Exercise Expert: Dr Stacy Sims On The Best Way to Train, Eat & Age Well (Project 100)

Dr Stacy Sims is one of the world's leading exercise physiologists specialising in women's health, and she joins Project 100 to explain why the science women have been given is largely based on male data and what that means for how women should actually train, eat, and protect their healthspan. From the cellular differences between the sexes, to perimenopause, creatine, protein timing, Alzheimer's risk, and why sleep beats everything else. This is a conversation every woman (and the people who love them) need to hear. Subscribe to the Mentored newsletter here: https://the-mentored-platform-pty-ltd.myklpages.com/l/WWJGc5 Join my exclusive Mentored+ community: https://mentored.com.au/become-a-member/ See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

• 0:00Speaker 00

  Dr. Stacey Sims, welcome to Project 100. How are you going?

• 0:03Speaker 01

  Oh, thanks for having me. I am currently freezing in New Zealand because it's winter, but pretty good.

• 0:09Speaker 00

  Oh, really?

• 0:09Speaker 01

  Yeah.

• 0:10Speaker 00

  It's cold there? Were you in the south part of New Zealand or the north?

• 0:12Speaker 01

  No, I'm on the North Island, about two and a half hours southeast of Auckland. But we get the wind that comes straight up off Antarctica and so it might be sunny and you go outside like, oh, it's freezing.

• 0:25Speaker 00

  I appreciate the opportunity to talk to you. I mean, like, you've really been at the forefront of talking about women's health, particularly in relation to exercise and all the regimes that we have to have to be, you know, to be healthy and live longer. What is it, though, in particular that females or women should be looking at relative to muscle strength, you know, long-term health, longevity, generally speaking? Why is it different for women, say, relative to men? Or is it the same thing?

• 0:55Speaker 01

  Well, I have to bring everyone back to like the origins of research and medicine and how all of this trajectory of health started. And we have to think about who was in the room and it was men because women weren't allowed in the room because they weren't deemed to be smart enough or have a seat at the table to have a voice. So as we start looking at all the research and everything that's come out and the trajectories, it's all on a false baseline for women. So based on male data. So if we look at the trajectories of longevity, it's also viewed through that false baseline because men and women age differently. Their systems age in a linear fashion, but that linearity is different. So we'll see different time points of cardiovascular issues that happen between men and women.

• 1:40Speaker 01

  We know women have an uptick in cardiovascular issues when they hit late perimenopause, but men, depending on if they're an athlete or not, might start in their 40s or it might start in their 60s. So we see different delineations. And when we talk about muscle and bone, there are specific delineations for that as we think about aging between men and women. We know that as women age, we tend to have a dual effect of the loss of hormones as well as an aging factor. So that affects our ability to Have a really strong muscle contraction to produce power, to have the ability to have lots of proprioception and agility. And this happens a lot faster and a lot sooner than is in men. Men have a linear decrease in both lean mass and that power.

• 2:26Speaker 01

  But it's at smaller increments where women have a big whack of a loss of power and then they start to lose mass. So we start talking about what is optimal for men versus women for longevity and health span. We have to actually think, what is the baseline for one sex versus the baseline of the other sex? And what are the risk factors for major implications of avoiding frailty and things like Alzheimer's as we get older?

• 2:49Speaker 00

  Is there enough data around or do you need more data on women to be able to start to build out really solid, good baselines as to how women should protect against all these differences?

• 3:01Speaker 01

  We have enough data to start writing the guidelines, but what we do need is more robust data on the outliers. So if we think about the typical woman who has access to health care and therefore has access to being in databases for research or being a research participant. It tends to be an upper middle class white woman. And so we know that there are complete ethnic differences, socioeconomic differences. So we have enough for the middle of the bell curve to make general recommendations and to guide the middle of the bell curve. Right now, we're really trying to upskill the outliers. Like what happens if you come from a Latino or a Pacifica background? Well, how does culture and your genetics impact different risk factors?

• 3:46Speaker 01

  So the data gap is still there, but unfortunately it is still growing instead of shrinking between men and women, especially in the age of AI. Cause we start seeing AI and AI is turning out outcomes and insights based on that broken baseline of male data. So, you know, we have healthcare professionals that are turning to places like Open Evidence for information. But when you compare Open Evidence versus a general chat like Anthropic's Claude, Claude is actually better than what this particular medical one is supposed to be. Because the algorithms are learning from that poor baseline, whereas if you have a large data lake, then it can learn from more robust information.

• 4:26Speaker 00

  That's pretty amazing. I don't think many people know about this and I'm sort of already taken back by that. Are you saying there is a difference in the?

• 4:37Speaker 00

  Chemical system of a woman relative to a man or a female relative to a male? Or is it getting right down to the cellular level? At a cellular level, is there a difference between male and female?

• 4:48Speaker 01

  Both.

• 4:49Speaker 00

  Right.

• 4:49Speaker 01

  Both.

• 4:50Speaker 00

  Wow.

• 4:50Speaker 01

  So if we think about in utero, we have XX versus XY. Like, this is primarily the research that we have right now on the binary sex differences. So we know that what happens is the Y is just a small-

• 5:04Speaker 00

  We're talking about the chromosomes here?

• 5:05Speaker 01

  The chromosomes, yep.

• 5:05Speaker 00

  Right.

• 5:06Speaker 01

  So the Y chromosome is actually an X with half of its turned off. Because as we start to have testosterone, it mutes the second half of an X. So when we see under a microscope, the X is huge and the Y is very small. So when we start thinking about sex differences from a chromosomal standpoint, it depends on the X. And we have a silent X factor. That means when you have two Xs, they talk to each other to be able to turn certain genes on and off. When you have an XY, you lose some of that capability of having that conversation, which is why feeding forward, we see things like less metabolic dysfunction in men versus women when we're looking at something like shift work.

• 5:50Speaker 01

  Because the two Xs are having a stronger conversation and a turn on the genetic profile to create metabolic dysfunction under circadian misalignment than the XY. So we have these specific sex differences. And then we have environmental considerations as well as sex hormones that then can create an epigenetic change. So we think about a lock and a key. So the hormones can be the key that unlocks a certain gene code, even though it's not changing DNA. So what I mean by that, I'll take estrogen for an example, a muscle fiber. So everyone thinks that testosterone is responsible for building muscle tissue. This is why men get so bulky and can really put on lean mass really effectively.

• 6:34Speaker 01

  We look at testosterone in women, it doesn't work that way. Testosterone actually can inhibit muscle growth.

• 6:40Speaker 00

  Wow.

• 6:40Speaker 01

  But estrogen is a driver factor, a driving factor for women's muscle. So it's responsible for how our basic basal cell or our satellite cell of muscle responds to tension. So it'll upturn it and turn on some stem cells of muscle to grow muscle. It's also responsible for how our contractile proteins will come together to create a contraction.

• 7:05Speaker 01

  So we know that estradiol or estrogen is so important for muscle function and bone function in women, where everyone on the outside of the bubble thinks it's testosterone. Because we've had all of this conversation about testosterone being muscle and bone building, yes, in the male body, in the XY, but in the female body, it's completely different.

• 7:23Speaker 00

  Women have testosterone as well, but obviously not to the levels that men have. So what is the function of testosterone in women then?

• 7:31Speaker 01

  So we see that it does help with bone strength. It's libido oriented. It also counters some of estrogen's, what we call cell building capacity. So it counters some of what estrogen does. So does progesterone. And then all three of our, of the female sex hormones can kind of break down to certain steroids to then help other systems of the body. So they work in conjunction. It's just what is the ratio? Whereas men have a lot of testosterone and they have a little bit of estrogen and a little bit of progesterone. So they counter each other, but in different ways.

• 8:07Speaker 00

  Is it fair to say therefore, when you were talking about the X and Y chromosomes and how the Y chromosome is effectively the next, sort of like an X chromosome with half the, half the function is turned off? Is it because we have those, like a male have those XY chromosomes in them, in their cells, that as a result of that, those chromosomes then express different chemicals or different hormones into our whole system? And as a result of that, we, males respond differently to the way the two X chromosomes in a female cell will get, express certain hormones for them to respond their way? Is that what we're talking about when it comes, we're going from the cellular level now to the chemical level? But that is the, that seems to be the procedure.

• 8:51Speaker 01

  Yeah.

• 8:51Speaker 00

  Is that right?

• 8:52Speaker 01

  Exactly, yeah. And I mean, I like using caffeine as an example, right?

• 8:57Speaker 00

  Okay.

• 8:58Speaker 01

  We know that caffeine can affect you or not affect you. And so when we look at a genetic standpoint, we see that there are certain, what we call alleles. So that's part of a genetic code. And if you have two alleles of this particular gene, then you're really sensitive, regardless if you're a man or a woman.

• 9:16Speaker 00

  And you get one from mom, one from dad.

• 9:17Speaker 01

  Right.

• 9:18Speaker 00

  Yep.

• 9:18Speaker 01

  But when it comes down to when you drink caffeine, what happens? So when you drink caffeine, women's bodies tend to hold on to it for a longer period of time because those alleles that turn on the response to caffeine in women, they turn on an enzyme, but the response of that enzyme is not as fast or as robust as it is when it's turned on by the XY. So we can have the same chemical coming in. We can have the same, what we call SIP gene and alleles, but it's the expression of the chemical response from those alleles based on XX versus XY that determines caffeine clearance.

• 9:55Speaker 00

  Can I just check on that caffeine, Pete?

• 9:56Speaker 01

  Yeah.

• 9:57Speaker 00

  Pete, so when you say caffeine clearance, do you mean the time it takes for the caffeine to have an effect on, on the, on, you know, on my, on my brain? Or do you tell me the time it lasts?

• 10:11Speaker 01

  How long it lasts and how long it clears. So this is why you have a lot of guys, you're like, oh, I could have an espresso after dinner and I could still go to sleep, not a problem.

• 10:18Speaker 00

  Not me.

• 10:19Speaker 01

  Okay. But then women are like, oh, I can't have it afternoon because then I like, I really can't sleep.

• 10:25Speaker 00

  Wow.

• 10:26Speaker 01

  Yeah.

• 10:26Speaker 00

  How does that then inform a woman as to, let's say we're talking, because it's going to be difficult because you've got different age groups, but let's say a 30 to 40 year old woman.

• 10:36Speaker 01

  Mm hmm.

• 10:36Speaker 00

  Who maybe hasn't had kids.

• 10:38Speaker 01

  Yep.

• 10:38Speaker 00

  Perhaps. How does that, what you just told me then, inform a 30 to 40 year old woman to prepare for an exercise regime? And, and what is it that you, if you were advising this particular individual, this is not advice show, but if you were advising this particular individual hypothetically, what would they be trying to build?

• 10:59Speaker 01

  So this is a really interesting decade from 30 to 40.

• 11:03Speaker 00

  Yeah.

• 11:03Speaker 01

  Because one, we're still trying to understand, did you reach peak bone mass? And were you capable of reaching peak bone mass and muscle mass when you were in your teens and twenties? Because if you start hitting your early 30s and you didn't hit your peak bone mass, then that's what we have to worry about. Because you get to your mid 30s and you start getting into more hormone dysfunction or perimenopause, which can accelerate bone So when we're talking to someone about an exercise routine, especially in our 30s to 40s, we lean into what has been lifestyle habits and what is the trajectory if you haven't reached the peak span of that particular system. So for someone who's 30 to 40, those are the first things I talk about. I'm like, okay, what was your lifestyle when you were

• 11:47Speaker 01

  a teenager? What was your lifestyle when you were in your 20s? What's your training history? Because from there, I can say, hey, you know what? We want to really boost the peak span of your bone because we know that bone mass peaks for both men and women in their early 20s. And if we haven't reached that peak bone mass, we've missed peak span. We want to build that before we lose it because if we don't build it as much as we can, then the cliff of the drop off is so severe that we're facing osteoporosis in our late 40s.

• 12:16Speaker 00

  Wow.

• 12:17Speaker 01

  So this is where it becomes really, I guess, particular in the type of exercise that we do in which decade we're in. In our teens through our 20s or early 30s, you can pretty much do what you want and you're going to get pretty good results. When we start getting into our early 30s to our late 30s, women really start to question what's going on. We start seeing more and more what we call anovulatory cycles or regular menstrual cycles. That's an early sign of perimenopause. If you're not seeing that and we start to see a less of a response to the training that you're doing. So it might take a greater

• 12:57Speaker 01

  effort or more recovery to get the same gains as a male counterpart. Or even if you're comparing yourself to your early 30s to your late 30s, you'll see that there is a significant difference between the way that your body responded. And it's not an age factor, it's a sex hormone factor. Because men won't start to experience that until they're in their mid to late 40s to 50s. So there is this whole decade shift and the 30s to 40s is really important. We're talking about how are we going to maximize our peak span, which is each system reaches a peak at different points in our life. And we want to be able to maximize that so that the cliff of drop off is way less that we have to worry about

• 13:38Speaker 01

  hitting the bottom when we get to our late 40s, early 50s and having to rebuild.

• 13:44Speaker 00

  And I'm picking on thirty forties for a particular reason because I don't want to go to forty fifty fifty sixty. But just starting off thirty forties. What are the sort of questions they're asking themselves in informing themselves as to how they should exercise between thirty forty? Relative to say what they should have been, they may have done from fifteen to thirty. I mean, do they ask themselves, or did I play soccer or football? Was I a basketballer or a netballer? Did I lift weights? What are the sort of questions or none of those probably? What are the sort of questions?

• 14:13Speaker 01

  Those are, those are.

• 14:14Speaker 00

  Ah, they.

• 14:15Speaker 01

  So if we're looking at intermittent sport like soccer or rugby or even netball. Those are all high intensity, low intensity. That's really good polarization and it's lots of agility and proprioception. Did I lift weights? Great, yes, because then we know that you're also putting impact on the bone that's going to help reach that peak bone mass. The other question that we really need to dig into is what was your nutrition? Were you able to fuel for your exercise and recover appropriately from training? Were there times where you lost your period? Or times where you came really irregular? Or did you start late? Like the menstrual cycle is a big telling on what we call energy availability. Because if we get into times of low energy availability, it mutes all of our systems.

• 14:57Speaker 01

  So we're not really maximizing muscle cell development and growth and strength development. We're not really maximizing bone turnover. If a woman is saying, oh yeah, I played soccer, but I had a lot of stress reactions. So not full stress fractures, but stress reactions in the bone. Then I know that they didn't reach peak bone mass. Because their bone isn't strong enough to withstand the intermittent activity of soccer. Did you have an ACL injury or any kind of other soft tissue injury from a mechanistic standpoint? Most women who play soccer have some kind of knee issue and that's because they're overdeveloped in their quad. And not developed enough in their posterior chain. So then we have to look at the strength training that they're doing.

• 15:39Speaker 01

  So it's really, if I was going to sit down with someone and ask them a question so they can ask this themselves. When I was fifteen to thirty, what was my sporting life life? Did I have big holes in my sporting life? Was I someone who just ran or someone who just rode? Or someone who just swam, that isn't kind of the kind of stuff that you can do to build bone. So we have to think about putting in some strength training, some jump training. Was I someone who did lots of intermittent sport? Fantastic. You have a leg up on peak span because we know that that's taxing cardiovascular system. It's helping with metabolic control, it's helping reduce body fat and it's putting different load on the bone. But we still don't have a large aerobic base, so maybe we need to work on that.

• 16:22Speaker 01

  And we also need to work on the weaknesses within the, in the weight room. So we don't get into soft tissue injury and we can keep building the bone and the muscle that we need. So it's really, what have you done from a training history? And what do we need to maximize what you didn't do?

• 16:39Speaker 00

  Is it too late at thirty to forty to start to do this resistance work?

• 16:44Speaker 01

  Not at all, not at all.

• 16:46Speaker 00

  Right.

• 16:46Speaker 01

  It's never too late. There was this really cool study that came out two months ago from the UK that was actually looking at this specific question from muscle and muscle strength. So it took eighteen to twenty-two-year-old men and women and seventy-five to eighty-year-old men and women that had never lifted weights before. Put them both on the same four-week progressive resistance training. So they're all doing relative strength work to their body weight and ability. And then they were looking at, at the strength of the contraction and the tonality. So that means how fast the nerve conducted to create a contraction. So the old line of thought was as you get older, you can't develop a really fast contraction. That the ability to generate power is not there.

• 17:30Speaker 01

  This study showed it's completely not true. That regardless of where you are, because the body is very malleable and responds to stress, that wherever you are in an age span, you can improve your muscle function. And this is what we're after, especially when we're talking about avoiding sarcopenia or avoiding osteoporosis. Does not matter how old you are, you can still develop power and strength and lean mass and bone.

• 17:56Speaker 00

  Maybe you could define what you mean by muscle function because it's durability, power, strength, endurance. I don't know. I mean, there's probably a number of factors towards it. What, from a scientific point of view, what are you talking about?

• 18:09Speaker 01

  So when we're talking about muscle, muscle function, I'm bringing it right down to central nervous system, not how much muscle we have because we could have a lot of muscle mass, but that doesn't mean that it can respond really quickly. Say you step off a curb when you're older and you don't have the muscle function to quickly correct yourself.

• 18:29Speaker 00

  So you don't trip over.

• 18:30Speaker 01

  Exactly. Because we know that if you're in your seventies and you, you break your hip, you have a 60% chance of dying.

• 18:37Speaker 00

  Within two years or some, some sort of stat, yeah.

• 18:40Speaker 01

  So when we're talking about muscle function and how fast that nerve conducts and how fast it can affect the muscle fibers to contract, that's what we're after. And that's also why we say pure strength and power, because that's connecting the central nervous system to be able to respond quickly to a stimulus to then create a nerve impulse down to a whole bunch of muscle fibers to coordinate them to contract quickly. And that's what we're after. So when we talk about strength training, that's the very first mechanism of adaptation is the central nervous system being able to tap into quick conduction and, and really grabbing muscle fibers together to coordinate them to contract at the same time really strongly. And that's the important

• 19:22Speaker 01

  part of muscle function. Then we can start talking about developing more mass. And as you're developing the mass, we also want to have that central nervous system thing. The good thing about strength training is it doesn't matter what rep range you're in, you're going to develop mass. But as we get older, we want to focus on the heavier loads and the lower rep range to keep tapping into that central nervous system because we want to generate that power and that quick conduct, conduction of the nerve because that's very protective. We talk about preventing frailty. We talk about skeletal longevity and all of that is on this power base part. And yes, you will develop mass regardless if you're a man or a woman, regardless of what strength or what rep range you're in. But we really try to pull

• 20:08Speaker 01

  people who are their 40s plus down into the power base of zero to eight reps at a heavier load to really tap in central nervous system to maintain the type two fibers, to maintain agility, proprioception and reaction.

• 20:23Speaker 00

  Is that the reason therefore that some exercises like, for example, and this applies to male or female, like for example, our deadlifts are important because say the central nervous system is sort of activating a lot of muscles, not just one. A compound movement is probably a better way of putting it. Is that the reason that's so important?

• 20:42Speaker 01

  Yes, because it is coordinating total body. And this is a functional movement. So if we talk about a compound movement like a deadlift, you can also think about it as you have to bend down and pick up your grandkid or your kid or a big suitcase, right? So you're effectively doing a deadlift when you do that because you have to activate the whole body. If you're not used to doing deadlifts, you might hurt your back. You might not have the strength to pull it up, right? Because if you're just doing leg press, you don't have that full coordination. There's a time and a place for those complementary machine stuff, but when we are talking about being really focused on functional movement, it's compound movements of the push-pull,

• 21:20Speaker 01

  the front, like your squat movements of a knee focus or your hinge motion for posterior chain. So you are looking at your squats, your deadlifts, your Bulgarian split squats, your push presses, all of that because it is coordinating every muscle in the body to do a movement. And the other thing that we know from doing heavier compound movements, and this is primarily because I have some research going in the Alzheimer's space, that we're seeing that with heavier movements, because it's such a neural load, so that means it really taps into central nervous system and the brain to be able to coordinate and lift things like that, that with the heavier loads, we have a really good neural connectivity in the prefrontal cortex.

• 22:02Speaker 01

  So that's the very first part that goes because that's our cognition and our reaction, and that's the first part that goes with dementia and Alzheimer's. So by doing the compound movements and lifting heavier, we are actually reducing the onset of dementia by keeping those neural conversations and connections going. We see that lighter loads and body weight doesn't do the same thing. It increases what we call B D and F, which is like miracle growth for the brain. So it does help with brain volume and brain health. But not with neural connection. I think this is the conversation that is not had in the strength and conditioning world about what are we doing besides just trying to put on mass?

• 22:43Speaker 01

  For me, I'm trying to get women and men to understand we want to protect the brain because that's how we actually can have health span. How do we do that in the gym? Heavier loads, jumping, plyos, lots of different kind of confusion to the muscle. So you might be doing lateral ball slams or twists and catches and landmine presses, which are all still total body movements, but it creates such a neural load that it improves brain function.

• 23:11Speaker 00

  I wouldn't mind talking about that for a moment is because, you know, like, let's say we are stepping off a curb and potentially, you know, we could fall over. And if we're building muscle strength to help us with those functions and we decide to do deadlifts, which is quite a linear sort of movement. What about these plyos, I mean, like jumping up on a box and then jumping from box to box and all those sorts of things? What about that type of exercise regime? Does that have the same effect as, say, lifting a heavy load? Or where's it fit into the regime?

• 23:44Speaker 01

  Yeah, so if we think about plyos and we think about box jumps and you see these people doing amazing kind of bounds and jumps and things. That's our plyometric work. So, I mean, I've seen people who are taking one of the trap bars, you know, the hex bar for deadlift and they have 100 kilos on it and they're jumping with it because they have so much power, right? So that's been trained into them and they've maintained their fast twitch. You can, from a benefit standpoint, we know that plyometric work, not having to jump high, but having to work on that rebound. So we, maybe we're doing what we call contrast training with squats. So we do two or three reps at a heavy load, then you have 20 seconds rest and then you do squat jumps.

• 24:29Speaker 01

  So you're getting that plyo work and under, for she is a heavy load, then you do the squat jumps and then you go back.

• 24:34Speaker 00

  No weight, no weight.

• 24:35Speaker 01

  No weight, no weight, just body weight. Then you go back and do another heavy load. You're incorporating a little bit of confusion, but also improving that power. So it's not about necessarily having to have specific high jump plyometrics. It's like, where can we instigate some agility and power within what we're already doing? If we want to challenge ourselves, then maybe, yeah, we want to build up our box jumps, but that's not as important as making sure that you are jumping.

• 24:59Speaker 00

  Do you think there's a lot on, you know, obviously all of us look at Instagram and social can be good and bad, can motivate us, but at the same time can sort of be a bit misleading because like there seems to be a competition at the moment, at least on my, on the algorithm that is applying itself to me, is that plyometrics is becoming, it's nearly becoming a bit of a show-off game. It's nearly like saying, those deadlifts are useless and you should be doing this plyometrics. And actually, when you look at these dudes, like they're unbelievably built. Like I'm thinking, my God, I never looked like that. And I don't know anyone who's ever looked like that. And maybe I should have been doing this sort of stuff before. Is this misleading us? And where's social fit into this whole game that you're in?

• 25:42Speaker 01

  Yeah. So if we think about social and clickbait, that's the problem, right? People will put really polarizing things on social to get people to watch them. And it's just like reality TV is completely scripted, it's curated to be what, what is coming out, right? So when we start really leaning into social media, it doesn't give you the full story or the nuances. So if I'm thinking about the algorithm that you're locked into with everyone showing off about their power moves, I always go back to, well, how did you develop that power in the first place? We know that hip thrusts and deadlifts are paramount for being able to build up the posterior chain in order to have a high

• 26:25Speaker 01

  sprint capacity and a high power of jumping capacity. So that's the part that they're not telling you. They're not saying, I had to build a base of strength first before I could do these power moves. And this is where we start to see injury and deflation and lack of confidence, because people are leaning into these clickbait reels or these short snippets of time that have been curated for a message, rather than giving the full story.

• 26:52Speaker 00

  So it's a slow build too.

• 26:54Speaker 01

  Absolutely.

• 26:55Speaker 00

  So how important is that for people to understand? Look, I've never done any exercise. I would like to do some exercise because I now understand that there's a lot of benefits in terms of lifespan, but also probably equally important, probably maybe more important, health span, being healthy during that long life. I'm going to start doing some resistance work. For example, my dad never did resistance work, but around about eighty five, he started, he asked me, could I get him some hand weights? And then he conquered those ones, they're only two and a half, then he got to five kilos and he started, you know, standing up, sitting down the chair and those sorts of things. He realized, I don't know why he realized, but he realized that lifting some resistance stuff is important.

• 27:39Speaker 00

  What should we be doing now if we're, you know, if a forty year old person is sitting here, listening to you speak, woman, what should she be thinking about? I don't mean to sort of building a program, but what should she be thinking about as having like an appropriate program, like between, say, heart, lung? And resistance work? I mean, she should be doing resistance for one hour a week? I mean, I listened to Peter T and Peter sort of says things like, you know, you should be doing, you know, a hundred and fifty minutes of zone two and three and then you should be like, it's sort of like, I think, fuck, like, I don't have time to do all this sort of stuff. That's like, I don't, I'm trying to work out where the optimum is and what should a woman be thinking about?

• 28:19Speaker 01

  There was a study that came out last week about weight lifting and what's the optimal sweet spot?

• 28:25Speaker 00

  Yeah.

• 28:25Speaker 01

  Ironically, it's a hundred and nineteen minutes a week, not a-

• 28:29Speaker 00

  A week?

• 28:29Speaker 01

  Yeah, so I mean, that can be divided up into what, three thirty ish minute sessions a week?

• 28:37Speaker 00

  Yep.

• 28:37Speaker 01

  Right? So it doesn't take a lot and ideally total body. So you're doing some compound movements. After that, they see the risk factors for all cause mortality doesn't go down.

• 28:50Speaker 01

  But it really does significantly have an impact on things like dementia and bone and sarcopenia when you hit that 119 minutes.

• 28:58Speaker 00

  Positively.

• 28:59Speaker 01

  Positive, yeah.

• 29:00Speaker 00

  Yep.

• 29:00Speaker 01

  Yeah, absolutely. Which is a pretty far cry from the, you know, two moderate, moderate exercise resistance training sessions that things like ACSM have out there. We're starting to see more and more research on the benefits of resistance training. Not only that, but resistance training does give you metabolic changes. As we talk about zone two and mitochondria and that kind of stuff, we still get mitochondrial changes with resistance training. And when we're talking about cardiovascular and like reducing things like visceral fat, we need a really high intensity work for that. We know that short bouts of really high intensity work improve cardiovascular because,

• 29:40Speaker 01

  one, we're having to really shift blood rapidly to the muscles in the heart under high load. So we have a vascular component that improves our blood pressure and the way that our body controls blood flow. We see that when you do high intensity, it uses a lot of blood glucose. So it improves insulin sensitivity because the muscle cells then adapt to be able to use insulin with or use glucose without insulin. If we have less insulin resistance, then we also decrease our leptin resistance, which becomes a problem for women in their mid to late 40s where they never feel like they're really full and they're craving lots of carbohydrate. There's a change in the gut microbiome, but we are also starting to see a little bit of

• 30:23Speaker 01

  leptin resistance because that goes up as insulin resistance goes up. So if we're talking about high intensity work, that helps with metabolic from a hormonal standpoint. It also creates a change so that your body doesn't have a stimulus to store visceral fat, which is that deep abdominal kind of dangerous fat. And it improves our heart and lungs because we have to be able to shift blood quickly and get oxygen to the working muscles. So then when we're looking at what does that look like in a week, right? So if we can hit three 40 minute sessions a week, in that 40 minute session, you're spending some time doing some mobilization and warm up because we have to make sure

• 31:04Speaker 01

  our tendons and ligaments are warmed up as well as our muscles, get into some compound, uh, compound loading. And then we finish with a couple of sprints or a couple of one minute efforts with one minute off so that we're getting to that higher range of our anaerobic capacity. And if we think about it from a longevity marker, it's hitting those capacities, right? We're hitting VO2 with our high intensity at the end. We're hitting our grip strength through total body compound movement. We're helping with brain health, cardiovascular health. We're helping with mobility and agility because we're warming up properly. So you're hitting all the notes that help protect you from having just lifespan. But it's really improving your ability to have a health span.

• 31:47Speaker 00

  You mentioned something really interesting, Stacey, about Alzheimer's, something that I've observed here in Australia, I don't know if it's the case anywhere else in the world. But more women have dementia or suffer from Alzheimer's here in Australia, dementia being the broad, but like underneath that Alzheimer's, Alzheimer's than men. Do you think that's, are there any studies to say that's because women haven't historically done exercise? It's not, or is it genetic?

• 32:13Speaker 01

  Well, this is one of those interesting sex differences. So we're seeing that it's, has to do with some of the X chromosome and some of the genetic coding. We do see that there are men walking around that on a brain scan look like they should be fully late Alzheimer individuals, but they're fully functional because they have a genetic coding from the Y that allows their brain to have lots of plaques and tangles and still be very cognitively with it. That doesn't happen with women. So there's, in the States, it's one in six men might be diagnosed. But for women, it's five out of six.

• 32:56Speaker 00

  Five out of six?

• 32:57Speaker 01

  Yeah, when you get into your eighties, it's massive. There's so.

• 33:00Speaker 00

  Like eighty-five percent? Whoa.

• 33:02Speaker 01

  We're talking about brain and cognition, not full Alzheimer's, but cognitive decline.

• 33:07Speaker 00

  Four times the risk. Whoa.

• 33:10Speaker 01

  Yeah. So there's a lot of rapid acceleration into looking at what is causing this and what can we do? And that's part of the research that I'm doing with some groups in the States is looking at, you have a genetic risk factor, you have early dementia, you have late onset Alzheimer's and you're living at home. Can we do specific interventions to either halt it, attenuate it, or stop it? Because it's so important, because it's such a drain on the health span of women.

• 33:40Speaker 00

  Wow. Sort of late 30s, early 40s, perimenopause starts to kick in. I mean, obviously, that's a broad statement, but you know, let's just pick it, take it as a fair statement. What are the indicators that someone, a woman is experiencing perimenopause, apart from, I don't know if you said dysregulated period cycles and things like that, but what is she looking at and what she should be doing in terms of her exercise regime around that?

• 34:07Speaker 01

  Yeah. So there are no specific blood tests. It's all symptomology. Some of the first early symptoms, unfortunately, a woman will probably go to her doctor going, I feel like I'm having panic attacks and I can't sleep and I feel highly stressed. Those are actually really early symptoms of perimenopause. Because what's happening is you're having less and less progesterone counter estrogen, because you might still have a regular period or a regular bleed, but you didn't ovulate. And you can't discern unless you have specific tests if you ovulate it or not. So when a woman is in her mid to late 30s and starts going, I'm having panic attacks and anxiety and I can't sleep, then start tracking symptoms

• 34:51Speaker 01

  against a perimenopausal chart, or go see a physician that is well versed in menopause. Because if you go as a general woman in her mid 30s to your GP and say, I'm having, you know, problems breathing, panic, anxiety, depression, high stress, then most likely they're going to lean into the clinical avenue. Of going down an SSRI or some other kind of cognitive and behavioral drug therapy, instead of looking at hormone flux and understanding that it's a whole body system that's that's starting to be affected by less progesterone.

• 35:27Speaker 00

  So they're going to treat you like you're depressed?

• 35:29Speaker 01

  Exactly.

• 35:30Speaker 00

  Yeah, yeah, as opposed to it's a hormonal problem.

• 35:33Speaker 01

  Exactly.

• 35:33Speaker 00

  Creating these these symptoms.

• 35:35Speaker 01

  Yeah.

• 35:35Speaker 00

  So the symptomology, so when you're, let's say, someone starts to recognize these symptoms, where does HRT, uh, hormone replacement therapy, HRT fit into these programs? Or what would you say about that?

• 35:47Speaker 01

  So when we look at menopause hormone therapy, it's a tool in a tool basket for sure. But a lot of people are leaning into it because they think it's going to stop perimenopause. And we know absolutely that's not true. The only thing that has been proven with menopause hormone therapy is it's very effective for protecting your bones. So if you have a family history or you yourself have gotten your DEXA and you see you have low bone density, then definitely have that conversation, especially if you're in your late 30s, early 40s. When we start having lots of symptomology, this is where we look at lifestyle. So we know that dietary changes help. We know that training changes help. We know that getting and nailing sleep is one of the pillars. And having that social connection so that you can have times of laughter

• 36:32Speaker 01

  and being out from under the stress of life. Those are all really super important lifestyle factors that help with symptomology. There are other non-hormonal options, but it's all symptom symptom driven at the moment. There's no, like I said, there's no specific blood tests. It's, I think the whole, everyone needs to be on it or you should never use it, comes from two different studies that happen to be going on at the same time. So everyone hears about the Women's Health Initiative study in the States that said, you know, no one should use hormone replacement therapy because it causes cancer and dementia. But that was based on women who were 10 years plus post-menopause, where you had a whole bunch of biological changes with the receptors where they weren't able to use hormones.

• 37:17Speaker 01

  So it wasn't surprising that study was set up to see if we put women back on hormones after they'd been off it for a long period of time, would it help? And it didn't. But at the very same time, there was a study in the UK going that was called the Million Women's Study. And it was looking at using hormone replacement therapy for women who were in their. Early 40s, mid 40s, who were definitely in perimenopause and it helped. So now we see this playing out in today's society where in the US, maybe 5% of women who can access hormone replacement therapy do, and the rest are too afraid or don't have access or haven't asked about it.

• 37:56Speaker 01

  But any of the commonwealths, especially UK and UK doctors who have trained, doctors who come to Australia and New Zealand, Canada, everyone is very pro MHD and say, yeah, let's look at this as a means to help. Just like if you're having severe depression, we would use an SSRI and cognitive behavior therapy. It is a medication that is a tool in the toolbox. So we start to have all these conversations of yes, no, should I or shouldn't I? But it depends on where that conversation origin.

• 38:29Speaker 00

  I don't want to be looking like I jump around all the time, but you said, as you're speaking, I thought of something really quite important, I think. Where do you rank the significance of accessing a DEXA machine, which is not expensive and they're pretty accessible everywhere here in Australia at least, to get yourself a baseline? And what would you suggest to people, when should they start getting these baselines in terms of their bone density, muscle mass, et cetera?

• 38:55Speaker 01

  Yeah, I started getting a DEXA every year since I was 41. And I do it, do it every year around my birthday.

• 39:02Speaker 00

  Happy birthday. When you see what the result is, happy birthday.

• 39:08Speaker 01

  I know, exactly. I've been pleasantly surprised that, you know, body weight on the scale hasn't fluctuated that much in that decade, as I say, my real age, maybe a kilo or two, but body composition has significantly improved. Lean mass has gone up, bone mineral density has gone up, body fat has gone down. And so I think having that baseline and being able to compare year to year can tell you different stress points. There was one, one DEXA I got where my body fat was so incredibly low, I was like, whoa, what happened? And it was because I just came off a massive amount of stress and hadn't been training and eating properly. And so I know that's an unusual case, but that's the way my body responds.

• 39:52Speaker 01

  So I tell women, you know, when you start hitting 40, get a baseline.

• 39:58Speaker 00

  Yeah.

• 39:58Speaker 01

  And for men, I mean, you could start forty as well, but you know, fifty is really the benchmark for men. Start really looking at bone density, uh, muscle quality, where you're you're storing your muscle or your fat, is it more subcutaneous or visceral, um, so that you can start interventions earlier rather than later.

• 40:18Speaker 00

  One of the things that's really interesting about it, and probably a lot of people who have never had a DEXA don't know this. They'll tell you your right arm compared to your left arm, your left leg, your right glute compared to your left glute. Have you got sort of changes or differences between the two and you can look at it from period to period? I think they're critical and they're only, they're not expensive. You pay about, in Australia, I think you pay a hundred fifty bucks or something. Can I just talk about nutrition? Because, you know, there's a lot of stuff at the moment, um, about nutrition. And one thing in particular is about, um, the import, the, uh, the value of creatine for women especially. Um, once again, men have been using creatine in gyms for a hell of a long time.

• 40:53Speaker 01

  Yep.

• 40:53Speaker 00

  Maybe, maybe too much creatine. It was more about, um, I'll build more muscle if I had more creatine. And you go through a period of building creatine and you take it up, you stop it, then you, you know, you go through periodization with it. But now it's become a thing. You take it for brain health and just general physical health. Could you talk a little bit about creatine for women?

• 41:12Speaker 01

  Yeah. Um, so, I mean, creatine's the most studied supplement. It's, has so much really robust peer review behind it. And the thing about it is it's in every fast energetics of the body. So if we talk about the way the body fuels itself, every cellular function in the body uses creatine. Women don't have as much lean mass or muscle mass as men, so by that nature, we have less available creatine. Women tend to eat less creatine containing foods in general than men, so we have less stores. If you're a vegan or vegetarian, you definitely have less stores. So we talk, talk about using a very low dose creatine monohydrate supplement, maybe three to five grams.

• 41:54Speaker 01

  So it can saturate your tissues. So what does that mean from a health perspective? We know that there's a sex difference in things like IBF. And so that means that you have more irritable bowel syndrome as a woman and more gut issues. You start taking creatine, it maintains the integrity of the intestines and reduces that. And some women don't have issues once they start taking creatine. We talk about muscle and muscle function, of course, but creatine is also really important for bone and bone function. We see it does help with gut microbiome diversity. And we need that for vitamin production and the gut-brain axis. Talk about creatine and brain health, because the brain is such an energy hungry organ. It uses a lot of creatine and glucose.

• 42:39Speaker 01

  So if we are saturating the tissues and we're providing more creatine for brain function, then we have less depression and less fatigue. So when we talk about creatine as a supplement, it's been so well studied and now we're having more and more research done specifically on women in the health space, not the performance space. And there have been a couple of reviews looking at all of that research. And the groups that benefit the most from three to five grams of creatine monohydrate a day are women 18 to 65. And that is, I mean, that's the research. It's like, so if you are really looking for something to improve just mood, trying to improve muscle function, gut function, heart function,

• 43:24Speaker 01

  then I tell women lean into just starting with a low dose of creatine, not going up to the five times four grams a day where you're getting 20 grams. There's a time and a place for that, but that's like shift workers or people who are chronically jet lagged or having lots of issues sleeping. Because then higher doses of creatine can help in those situations.

• 43:44Speaker 00

  Then what about protein? Because that's the big conversation that we keep getting hammered, definitely on social media about we don't have enough protein. And then, you know, the general, as I understand, the consensus now in the science community is somewhere between 1.58 grams of protein per kilogram to 2.2 grams of protein per kilogram of weight. I guess that depends on how active you are and how much exercise you do. And maybe everybody's different, but if, maybe if you say just two, it might be easier.

• 44:14Speaker 01

  Yeah.

• 44:14Speaker 00

  Two grams.

• 44:15Speaker 01

  Yeah.

• 44:15Speaker 00

  And, but how important is protein as a resource? And should we be getting it just from our, where do you prefer? Just get it from our natural foods? Or like someone like, I'm 70, my age. Like, I can't, these days, I can't eat enough food.

• 44:33Speaker 01

  Yeah.

• 44:33Speaker 00

  To get that, to to reach that number. I weigh eighty kilos. So that means I've got to have one hundred and sixty plus sixty, I've got to have one hundred and seventy six grams of protein, which means I've got to eat like five steaks or something. I don't know, whatever it is. And

• 44:45Speaker 01

  Forty five pounds of beans, come on.

• 44:46Speaker 00

  I I couldn't, I couldn't do it. You know what I mean? Like, so how, is it okay to have the supplements? And when should you have them? Straight after training? Or should I try to always eat it in a natural source? Where's a protein deal sit?

• 44:58Speaker 01

  Okay. So if we think about proteins now having its heyday, we've heard about fat, we've heard about carbs, and now we're having protein. And I always like to remind people that the RDI of protein in most countries is based on the minimal amount needed to prevent malnutrition. So I'll just let that sit there. So all these people are arguing fifty grams is enough. That's enough if you're sitting around doing nothing else, except trying to exist. Then you start

• 45:25Speaker 00

  Just breathing.

• 45:26Speaker 01

  Just breathing. We see that when you start becoming more recreationally active, man and woman, that comes up to one point six grams per kilo. And that's not even really focused activity. That's not trying to build muscle. That's not trying to train for a marathon. That's just you're going through your life and you're putting incidental and structured exercise in, because it helps with bone, it helps with muscle, it helps with satiation, it helps regulate our appetite hormones. All of these things are really important. We start training for purpose and we start getting older. We see that we have an anabolic resistant response to both exercise and protein. For women, when we hit our forties, for men, it starts about fifty. So that means no matter how much training

• 46:10Speaker 01

  and protein we eat, if we're not eating appropriately and at the right times, then we're not going to adapt to the exercise as well as we would have before that anabolic resistance came in. So this is where we start leaning into Hitting that two to 2.2 grams per kilo dispersed across the day. And if we lean into a little bit of Keith Barr's work on tendons and ligaments, because that becomes a very important conversation as we start getting older too. That if we have protein as close to the end of exercise as we can, then that nutrient uptake is so much better. And we see that the amino acids for tendons and ligaments gets absorbed and used a lot better too.

• 46:54Speaker 00

  Oh, wow.

• 46:55Speaker 01

  So it's an age factor rather than the exercise component that's more important. That you increase your protein and you have more of an eye on the timing of protein as we get older. When we talk about sources of protein, I've been plant-based since I was 14. But you know, I've also been in the gym since I was 16. It's very possible to get enough from plant sources. It's not necessarily ideal. So I always tell people be plant-forward and you think about protein from all sources, not just our steaks and our chickens, but also think about etnami, green peas, sprouted grains, and nuts, seeds. All of those things can work with the typical sources of protein

• 47:40Speaker 01

  to give you a good 30 to 50 grams per meal. Time and a place for supplementation, definitely. There's a reason why there are really good, clean whey protein and pea protein isolate out there. So that you can use them right after exercise or first thing in the morning when you're not hungry, but you know you need something. So it is a supplement and you can use it to help boost your overall protein intake. The thing is, we have this confusion now of collagen protein versus like a whole protein of whey isolate or pea protein isolate. Collagen is not a dietary protein. So you'll see protein waters. I, you know, you go to Oz and you're like, oh, great protein water.

• 48:21Speaker 01

  And you look at it and you're like, oh, it's bovine collagen and it says 20 grams of protein. It's not the same as if it was a whey isolate. The whey isolate is what we think of as protein. The collagen protein is just a structural protein. It doesn't go to help with our dietary intake of protein.

• 48:39Speaker 00

  Stacy, could you help me out on this? Cause I see a bit of a, it's like two teams. So, and I'm not asking you to criticize one or the other, just to help explain a little bit to me. But we got one team on one side, which is say David Sinclair, who is talking about fasting and even to a point of reducing the amount of calories. Not just fasting, not just intermittent fasting or going on days of fasting, but also during the period when you are eating, perhaps taking in less calories because it has a cascade effect in terms of turning, I don't want to get weird about it, but mTOR off and then turning AMPK on and or situins and all those other things that sort of go in and fix you up.

• 49:25Speaker 00

  You've got that, that camp over there. Makes sense to me. Then I got the Peter Attia camp over here who say 2.2, train your heart, get enough protein into your system, blah, blah, blah. You've got to make sure you have enough fats, carbs and, and protein and minerals and other things too. But then I get confused, which, which one's right or where do I go?

• 49:47Speaker 01

  You know what conversation is not on either camp there is the exercise conversation.

• 49:52Speaker 00

  Right.

• 49:52Speaker 01

  Because if we think about exercise, exercise in itself is a fasting state. We have an uptick of mTOR right after exercise. Yes, because we've had damaged muscles. But over the course of adaptation, it turns it off. mTOR isn't something that stays on or off. It is something that comes on in response to a stress of tissue breakdown to be able to rebuild it. So when we're talking about taking in protein, if your body doesn't have to rebuild protein or muscle, right? Then it's not going to have a high impact on mTOR. It'd be a slight uptick, but not a huge impact. We talk about fasting. This is where we start to get in a lot of gray area, right? Because if we look at the research on fasting, when you start holding a fast till noon or after, you're having circadian shift.

• 50:36Speaker 01

  It's more impactful on women than the men because men have a longer circadian rhythm. But.

• 50:41Speaker 00

  What's that, what's that mean by the way? You mean between sleep and wake?

• 50:45Speaker 01

  So when we talk about a circadian rhythm, for women, it's a 23 and a half hour cycle that our body is on. But for men, it's more 25 and a bit. We say, you know, in general, people are like, oh, it's a 24 hour circadian rhythm of light and dark and the way your body works in the day versus night. But every hormone and system is tied to a time clock within that. So we see appetite hormones are driven by that, or hormone pulses throughout the day are driven by that. So the two biggest zygotes of controlling circadian rhythm is exposure to light and when we eat. So if we hold a fast till noon or after, we're effectively telling our body, no, we're still in a sleeping state. So we don't want all of our hormone pulses going. So we start to see dysregulation of appetite.

• 51:30Speaker 01

  We start seeing more leptin resistance and insulin resistance. We start to see flattening of testosterone in men, a turbulence and luteinizing hormone in women. And the fact that we're having a smaller eating window is why we are seeing body comp change. But that doesn't necessarily mean it's positive body comps change. Because when we start looking at metabolic effects of holding that fast so long, it has negative impacts on women as well as sleep implications. Because if we are shifting our hormonal pulses because we're withholding food, then it's also telling melatonin that it's not supposed to rise and peak when it should in a normal brain for our circadian rhythm, which is around nine PM for women and about 10 for men.

• 52:15Speaker 01

  It blunts and/or doesn't peak at all. So then we have interrupted sleep. If we have interrupted and poor sleep, we don't have any metabolic control and we cannot instigate change. So if we're thinking about what are we doing for calorie restriction? It's like, let's just make it easy, okay? Let's not talk about the two camps and all the metabolic things that are happening. Let's look at how are we structuring our day to optimize metabolic health? Let's work with the way our bodies are designed to work with its intrinsic clocks. So for women, that means eating something within a half an hour or so waking up because you have a normal cortisol awakening response, which is why we wake up.

• 52:58Speaker 01

  Women's peak is higher than men's and is tightly tied to appetite hormones. We have something very small, then it unties cortisol and ghrelin so that they're not so tightly intertwined. So your body can then get on with its day and have appropriate responses to stress and hunger cues. For men, it's a little bit longer, like you could probably get away with not having any food for a couple of hours after you wake up because it's not as important. Because your circadian rhythm is longer and you don't have such a tight tie to cortisol and your appetite hormones. Then you eat regularly throughout the day, making sure that you're having protein and fiber at every eating opportunity.

• 53:40Speaker 01

  You have dinner, you stop eating when you finish dinner. So you have about a two to three hour break before you go to sleep. So then you end up with a 12 to 14 hour overnight fast, which encounters that fasting situation. You have more energy during the day. If you have more energy during the day, you also have more control over your hunger cues as well as what you're reaching for. We see a lot in the research that if you're holding or skipping breakfast, you tend to have more cravings for simple carbohydrates in the afternoon. So this is why we see people are leaning for the caffeine and the chocolate in the afternoon. It's because of that dysregulation of appetite hormone. So the big picture is let's eat during the day and fuel for what we are doing during

• 54:23Speaker 01

  the day and then not have anything overnight and let our body do all the autophagy and reparation it needs to overnight.

• 54:32Speaker 00

  Heard a lot of discussion around understanding your, when you do your blood tests, understanding a variety of things. But one of the important ones in terms of informing us as to how we eat and how we live our life, et cetera, is APOE. And it is, and particularly, you know, like make, well, not making sure, but trying to find out, do you I U E four, for example, as opposed to one of the other ones?

• 54:59Speaker 01

  Yeah.

• 54:59Speaker 00

  Three or two. How important is that for us? A bit like DEXA, but how important is that for us to get baselines about those sorts of things as to informing us as to, as to how we should approach our health span, lifespan?

• 55:12Speaker 01

  Yeah, I mean, if you have the opportunity of being able to get that, then that gives you that baseline to understand what your risk factors are. Right? So we know that APOE four is is a significant risk factor for Alzheimer's. So then let's do everything to prevent it. Just because you have that risk factor, it doesn't mean you're going to develop the disease. So this is when we start looking at baseline biomarkers and having access to that information. It informs you which direction to take. Because people sometimes feel like they have a death sentence when, oh, my gosh, my father got Parkinson's, that means I'm doomed for it. No, it doesn't. It means you have a risk factor, but we have a lot of things that we can do to help reduce that risk. So that's what these baseline tests are, and they are important. If you can access it and get it, then it gives you really good insight of how to direct your training in nutrition.

• 55:58Speaker 00

  Because it's definitely available in Australia. I know that.

• 56:00Speaker 01

  Yeah.

• 56:00Speaker 00

  Because I'm an E three, four, I mean, I found out. And and it's actually helped me because it sort of helped me work out about sleep patterns and stuff like that. And I do want to talk to you finally, if you've got a minute or two left, about sleep.

• 56:15Speaker 01

  Yeah.

• 56:17Speaker 00

  Generally, and lots of people wear, I've got a wearable, lots of people wear them and they sort of try to calculate your, what they call restorative sleep, which is, in my case, is the combination between REM sleep and slow wave sleep, or in a broader sense, not every part of slow wave sleep. But what are we trying to achieve here? Like, let's say, are we trying to achieve 30% of our total sleep time in restorative sleep? How important is slow wave sleep compared to REM sleep? Like, what's the deal? Should we get in three hours restorative a night? Some people I know get five hours restorative sleep a night, and I think, wow, that's not fair. I don't ever get that. What are we thinking about here?

• 56:56Speaker 01

  This is very individual. Well, first, our wearables are not sensitive enough to actually pick up sleep paces.

• 57:02Speaker 00

  Yeah.

• 57:02Speaker 01

  It just gives you a general estimation of how slow your heart rate goes and blood flow changes, which is.

• 57:07Speaker 00

  But it's good for comparisons from month to month. Yeah.

• 57:11Speaker 01

  Yeah. So under times of high stress, so this could be exercise, training block stress, lots of travel, could be work stress, you want to have more reparative sleep because this is where our brain gets to be repaired. We see that even lots of interrupted sleep the next day. You have lots of times where you have attention deficit disorders where you're like, oh, what was I thinking of? It's because your brain is now trying to improve the glymphatic system during the day because it didn't get to at night. So it's flushing itself in the day, which is not optimal. So if you know that you are under a period of high stress or you're going to go into a period of high stress, getting more deep reparative sleep is super important. We see that it changes across seasons.

• 57:55Speaker 01

  We see more people fall into a deeper reparative sleep in the winter than in the summer because of daylight hours. It's not something to be worried about, but track your own trends. When we're thinking about the impact of poor quality sleep over time, that's a significant issue. So if you're seeing poor quality sleep and it's been three or four months of poor quality sleep, we need to talk about an intervention. Like, what is our sleep hygiene? Have you gotten into a new bad sleep habit? Because we can effectively have really good sleep patterns, but if we develop a poor habit, then it will interfere with that. So what I mean by that is if you've had a series of interruptions in your nighttime

• 58:38Speaker 01

  sleep because of a noise or for some people, a new baby, then your brain learns that new habit and we have to unlearn that habit, soaking it back into its normal reparative sleep. So there are things like insomnia, cognitive behavior therapy, that's very effective. That's down the track. But first, let's look at, are we in a cool room? Do we not have screens in the room? Do we have access to dimmer light the hour before we go to sleep? Are we having earplugs so that our partner and small noises don't wake us up? So there are very small little habits that we can instigate to improve our sleep environment, which then will improve the sleep architecture.

• 59:18Speaker 00

  If you were to rank out of the three, sleep, exercise, nutrition, which one is the one you have to really make sure you don't stuff it up?

• 59:28Speaker 01

  Sleep.

• 59:29Speaker 00

  By far?

• 59:29Speaker 01

  By far.

• 59:30Speaker 00

  Yeah?

• 59:30Speaker 01

  Yep, there's still so much research to be done on why we actually need to sleep. There's lots of research that's done that shows what happens during sleep and how it is important for total body reparation and metabolic control and body comp and cognition and reducing inflammation and all of the things that promote our public burden diseases. So people, I always kind of step back because I used to be one of these people. I would compromise sleep so I could get in a training session, especially when I was racing high level. It's like working, I have to work late, but then I have to get up to get my training in. And I was always a little bit sleep deprived. My training wasn't going where I wanted, the races weren't going where I wanted. I was suffering in work and I was like, oh, wait a second, it's sleep.

• 1:00:12Speaker 01

  So then I started prioritizing sleep and putting parameters around how I'm sleeping, when I'm sleeping and really getting good sleep hygiene in, and then everything else improved. Because we can't show up for other people if we're chronically sleep deprived and inflamed and just not cognitively there from poor sleep.

• 1:00:32Speaker 00

  And a lot of people just think that sleep, so I just go to sleep, I'm going to go to sleep. I'll go to sleep earlier. But other people like you, and I've heard you speak, and you know, by the way, I just want to say, I appreciate, we appreciate what Stacy Sims does for longevity and health span.

• 1:00:48Speaker 01

  Thank you.

• 1:00:48Speaker 00

  Not just for women, but around the world, for everybody, all the people you've spoken to, the way you say it, the research you bring into it, the way you explain it. I wonder what it is that drives you to do this? Why does Stacy want to do this? What is it about it?

• 1:01:04Speaker 01

  Uh, um, I grew up all over the world, being an army brat. And I've seen so many different opportunities and cultures. And the bottom current is, we're all human, right? And for me, I want every human to have the opportunity to live the best to their potential. I say that with a grain of salt because there are some people that I wish would just keel over right now if I think about some of the things that are happening in my home country. But for the most part, the passion and drive is to create an equal playing field because we see so many discrepancies and part of it is is lack of access to information,

• 1:01:45Speaker 01

  lack of money for health, proper healthcare. So the more prevention and information that we can get out for everybody, the better potential people have for their own life. Because no one wants to face a life of being chronic pain and illness if they had the opportunity to prevent that. So the more that we can get it out there and the more we level the playing field, the more impassioned I am and empathetic I am with how we are going to survive our lives as well as take care of the people who come after us as well as our planet.

• 1:02:19Speaker 00

  And where do you think we are now in the in the curve? Because, you know, it's been fairly steep in terms of over the last five years in terms of learning more about these sorts of things. We have more and more people like yourself telling us about them. But at the same time, we rely on you to learn about these things, you know, through research, etc. Where do you think we are? Are we halfway up the up the hill? Or we know we're near that. We're just touching the touching the edges at the moment?

• 1:02:44Speaker 01

  I think for general purposes, we're almost at the top where we have enough information that we can disseminate and dispel. It's like the sprinkles and the icing on the cake that I'm very interested in. It's like when we start taking the nuances, we don't have a lot of research in the nuances.

• 1:03:01Speaker 00

  Like the extras?

• 1:03:02Speaker 01

  Yeah, like the extras. It's like if we were to look at peptides that are making such a big thing right now, right? It's like, I want to know what the research is, if it's really accessible and does it work? And does it improve certain parameters for someone like you, or someone like me, or someone like my husband? Which one should we use? And is it really something that we should lean into? Or should we spend our money and time in something we know that works like omega threes? So those are the nuances that we don't have captured yet. And that's what excites me about the research. But for the general pillars of how do we take care of ourselves to have skeletal longevity, to grab the Catchphrase that my friend Vonda Wright has coined of, you know, having good tendons, ligaments, bone, muscle, cognitive function,

• 1:03:46Speaker 01

  to be able to live our lives to the fullest, however long that is, is something that I think we we have a pretty good handle on.

• 1:03:54Speaker 00

  Well, I I think that's a great way to finish this off. Dr. Stacey Sims, so privileged to have you on the show. That was wonderful. I really enjoyed it. And I know our audience is going to absolutely love this.

• 1:04:04Speaker 01

  Thanks so much for having me. It's been fun.