mean, I've seen thousands of dollars for these boxes that people can go sit in at their house.

• 35:28Speaker 01

  Yeah. So low costs.

• 35:30Dr. Mary Claire Haver?

  I mean, can you just fill up your tub with hot water and soak in there?

• 35:33Speaker 01

  You could. Similar to like a hot tub. There are, I don't know, maybe not in Texas, but I'm not sure. There's lots of-

• 35:41Dr. Mary Claire Haver?

  Just go outside.

• 35:41Speaker 01

  Yeah, go outside. There's also pop up saunas where they're like portable saunas that will go and they'll say, hey, you've come for a sauna. So you can look in your neighborhood and say, oh, well, is there a pop up sauna to go to? That's a growing industry. For the cheap and dirty, you can always take the old fashioned way that we used to acclimatize and that is put on lots and lots and lots of clothes and a hot garage and get on a treadmill or a bike and not have a fan until you start really overheating.

• 36:10Dr. Mary Claire Haver?

  And then sweat it out?

• 36:11Speaker 01

  Yeah.

• 36:11Dr. Mary Claire Haver?

  Okay.

• 36:11Speaker 01

  Not a great way, but if you're really desperate, you can.

• 36:14Dr. Mary Claire Haver?

  Okay, we've covered a lot.

• 36:15Speaker 01

  We have.

• 36:16Dr. Mary Claire Haver?

  Breakfast before movement, protein coffee, meal timing, strength, sprint interval, sauna, creatine, cold plunges. So if a woman can only do two things, so what's your top two things or three things for her to take away from this conversation?

• 36:29Speaker 01

  Circadian rhythm alignment. Because then that helps with

• 36:32Dr. Mary Claire Haver?

  Everything.

• 36:33Speaker 01

  Everything.

• 36:34Dr. Mary Claire Haver?

  Mm hmm.

• 36:34Speaker 01

  That's the thing.

• 36:35Dr. Mary Claire Haver?

  So that means don't fast in the morning.

• 36:37Speaker 01

  Right.

• 36:38Dr. Mary Claire Haver?

  Eat as soon as you wake up and what is it? Eat like a princess for breakfast, a queen at lunch and then

• 36:45Speaker 01

  Other way.

• 36:46Dr. Mary Claire Haver?

  Is it backwards?

• 36:47Speaker 01

  Yeah, eat as a queen, then it's eat as a princess and then eat as a pauper.

• 36:52Dr. Mary Claire Haver?

  Okay, so like front load your meals.

• 36:54Speaker 01

  Front load your meals.

• 36:55Dr. Mary Claire Haver?

  For circadian, I never thought about timing of meals with circadian rhythm. I knew about light, right? We learned that in medical school, but never around. And then get, get exposure to light as soon as the sun is up, you know?

• 37:06Speaker 01

  Yeah, when you wake up, get that light. Yeah, open your curtain, look outside.

• 37:09Dr. Mary Claire Haver?

  Mm hmm.

• 37:10Speaker 01

  If you have a wall in your window and it's darkness, turn on some bright lights, stare at them.

• 37:15Dr. Mary Claire Haver?

  Yeah, okay. So that's circadian rhythm. What else?

• 37:17Speaker 01

  Movement. So if you haven't started any kind of movement journey, start. You have your 10 minute wellness meeting three times a week. Be consistent. If you already have a movement journey and you're looking to increase the ability for your body to respond, we mix it up through intensity, either cardiovascular intensity or strength training intensity.

• 37:38Dr. Mary Claire Haver?

  Mm hmm.

• 37:38Speaker 01

  Ideally, I want every woman to lean in the strength training.

• 37:41Dr. Mary Claire Haver?

  Strength training.

• 37:42Speaker 01

  And full, I mean, I grew up as an endurance athlete, as a cross country runner. I was on the rowing team. I've done Ironman. I raced bikes professionally. I did Xterra, all of the things as an ultra runner. But now I'm like strength training.

• 37:58Dr. Mary Claire Haver?

  Mm hmm.

• 37:58Speaker 01

  We have to do it and you learn to love it.

• 38:00Dr. Mary Claire Haver?

  Yeah. And then third thing, last.

• 38:03Speaker 01

  I would say it's 80 20 rule, right? Because I sometimes am an absolutist and I don't want people to think that there are rules because life can be fun, should be fun. So 80% of the time you're thinking about what am I doing now that's going to help improve my health? So that when I'm 80, I can be independent. And then the other 20% is life. It's like going on vacation, great, enjoy it. Don't berate yourself, don't have the guilt because women walk around with guilt and we berate ourselves all the time. Leave it.

• 38:32Dr. Mary Claire Haver?

  Okay.

• 38:32Speaker 01

  20% and if you're really trying to buzz a needle, maybe it's a 90 10 rule.

• 38:37Dr. Mary Claire Haver?

  Okay.

• 38:37Speaker 01

  But don't neglect the fun part of life. What snacks do you keep in your bag?

• 38:43Dr. Mary Claire Haver?

  What do you travel with?

• 38:44Speaker 01

  I travel with border friendly foods.

• 38:47Dr. Mary Claire Haver?

  Oh.

• 38:49Speaker 01

  So I have dried fruit and then I travel with dried edenami. So salted edenami, because that's border friendly. Protein powder, creatine. Those are always to go to oatmeal. So sometimes that gets passed, but sometimes it gets confiscated, which is kind of strange. And then as soon as I land anywhere, I have pre-ordered groceries to be delivered to my hotel. So that I have food.

• 39:16Dr. Mary Claire Haver?

  That is so smart. I haven't done that yet. So why should we avoid the ultra-processed foods? Like, like the protein, this one cracks me up, protein Pop-Tarts.

• 39:27Speaker 01

  I know, funny, huh? Because it isn't really what your body needs. Like, we don't know all the ultra-processed stuff, how it changes the gut microbiome, increases the obesogenic phyllo, all the extra additives. There's all the stuff that our body doesn't know what to do with and not meant to have. And the marketing on protein Pop-Tarts, we have protein potato chips.

• 39:49Dr. Mary Claire Haver?

  Protein popcorn.

• 39:51Speaker 01

  Yeah, just because it has protein on it does not mean that it is good for you.

• 39:54Dr. Mary Claire Haver?

  So if movement is the foundation of empowerment, stress resilience, brain health, mental health, um, and really longevity, so, and she doesn't know where to start, what would you say to her?

• 40:06Speaker 01

  First is not finding TV parking. And people are like, what? I'm like, you know, in all the sitcoms from the nineties and early two thousands, whenever somebody had to go somewhere, they'd find parking right in front of the door. Don't find TV parking. It's like, let's incidentally move more throughout the day. Because that's going to keep our bodies active and it's gonna eventually, like, it's gonna set yourself up so that you're hungry during the day and you sleep well. Don't get overwhelmed with all the things that you're supposed to do. Just pick one thing. And I often try to understand people's personalities, what drives you? So if you are really motivated by a nutrition change, well, let's implement small nutrition changes over the course of three weeks. And each one is purpose driven.

• 40:50Speaker 01

  So maybe we're looking at working with What are we going to plan to have first thing when we get up and what are we planning for breakfast? So those little things start to become a habit. Then, once we have established that, we can look at physical activity. What are we doing for physical activity? What do you feel like doing? What do you feel like your body needs? Do you need to be outside and we want to go for a walk? Great, let's start there. Or maybe you're like, it's really hot or southern hemisphere, it's snowing. Okay, well, let's look what we can do inside. Let's find some space inside that is not where the kids are or the family is. And we can do a 10 minute circuit. So each step layers on to the other because we find that when people start eating better, they start to feel better, they want to move.

• 41:32Speaker 01

  Or if they're moving more and they're feeling better, then they want the nutrition to match to help with that feeling. And then we also can't forget the mindfulness and the community. And this is where I'm like, okay, mindfulness, part of that is the, you know, I'm consciously aware that I'm making this, this meeting with myself for movement. And how am I going to put in some breath work to help with the exercise? And then that becomes more natural and we become more aware of our surroundings and we become more empathetic and we see how empathy has dropped off the face of the planet recently. So the more that we are in tuned and we have that mindfulness and more empathetic that we have. And it all comes with the package and then avoiding the isolation.

• 42:14Speaker 01

  And this is where I'm always like, out in nature, a park, you see people, maybe grab a friend, get a workout buddy, maybe it's your partner. I have a rule in my house, I don't train with my husband. Because it can often end in not so great things.

• 42:30Dr. Mary Claire Haver?

  It's a problem in my house, too.

• 42:32Speaker 01

  The competitive athletes in both of us. Yeah, so just start somewhere.

• 42:36Dr. Mary Claire Haver?

  Okay. Well, Dr. Stacy Sims, you have given our listeners so much to think about. Thank you so much for coming on UnPaused. It was amazing having you here.

• 42:44Speaker 01

  Oh, thanks for having me. It's super fun.

• 42:46Dr. Mary Claire Haver?

  Okay.

• 42:48Dr. Mary Claire Haver?

  You can watch full episodes of this podcast on YouTube at Dr. Mary Claire. Also, you can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and navigating midlife at thepauselife.com.

• 43:04Dr. Mary Claire Haver?

  UnPaused is presented by Odyssey in conjunction with Pod People.