Managing Heat Exposure and Hot Flashes

We are now in a time in history where there are so many people that are overfed and undernourished. twowo billion people worldwide have micronutrient deficiency. Eat a wide variety of foods. thirty different plants a week. thirirty different plants a week. There is an endemics happening. Osteoporosis risks DLP one, The loss of bounded state loss cle m For every ten pounds that you lose on a GLP one, up to four pounds can come from muscle. When people are talking about weight loss, what do we have to gain with putting muscle on? We have more control over what we're eating, better sleep, better immunity, better blood glucose control, better cognitive function. We have the capacity to gain H higher quality of life for whatever age you are. ctr. Stacy Sims is an exercise physiologist and pioneering nutrition scientist. My frustration of being an athlete and a researcher in academia, noticing that there was no real representation of women. I want to close that gender gap. What happens to the amygdala when you give oral contraceptives at a young age? We see changes the capacity for anxiety and fear. Tell us five things that every woman should be doing for her health I'm Jonathan Cohen, and welcome to our brereakdown. Today we're gonna be tackling some of the biggest myths and trends in the health and nutrition industry, specifically as they relate to female physiology. And if you're thinking, I'm not a woman, maybe I'll turn this episode off. Stay tuned because we cover things that totally blew my mind from the huge dangers of GLP ones to The real truth about creatine, the biggest mistake people are making and You're likely drinking water totally wrong. This episode also covers things that many of us take for granted, like our understanding of why people go on birth control, why people lift heavy weights, how to protect your brain, how to live a longer and more vibrant life. These are things that impact men and women differently, but understanding the differences in physiology can make a huge difference We're speaking to doctor Stacey Sims, the author of ROR, really, really fantastic book, Match your Food and Fitness to your unique female physiology for optimum performance, great health, and a strong body for life. But as we said, we're not just going to be talking about how these things impact women. We're going be talking about the differences in male and female physiology And how so many of the trends that you might be following you're actually approaching in the wrong way. We're also gonna to talk about a deficiency that impacts two billion people worldwide. And when you hear the list of symptoms, you might be surprised to find you may be at risk for this deficiency. This episode is also in honor of Women's Health Month. We could not think of a better guest to have for this very special episode than Dr. Stacy Sims. So without further ado, let's welcome to the Breakdown Dr. Stacy Sims Break it down for having. I'm excited We're very excited to talk about Rar and I'm really like your target audience for this book and this message. And I noticed that on page fifty, there is a crushing it as a fifty year old vegan. and I thought, Stacey, you didn't need to put me in your book. That is so embarrassing. Well, maybe yeah You know There you go. There's lots of us who are fifty year old vegans. So why not? I wonder if you can talk about sort of the why of this book What is special and unique about what you are helping everyone, but women in particular understand about their bodies. Yeah, I mean, it stems from my frustration of being an athlete and a researcher where as a researcher in academia and first learning it and then trying to actually do it, noticing that there was no real representation of women And if women were included, they're included in studies that were with men just to bulk up how many people are in the study O they're very small and they're only in like one phase of the menstrual cycle. So there really wasn't that much there because they just generalized stuff. And through my racing career, people would always ask me questions. And I was like, okay, well, I'm going to go to a lab and answer this And the book stemmed from my co author who saw me at USA Cycling. and she's like, no one is talking about this And to me, I was like, why are we not talking about this? I've been researching this for at least fifteen years because we need to do a book So we had coabed on she was a journalist, we coabbed on a whole bunch of stuff And every time we talked about the menstrual cycle Women needing different recovery, how we respond in the heat differently, hydration, everyone was like, oh my gosh, this is so interesting. So that was the birth of the book One of the things that I think it's important to talk about, you know, and this is really true for every aspect of research, you know, whether it's biology, whether it's neuroscience, whether it's medication, whether it's aging The reasons that studies tend to be historically all male is not just because of systemic misogyny and all of the reasons you can give, but one of the complexities of the human body for women and the physiology of women is that we have a very special monthly cycle that is really not ideal for a study where you're trying to reliably track basic physiological metrics. And so the solution has been to only do studies on men and treat women like kind of an extrapolation of what we find in men. Can you speak not only to your field, but to the general reason that we shouldn't just dismiss it as, oh, the patriarchy is just trying to you know, screw women with research. It's a lot more complicated than that Absolutely. I mean, I always start with It's a historical perspective, right? We know the patriarchy and who was in the room was men. and that's how scientific design started And I don't think people really grasp onto that and how endemic it is. But we know that it's not just the menstrual cycle and sex hents, it's also specific sex differences We know like when you're looking at stress and environmental stress for a woman who is pregnant, there's a higher and incidents of spontaneous miscarriage when they're carrying an XY rather than an XX So we look at You know, and people don't know that. I was talking to a well known OB and she said like, We never learned that. How do you know that? It's like, Be when you look at sex differences from birth, you start to see all these things that happen in utero. and then go through, but no one really says anything until like puberty and then like, o, the girls are going through this crazy stuff And look, my boy is getting so strong and lean. and yeah, he doesn't talk, but you know, that's kind of the aggression And then we get to like our reproductive years and it's always that taboo at that time of the month or Oh I'd need to go on an oral contraceptive pill because my periods are really heavy. And so it's just kind of been this dismissive And I always sit back and go, how does this really affect women? It's like, it's twenty twenty six. We still don't know why endometriosis happens We don't know why PCOS happens We look historically at research on like aspirin and heart attacks That whole cohort was men journalized women We see the original osteoporosis research was done on men that were like supplied estrogen to see how it would instigate bone growth So we see all this stuff that instead of actually using women They used men and tried to create an environment that was similar to a woman's body. L that's ridiculous. Like come on If only we could make men act more like us and understand us by giving them a little estrogen, but it's actually not that simple. It's not that simple at all. target tissue and a whole bunch of other things. I feel like we need a little more attention to what you just mentioned. in terms of sex differences and in terms of spontaneous miscarriage, can you explain a little bit what that is and what it means, even though it's a little bit off topic, but I don't want to pass that by Yeah, so when we're looking at they call it the fragile XY because the XX is actually the more dominant kind of genome. And the reason why we have differences is there are c when you have a dble X, there's certain things that are turned on and turned off according to the two X's. But with XY, you don't have that capability. So we see that the fetus who's in XY actually is more fragile So when you start looking at what's happening under high stress conditions, XX becomes more stress resilient. There's actually some epigenetic changes that are occurring within the growth and development that is making the female fetus more stress resilient. And that leans into being more stress resilient from immunity to mental capacity onward through life we start talking about the dominance of the male culture, I might you're the weaker sex, so to speak. Well, and I think, yeah, and sort of in genetic terms, the notion is that if you have two X chromosomes, which women do You have an X chromosome that can rescue Any that comes up that one chromosome kind of throws out there. If you're missing a little bit, if there's some micro deletion, the other X chromosome is like, we got this. like we're okay. and you don't have these maternal autosomal recesses. We don't have those issues. Whereas with an XY, if something goes a little bit different on the X chromosome, there's nothing to rescue it Because the male chromosome is very different. And it's funny, I don't know if you remember, back to biology class, right? The Y chromosome is actually very, very teeny tiny, you know, compared to the X. And obviously it does all the things it needs to do to create a male. But when people talk about this sort of default being female, it's because it's the Y chromosome that actually signals Hey, we got a boy here and puts into motion, you know the changing of the ovaries into the testes and all these sorts of things. Can you talk a little bit about sort of the differences then, you know, as we sort of view women and as we view men? It's not a competition, but there's so much that's different that really deserves its own kind of arena Yeah, I I try to get people to understand that it's not him versus her It's like you said, we're uniquely different. Women have smaller hearts. We have smaller lungs. and it's not because we're weaker, it's just that's the sizing. We look at muscle morphology. Women are born with more of our endurant type fibers. So what does that mean? That means that we have a greater capacity for using fat at rest and during exercise. We also have more robust mitochondria and the proteins within mitochondria to help with fat f acid oxidation as well as improve oxidative responses and anti oxidative responses. We also see that women's bones, we see that there's a difference, like there's a difference in the schematic of our biomechanics similar until puberty, and then the epigenetic exposure of estrogen actually causes a shift where we start to have our hips widen and our shoulder girdle widen to accommodate for those wider hips. Why? Because it's reproduction, right? So how does that affect things like gait? How does that affect the way that we carry ourselves? Our center of gravity is different. O We have more predisposition to ACO issues and soft tissue issues because we're more quad dominant. We don't use our posterior chain very much And then when we start to look at developmental like from a brain standpoint, we see that there is a difference in the way that the brain regions develop. And I'm sure you're very well versed in that with your background.ight see this difference And one of the things that I really try to get moms of young girls to understand is if they're having irregularity in their menstrual cycle and the answer is an oral contraceptive pill Hold on because you're putting that in a system that is developing and we see inherent changes in the amygdala that are not reversible They're reversible when you're older, but not during those developmental years. And then that increases the capacity for anxiety and fear That's never An issue with voys because they're never given that a seat I would love to double click here. What happens to the amygdala when you give oral contraceptives at a young age? There were a couple of studies that came out maybe a year and a half two years ago that were really looking at functional MRI and trying to understand what was going on because I think Lisa Musconi was coming out with all this evidence, right about estrogen and estrogen receptors. So then you started to look at, okay, well if we're looking at the younger set. So they had two groups. We had fourteen to sixteen year olds and we had twenty to twenty two year olds put on OCs and followed for two years And they saw that there was not as a robust development of the amygdala in either group And when those fourteen to sixteen year olds tapered off, there were no changes. But when the twenty Plus group tapered off it changed back to the way it was before, which meant that it was adequately developed and we had more volume of the amygdala. I mean, that's kind it's kind of mind blowing. and I think it's a good place to sort of, you know start and then continue this conversation because there's so many things that we take for granted or that we assume we have to listen to because a doctor says so And for so many young women, I was one of them when I started having hormonal swings and complexity That's what they jump to even if you're not sexually active yet. You know, this' regulate you, this will calm it down, or if you have irregular periods, which is actually not abnormal as you're just starting the kind of solution and I really don't necessarily fault, you kind of the medical system that I was raised in. It was built for efficiency and seeing the most people it could in an hour for the least amount of money. You know, the way to get people to not kind of keep coming back with problems is let's try and just kind of neutralize everything. Let's just, know, put you on a hormone system that at least you'll be regular and that should do it. But can you talk a bit about sort of what that framework does for the way that we're treating not just women's health, but health in general Yeah. I mean, I find it really interesting because I don't live in the US. I now live in New Zealand and there's more of a socialized healthcare And when you look at the difference of when you have a for profit system like the US, everything is kind of compartmentalized unless you have the money to pay for innovation So we're looking at the lack of robust education, I again am not faulting doctors or the medical school. It's just the way that it's been defaulted. So when someone comes in and they have irregular periods There's not a lot of education in women's health unless you're having a baby We don't see much in menopause. we don't see much in reproductive issues unless they specialize. and it's a very small amount of wom or women or men male doctors that actually specialize in it. So a young girl comes in, her mom is not aware that irregularity is normal. She sees her daughter suffering with really bad cramps and heavy bleeding, which is also not abnormal at the start So what's the solution? Well, okay, well let's give you this OC because that's what we've always done and not knowing as a mom, well, I know, in most People don't know is that it down reggulates your natural ovarian function, kindind of mixed stuff So we're thinking about giving someone an exogenous hormone to stop an endocrine function that still hasn't developed What's the forefront? right? We have longit of research that says, yeah, it's fine. when you get off it, things go back to normal. But then there's a subset of people who are like going and using the depot. No one knows that you shouldn't be on the depot for a year and no longer because it affects bone density I've had a couple of people who've been on the depot for twenty five years and they come off it and they have no bone density, like very low bone density, osteopenic They don't have their ovarian function come back and they're in their early thirties and then like, what is going on? So there's so much of a misinformation and the ramifications of the type of contraception that you use can be massive. We know just in a typical oral contraceptive pill, there are different doses of estrdol and there's different generations of the progestines. Each one of those can have a different effect And then for looking at like the IUD, is it a copper or is it a low dose progestin as much of an issue as systemic, but it's still going to affect. And the younger we are and don't let the whole body develop the way it should What are we doing? Like how How was that interference actually playing in the development of an endocrine system in the brain and bone d state? And I think also, you know, we'd be doing a disservice to women and to all of the incredible advances that the women's movement has You know, brought us to a moment of in terms of You know, I also understand that for women who don't want to get pregnant Many are willing to also take on a certain amount of risk in terms of other things. And when you're young and, you know, you feel like these things are so far off, right? It's like, oh, I'll be fine. I'll go on it, I'll get off it. And for a lot of people, that is the story. So I think it's important, you know, and obviously for the work that you do, it's important not to sort of have one solution for everyone But you know no one's trying to be a feminist downer in saying, wait a second, the way we've been approaching things actually may not be ultimately the most supportive, you know? And the fact is, you know, men have this twenty four hour cycle, right? And sure they have fluctuations over the months. and you know, it's very important. I'm not dismissing it. But if we were to say to men Every single day we're gonna disrupt your natural like hormonal circadian rhythm everyvery day, we're gonna do it every day because that's when we have to do it. I have a feeling, right? that it would have been approached a little bit differently. So I think it's important to kind of cater that as well. Do you wantna comment? I'm just saying if the side effects were your testosterone iss gonna to be totally messed up, your bones may not develop properly and you're gonna have a high level of anxiety Itt happen, right It's not gonna happen. No. Yeah. But I love the way that it started, like hormonal contraception was developed at Stanford. There's actually two women that one was the money behind, the other was a scientist, but they actually couldn't go into the lab to develop it. They had to have male sci scientists colleagues develop it And they were all in the We want to give women control and it was part of the feminist movement. and I love that Now it's like there's so many options. Everyone needs to be educated about it of how it's going to affect them now and longer term down the pipe because now we're looking at resources just coming down the line that it's taken so long and people like, why didn't I know this in advance? We actually had't had the research until now. And now that we do, we need to be able to talk about it and spread it so you can make an individualized choice that's appropriate for you and your situation and what you need it. But if it's just for health reasons, there could be other things that we can consider rather than just blanket saying goo on exogenous hnas I do wonder how Why does the Oall connection between that and the massive spike in anxiety that we're seeing across the culture. Yeah, I mean, it could have a tagline, but we also know that the isolation and social media stuff has a massive effect I mean, you know, if you're consistently seeing and getting a dopamine hit when you your young age s like, how was that also affecting the brain ve been watching the whole no social media for sixteen and younger that's happening in Australia. Yeah, there's some loopholes, but now the kids are actually going out and doing puzzles and card games because I was like, Wait, that's how we grew up. Let's call the landline. Hey, want to meet up? Sure. So it's just taking them out of what was considered the norm and giving them the opportunity to find something else, which is reducing those anxiety level. Well, and I also, I mean the spike in anxiety and depression, in particular for girls and unfortunately, this has spread to boys as well. So much of the focus, and this is kind of where I want to segue, so much of the focus is about body image, right it's about what we look like. you know, there was a period where body positivity seemed to be a thing, but now it's not a thing and we're kind of back to, you know, at least sort of in public arenas of beauty standards, right? We're seeing a swing back to very, very, you know thin. And you know, we have these GLP drugs, which are incredible and can be lifeifesaving, you for people who need them medically, but a lot of people are, you know using them, I guess somewhat cosmetically I'm curious if you can talk about even when you started studying, you know, when you were working towards all of your degrees, you know, what was your kind of perspective as an athlete on what health looked like for women? And how has that changed? Well, it's changed. I mean, when I first started, it was still the calories in calories out, exercise for a really long period of time to lose weight And when you start looking at metabolism and not putting it into the context of what it actually means, that was so very pervasive. So the general recreational person, when you go into like the university gym back then, everyone's on the stair master. L no one's in the w room. Not all of the women. someome of us were weightlifting. Some of us were weightlifting Or you know, you're looking at that. and then how it's changed over the years is people started doing more research in the strength training I mean, I do have to credit Crossfit for bringing it into the mainstream of lifting weights is fine As you're starting to get more research into strength training, we're seeing this huge massive shift in the whole fitness industry where they're getting rid of more and more of the cardio and bringing in lifting plat But now that might change because of the GOP one things that are happening And that makes me angry because I've spent so much time with it you know I have a daughter and she's just now thirteen and we spent so much time with her and her friends to not have diet culture in and around our household and her soccer team We've always been let's be strong, let's be fast, let's be powerful, let's fuel for what we're doing And they still say that, but then Someone will come in with Instagram or TikTok and they have a different image now It's like What are we doing? What are we saying? It's like, no, that's that is not a picture of health So I explain what's going on and the loss of bone denscy, the loss of muscle mass. We don't know the long term effects of it, and I'm pretty sure the people who are at the Grammys with the camera on them cannot do corner kicks and Rint down the field like my daughter and her te. So I just keep bringing you back to in the moment, we need to be strong and powerful. And for the general woman, being strong and powerful, I mean you sit up straight and you walk into a room, you have confidence even if you don't have confidence And that comes from being able to be strong in what you are doing. So yes, I'm I've seen the evolution and I don't like the way it's going backwards Can we talk for a moment about the risk of lack of a loss of muscle with these GLP ones? What are people actually doing to themselves? Yes, so I've been following this because we get ask this all the time in the fitness world, like what does this mean So Jamma published a review And it was a systematic review of all the papers that we're looking at the individuals that went on it and then went off it So they're comparing that to the literature that was based on the biggest loser, you know And they were looking. So they found that it's very similar You lose all this weight And then you have this massive rebound, but it's not muscle and it's not bone, it's fat. And all the metabolic control that you got with the GLP one, reeverse and got worse, cardio metabolic risk factors went up So when you're looking at that, for us in the fitness world, we're like, you have to put that lifestyle intervention in play In order for someone to make a decision to come off, they already have these good habits and they have really strong bones, and they have strong muscle. because if you're thinking about what is muscle? It's an active tissue. It's a glucose sink. It is a cardiomet metabolic Health profile And it helps you age well and not be decrepit and we see that the sex difference in health span and lifespan is completely real a longer amount of time of women living in a poor state of health. And part of that also is Alzheimer's and dementia. So if we look at some of the ways that we can attenuate that dimension, Alzheimer's risk It's through not having sarcopenia. It's by doing strength training. It's by doing a whole bunch of things that are going to create increased neuroplasticity and neural connectivity in the prefrontal cortex. And we see that happens with heavier strength training and building that muscle So when I look at this population, all I can think about is Wally, the movie Wally, where everyone was floating and he fell off and he couldn't stand up because he didn't have the capability of standing up And I'm like, oh my gosh, what is going to happen to the health carere system in ten years with all these people who have been on it for either cosmetic reasons or other health reasons but haven't been given the lifestyle intervention that they need in order to progress Well, and I think one of the know ways to kind of practically think about this is, you know what it looks like from some of these large studies is that, you know for every ten pounds that you lose on a GLP one Up to four pounds of that can come from muscle which means almost fifty percent. And that's a reduction in that lean muscle mass. So the reason that you're so skinny is that your muscles do no longer exist They're just falling off your body and they carry weight. And so now you weigh less and you're thinner and clothes fit differently. But I think, you know what I've heard from just you know anecdotally from friends of mine who have been on it, when you go off it, it's as if nothing changed, meaning the voices come back All of those patterns, behaviors, you know, all that stuff comes back. and this is not Not for us to say, don't go on a GLP one, but there's there's definitely this is not as simple as I think it's been made out to be, especially in all those commercials. I mean, it's not simple We I mean, you can look at some of the lifestyle programs that are in the obesity clinics and they're really careful to also include cognitive behavior therapy, other methods that people can actually practice and lean into when they are on the GLP one because of the silencing of the voices. So again, it's giving the tools that you can have if you need to or want to come off the drug But the pharma companies don't want us to say that because they want everyone to stay on it forever. We love to say the things that the pharma companies don't want us to say I think it's important to reiterate The importance of muscle mass overall health as well as longevity because it can I think we're saying You could be thinner. That doesn't mean you're being healthier in all regards. But you're thinner talkalk about importance of muscle mass, as you describe it for overall health as well as longevity. Yeah, there is actually an endemic right now that's happening in are teenagers through twies and thirties where they're not reaching peak bone mass And part of that is also not having enough muscle because we know that when you have pull on the bone, you also have You know, you're developing muscle, you're also developing the bone And when we're looking at the rates of sarcopenia that's happening in an earlier standpoint, which means that you don't have high quality muscle and the osteoporosis risks that are coming because of the sedentary lifestyle and all the things that are happening in Western world, then if you're adding GLP one onto them Okay, wait a second, we really have to take stop because what does muscle do It's not just holding your skeleton together. It is responsible for so many processes in the body. So if we want glucose control because we don't want diabetes muscle because it is a huge glucose sink We want to be able to walk up the stairs without being completely out of breath You need muscle, you need to train that muscle We see that we want more brain development for innovation and having capacity to be stress resilient muscles associated with that. So it's not just about looking lean and strong, It's about actually being strong And when people are talking about weight loss, I really like to lean into Gabrielle Lyion's idea of let's be muscle centric. Let's not think about what we have to lose. but let's think about what we have to gain. So if we are muscle centric and thinking about what do we have to gain if we are putting muscle on and bone on, we have the capacity to gain higher quality of life. And that holds true for whatever age you are. And this whole rhetoric of we need to be thin or we need to lift light weights. and And there's this this disconnect. It's like No, we want to really focus on who the person is, what their needs are and really build from the inside out. And so I'm always pushing people to think about If you are focused on weight loss, what do you have to lose? You have bunch of things to lose. You might lose some fat tissue, great. But we are losing our quality of life. We're losing our ability to make wise choices because now we're like concentrating on the fact that I can't eat that, I can't eat this Sleep gets interrupted because we see a lot of people who wake up with hypoglycemic spikes, which comes up as little awakenings during sleep because they're actually not fueling well enough And for a lot of women tryrying to do calorie restriction or fasting and having these large periods where they're not eating rebounds, they put more fat on and they get micronutrient depletion So if we switch it and say, what do we have to Dam putting muscle on. It actually flips the switch. We have more control over what we're eating. We have better sleep, we have better immunity. We have better blood glucose control. We have better cognitive function. So this is the pushback that I'm having right now against everyone who is like, oh, Thin is good. It's like, no. we lose so much more than just what we look like We lose so much more when we're looking at health and stress resilience capacity There's three points here that we need to expand on. The first is Speak to the person who is like, I just want to be toned, but I don't want to bulk. Why is it so important to lift heavy So for women we see that as you get older, there's an aging discrepancy in the way our muscle functions. So if we think about the actual contractile proteins, so if we think there are two key contractile proteins, we have actin and we have myosin Actin grabs ontomyacin and they come together and they become very strong in a bond. And then when they get the signal from the nerve to let go, they let go Myosin becomes dysfunctional. It changes its form. so the iso of myosin becomes a little bit less apt to be able to grab on to act in So if we're looking at why are we lifting heavy We want to have a neuromuscular connection that is telling myacin not to become dysfunctional The other capacity about it is estrogen is tightly tied to the way myosin functions as well. So as women get older, not only do you have this aging discrepancy, but you also have a change in our sex hormones, especially estrogen, It becomes even more dysfunctional So if we're looking at lifting heavy, it's that neuromuscular connection to create that strong and powerful contraction which we know is a significant predictor for really good health span. We also getting neuromuscular connection, which helps with prefrontal cortex, cognitive decline attuation, and you don't get bulky Like that's a myth. You have to work really, really, really hard get bulky Being in the gym for days on end for long periods of time, having an appropriate periodized program, eating a lot So if you're like, I just want to tone up some heavy lifting because you will and you'll get all of these benefits and it's a very short compact time frrame so it doesn't take a lot of time Amazing Touch on this idea of disturbed sleep from not fueling enough. That's fascinating. It comes a little bit from what we were seeing in our female athletes who had low energy availability. They were having really poor disruptive sleep and not recovering well So we put some CGMs on them and we saw all these variations in the blow glucose profile across sleep and most of them dropped into hypoglycemic time periods that corresponded with awakenings on their whereables So then we put them into a sleep lab to make sure that the awakenings were true and not just a wrist movement. and it was the same thing So then we're like, okay, we know that you're not eating enough in the day. so we could look at where you're eating through the day to work with your circadian rhythm and your training. And then if we see that you're still having these awakenings, we're going to have a bolus of protein before bed because that's going to a kind of mainstay, slow digestive aspect and it's going help maintain your blood glucose And then they were sleeping really well, sleep architecture changed and they woke up feeling amazing. What would you give them a bollus of what? Fine. So it was really just a half a cup of non fat Greek yogurt because you cin in w And that is the two proteins that one is a fast digestive. way is fast digestive. Cine is flow. It's not a massive amount of food. so your body doesn't go into, I'm going to digest instead of rest So it was really twenty grams of protein from yogurt that helped significantly Yeah. And so we transl it into like recreational athletes and people who are having difficulty sleeping and are trying to follow like a fasting schedule or so we just kind of have to rejig it all let's fuel for what the circadian rhythm is doing. And then if you're still having awakenings then we'll look at having some yogurt before bed How long before bed and What's the vegan alternative? Is there one There is a vegan alternative, actually, P protein isolate And if you're like,, that doesn't sound so great right before bed We would take some unflavored P protein is lid and put it into some coconut yogurt. So it was similar to yogurt And it hit all the notes because pe protein isolate is very similar in amino acid profile as yogurt. and it worked the same. And we're looking an hour to thirty minutes before bed. And again, it's not a lot of food. It's only half a cup, so it's not that much. You've been prescribed. You've been prescribed. But I'll be like, what if I add some sunflower seeds and what if I you know make it a little party? and What if I put some granola and chocolate it. Okay, no. different message. P probably wake up. But maybe I don't know, a little drizzle of caco nuds for a little bit of chocolate crunch because it doesn't have caffeine in it This leads us to fasting and the difference in fasting, especially time restricted eating that How do men and women respond differently to that? Should they be thinking differently about it I get a lot of pushback on social media for this because I'm coming from it from a physiological and chronobiology standpoint I'm not coming from the fitness world. So when we look at it reallyally paying attention to the sex differences in our circadian rs We know that men's is a little bit longer than women's and women's is tightly tied as men's as to our hormone perurbations throughout the day We know that women have a higher peak for their cortisol awakening response. And with that is a peak in what we call our asylated garalin, which is our active form of our hunger hormone and also peptide YY or PYY If we don't eat within a half an hour or so waking up, that cortisol stays elevated and keeps that isylated garallin elevated. And peptide YY kind of just kind of hangs out and it doesn't do the that it's supposed to do by stimulating the hypothalamus sayate There's some nutrition. we don't have to be hungry So when we're looking at holding it fast, we end up having more of a walling in the afternoon? We don't have as much incidental movement throughout the day. And we see there's this big craving for simple carbohydrates in the afternoon and a significant drop in energy. Because what we've done is we've effectively phase shifted as if we were doing night shift or we're jetl. because it interferes with the normal hormone pulse throughout the day, which also includes our appetite hormones So the brain is perceiving this as what's there's a little bit of a dysfunction here. So it becomes a disconnect between what it means to be hungry and what it means to be nourished When we look at Mins, it's not as tightly tied to that because the baseline for dysfunction is different When we see women who drop below thirty five calories per kilogram fat free massk end up with dysfunction for minutes fifteen So for're thinking about that baseline set point The idea of not having as much nutrient density is not as severe response to men's hypothalamus as it is to women's So when we talk about time restricted eating versus fasting, If you're looking at how we work with chronobiology, if you wake up and have some food within half an hour or so and then you're fueling throughout the day, then you have dinner. you don't have anything after dinner unless you have to have your nighttime bolist protein. then you can end up with a twelve to fourteen hour overnight fast. We used to just call that sleeping.ing, right? That's how we grew up. It Oh it's a twelve hour fast. It's called I slept Right, exactly, Eactly. I ate dinner. I didnt sack all night and then I didn't stuff my feelings down with food. And then I slept and I didn't wake up in the middle of the night and eat a sandwich. Exactly. But the world has become very strange because calories are available all the time Then we have this whole like the clinical world is different from the fitness world, but yet so much clinical stuff gets pulled over without saying if it's actually generalizable or not. As you see that fasting and holding and calorie restriction and holding food is very appropriate in the obese and some other populations, but it's not. when you're looking at the health and fitness world, when people are trying to maximize what they're doing from an exercise standpoint, maximize their sleep So if you have to have a small calorie restriction, then it's better to frontload your calories and not hold your fast till eleven or twelve when you start to see dysfunction in both men and women. There's population research that shows that both men and women having a late break of their fast, end up with no improvement in metabolic control or cardietabolic respectse So if you do fast, end earlier versus starting your eating later in the day Exactly. And if I can just reflect back, what it sounds like is at an overall body fat standpoint, men can drop to a lower body fat before there starts to be metabolic issues and hormone disruption where women need that additional body fat percentage. And if you start to reduce that too significantly, you're gonna to have issues Exactly. You brought up peptides, which Everyone is talking about right now There's a ton of people who are absolutely pushing them as the world's greatest thing. otherther people who talk about how they're unregulated and unproven and there isn't the data Wh how should we be thinking about this, especially for BPC one fifty seven that promises to have this faster recovery time. Other people who are you know supercharging, injecting with NAC or others How can we start to understand the risks and benefits of peptides? Okay, so I'm going to bring you back to an image of a really badly made cake coming out of the oven that's kind of lopsided and burnt and then you try to put a beautiful buttercream on it what happens The buttercream melts and becomes a mess. That's what bptides are. If you're not taking care of your foundation then why are you going to try to use something that's supposedly supposed to create enhancements But only that when we're looking at how people are approaching this There is not a lot of robust research. And when you're looking at the formulations that are coming through, they are not regulated. I think the New York Times did a deep dive and showed the lead qualities that were in all of these things. And the way the companies get around it is to say research purposes only. full disclosure, I've used them after I had a significant hamstring tear and knee injury. because I was desperate, but I didn't see any difference And then I started doing investigation into like what was actually in it. and I'm like, oh my God, I can't believe I injected myself with that stuff What's in it Well, you see a high level of different metals because it's not regulated. So the way the process of breaking down and creating these peptides in the process, you're getting a high amount of lead, we're getting some mirk mercury and some of these other like noxious metals that shouldn't be in any of the peptide products because they are not purified and regulated It's derived from Like gastric juices? I know What does that actually mean? What is it? So if we think about peptides are parts of proteins. And gasu use is an acid and it also has a molecular structure of some proteins in it So for some reason, someone decided that was a really good thing to extract. And the reason why it's in gastric juice is because if you have some kind of intestinal leakage or stomach leakage. you don't want that acid getting out and causing damage into the body. So if it does get out its normal place, then it's protective So they're extracted because they're like, hey look, it's protective but it hasn't been done in any kind of real human studies Obviously are they are not regulated to the way that we need them to be I assume that they're not all like that. somewhere like that depends on the manufacture. It's it's impossible to know Yes. so I look at it as like they're banned in a lot of other countries and they're on the watdle list as a banned substance as well because the efficacy isn't there and the risk to benefit ratio leans into the risk is greater than the benefit. I mean, we just don't have the research yet to support the marketing behind it. It doesn't mean it's not coming It just means it right now I'm going to let other people biohack and see what happens u we get they can be their own labortate Until we get more evidence, and I'm going to keep pushing people to look at other alternatives, like do all the things, but then let's also look at using heat, heat exposure that controlled hypothermothermia from cool water exposure. hyperothermia from controlled heat exposure, because those two things create a cascade of responses that are beneficial. We see greater anti inflammatory responses. We see increase in heat shock protein production, which means that all your extra little cellular bits are going to be re repurposed and picked up We see a slight increase in ovarian function in controlled hyperothermia. We see better endocrine function in both cool water and and sauna exposure. So those are the things that I would push people to do first before trying to do any kind of injection. Pepides like from, you know chemistry and biochemistry are just short chains of amino acids. So are people using this general term Pepide to mean a variety of different things because I keep hearing people say, peepidide, peepide, but that's just a generic term. What are we actually talking about The different molecular structure. So you have like TV five hundred, which is a certain set of amino acidide And then you have VP one hundred fifty seven, which is another set. Okay, so they're literally short chains that are being isolated to perform the function that they may naturally perform in the body, but it's a way to sort of you know, try and accentuate their impact by injecting them directly. That just doesn't sound like a real thing I know. Isn't it strange? Is like We know that this works if the stomach acid leaks out, but if you're going inject that into the body, is it gonna do the same thing Yeah, I don't know. it feels like we needed a scientist to weigh in before people just started doing this. but I know, I know I want to get to Sunas and Cold plunges, the benefits, the protocols. But first, you mentioned micronutrient efficiency earlier people at risk of that shouldh we be Just eating more variety What is the risk of micronutrient deficiency Yeah. So it is a pretty widespread when we're looking at the different ways that people are restricting food but also the generalization of what food is available, especially in the US with ultra processed foods and all the things that go with if you go to Safeeway, know like it's a whole store full of stuff that I'm supposed to eat, but I can't eat any of it, right? So if we look at micronutrient deficiency, Most people think about iron, but we also see copper, selenium, trace elements that go with that, that are very important for things like collagen and collagen development and And we are seeing a decrease in some of our fat soluble vitamins because people are eating a lot of fat, but it's from not a natural source. so they're not Like an avocado, yeah, you have fat soluble vitamins in there because there's fat in there and that they work together synergistically. But that's not the same thing as a cake. Exactly. Exactly, right So when people start thinking about micronutrient deficiencies It's because heard it or they feel awful. and so they want to go get all these panels of tests done And it's definitely a real thing in coming up. And we see that A lot of the collagen intended dysfunction that's starting to occur, especially in women who are approaching forty, it is a lack of copper And it's like, okay, how much copper do I need? It's like J eat a wide variety of foods, especially our leafy crereens and things like that. because if we are aiming in general for thirty different plants a week and having protein and fiber at every meal, you're going to cover those micronutrients. Did you say thirty different plants a week? Yeah, it sounds hard, but it's not because you're thinking about our herbs, our spices plus the typical nuts, seeds, sprouted grains veg. But basically what you get these kind of micronutrient deficiencies is when people are eating a lot of foods not in their natural state, I think is a way to kind of think about it, meaning overpcessed or highly processed foods, which I know like some large food organization that's, you know funded by the government came out and was like, there's no such thing as ultra processed. Every's fine. but if you eat a food has very little semblance to something that actually grows naturally, that's going to have l and you can do it once in a while, but that's not going to give you all of these things. Like honestly, if you would ask me if I'm eating copper, I don't know, but apparently it's in leafy greens. Also leafy greens seems to be the answer to just about everything Isn't it? It's Fina Have you tried blue or blue? Oh yeah. Yes. everything Its everything green. Yeah. No, if you use the blue spirulina, It doesn't taste grassy, it doesn't smell funny. And it has a higher amount of protein and iron than greensparow And you can put that in smoothies if you're blending something up. It makes it for a beautiful unicorn smoothie Well, but other thing about the micronutrient deficiencies is and when you start looking at people who are fasting and they only have a very small window of time to eat They actually aren't able to consume everything that they need in that small window. No. I knew a woman who only ate for two hours a day. Oh my God. And I was like, what do you even mean? She wass eating candy? She's like whatever I want. I'm like, that's not you're not it doesn't make sense. differentnt story. Yeah. She was losing weight though. and I said, Yeahah, because you're not eating because you're starving. If you may think that you have a nutrient deficiency or you're not getting that variety, obviously nothing replaces getting it from natural foods should someone be considering and trace mineral supplement or That and a multiv vitamin, like there seems to be mixed reviews. So get tested first to see And then we try to do it through food because if you're looking at the supplementation type thing, there tends to be Almost no effect. Like with iron, yes, if you're doing it right every other day, you can absorb it. But you have to be specific about that because if you have too much iron, then your body up reggulates the hormone that's going to prevent iron absorption So we start looking at when you're using supplementation, it can be too much. So we need just very small amounts to slowly saturate and build up over time, which you do with food. But people are so pill happy because we are in that society. It's like, you need this. Here's a supplement And there's not a lot of efficaciousness around taking a high dose we also see that a multivitamin is pretty much just paying out money because it's not readily absorbed. ofen cheap forms Be they have to work together to be in the small tablet. And if you look at the back of one, it says calcium and iron together, then you know that someone who put that formulation together doesn't know what they're doing because calcium and iron bond together and are excreted. So it's just better to try to do it through food. and there are really fantastic high amount in natural foods. It's just of outside the scope of what medicine practices because that's not what they're taught. Well, it's outside of the scope. alsoso, I mean, Jonathan a little bit rolls his eyes at me and I understand that like it all comes down to also like a capitalist system and, you know, the class the you know, race class and gender, like it comes down to like, we're talking two billion people worldwide approximately have micronutrient deficiency. this is And the symptoms, in case you're wondering, are everything you have. if you are a human woman in particular, between the ages of thirty five and dead, fatigue, lowered immunity, you know, having like cognitive issues, brain fog, at risk for other diseases. That's like literally everyone may be walking around, right with micronutrient deficiency. This is a global problem And we are now in a time in history where there are so many people that are overfed and undernourished and the discrepancy of calorie availability So many calories available in the western world And they're not actually doing anything to improve population health. And also we have, you, this whole movement of make America healthy again. L it's actually not that I mean, I know from it's easy for me to say from here, but like it shouldn't be that difficult. You know, These are some basic needs that, you know, even the notion of what we feed kids in schools, right I mean, I remember when people lost their ever loving minds about meatless Mondays in schools, right? How can you not feed a child that That weird hot dog or hamburger. I did like burger days. It was Thursdays at my elementary school. We did love on Tuesdays. That's right. But I'm saying like You know, there are things that also we can do for populations also that have no one speaking for them, right? To be able to say on a larger level. He's rolling his eyes. No, I'm stuck on overfed and undernourished. Yeah We're just consuming, consuming. We're eating everything out of plastic containers that have been sprayed with fire retardant. and we're wondering why we're hungry and don't feel well. You could apply that also to our psychological state. We are overfed with labels and boxes to put ourselves in and social media telling you that this one's a narcissist and you're getting triggered But in terms of like the nourishment we actually have about What are the lifestyle changes we can make that can impact our mood, right? Get off your phone for eight hours a day and watch you know how many changes happen over the course of a week or a month Here's a challenge for everyone How many meals did you cook at home this week Oh yeah. Congratulations. That's amazing, right? Like' everyvery's like she lives in New Zealand. There's no stores and she's in the mountains. L She's down the middle of the waps. There's no place I appreciate that, but I always to you know the assistance of the theoretical woman in my head who is not only now working, right? Since World War two, more and more women are in the workforce, but in many cases, when women are the primary breadwinner for their family, they are also bearing the brunt of childca and care around the house. So there's so many other factors here that like Women are overworked, you know, und supportupped. And for many people, especially if you are a single woman, a divorced woman, a widowed woman, the last thing on your mind is being able to figure out how to cook a healthy meal at home while managing all of the humans. It's, you know, I mean, I saw my mom do it You know, when she was working, she was also still cooking three meals a day for all of us hard and I think they call it the invisible woman's syndrome where the extra load that's not paid. And it is hard. And when you're thinking about having to do all the things in a day And then it's like, okay, I can barely take care of myself. How am I going to c And I mean, you go back to the whole, you get your Hello Fresh or your blue apron delivery which is kind of helpful, but it's expensive So how are we going to get rid of food deserts? How are we going to improve? Be in New Zealand, the reason why we cook at home all the time it's really expensive to go out. Like you're paying twenty bucks for a taco It's like just not feasible But is it a good taco? No I'm. I do want to get back to some of these kind of more fitness and kind of health related differences between men and women really surprised you know, in terms of oxygen use, right? And you know, for me in my head, when I think about where I wish I was or where I'd like to be, I feel very intimidated by like Lady on the cover. Do you know what I mean? Like Like this sort of intimidates me because I feel like when I look at the chart, right of maximum like oxygen capacity, I'm like, yeah, that's why I cannot do what men do because statistically speaking, generally speaking, our bodies are different, our physiology is different. But I think one of the scary things in our culture, especially when we have like this fantastic emphasis on strong women How that's beautiful and that's powerful. It sometimes can make us feel like we're still not meeting the expectation because many of the women that we're supposed to compare ourselves to are outside, I think, of the middle of that bell curve, meananing it's like, oh, like name of female athlete, know, Gabby Reese, I think that was like a popular person, you know, when I was young She was on the cover of everything and I was like, there's no way I'm not six feet tall. I don't have that capacity. How do you sort of balance that when you're you making suggestions for women so that we can also feel like we don't need to be like men, but we also don't need to be like those women who are closer to men in terms of their physiological capacity Amazing genetics or they're Olympians. Right And I am really I've been following the VO two Max thing in the sphere of things. And as a sports scientist and a research scientist, why are they putting that metric out there becausecause there is a discrepancy not only of maximum oxygen carrying capacity for women versus men, but the way women use oxygen. Because we can work at a higher workload for a longer period of time compared to men, but all the metrics are being compared to men. So when we're looking at what does that mean? It's like don't think about those absolute numbers. What we want women to do is work at a point where they feel like, oh my gosh, I I'm breathing really hard and I can feel my muscles We're there right now, Staisy., I'm in it. Okay. I think I'm at maximum capacity right now. And then you recover and bring your heart down and then you go back up It's about pushing yourself outside of the norm. So if you think about all the classes and stuff that are out there, they're never really polarizing. They're not telling women to go as hard as you can and then really recover becausecause then that doesn't fall into how we grew up of you want to get a really hard sweaty session and come out feeling smashed That's actually not what you want to do when you come out of cardio session. You want to feel elated and tired because you push yourself really hard but you had the opportunity to recover. So that possibly push yourselfalth really hard again. And it's not about how long it is, but it's about the quality. So it's a very short period of time where you're pushing yourself way out of your comfort zone. So if you usually go for a walk and you go by a hill Push your pace a little bit up the hill. Get out of breath. St to really push yourself a little bit. because I don't think women have ever been encouraged to just push a little bit more, push a little bit more I ask him to push me when we get to hills It's a great workout for me. Well now you just have to reverse it. So you can push her up the hill, but then she has to push you while you're going downhill so that she has to walk backwards and have the load going down That sounds like fun. That's great. I could do that. Okay. I have a very hard question because Everything out there on it says it's the most researched supplement in the world. It helps with everything reat Creatine, exactly The News now is and it's coming from very small pockets of the world is that it's From a synthetic source, it's created as a byproduct of of a petroleum output. I don't know enough about it and I feel confused. Wh Should everyone be on it or should they not and are there risks associated with it that may not be in the studies yet Okay, so I will explain how it's made first. Yes, all cotine comes from the lab But there are two ways of doing it. One is derived from formaldehyde and petroleum products and it's washed with an acid. That doesn't sound good at all at all. No one should eat that. No one should eat that. And the other is a patented way of producing it with a water wash that comes from more organic materials. So it actually comes from formulating certain things within the lab that come originate from plant sources You're good if you're vegan and it comes through water wash So no petroleum, no formalldehyde from plants and water. And as well Yeah So we're looking at the cheaper forms of creatine monohydrate come from the formalehydren acid wash The more expensive forms you want to look for a business business brand or B to B brand on the back of the cateine label that says Creaure or Crea Vitalis. It's a German brand that has a patent on producing it from a water wasash so they supply more of the high end supplements So when we're looking at what's the difference? Yes, go for a little bit more of the expensive one because you know that there isn't any formaldehyde, petroleum, acid, anything. In general, I'd try to limit formaldehyde my diet. Yeah me too And Probably petroleum too especially the cost of it at the moment. we're actually looking at what does it do We see that your body does produce one to three grams a day from your liver, but it's involved in every fast energetic in the body. So you think about brain metabolism, heart, lung, bone building, muscle building. every cellular process because it's the very zero to twenty seconds of all kinds of Every fuel in the body uses creatine If we're looking at how much our body stores Around seventy to eighty percent of our muscle is actually saturated with creatreatine because we use so much of it in the day. So we start seeing how using a supplement can benefit. We see it benefits brain and brain function and brain metabolism because relies more on creatine because it's the nerves and everything that're conducting are so fast. so it uses a lot of creatine We see that the mucosal lining of our intestines, it gets eroded pretty quickly. If we have more creatine in bard then That mcosal line stays and it reduces IBS symptoms, it reduces issues that women have when estrogen fluxes as well We see it's beneficial again for bone and bone density because it's involved in all the energetics for creating bone and then of course muscle performance. There was a systematic review that came out, and the reason why I know all these things is because I've been on planes reading, trying to fill in time. systematic review came out two weeks ago that looked at all of the studies that were done outside of muscle performance, health and fitness on creatine. And the group that benefited the most from using creatine supplementation were women eighteen sixty So we look just a very small dose. It's three to five grams and that's over the course of three weeks fully saturates all the tissues in the body. and it just brings your body up to another level of stress resilience It helps with cognition and brain fog. and everyone benefits from that. men and women, especially in this era of lights and everything on all the time orre just bombarded by stuff. So it just allows your brain to have a little bit more stress resilience What about the notion of taking, you know the higher doses? I've heard it you can you recover or function better if you've had a poor night's sleep or two, if you have to perform. What about the ten, fifteen, twenty gram dose So that one's interesting. Darren Candaow is one of the lead researchers, and he's out of California. He's been looking at this. and he's like Initially, yes, But the problem is it takes longer for creatine to pass through the blood brain barrier so in acute dose doesn't necessarily help right away So if you're a shift worker And you know you have three days on and then other days off, it works significantly to help and reduce carbohydrate cravings because the brain doesn't feel as tired, so you end up having better metabolism and glucose control We see it helps with jet lag too because it's a circading rhythm shift We also see in early studies it helps with individuals ADHD because ADHD is also a circading rhythm shift So all the things that have a circadian rhythm shift benefit from having the higher dose, and I think it's what zero point three eight grams per kilogram, which ends up being around twenty grams for one hundred and thirty pound person I'm sorry, Circadian rhythm for ADHD. canan you repeat that Yeah, so they're looking at things like sleep and melatonin and issues with ADHD, and they found that it actually is a circadian rhythm shift So for individuals with ADHD who are trying to get better sleep and they're looking at things like melatonin and other sleep supplements. you want to take it three to four hours before you need to go to bed so that it allows your brain to're microdosing with these things allows your brain to settle back into en normous cadian rhs I want to get into some of the kind of perimenopausal and menopausal concerns that some of us might have. But there was a part in the book that kind of me cold Can you talk about hydration? Can you talk about kind of like Everything relating to this chapter is kind of interesting to me. I'm a person who loves salt. like everything has to have salt. like salt salt, like I will salt it before I taste it. I do all the no nos, right? And I also am quite thirsty, but you talk a lot about You know Should you drink obviously before you feel that thirst? Yes. but I didn't know how many problems people can have from Hydrating inappropriately. canan you explain like what we actually should be doing? That's your nickname, inappropriate hydrator. I am an inappropriate hydrator in both directions. becausecause also sometimes when I'm just giving you all my problems. sometometimes when I get to a meal, I cannot be the only person who has this. Sometimes when I get to finally sit down and eat a meal I am so thirsty that I drink so much water and then my stomach hurts and I swell up like a mushroom. He calls me mushroom belly. I swell up like I've ingested a mushroom because it's all bloated. and I don't know if I'm drinking Too much or at the wrong time. Like what's happening with hydration? digestion, right? Explain it to us So we think about all the water in the body is not just plain water. It's a solution of primarily sodium and glucose If we look at just drinking plain water and we see people walking around with their stanleys and their're drinking liters a day, they end up peeing it out not actually hydrating because the plain water is not absorbed very well because the body's like, oh, I have to dilute this. No I don't need to dilute it. I need to add stuff to it. Maybe I don't So when we're talking about hydration, there's a very tight amount of pressure that the intestines can withstand, and it likes an ideal pressure If we look at having something that's just plain water, it doesn't exert enough pressure. So the body has to bring in some sodium and some glucose from other places in order to absor If you have too much sugar, like all the cokes and power raids and stuff in there The body has to take water from other places in the body to dilute that in order to absorb it. So we talked about hydration. If you're drinking water, you just add a little bit of salt. So it might be a sixteenth of a teaspoon in twenty five ounces So it's just a very it's about two hundred milligrams of sodium. Why did you pick the hardest measurements for me to understand? A sixteenth of a teaspoon in twenty five ounces. Okay. People like numbers, but here's Okay, but that's it's a modest pinch right? This a little pinch into your bottle of water All Then you get hydrated And you end up drinking less and being more hydrated. Beause if you're walking around drinking water all day and you're putting it on your tongue, it kills your thirst sensation. So people are like, oh, I don't feel thirsty until they sit down and they realize that, wait, I'm really dehydrated. I've been drinking water all day you've been peeing it out and not absorbing it. So just a little bit of salt I mean, if we learn nothing else from Dr. Sims, is that I've been drinking water all wrong all this time. For now, right I'm just thinking about how many people this affects. No one is doing this If you're drinking water with the meal, there's sodium in the meal. That's fine But if we're talking about like the focus on being hydrated, which is becomes the thing, right? Everyone's talking about, I need to be hydrated. And you see all these massive water bottles of people are going on a walk and they're just using water and paying it out and they're becoming dehydrated or what we call hypohydrated. So it's actually doing the opposite. So again, if we just put a little bit of sodium You don't have to drink all those bottles of water and you're not interrupting your biochemical processes either This has blown my mind. It's kind of blowing my mind too, but now because of the things that I know about pressure and also the stretch receptors, that's what bloating is. It's that you've disrupted the pressure, much like high blood pressure, right? And what do we give for high blood pressure? a diuretic, right to pee it out. So basically you're creating, oh, that's terrible. That's exactly what's happening This is a little segment I like to call crazy hippy ideas that may have some scientific merit. So help me understand this. Someone turned to me and said, you know Our bodies need structured water. We shouldn't be drinking all this water regularly anyway. We should be getting all our water from fruit because that's the way it is in nature. And I looked at him and I said, That's too complicated an idea for me to implement into my thinking. I'm going to ignore it Can you explain if there's any merit in that Well, it does count as a water source But it wouldn't be your only thing. Like peopleeople are like, I need eight glasses of water. Well, that's from marketing. that was from a whole wh. campaign and people grabbed onto it. It's like if you're thinking about water and staying hydrated throughout the day, it's not about how many things that you drink. You have a wateray fruit and veg, that counts too. But it's not being exclusive in just drinking water or just eating fruit or just eating veg. It's like, okay, all the things that have hydration in it we can use to hydrate our bodies and ourselellves So there is a little bit of. Well, and also and you know, correct me if I'm wrong, the notion of kind of structured water means if water's being taken in through fruit, for example, or vegetables, it's processed differently than if you're sort of just inserting water and it basically is just coming out of your urethra Yeah, kind of. because as you're like looking at digestion, the water will be absorbed first. while all the fiber processes are being digested. So the body is like, I'm mushing it up Leaking it into the small intestines, ninety five percent of your water absorption takes place in the small intestines. And then you further digest as you go down So you're having lots of watery stuff. That stuff gets absorbed first while the rest surface. Can we move on to This ten year period called perimenopause And then menopause. But I think a lot of the focus right now is on perimenopause because that seems to be this place where so many women and the people who love them are noticing all of these differences and all of these changes. And I think I'd like to make this really simple for people because we hear so many different things we should be doing kind of I'm happy for you to speak to hormone replacement therapy, but I also am happy to set that aside for part of the conversation. If you had to tell us five things that every woman who is perimenopausal should be doing for her health. What would those five things be? Like make it really simple for us because you can't change anything without sleep That's the first thing. Sleep looking at increasing fiber. because we have a decrease in our gut microbiome diversity, which exacerbates a lot of the body composition changes being very specific in the movement that you do putting an emphasis on strength training and not aerobic cardio stuff If you are doing aerobic cardio stuff, you have to be very specific in intensities. So this is your big three having support and community So you have your buddy Right? And having someone who you can invent to and who isn't going to try to fix things, this could be your partner. I've been talking a lot to men about how they can support their partners. And this is like just listen, donon't try to fix things because it's a very confusing time. And then when you're looking at specificity of symptoms, like Are you having severe brain fog? Are you having severe mood swings?ike Th that's where we start looking at pharmaceutical options if things like adaptions don't work for you, then yes, menopause hormone therapy is definitely on the cards as a way of helping get women through this What I don't like is the conversation every woman needs to be on it. because that's not. That's not We don't have the data yet to say what is the long term effect of this And we look at the, the womomen's Health Initiative study that took it off the table many women, But at the same time, the UK womomen's million womomen's study was going on, and that's why there's a difference in the way that people approach it in the UK versus in the States. No, now they're saying like as soon as you're twenty, just go' like what? No. That's really helpful and also makes it a little more manageable, you know, I think to sort of think about Can you talk about fiber Be like I think of fiber bias you know, as like something for old people to make sure they don't get constipated, you know? But I'm hearing more and more people talk in particular for women with autoimmune conditions. like what is up with fiber and why is she being so sneaky late in life? know So fiber is the food for our bacteria and our gut, right? And we see that there are different phylops For women who are in perimenopause, there's a significant decrease in the good gut bacteria. Un Fortunately, this causes an overgrowth of the bacteria that makes you highly sympathetically driven, makes you crave simple carbohydrates, increases our visceral and our subcutaneous body fat So for looking at fiber, it's all over a fruit and veg because that has fiber, like fibery fruit and veg, sprouted grains, whole grains, like real food. We're not looking necessarily at a fiber supplement unless there's a case where you've been sick, you've been traveling, you've had some kind of issue where you actually need fiber supplement. Not telling everyone you need metamucl every day. It's like let's just that's where that whole thirty plants a weeek comes into play because it really does help increased the amount of fiber, but not a big wallet at once This helps with that gut microbiome diversity And we see this decrease because of the way our sex hormones are now changing because we're not having as many sex hormones come in. There's not a second pass. Be when our sex hormones are bound up with sex hormone binding globulin, they're shot into our intestines through biile and then unconjugated by these gut bugs When we stop having as much progesterone or we start having different rations of estrogen, that kills off those gut bugs So we really need to focus on fiber and diversity so that we keep producing the good gut bugs, which then enhances things like brain drive neurotrophic factor, BDNF. We it helps with vitamin production. we see it helps with serotonin production, dopamine, all these other things that the gut bugs are responsible for So that's why I keep telling women like it's about the nutrition and the fiber. Yeah, that's very helpful because you, I remember after giving birth, right? That's the thing they tell you is like, if you'd like to leave the hospital, you have to eat your fiber because you have to have a bowel movement, right? Because you're trying to rebalance everything. And I remember, I was like, what do they mean? And they were like, lettuce, just, you know, But even that notion that we need those kinds of foods to keep things kind of functioning And especially as we get into this kind of situation where sex hormones are behaving so differently, I wonder if you can kind of speak a little bit on you know, for the people who say and look, we've hosted, you know, many of these u many of these people, you know, who say that kind of we shouldn't ever not have the hormones we had when we were younger. And you know, estrogen is everywhere and it's, you know, it's in your brain and it's in your gut. And so like the, you know, all of these connections with cognition, with mood, you know, all of these things need the same level of estrogen. What does it look like to gently go through this phase of life, Is it possible to come out on the other side without that kind of supplementation? Absolutely Absolutely. because one of the things that's not being described when people are talking about everyone needs these exogenous hormones is target tissues We see each different for form of estrodone and progesterone actually is absorbed and affects target tissue in a different way So if you talk about bioidentical and micronized, yes, they're molecularly the same, but they don't affect the target tissue the same as if your body is naturally producing it So when we start looking at receptors and Yes, we see that all the receptors in the brain light up when estrogen is going down because yes, they want estrogen, but do we need to feed it or is that just a natural process? And the body finds a new baseline This is the research that's being done but isn't done becausecause we haven't done the actual investigation of how all of these things affect target tissue ight And there are plenty of women who kind of holistically are like this is your age of wisdom and like you go through this really rough period, but then you level out at a place where, you know, for For you quite some time, women have weathered and it is a different phase of life. I think Margaret Cho has a hilarious thing about the haircut you're finally allowed to get. You know, when you're through menopause, like you just get a boy haircut because like that's all you can deal with, right? Yeah, exactly I think a lot of the push for it is aesthetics driven. Because so many things happen with body composition and people are like, oh, well, if I go on hormone therapy, then it's going to help me preserve my body composition, but it doesn't. There's no research to show that actually does preserve body composition, is slows the rate of change But you have to put in lifestyle changes to actually benef Right. And this is where it becomes a cosmetic conversation because You know, I'll be super honest. I never heard women interested at all in the Vulva the way they are now because the conversation is Sorry, Jonathan, cover your ears Learn So you can listen, everyverybody's talking about plumping and I'm thinking like, this is not a conversation I ever thought we'd be having, especially when there are so many physiologically, you know critical things also happening, you know, in addition to the cosmetic, but it's kind of like the conversation with GLP one s, right? Like so much of the conversation because of the industry Right? And because of what we're told to kind of factor in as the most important, it gets shifted away from some of these more, you know, kind of clinical conversations, which are so important Definitely you have a history family history or you yourself have a history of low bone density, then yes, it's shown that it does actually help with bonees helps with mood, but there are other things that help with mood U vaginal dryness definitely helps with that, but there are other things help with that. So it's like you have the camps. the pendulum is swung from one to the other. But we need to settle in the middle because there are absolutely things that you can do And I mean, I used it very briefly when I had severe rage because it got to a point where my daughter was I don't mean to laugh at your rage. S. I actually share the story. I was like, ye, my daughter will turn to me now and say, Mom, when I was born five, I was very afraid of you because you had such rage and that like breaks my heart. But I had a friend who pointed out. She's like, you've done all this research on hormone therapy and menopause. Why are you not trying it becausecause you are not person that I thought you were, you were like I was like, oh my gosh, you're right He feels so validated right now. But I think you talk about it in the book and, you know, for women who have not experienced this, I' I'm glad and I hope you never do. But as you described it and this was this was my experience about once a month anything in my path I would take a blow toorch too. and that meant The human in this vicinity. You know, it meant work, it meant, you know, everything, it really felt like burn it all down. And you know for many people, it's very confusing. It's not healthy, you know for kids. And you know, we always joke like we just thought our moms didn't like our dads, you know. The highest incident of divorce happens during Perim Menopx Yeah and rage apparently. And rage One more thing we wanted to talk about with you. There's so much conversation about temperature and body regulation. and you had kind of mentioned it a little bit, but this notion of Cold plunge, you know, kind of took the mananosphere, you know by storm. But I'm curious, like is there a perspective you have both for men and for women about cold plunge, about sauna, about heat? What should we be looking to if that's something that's interesting to us and something that's available. Yeah, I don't So I think I cause an international shit storm when I was like, women shouldn't be in ice because there is no data to support it I was just looking at the science that's been around since the nineteen nineties. sex differences like XX versus X, Y, not hormonal differences. We look at thermore regulation. So if a woman gets into that zero to four degrees Celsius or the ice water It's such a sympathetic drive and survival mechanism that she doesn't actually accumulate the right kind of stress to create adaptation that you want This is what I say when I've tried it. And people are like, oh, you need to breathe through it. I'm like, no, this feels like a specific o, oh. I'm gonna caveat by saying she's never been in zero to four degrees. You've you've been in Hold water then Once my bath got cold and I was really upset So if you want to go down that route, for women, we look at about fifty five degrees Fahrenheit, which is that fourteen to fifteen degrees Celsius It's uncomfortable, but it's not as severe stress as ice. So you will get metabolic intrineinine changes that are beneficial, but They're still not as robust. as male responses. Interesting. What are the beneficial responses? More parasympathetic drive, more focus that are serotonin and dopamine responses, that are metabolic controls, so better glucose control Those are the main ones These sound like great things. And that's at fifty five. What about sixty? what's the range So the research is always held tight at fourteen to sixteen degrees Celsius. Is it warmer? Well, then we start to say, well is it cooldy enough to invoke a response, but depends. Where I live, the sea temperature never really gets above sixty five degrees. So if you acclimatize to that, are you going to get responses The benefit for women is to get in the heat because we actually get really robust responses when we get in the heat We have a fluctuation of our internal temperature across our menstrual cycle anyway. So our body is really already prime for You know, different threshold shifts. So if we go in the heat, women last longer in heat. we vasodilate first and then start to sweat. men get in there like, oh my go after five minutes, I'm sweating like a horse. can't be in here any long So men have to kind of fight through, but we still get really robust responses very equivalent to what men will get. So that means we have an increase in our cardiovascular function because we increase our blood volume, we have better heat shock protein responses so more autophagy that can occur. We see better blood vessel and blood pressure responses because this is a strong stress so we get more vascular compliance. It also helps with our dopamine and our serotonin and neurotransmitters. It also helps with our metabolic control just like the cold. But a lot of women will gravitate towards heat more so because it's not as as a sympathetic like, oh my god, I'm gonna to die. It's like, oh, it's really hot in here, but can tolerate it because the body's used to shifting So either one is fine. You just have to be am I leaning into the code but not too cold, or do I lean into the heat, but they both give really advantageous health responses we look at how much, which is always the question. If you're not trying to acclimatize the heat because you're going someplace hot hot, Then we look at ten minutes, maybe three times a week, because you're getting that robust heat exposure, but it has to be about eighty degrees Celsius. So you get in there, you're like, o, it's hot sit high and then move low and then get out. You don't have to be in there. I think Brian Johnson said till his core temperature got up to be thirty nine and a half and then he stayed in there. I was like We poull people in the lab when their core temperature gets up to thirty nine five. You could benefit way before that. So it's not about keeping your report temperature up high I do think that this is sort of the testosterone driven aspect of the fitness industry is like everything becomes so extreme You talk about that in Rar. you know, you talk about if you are interested, if that is your life is extreme temperatures and extreme sports and extreme fit like great. But for most of us, yeah, it doesn't feel like doing forty five minutes in that kind of heat, especially you know for women who are dealing with our own temperature regulation issues, which is like a real thing, you know, for many, many years. Yeah. so When I was doing my postdoc at Stanford, I had the luxury of being able to work with one of the top compleimmentary alternative medicine and thermore reggulation research scientists. She came over from Colombia. We were really trying to quantify what a hot flash or hot flash was we had women sitting in a neutral room sauna without the heat on and we were looking at the spikes and being able to predict what would happen. And then we did controlled hyperothermia. So we'd exposed them to saauna temperatures for fifteen minutes a day And we did that every other day for a week And they would have severe hot flashes in there because it's hot, right? then after those five days They would have less severe and less number of proble. ious So then they're like, this is great. they're controllable and it's you know, the hypothalamus and is able to understand what that severe heat is and how to bring it down So we can use controlled hyperothermia to help with hot flashes Is there a better time of the day to be exposed Not necessarily It's like when you can fit it in. You've done so many podcasts. You speak so much about health all the time Are there any topics that you wish people would think about more that you're not being asked about That's a hard question. because my brain is always going in different directions, right? And so that's why I have All these different projects going because For me, I want to close that gender gap We have a new company that we're launching that's aiming to do that by going after AI because AI right now is just perpetuating the problems of misinformation for women When we start looking at the research, someone asked me, what's the one research study that you would want to do to help all women? I was like, there're too many. I can't A pase. specify one And So I guess questions that have been asked depends on what stream we're in. Like we're just talking about overall general woman's health I always talk about different things. so it's always interesting. If we're talking about the research perspective and what needs to be done, well, we can look at every body system and we can go down that route. But againain, what I'm really pushing right now is we have to look at how AI is perpetuating this problem because it's an echo chamber in that bulker And who are the nuances in the information, the publication of women's health is lower than that of men because there are not as many studies. So those are the nuances, ethnic differences and racial disparities. thoseose are the nuances. They're not being included. So as we're getting this upsurge of clawed and anthropic and all those kind of data likes The parameters are set on mail data. The human touch is so factored on mail data So a woman will look at her wearable and think that she's dying because the output says your core temperature is up, your heart rate variability is down, you're getting sick. When actuality, it's just she's ovulated. Am I dying or am I just ovulating? That's ovulated, but the wearable thinks you're dying because you're not a man Whoa Dror Sims, thank you. The book is Rar, Match Your Food and Fitness to your unique female physiology for optimum performance, great health, and a strong body for life. We so appreciate our time with you. Thank you so much for sharing all of the research and experience you have with our audience. Thanks for having me. This has been so fun. I appreciate doctor Sims is one of those people that like if I were running the world, I would want her like advising on so many things just to help us understand things better, to help us do things better, like to help us approach things in a way that really seems to work for optimal health. Like I want her in charge of something New Health Secretary nomination, Stacy Sims Also, think about the amount of water that you have not absorbed I don't even know what I've been doing with my stupid water bottles. Just a little pinch of salt. But you know what? I'd like to remind people when you see someone walking around with their giant water. Shake your head now. No, you don't know what's in there. It could be vodka. You don't know, donon't judge. Could be salted water. It's okay. That's what I'm saying. It could be anything. You know, I don't envy Dr. Sims because she She has to speak out on so many things that people just wanna take for granted even the conversation about birth control and the amygdala I'm like, I need to look this up. I need to look at what we think these medications are doing, but it may not be for everyone. And I think that's important to point out too. We're not saying do away with birth control, do away with hormones, but everyone's experience is going to be different No two people are the same And in particular, no two women are going to have the same hormonal journey. There's so many other factors diet, you know, other pharmaceuticals, you know, the hormones in meat, in dairy, like all these things that people are realizing may have an impact. All those things have to be considered. There is not a one size fits all solution for all people and in particular, for all women I also think a lot of people want to believe that There are these miracle cures in which she talks about the cake. If you're not wororking on the foundation. You can't just throw icing over it you know, we have to be doing those fundamental things. There are no shortcuts and we are trying to get ahead. There's so much pressure. People are hustling. It's so much harder to cook these days than it ever has been before. And yet without that You're running towards a cliff. I mean also speaking of cake, like How about an avocado Just that notion that not all fats are equal, right? And that having an avocado and getting those fats, it does. It processes all of those micronutrients differently than if you're getting your fat from icing on a cake. That's not the best form of fat That's the take home message here. That's the take home message I was also going to say Rar, it's a really fun book because it has exercises and it has recipes and it has nutrition, but it's a really good guide. It's a really good reference. You can kind of look up everything that you're curious about and sort of tailor it to what you need. So really loveved speaking to doctor Sims. Hope you enjoyed it as well. Make sure to join the community over on Substtack our growing community of breakers, go to My and Bialic's brereakdown on sububstack or go to beolicbreakdown. sububstack d. com and we hope to see you over there from our breakdown to the one we hope you never have. We'll see you next time It's Mayia Blexs break downown. She's going break it down for you. She's got a neuroscience B HD or two on fiction. And now she's going to break down. It's a break downown. she's going to break it down