Transcript

00:00:01.34
neelyquinn
All right. Welcome to the show, Stacy. Thank you so much for being here today.

00:00:05.37
stacy
Yeah, thanks for having me. I’m looking forward to it.

00:00:07.99
neelyquinn
Yeah. So for anybody who has been living under a rock and doesn’t know who you are, can you please tell us a little bit about yourself?

00:00:15.52
stacy
um I am technically a female athlete health and performance physiologist, but basically that means that my entire career has been looking at sex differences and women’s health, especially it as it pertains to the exercise and performance space from

00:00:21.51
neelyquinn
Okay.

00:00:33.57
stacy
I started off high elite athletes and now I’ve opened up to the everyday athlete, which we say if you exercise on purpose, you are an athlete.

00:00:43.31
neelyquinn
That’s great. Yeah. So it seems like you’ve studied a lot of different things and you’ve written a couple books and you have programs and and which I have taken, which I loved. And um so what I want to ask you about today is um generally about perimenopause and menopause for women athletes and specifically climbers because people can hear you talking even on the Huberman lab now about general athletics and so I really wanted to specify for climbers.

00:01:08.08
stacy
Yeah.

00:01:17.89
stacy
Yeah, absolutely.

00:01:19.73
neelyquinn
Yeah. um And then before we start that, though, can you tell me a little bit about like your own experience with exercise and as you’ve aged and like anything that you want to shout out about yourself?

00:01:37.07
stacy
Yeah, I think the biggest misconception because of ah you know like the social media preference um you know profile versus like reality is that people think things have been easy for me.

00:01:48.15
stacy
like i just but it hasn’t. It’s like um I was a high performing cyclist and x-terra and triathlon and all that kind of stuff. Then I had a really, really difficult pregnancy. And so I never really got back to that. I ended up with hip surgeries and a lot of hormone dysfunction, really trying to fight back from that. um And then hit my mid-40s, started going, what’s going on? Really swung through.

00:02:17.80
stacy
um episodes of rage and depression and trying to figure out was that because of circumstances or was it perimenopause so retrospectively looking back and going oh my gosh all of this is you know all these things that have been happening with body comp and mood and anxiety and sleep is all perimenopause So I’ve had my academic chops in women’s health initiative and high performance. And so in my bubble, I knew these things. But then actually trying to apply them, it took a point of, oh my gosh, what is going on for me to like step back and say, yep, you are definitely in perimenopause. You need to start taking your own advice. So I mean, my love is endurance sport. I’ve been long term endurance athletes, started

00:03:04.66
stacy
running when I was 13, I did 20 marathons before I was 20, like really serious endurance. And I just couldn’t do that. It was making me so tired and body comp is going all over the show. It was making me injured. And so I had to like sit back and say, what am I telling people to do? And I need to do that. So that’s, I pulled it way back. Now I’m like really struggling to stay strong and fit and maintain lean mass. And that requires a lot of work in the gym.

00:03:34.59
stacy
And I’ll have soul food while I go ride my bike and just get outside and do stuff. But it’s ah it’s a struggle to find motivation every day too. And it’s hard to implement things that you know are going to be beneficial when your love for something else is not that beneficial. So it’s been a journey. And I i kind of ascribe the same things that I do now as when I’m in the lab researching stuff.

00:04:00.05
stacy
I’m always a a pilot participant in any of the studies that I do so they know exactly how the participant feels. Because you can’t make someone do something if you don’t actually know what it feels like. That’s my perception. So if I’m going through all of this, I want people to know that I’m right there with you and I’m trying to implement things and I’m trying to change my lifestyle even though as a long-term endurance athlete, I find it really difficult.

00:04:26.44
stacy
So, you know, it’s it’s not an easy journey. And I want people to realize that it’s not an easy journey for anyone.

00:04:33.52
neelyquinn
Yeah, honestly, I mean, I feel really sad that you’ve had to go through that. And it’s sort of comforting to know that, like, even if you know all this stuff, it’s not necessarily going to be a perfect journey.

00:04:46.28
stacy
Right.

00:04:48.04
neelyquinn
um Can I ask how old you are now?

00:04:51.28
stacy
I just turned 51.

00:04:53.78
neelyquinn
Okay, so you’ve had some years to sort of try to figure it out and balance what’s going on as much as you can.

00:04:58.69
stacy
Yeah. Yeah.

00:05:01.20
neelyquinn
And can I ask the main things that you’ve discovered are really helpful for you?

00:05:05.95
stacy
ah Putting a precedence on sleep and also having that space away from people because I’m an introverted extrovert where I need my own time to be alone and have quietness.

00:05:08.56
neelyquinn
Yeah.

00:05:21.98
stacy
And I find that if I don’t have that, then things are, I i just can’t center myself, like I can’t focus, I can’t um have a creative of thought process or any of that. So I really need to have that quiet time and good sleep. If I have those two, then the rest of what happens in the day or the week with regards to like the training that I’m doing, or if there’s a disruption, like I’ve just gotten through 10 weeks of international travel and every day seemed to be something different.

00:05:51.07
stacy
As long as I could maintain those two specific things, then I was able to keep a handle on all the other things I had to keep doing.

00:05:59.36
neelyquinn
Okay, and when you say ah focus on so good sleep, what does good sleep mean to you?

00:06:07.30
stacy
um not Yeah, I should say quality sleep. so going Going to bed i tired, but not like mentally tired, it can be, but more of the whole like, yeah, I’m ready to shut down and go to sleep. And it takes some work to do that. Like, you know, with the good sleep hygiene things that we all talk about, no screens, two hours before bed, a cool room, end trying to sleep in a dark room, all of those things, you can do all of those things, but still get into bed and toss and turn.

00:06:41.87
stacy
So finding things like um how to activate parasympathetic response, maybe doing some simple stretches, or there was a new study that just came out and I’m like, hey, wait up in doing that, where you have small micro bits of exercise before you go to bed. So it could be a couple of planks, it could be a couple of stretches, just to like really open the body up to relax. So it does take a bit of time to figure out what’s gonna work for you to be able to get into that parasympathetic response. I also use adaptogens now. I used to not have to use anything, but now I have to use adaptogens in order to really relax to get to sleep.

00:07:21.95
neelyquinn
Yeah, I just read that. What is one of them? Is it Rodeola?

00:07:25.43
stacy
Mm-hmm, yeah, and Rodeo is interesting because it wakes some people up And then it calms other people down. So when I say I use rhodiola and L-theanine before bed and people try it and they’re like, what are you talking about? I’m completely awake. It’s like, well, maybe not do the rhodiola. Try the L-theanine and maybe Ashagandha because there’s different responses to the adaptogens depending on who you are and what you need.

00:07:49.50
neelyquinn
Interesting. Yeah. And okay, I have so many questions and I want to talk about sleep a lot, but I also want to touch on the ah the exercise change because I think that a lot of people that just heard you say that I love running.

00:08:05.89
neelyquinn
I love endurance sports. I mean, I have three very close friends who would say that and they’re also experiencing the fatigue and everything that you’re talking about. And I see that with my clients too, as a nutritionist.

00:08:15.23
stacy
Mm hmm.

00:08:18.35
neelyquinn
And so Can you talk a little bit about like how difficult, first of all, that was for you to change? What changed in your body that made you not able to do that at that level or intensity anymore?

00:08:30.97
stacy
Hmm hmm.

00:08:33.23
neelyquinn
And then like what you’re doing now?

00:08:37.41
stacy
Yeah, um I think the best way to describe the fatigue is a lot of times we use exercise to wake ourselves up and to feel better and get kind of like that endurance or that endorphin high. And I was finding that I wasn’t getting that. I was coming back feeling more tired and drained than I was invigorated. And if you’re doing like intervals or you’re doing a long slow distance, you have a different feeling about it, right? So if you’re doing intervals, like I worked really hard and you kind of have this Yeah, really I worked really hard, I feel good, but I feel tired, but it’s a physical tiredness.

00:09:12.51
stacy
I was never feeling that and again. I was just feeling just completely dead to the core and no matter how much recovery or sleep or anything, I just could not get rid of it.

00:09:24.10
neelyquinn
Hmm.

00:09:24.41
stacy
And when I started looking at it, it’s like, yep, and okay. This is a symptomology of hormone ratio shifting. And every system of the body is starting to respond differently to these different hormone ratios. So taking what I know and what I tell people is now we have to look for that external stress. So instead of going, I’m going to go for a three hour ride or I’m going to go for an hour and a half run, I would bring it back down and focus on strength because I was finding I was getting weaker and weaker. I couldn’t push power.

00:09:59.14
stacy
I was having a lot of soft tissue injuries, I was having knee problems, I was having hip problems, low back problems. And then body comp, I was like, whoa, I’m losing lean mass. I wasn’t putting more body fat on, but I was just losing weight.

00:10:12.55
neelyquinn
Hmm.

00:10:12.61
stacy
And I was like, I don’t want to because it’s lean mass and I’m losing. So taking that step back is like, okay, have to prioritize strength and range of motion, mobility work, really trying to keep the body together. And so I would do a precedence on strength and then I would follow it up with some intervals. So especially like traveling or winter time, it’s like, okay, I’ll go to the gym, I’ll do the strength stuff. And then I’ll do a couple of five minute hill things on the treadmill. So I’m getting a little bit of that,

00:10:46.29
stacy
high intensity work that makes people feel like they’ve done something, but it wasn’t enough to tip me over into getting that deep, deep seated fatigue.

00:10:55.14
neelyquinn
Mm hmm.

00:10:55.31
stacy
So just experimenting a bit, finding that yes, less volume, better intensity, better quality training. is how my body was responding to get out of that brain fog and fatigue without the help of other substances, which a lot of people don’t find. So when I’m now working with endurance athletes and I trust the process, you’re going to get stronger and fitter with less volume. And it’s counter to what most people or almost everyone thinks. If we have to think about coaching and preparing for a long distance event,

00:11:29.67
stacy
People are always, we need base, we need base, we need lots of volume in order to get you strong enough to be able to then do the intensity and finish the race. But when we look, women who were in their 40s onwards, we start relying more and more on our natural physiology without hormones. So that means that we know that women are already really fatigue resistant with regards to muscle contraction because of our more oxidative or slow twitch fibers.

00:11:55.91
stacy
we’re not so great at high intensity work because we start to lose those type twos a lot faster. And we see this, this decrement when we get older where we just can’t push those higher intensities because of this fatigue factor.

00:12:09.45
neelyquinn
Hmm.

00:12:10.11
stacy
So when we pull people back and working with endurance athletes, it’s like, okay, we’re going to focus on quality. And then every two weeks or so we’re going to dose you with a longer, really, really low RPE e session.

00:12:24.11
stacy
so that you can go out, get your soul food, and know that you’re gonna be able to make the distance. But during the weeks, we want to really focus on really good quality strength and really good polarized training, because that’s how we are going to allow our body to adapt now, without that debt and fatigue, recover better, which means we can sleep better, which fast-fords to better adaptations, better responses, and just overall,

00:12:54.17
stacy
feeling like ourselves again.

00:12:58.50
neelyquinn
Okay. All right. So what I’m hearing is one of the main reasons that you’re, you were feeling that fatigue is because your our muscle fibers change. And so you weren’t able to output that and it was exhausting your body. Is that kind of right?

00:13:15.45
stacy
Sort of the other aspect is when we look at cortisol and cortisol responses. When women get into perimenopause, we become more sympathetically driven. And so that’s that fight or flight response. And we’re always in that tired but wired state and we have a higher baseline of cortisol. So if we go and we keep doing the moderate intensity work where it’s too hard to be easy and too easy to be hard, we never let our bodies kind of settle into a lower baseline of cortisol.

00:13:42.16
stacy
So we never get out of that sympathetic drive. So that sympathetic drive is why women feel tired but wired all of the time.

00:13:50.01
neelyquinn
Mm hmm.

00:13:50.28
stacy
So if we can remove the stimulus of keeping that cortisol elevated and start doing a stimulus that’s going to over time drop baseline cortisol, kind of like your resting heart rate. When you start getting fitter, your resting heart rate drops. It’s the same concept. But in order to do that, you have to do that polarized intensity work. Because every time you do super high intensity, your body does produce more cortisol to be able to hit those high intensities. But the subsequent response afterwards is an upsurge of testosterone and growth hormone, which then

00:14:23.31
stacy
counters cortisol drops rapidly.

00:14:25.89
neelyquinn
Okay.

00:14:25.89
stacy
So when we start looking at the intensity versus duration, when we get into our forties, we have to think less duration, more intensity because of the cascade of hormone responses, not our sex hormones, but other hormone responses to allow our bodies to get out of that tired but wired state.

00:14:44.16
neelyquinn
And in contrast, if we were just doing like tons of miles, it is slow, not high intensity, what happens with cortisol there?

00:14:54.98
stacy
you never get a stimulus to change. So if you’re just doing zone two or really long, slow distance work, I see this because there’s a ah massive uprise of women in their forties plus who are doing ultra endurance events and they just get slower and their body composition changes for the worse, even though they’re not doing high intensity work, which doesn’t stimulate that, you know, the cortisol change.

00:15:09.92
neelyquinn
Mm hmm.

00:15:20.61
stacy
And they’re not necessarily doing that modern intensity that doesn’t cause any change because they’re continuously in this low, low intensity. They’re not able to change anything really because their body defaults to that long, slow stuff.

00:15:37.16
stacy
We’re naturally able to go long and slow if we want to create any kind of change to be able to produce more power, to have more strength, to change body composition, we have to polarize. We have to look at resistance training and high intensity work to create an adaptation response the way our hormones used to allow us to.

00:15:56.23
neelyquinn
So if you’re doing long, slow runs or bikes, bike rides, you won’t then later have that surge of testosterone that you were talking about.

00:16:07.19
stacy
No, you won’t.

00:16:09.24
neelyquinn
You’ll just be tired.

00:16:11.22
stacy
You’ll just be tired. Yeah.

00:16:14.88
neelyquinn
Yeah. And how does estrogen and progesterone play into all of this?

00:16:21.28
stacy
Estrogen is a is our or woman’s testosterone, so to speak, when we think about it being anabolic or building tissue. It’s also responsible for how fast we have muscle contractions and how strong those muscle contractions are. So when we start losing estrogen, we start losing our ability to be strong and powerful.

00:16:42.86
stacy
Progesterone counters estrogen and every system of the body likes this counter. We like to have estrogen and progesterone that are in ratios. It fluxes across the menstrual cycle, of course, but we always need to have an antagonist to the agonist. so Progesterone is responsible for things like fluid balance and heat tolerance. and Both estrogen and progesterone are responsible for strong bones and ah metabolic control or glucose control.

00:17:12.50
stacy
So you start having a misstep in these ratios of estrogen progesterone. We see things like losing our bone density. We see things like higher insulin resistance. We see an accumulation of that deep abdominal, the serial fat. So what we want to do is we want to counter that and we can use exercise intensities to counter that by creating an environment where the body adapts and responds the way these hormones used to allow us to respond. And I think this is what gets missing in that whole menopause conversation because most people we’re talking about menopause are coming from a clinical perspective or their OBs or their menopause doctors. And they’re just looking at hormones and saying, okay, well, you’re losing estrogen progesterone, we’re losing the ratio of these two, you’re accumulating the cereal fat, body composition isn’t

00:18:03.67
stacy
that Great. So yes, we’re going to do some resistance training, but also you need to think about menopause hormone therapy. They’re missing a whole series of really important connections within that when we talk about exercise. So when we talk about high intensity interval training, which is really polarizing, we can see that it creates an epigenetic response within the muscle to allow more of what we call our glute foregates or protein gates to open up and allow carbohydrate to come in without insulin.

00:18:33.55
stacy
So it is a response that your muscles will adapt to that will reduce insulin resistance. We also see that sprint interval training, which is at super top in 30 seconds or less, really, really hard as you can go type work. That also causes a response that is so intense that the liver no longer collects additional fat to create the cereal fat, but it gets a signal from our working muscles.

00:19:04.45
stacy
through what they call myokines or extra kinds that we have to use that fat we have to be able to pull it into the muscle we have to be able to allow the mitochondria to understand it and use it so now we no longer have extra circulating fat but it’s actually being brought in to be used at rest to conserve carbohydrate. So it’s really important that women understand that exercise is such a powerful tool if we are doing it correctly according to how our physiology has been changing through perimenopause and opposed menopause.

00:19:35.98
neelyquinn
Okay. Okay. I got it. But I, did and I didn’t hear you say the word estrogen really throughout there. It seems like we’re trying to do things that estrogen would have done for us.

00:19:47.92
stacy
Yeah.

00:19:48.38
neelyquinn
Is that right? Okay.

00:19:49.90
stacy
Yes, exactly.

00:19:51.20
neelyquinn
Got it.

00:19:51.42
stacy
Because the way that I like to explain the way estrogen works in the most simplistic ideas is we think about skeletal muscle, and skeletal muscle is how we’re strong. So if we’re climbing, we need to be strong, but not really bulky, right?

00:20:04.74
stacy
Because it’s a power to weight ratio. So when we’re thinking about estrogen, what estrogen does is it allows us to have really strong contractions because it is responsible for how myosin, one of our key contractile proteins, bonds to act in the other contractile protein.

00:20:22.87
stacy
And when it has a really strong bond, you’re strong without a lot of bulk.

00:20:27.18
neelyquinn
Hmm.

00:20:27.25
stacy
When we lose estrogen, we lose that stimulus. So what we need to do is we need to find an external stimulus to create more of a response of myosin from Really, it’s a nerve response to say, hey, you know what? We need you, Myosin, to really bond to act in tightly because we have this thing that’s happening and we need you to be really strongly bound to act in. So we do that through strength training. We do that through heavy lifting.

00:20:54.65
stacy
So if we’re looking at a central nervous system response of doing six or less reps at a relatively heavy load, it creates a nervous system response that stimulates myosin to bond to actin. It also stimulates the nerve to jump this gap junction that happens all the time just to depolarize and create a muscle contraction or stimulate that muscle contraction. And it also um tells the body we need to preserve our lean mass.

00:21:24.50
stacy
and or build some more. But it’s not about getting bulky, it’s about how strong is that muscle contraction going to be. And if we’re doing it through a nervous system response, then because we’ve lost estrogen, it doesn’t matter.

00:21:39.77
neelyquinn
What do you mean it doesn’t matter? Why doesn’t it matter?

00:21:41.22
stacy
because and Because now we’re using a central nervous system response.

00:21:44.22
neelyquinn
Oh, got it. Yeah. We’re like overriding our bodies.

00:21:47.63
stacy
Yeah, yeah.

00:21:48.19
neelyquinn
We’re like tricking the system.

00:21:49.86
stacy
yeah

00:21:50.59
neelyquinn
OK. So in terms of climbing specifically, I’m thinking about all the women listening to this where there’s bouldering and there’s sport climbing, route climbing.

00:22:03.26
neelyquinn
And it’s, i I would say that bouldering is like mostly anaerobic with some aerobic thrown in there. And then route climbing is more, they’re kind of both, both, but, um, what, how does this relate to climbing?

00:22:13.68
stacy
Yeah.

00:22:20.36
stacy
Yeah, um so I love bouldering, so I’ll put that out.

00:22:23.42
neelyquinn
Nice.

00:22:24.15
stacy
Yeah, I love it. It’s great. I used to do that. I started in Dunedin when I was doing my PhD because there’s a ah bouldering community out on the cliffs by the beach, so it would be a place to go to get that quiet too that I told you about.

00:22:38.16
neelyquinn
many Cool.

00:22:39.62
stacy
So, um and then we train some speed climbers here because we’re sitting right at the place where all the New Zealand speed climbers come to train. So work with them as well. So we’re talking about the aerobic versus anaerobic. One of the other things that happens as we get into perimenopause is because we start putting on more of that central adiposity or more body fat in our middles, our center of gravity starts to change a bit.

00:23:05.69
stacy
So women’s center of gravity ah is lower than men’s to begin with. It’s more in our hips. We start to have a shift of that center of gravity and we start putting more weight on in our bellies. So it’s important that we have to learn how to lose that if we want to keep climbing well, because we know it’s all about the balance, right? It’s not just aerobic and aerobic strength, but it’s about how we’re balanced on the wall or you know where our center of gravity is so that we can push off and have that strength to push off and know that we’re not going to you know suddenly have misconception, proprioception, and fall. So when we’re looking at these changes that are occurring,

00:23:42.52
stacy
Yes, I talk about strength and being strong, but it’s also really important to look at our gut microbiome because we’re having a ah significant change in the diversity of our gut microbiome from mid to late perimenopause. And I bring that up because when we’re looking at why that is important, if we have a low diversity in our gut bugs, then we have less of a chance of changing our body composition And we have more of ah a predisposition to keeping on body fat because of the types of gut bugs that are in there. We lose diversity because there’s a ah section of gut bugs that work with our sex hormones. So when we release our estrogen and our progesterone, goes through the circulation, it’s called a second pass where it goes to the liver or they go to the liver and they get bound up by sex hormone binding globulin.

00:24:40.19
stacy
And then that compound gets shot into the intestines via bile and our gut bugs decongigated or unbind it and shoot them back out in circulation. So when we start losing our sex hormones, we start losing those gut bugs. And unfortunately what happens, we have an overgrowth of the gut bugs that cause more of an obesogenic response.

00:25:04.89
stacy
And that is because we’re sympathetically driven. We have this tired but wired elevated cortisol. Our system is really you know really turned on and that is that flight or fight mode.

00:25:16.93
stacy
And so what happens is you develop more of the gut bugs that want you to eat more simple carbohydrates as fuel to get out of there.

00:25:25.86
neelyquinn
Mm hmm.

00:25:26.14
stacy
So you see the significant change in our gut microbiome. If we are aware of that, then we can put steps into place to eat more fibrous fruit and veg, to feed the deep gut bacteria, to maintain those gut bugs that ordinarily die off because of our our lack of sex hormones, but also feed the gut bacteria that’s gonna kill off more of those obesogenic bugs so that we end up with not this massive amount of stimulus, a sympathetic drive, and

00:25:58.94
stacy
predisposition to putting on body fat.

00:26:00.78
neelyquinn
Hmm. Okay. So more fruits and veg through in fiber in that so that we feed the good bugs and keep them there.

00:26:06.41
stacy
Yeah. Yeah. Yeah.

00:26:10.46
neelyquinn
Um, and that helps us keep our body composition.

00:26:15.08
stacy
Yes.

00:26:16.04
neelyquinn
Okay.

00:26:16.67
stacy
Yes. And so that’s a really essential part. Also helps with mood and serotonin production and all the other things that we know the gut helps with. So that’s, that goes in conjunction with the type of strength training we’re doing. So if we think about resistance training, I know a lot of climbers will do some basic resistance training in the off season and they’ll be looking at doing higher reps because they think they need to have higher reps for, for greater endurance to be able to hold longer on the holds and be able to get up and stay on the wall for a longer period of time.

00:26:52.99
stacy
But that’s not beneficial at this point in time, again, because we think about central nervous system and how strong those contractions are. Because we already are very enduring. We need to work on the other side of things. We need to work on strong contraction. We need to work on the anaerobic capacity. So this is where we start to change up the type of programming that we’re doing off the wall or off the boulder.

00:27:15.19
stacy
So we’re looking at, okay, three times a week. We’re doing a couple of maybe four to six exercises each session. We’re doing heavy weights. We’re working on technique. We’re really working unilaterally. So one side at a time so that we’re getting that even strength and even distribution. And that becomes the base.

00:27:35.86
stacy
And then we can think about what do we need to do to improve our anaerobic capacity. We can look at doing plyometrics. We can look at doing sprint intervals. Our sprint intervals can even be some speed climbing. So there’s all sorts of ways that we can manipulate the energy systems based on what we’re doing in the climbing world.

00:27:55.29
neelyquinn
Okay. All right. So it kind of sounds like what a lot of coaches are telling people to do really is strength train and o learn better skills on the wall and don’t do it too often.

00:28:14.68
neelyquinn
Like rest and recover in between sections.

00:28:16.25
stacy
yeah Yep. And the strength training programming is what differentiates just the general conversation to what’s specific to perimenopausal women. So if we’re looking at general strength training and a lot of times you’re seeing four by eight or four by 10 reps of something specific.

00:28:37.16
stacy
We need to change it up and go five by five at 80% or more one rep max, or maybe three, three by five at 90%. So it says heavy, heavy loads. And because it takes time to actually develop the skill to lift those heavy loads, when we start off, we go by reps and reserve or sessional RPE.

00:28:59.17
stacy
So reps and reserve, if I want you to do five by five with two reps and reserve, that means that your first set of five, you can complete those five really well with the ability to do two more at that same load with perfect form. And that’s the weight that you want to hold for all of those five by fives. Because then that’s a pretty good indication that you’re around 80 to 83% of your one rep max.

00:29:27.87
stacy
And it’s easier for some to comprehend that than trying to program based on a one rep max.

00:29:33.47
neelyquinn
Yeah. Mm hmm. That makes sense. And when you say I think you’ve said four or five exercises, are there specific ones that you recommend to generally all perimenopausal or menopausal women?

00:29:47.72
stacy
Really working on lower body and posterior chain. So if we’re looking at, squat composition, Bulgarian split squats, deadlifts, hip thrusts, um a lot of core work. ah One of the things that I’ve really started implementing recently is doing things like sit-ups or V-ups with overhead dumbbell walking lunges because then you have to fatigue the core but then you still have to have that upright tightness to hold the arm overhead which is really good for climbing if you’re thinking about core and reach and being able to hang on so you have to have that core integrity so it’s those kinds of things you want to think about like how are we going to get the core and the lower body really strong because our upper body proportionally doesn’t lose strength as fast as our lower body

00:30:36.12
neelyquinn
Hmm.

00:30:36.47
stacy
Because proportionally, women are stronger lower body than upper body, same with men. But from a fast-twitch fiber aspect and the ability to hold on to strength, we find women lose that strength lower body a lot faster than upper body.

00:30:49.87
neelyquinn
Well, and it seems like as we get older, the risk of um like bone fractures and having all all that happen is it requires us to do strength training on our bottom half.

00:31:00.45
stacy
Yes.

00:31:04.14
stacy
Yes. And we see that women who aren’t paying attention will lose up to one third of their bone mass in that five-year perimenopause menopause transition.

00:31:14.31
neelyquinn
Whoa.

00:31:14.79
stacy
So it’s really, really important to implement that strength training. And if we can implement some jumping, that’s great too. Because jumping is multidirectional stress that goes through the whole skeletal system to be able to stimulate bone turnover and bone strength.

00:31:31.48
stacy
Because again, as we lose estrogen progesterone, we lose an impetus for that bone turnover and bone strength.

00:31:39.49
neelyquinn
Yeah. And just a quick plug for strength training for bone loss. My mother-in-law has had some great success with lifting heavy.

00:31:49.74
neelyquinn
She’s 70 years old and up doing her heavy deadlifts and her heavy squats. And she, her doctors like keep doing what you’re doing.

00:31:57.47
stacy
Yeah.

00:31:58.20
neelyquinn
It it didn’t reverse it, but it did stop it. So yeah.

00:32:01.15
stacy
Yeah. yep we see the same i have a ah good colleague and friend who works specifically with older women who have bone issues.

00:32:12.70
stacy
And over the course of a six month training period in his program, most women will go from osteopenic to normal bone density because he implements heavy lifts and specific jump training.

00:32:21.44
neelyquinn
wow

00:32:25.66
stacy
And so, you know, you get the stronger bones, but then you also are stronger overall, which is what women are, especially older women are looking for.

00:32:26.81
neelyquinn
Wow.

00:32:34.89
stacy
so that they can live independently and not fear falling and breaking something and, you know, all the cascade events that comes with that.

00:32:43.28
neelyquinn
Yeah, yeah, that’s great. How inspiring for women who have osteopenia. Okay, I’m thinking of some certain friends of mine who are climbers and they’re they’re in their late 40s or early 50s females and they have been struggling with fatigue, lack lack or loss of strength.

00:33:07.49
neelyquinn
um mood issues, headaches, things like this. And I can see them listening to this so far and being like, this is all really interesting, which it is.

00:33:18.39
neelyquinn
And also what exactly do I do to feel better? So what would you say to that?

00:33:22.54
stacy
Yeah. I pick one thing at a time where I look at there’s the four big areas that we talk about. We talk about the mind, we talk about the sleep, we talk about the physical and we talk about the nutrition. And I always tell people pick the one that you want to work on the most first.

00:33:44.01
stacy
So I always tell people as much as you don’t really want to realize that it is sleep because you can’t change body composition or anything without really good sleep.

00:33:53.46
neelyquinn
Yeah.

00:33:53.88
stacy
So for three weeks, we’re focusing on our sleep hygiene. We’re implementing some adaptogens. If you’re really, really having severe menopausal symptoms, you might talk to a endocrinologist about using menopause hormone therapy because that also helps sleep.

00:34:10.74
stacy
So looking at all of the tools on the table, to really get that good sleep habit going. Once we get the good sleep, meaning quality sleep and waking up feeling like you’ve had sleep instead of waking up feeling like I could stay in bed all day, then we look at the next thing. And that could be you want to change your training.

00:34:32.13
stacy
So what do I do in my training? Let’s look at mobility, how you’re moving, where are your weak points. So we take two to three weeks to really focus in on what are our weak points and what do we need to to work on.

00:34:45.67
stacy
And you could hire a personal trainer or work with a physical therapist, one or two sessions.

00:34:47.64
neelyquinn
Mm hmm.

00:34:51.10
stacy
and build a program or you could look at something like Empower or Hayley Happens Fitness or some of the other that programs that are specific to menopausal or perimenopausal women who are already active and you can build the the strength program based on that. But it’s really three times a week of focused strength training.

00:35:12.23
stacy
After three weeks of that, then we can start looking at what are we doing to compliment our are climbing, our climbing abilities. Then we are adding in skill and high intensity work. Then we can go on to nutrition. I know people are like, you’re putting nutrition last. I’m like, yeah, because that’s the hardest thing to change.

00:35:30.52
stacy
If we’re looking at getting good sleep, then we start moving well. Those two things complement each other, and then we can start focusing on nutrition because that becomes the hardest thing that people grapple with to change. so Then we start looking at nutrient timing, getting adequate protein, taking care of the gut, and that takes a significant amount of time. It could take up to six months to really good good habits in there.

00:35:55.69
neelyquinn
her.

00:35:55.79
stacy
But understanding the 80-20 rule, like 80% of the time you’re really dialed in and then 20% is life. Like if you’re traveling or your kids are sick or you’re on holiday, let the guilt go, just enjoy life. And that takes a lot of time and understanding, especially in our mentality where we grew up with everything has to be perfect and the snack wells and all that kind of stuff. It’s like, just live life, have that 20% be in on it.

00:36:26.36
stacy
So then we start seeing that change. And like I said, it could take six months of the nutrition point. So if you take the sleep and the physical and the nutrition, it could be a year. So we have to think about it as not a short time block of training, but what we’re doing to implement change for longevity, because what we’re doing now.

00:36:45.11
neelyquinn
Mm hmm.

00:36:47.40
stacy
when we feel like crap. We want to change that, yes. But we want to change it with the eye of how are we going to move and feel fantastic when we’re 70, when we’re 80, when we’re 90. Because we’re active and we love it and we want to maintain our bodies to be able to do that.

00:37:02.01
neelyquinn
Yeah okay that’s a great answer and great a great starting point and I’d love to dig in a little bit deeper on the second one with the training.

00:37:10.59
stacy
Yeah.

00:37:12.25
neelyquinn
So a lot of these people who I’m thinking about are they’re climbers like I said but This is very common in the climbing world where people will be like, all right, I’m going to climb outside two days a week and they’re out there all day and they climb a bunch and at their limit.

00:37:31.61
neelyquinn
So it’s really hard and and whether that’s roots or boulders.

00:37:33.30
stacy
yeah

00:37:34.72
neelyquinn
And and then then they train also and doing weights and then they are runners as well.

00:37:43.65
stacy
yeah

00:37:44.84
neelyquinn
And so what I see is very clear, like they’re doing too much, so but I want them to hear from you.

00:37:52.02
stacy
Absolutely.

00:37:53.04
neelyquinn
Oh, some guidelines, I guess.

00:37:53.27
stacy
I was like, wait, this sounds like two or three of the case studies I’ve written up recently.

00:37:58.20
neelyquinn
Yeah.

00:37:58.57
stacy
Um, where like Tuesday, Thursday are the outside days and maybe one of the weekend. And so they’ll go drive somewhere to climb all day on Tuesday. And then they’ll come back and feel like, oh, well, I so probably should try to fit in some strength training.

00:38:13.54
stacy
So they’ll try to fit in some strength training at the end of one of those days. And then on the weekend, one of the days, again, is going out for a really long climb. And then the next day is a really long run.

00:38:23.82
stacy
It’s like, hold up, right?

00:38:24.13
neelyquinn
Yes. Yes.

00:38:26.07
stacy
Yeah, that’s the basic pattern, right?

00:38:28.20
neelyquinn
Yeah.

00:38:28.25
stacy
It’s like, okay, hold up. Now we have to focus. Okay. If we are going to do strength training, we’re going to go Monday, Wednesday, Friday, really good strength where we have a program, we’re set with it. It’s 30 to 45 minutes of of really good work. Then on Tuesdays and Thursdays, when you’re going to go do your long days outside, you better make sure you have adequate fuel with you.

00:38:53.77
stacy
and you’re resting appropriately. So I know people get hung up and they hear this really hard root and I’m trying to get this one part of the root done. And so they’ll keep trying and trying and trying and trying and they exhaust themselves. It’s like, wait, pull back a bit. And it’s the same thing as I tell ah you know all the my daughter and her friends, it’s like, you will succeed when you have that recovery.

00:39:16.59
stacy
and people don’t often think that way. They’re like, I’m out here, I gotta get it done. So you want to fuel well, take those breaks so that your body can recover from a central nervous system standpoint so that you have the ability to create that pattern to make that part of the root that you are missing or to get around that overhang that you want to and you keep falling off.

00:39:37.85
stacy
And I don’t think people really realize they need fuel to do that. They don’t fuel appropriately. And it’s even having stuff in the car. So on the way home, you are refueling. And then when you get home, it’s not about doing strength training. It’s about the recovery. And then if you want to run, we have to think about what’s the priority here, right? So are you looking to climb for competition? Are you looking for climb for soul food?

00:40:05.96
stacy
If you’re looking for a competition, then we had to focus on that. But if we’re looking for soul food, maybe we go outdoors twice a week for climbing and then we add in a couple of um tempo runs and not a long run on the weekend. So if we’re doing tempo, that means you’re doing proper intervals. You’re going to get more fitness out of that shorter period of time.

00:40:27.96
stacy
And this is regardless of how old you are, but it really works for peripose menopausal women. So that could be, you know, Monday, Wednesday, Friday, you’re lifting in the morning and maybe Monday evening, you’re doing a 20 minute tempo run. And then Friday afternoon, you’re doing another 20 to 30 minute tempo run. And then you’re doing another outdoor day on Saturday or Sunday. And whatever day you’re not doing outdoors, then you’re recovering and resting.

00:40:58.57
neelyquinn
Okay, so you’re saying there’re there’s one rest day a week.

00:41:03.50
stacy
At least we look at it as if you’re doing something Monday morning, you don’t necessarily have to do something Monday night. I’m saying that if you want to try to fit in a run, you can, but ideally it’d be Monday morning and then the next thing would be Tuesday. And the next thing would be Wednesday morning and then Thursday. So you’re getting a ah period of recovery all through Monday afternoon, Wednesday afternoon. So we’re looking at time of recovery.

00:41:30.08
neelyquinn
Hmm. Yeah. I mean, what I’m hearing you say is what I’m seeing, honestly, burning people out.

00:41:37.75
stacy
Yeah.

00:41:38.83
neelyquinn
No, I mean, like what you’re suggesting is it’s too much for a lot of people.

00:41:41.61
stacy
It’s burning people out.

00:41:45.75
neelyquinn
That’s what they’re doing. And that’s what I’m, I’m questioning is if it’s too much.

00:41:52.62
stacy
If someone’s being burnt out for sure, like this is what I mean, if we’re looking at what is their focus, for me an ideal scenario would be Monday, Wednesday, really good total body strength days.

00:42:06.52
stacy
Thursday’s outdoor climbing. Tuesday is off. Friday is off. Saturday would be outdoor climbing. And then Sunday would be active recovery. But people who want to run, they’re like, well, where do I fit the run in? They’ll try to fit it in on one of the off days.

00:42:24.06
stacy
And that’s not ideal.

00:42:25.79
neelyquinn
Mm hmm.

00:42:25.66
stacy
So this is where you really have to sit down with the individual and say, what is your focus? What is your goal? What do you want to do over the next three months? Let’s plan in the next three months out and want to have at least 36 hours recovery from session to session.

00:42:38.13
stacy
So how do we fit that into your week? So is that having a full day off? Is it doing one morning session and then an evening session the next day, and then having a full day off? So you have to manipulate the hours in the week to fit the sessions in, and they have to be quality sessions. So when you’re looking at the generalization, it’s like from a generalized standpoint, you would have two really good quality lifting sessions. You’d have two climbing days. You’d have one active recovery day.

00:43:09.71
stacy
And then you would have the other days is off.

00:43:12.69
neelyquinn
and What’s an active of recovery day?

00:43:15.33
stacy
Maybe going for a hike, and if you get to a hill, you’re really slowing down. You don’t want your rating and perceived exertion to be above a four on a scale of one to 10. Or it could be mobility. It could be playing with the kids. So you’re not just doing nothing. You’re moving your body, but you’re not being specific with intensity. You’re not being specific with duration. You’re just moving.

00:43:37.57
neelyquinn
Mm-hmm. And I’m assuming it’s always dependent on the person. And like you said, if it is burning somebody out, then we look at changing things and doing less.

00:43:48.82
neelyquinn
And if it’s not, then it’s okay.

00:43:49.05
stacy
yeah

00:43:51.80
stacy
Yeah, and then we still want to look at what they’re doing so they don’t lead down the path of maladaptation or no adaptation and or getting burnt out.

00:43:52.00
neelyquinn
So obviously, yeah.

00:44:00.11
neelyquinn
Mm-hmm.

00:44:04.16
neelyquinn
Yeah, that makes sense. OK, can we talk about nutrition a little bit?

00:44:09.97
stacy
Sure.

00:44:10.84
neelyquinn
Okay. Cause one of the things that I love about your work is that you a advocate that women, especially at this age, do not intermittent fast and be that they get enough carbs and that carbs are good for them because as a nutritionist, and I’m sure you see this all the time too, people come in and they’re like, carbs are bad. I do not eat them. I’m not allowed to eat them. I feel guilty for eating them and I shouldn’t eat them. And they’re going to make me fat. So can you talk a little about that?

00:44:38.92
stacy
Sure. ah So when you think about carbs, i think the I think the misconception around carbohydrates all stems from the 80s of the low fat, high carb days, right? And we saw the uproar where people are starting to develop things like the snack wells and the low fat pop tarts and the fig newtons, and it was all high sugar. So when people started putting weight on, people started blaming the obesity epidemic on the high carbohydrate intake.

00:45:07.64
stacy
But when we disseminate it down, it’s not the high carbohydrate intake, it’s the refined food and the high sugar intake that was responsible for a lot of the misstep in body composition that we started to see. So when we bring it down to women need carbs, because from an endocrine point of view, we’re more sensitive to nutrient density and we need more carbohydrate to have a robust endocrine system,

00:45:34.70
stacy
as well as our ability to fight off disease, as well as our ability to just be able to live life. So we talk about carbohydrate. I’m not talking about like I was just in the States and going into the grocery store, I was like, oh my gosh, this is a huge building full of supposed food, but there’s nothing to eat because it’s like so much packaged stuff. And then things are branded with net carbs where net carbs isn’t a real thing. It’s something that came from the keto diet and got put on as a marketing brand.

00:46:09.35
stacy
But people are confused about it. is They’re like, okay, net carbs, low net carbs, I should eat that. But no, because it’s ultra processed. So when we’re talking about carbohydrates, we’re looking at the old fashioned shop, the perimeter, eating lots of fruit and veg, whole grains. Don’t be afraid of sourdough and sprouted grain bread. Those things are really good for your gut. Like we want to take care of our gut microbiome.

00:46:30.23
stacy
And our gut microbiome needs carbohydrate. We need the fiber from the fruit and veg. We need the fiber from the sprouted grains and the whole grains. We need that to keep our gut microbiome. And we need that for muscle function. We need it for endocrine function. We need it for brain health. So people start to really be afraid of no you know, eating carbs because of the refined idea. But we have to reteach them what carbohydrate means. And when we start telling people what carbohydrate means, women are like, oh, you mean I can eat those grapes? It’s not just pure sugar. It’s like you have so many great nutrients in grapes. Yes, eat them. And they’re like, oh, OK. And they start to feel better. Right. So we’re taking all the supplements out. We’re taking the ultra refined stuff out. We’re putting real food in.

00:47:19.55
stacy
And now all of a sudden women have energy and like, I feel great. This is great.

00:47:24.12
neelyquinn
Yeah.

00:47:24.07
stacy
So yes, carbohydrates, so important, but it’s a kind of carbohydrate that we have to emphasize. We want to go back to like the real food aspect, not grabbing the energy bars and the, I think there were protein fortified pop tarts and stuff like that.

00:47:39.37
stacy
It’s like, no, it goes away.

00:47:39.79
neelyquinn
Oh, no.

00:47:40.63
stacy
yeah

00:47:41.57
neelyquinn
Okay. So do you have any guidelines on what percentage of carbs a person should have as a baseline or grams or what do you use?

00:47:54.02
stacy
I look on what their sport is and what their lifestyle is. So someone who’s running around crazy all the time and focusing on endurance, 40 to 50% of their diet should be from um complex carbs. If we’re looking at someone who’s a little bit more sedentary and is more power focused, then we’re dropping it down to about that 40%.

00:48:19.09
stacy
Um, and then putting that precedence on the protein because we become more anabolically resistant to both exercise and protein as we get older. So we really need to put that emphasis on protein.

00:48:30.17
neelyquinn
h Yeah. And can you talk about protein guidelines for people?

00:48:36.02
stacy
Uh, yeah, so we talk about it. I really try to have people visualize that palm size portion is about 20, 25 grams of protein.

00:48:48.15
stacy
we’re thinking about chicken breasts or lean meat or something like that. And women by the nature of being 40 plus need around 40 grams per meal. And I’m not saying you have to get all animal products. I’m not saying two chicken breasts. I’m saying you could have palm size of animal product or tempeh or tofu, getting that big hit. But then you’re thinking about ednami and peas and nuts and seeds and whole grains that all add up into protein.

00:49:15.89
stacy
So you’re getting around that 40 grams per meal. And then we say 15-ish per snack. So that could be some cheese and crackers, could be some nuts, it could be yogurt, cottage cheese, anything that has protein in it. And if you’re really, really pressed for time, then yes, using a protein powder is is fine because you’re supplementing and that’s what it is. And we just don’t want to reliance on protein powder all the time for every meal.

00:49:44.48
stacy
and

00:49:44.80
neelyquinn
Right.

00:49:45.52
stacy
It’s you can get that kind of protein from real food. But you can also feel free to supplement with a protein powder.

00:49:53.21
neelyquinn
Yeah. So what I just calculated was around 135 grams a day.

00:49:59.41
stacy
Yep, yep.

00:49:59.98
neelyquinn
Yeah.

00:50:00.82
stacy
We say around a gram per pound, that two per kilo.

00:50:03.37
neelyquinn
Yeah.

00:50:07.25
neelyquinn
yeah

00:50:08.05
stacy
Yeah.

00:50:09.49
neelyquinn
That’s very much along the lines of what I’m recommending to people. And one of the things that I’m constantly explaining is that women, as we get older, we’re less tolerant to carbohydrates, though.

00:50:24.34
neelyquinn
And so it has that the ratio seems to need to change in order to keep our are ah lean mass and to not gain weight.

00:50:33.62
stacy
Yeah, yeah, and that’s where it comes to the type of carbohydrate because we are a bit more insulin resistant. And we’ll see this also with caffeine use because we have a little misstep in our and blood sugar control. So people who used to be able to have caffeine and not be affected and they’ll have like a couple of shots before training, espresso before training, then all of a sudden they’re like, whoa, I feel really lightheaded and over anxious from the caffeine use.

00:51:01.88
stacy
It’s because caffeine clears blood sugar out really quickly. If we’re already having a misstep in our blood sugar control, then adding caffeine can cause these issues. So we want to think about what kinds of carbohydrates are we having to maintain blood sugar control. So the those carbohydrates have fiber because nature is really super smart where it wraps things with, ah you know, high glycemic index things with pectin, like grapes have pectin in it. So you don’t have as big of a blood sugar rush as if you were just have grape juice, right? So that’s where the type of carbohydrate comes into play. And of course protein does help counter

00:51:37.87
stacy
some of those blood sugar swings that you get with less complex carbs.

00:51:43.41
neelyquinn
So can you give me an example of a meal that you might even eat for dinner?

00:51:51.32
stacy
Yeah, so um my dinner usually at night is a big plate of mixed greens. And then I will have some cauliflower rice that’s sauteed um with some tempeh and some garbanzo beans.

00:52:07.51
stacy
And then I’ll put that on top of all the mixed greens, and then I’ll top it with some blueberries, some apple, some cottage cheese, some tahini, some pumpkin seeds, and ednami. And that’s pretty much some kind of version of what I have every night.

00:52:23.78
neelyquinn
So with the cauliflower rice, it’s pretty low carb. It’s not like you’re having starchy anything.

00:52:31.60
stacy
Right. Right. But the and the components of the car but are of the cauliflower, when we’re thinking about um some of the smaller, I guess, active components of it, it helps with estrogen metabolism. And it also helps fill you up.

00:52:50.67
stacy
even though it’s low carb, it still helps with that fiber, it helps with the bulk. Yeah, so I like it for that reason. And yeah, and other people are like, eh, cauliflower rice, that’s not so great.

00:53:03.91
stacy
It’s like, okay, well, you can have

00:53:04.38
neelyquinn
Oh. i

00:53:06.21
stacy
Quinoa and often I’ll do and bulgur wheat mixed with black rice so we know that you’re having and some of the bulgur wheat buck or bulgur wheat and black rice together Which bulks out more than if you’re just have the rice Yeah,

00:53:24.39
neelyquinn
Yeah. So some of your meals are going to have some starchy grains and some of them are going to be more veg based. Yeah.

00:53:30.77
stacy
yeah

00:53:31.64
neelyquinn
Got it. And can we talk about intermittent fasting?

00:53:36.17
stacy
Of course.

00:53:36.96
neelyquinn
Okay, so a lot of people come to me, intermittent fasting, they’re not having breakfast until 11, 12, and they feel very tired.

00:53:46.47
stacy
hey

00:53:46.77
neelyquinn
And so then I have to have a talk with them. So tell me the science about this.

00:53:52.79
stacy
yeah So when we think about all the um information that’s out there about intermittent fasting, it’s primarily based on clinical populations. ah Initially on obese men who needed to lose weight rapidly for surgery. And of course, if you’re intermittent fasting or holding along fast, then you’re going to rapidly lose weight. We look at female data, all the stuff we hear about with parasympathetic ah improvement and autophagy and better blood glucose control doesn’t happen for women. When we see what does happen is

00:54:30.92
stacy
It’s such a strong stress on the body that it increases that sympathetic drive. It increases that autonomic sympathetic nervous system response and our cortisol stays up. So when we wake up a half an hour after we wake up, we have a cortisol peak. If we don’t eat that peak is held and your body’s like, Oh, that’s a minute baseline.

00:54:51.15
stacy
So for women, if we are already in that sympathetic drive and we’re trying to drop cortisol, doing intermittent fasting or holding a fast till 11 or 12 is counterproductive for increasing parasympathetic responses and being able to have that cortisol under control. But the other thing is when we are holding a fast like that and trying to do our training,

00:55:13.17
stacy
or we’re trying to get through the morning of work, we’re creating a feedback to the hypothalamus that we’re under duress. So we start to see a downturn of our resting metabolic rate. We start to see a dysfunction in our thyroid because women are more sensitive to low nutrient density than men.

00:55:33.71
stacy
So I like to use the example of calories per kilogram of fat-free mass before we start to see endocrine dysfunction. For women, it’s around 30 calories per kilogram of fat-free mass, and we start to see endocrine dysfunction around that mark. For men, it’s 15.

00:55:51.53
stacy
So it has to do with the hypothalamus and how sensitive kispepton neurons are to our our nutrient density. And because women have a more robust endocrine system, we have two areas of sensitivity of kispepton neurons, so where men only have one. So if we’re trying to do stuff without food, we’re perturbing those areas in our hypothalamus, which then feeds forward to first, let’s break down lean mass. Two, let’s downturn our thyroid.

00:56:20.72
stacy
and let’s downturn our resting metabolic rate because we don’t know when we’re going to get food and we still have an entire body to take care of. We look at population research as well in both men and women. When they’re looking at people who hold a fast until noon or after, and then they’re eating windows from 12 to 7 or 8 p.m., they’re outcomes are more obesogenic than those who break their fast at eight and then stop eating at six.

00:56:49.84
neelyquinn
Mm hmm. Hmm.

00:56:51.95
stacy
And we look at the rationale and the reasoning behind it is our circadian rhythms and chronobiology. So if we’re working with our hormones and the way that our body works, we know that our circadian rhythms are often set not only from daylight and nighttime, but also times of the day when we eat.

00:57:10.52
stacy
So if we’re not eating until 12, our body thinks we should still be sleeping. So it’s very confused.

00:57:15.95
neelyquinn
Hmm.

00:57:16.00
stacy
It’s like, ah okay, I’m awake, but I i shouldn’t be because I haven’t had any food to get through this. So it starts to have those breakdown effects and elevated cortisol.

00:57:26.84
stacy
And we see all of these compounding effects. in both men and women. And so when you start adding exercise into that, it further compounds the effects because exercise in itself is a fasting state because you’re using a lot of energy, you’re breaking things down.

00:57:43.00
stacy
So it’s just an extra stress on the body that you don’t really need to have.

00:57:47.84
neelyquinn
Right. And it increases cortisol as well.

00:57:50.36
stacy
Absolutely.

00:57:51.33
neelyquinn
Yeah. And then what’s the, how does this relate with menopausal or perimenopausal women?

00:58:01.77
stacy
So if we’re looking at peri and post-menopausal women, we’re having such a significant change on our autonomic nervous system. We’re sympathetically driven, and then we see that in the late stages of peri-menopause and to the early stages of post-menopause, women’s heart rate variability is decreased. So that is technically a sign of high stress.

00:58:25.44
stacy
So if we’re looking at doing intermittent fasting, again, we’re increasing the stress on the body, which is something we don’t need to do. And when we hear about calories in, calories out, and the best way to do it is to do an intermittent fast to help with body composition, it’s not true. When we think about how do we lose weight and change our body composition when we are peri-post-menopause, it’s you want to eat during the day.

00:58:50.29
stacy
and then don’t eat two hours or three hours before bed. And if you need to think about doing a calorie reduction, then you have a about 150 calories away from the evening meal.

00:59:02.28
stacy
So for a lot of people, it’s don’t have a glass of wine, maybe cut back ah on you on the size of your serving plate, so it’s just a little bit smaller.

00:59:04.13
neelyquinn
Mm hmm.

00:59:10.28
stacy
It’s not hard to eliminate 150 calories. One, that feeds forward to better sleep, and two, that feeds forward to a reduction in calories but not drastic enough to cause signaling to the hypothalamus that we need to conserve things.

00:59:24.83
neelyquinn
Right. Yeah. To hold onto fat instead of losing it.

00:59:27.51
stacy
Mm-hmm.

00:59:28.85
neelyquinn
Yeah. So then I’m assuming that what you recommend is that people eat regularly throughout the day.

00:59:34.28
stacy
Yeah.

00:59:35.21
neelyquinn
Yeah.

00:59:35.45
stacy
Yeah, the fancy word for regular eating, they say, is time restricted eating, where you eat within a half an hour waking up, you have dinner and that you don’t have anything else.

00:59:45.80
neelyquinn
Okay.

00:59:46.55
stacy
Well, regular meals throughout the day, but your eating window is in the day.

00:59:48.32
neelyquinn
Right.

00:59:51.61
neelyquinn
Oh, this is another question that I get a lot. It’s about, well, what should I eat before exercise, during exercise and after exercise? And I’d love your thoughts on that.

01:00:01.96
stacy
Yeah, so Abby Smith Ryan out of UNC, she’s done a lot of work on this, especially in the Perium Post-Menopause space, and found that if you are going to do more cardiovascularly intensive exercise, then you want 30 grams of carbohydrate with 15 grams of protein before exercise.

01:00:19.31
stacy
So what does that look like? That’s like one single serving of Sigi’s vanilla yogurt.

01:00:26.10
neelyquinn
Mm hmm.

01:00:27.18
stacy
So it’s not a lot, right? So you’re getting some carbs, you’re getting protein, boom, go do your training. After training, you want to get around 40 grams of protein. And so that’s a big, when people are thinking about what’s 40 grams, it seems like a big whack and a little bit of carbohydrate, or you can think about it as having your breakfast right after training and then feed forward from that. If your training session is going to be more than an hour and a half, then you have to think about taking some food with you.

01:00:57.67
stacy
So if you’re doing a long climbing session in the gym, maybe you’re having hydration drink, ah which you know is really simple. It could be water with a little bit of salt in it, like sixteenth of a teaspoon. So it’s absorbed. And then having some figs or having a banana or some amino acids that are put in your drink bottle with some ah like com our carbohydrate rich ah food component.

01:01:27.48
stacy
and then having your breakfast afterwards. So you want to think about maintaining your blood sugar while you are training. And so that is where some carbohydrate comes into play.

01:01:36.72
neelyquinn
Okay. Yeah. And that’s another great topic is when people exercise in the morning, it’s hard for them to eat something beforehand. And and so what do you recommend?

01:01:50.51
stacy
um It depends on what time they get up, but there’s a couple of options out there. Because if we’re focused on bringing blood sugar up and stimulating the brain to say, yeah, there’s some nutrition coming in, it’s fine, we can do this and not have ah an incredible sympathetic increase and that kind of stuff. For people who absolutely can’t eat, and they’re like, ugh, I get up at five, I get to the gym by 5.30 or six, do my training session, come home, and then I have to get the kids out the door, I have to get to work, you know, it’s really busy.

01:02:20.95
stacy
I don’t feel like eating first thing in the morning. It’s too much. You can do the infamous protein coffee where you have a cold brew, a scoop of protein powder, which is around that 15 grams of protein, which is two tablespoons of protein powder and some sweetened um almond or just oat milk. So you have some carb and a little bit of caffeine and that’s enough to get you through the training. Then you come home and you have breakfast with your kids or you have overnight oats in the fridge that you’re eating on the way home.

01:02:50.35
stacy
Um, so you’re getting your booking and your training with that. If you’re someone who’s like, I don’t drink coffee. I don’t want to use protein powder. You can look at, um, having.

01:03:01.67
stacy
you know, maybe a fourth or half a cup of your overnight oats before you go, or we sometimes do an oatmeal slurry where you are taking oat milk and some instant oats and and blending them up in the night before, so you’re drinking that on the way to to the gym, because then you’re getting some protein, you’re getting some carbohydrate, you’re getting some hydration, all of those things work. So it’s just really about finding something that’s really easy for you to do Keep it in the fridge. That isn’t going to be over filling and make you feel flat.

01:03:33.76
neelyquinn
Mm hmm. And then the point is to then do their workout depending on how long their workout is, take food with them and then come home and then have a full meal.

01:03:42.33
stacy
Yeah.

01:03:43.29
neelyquinn
Yeah. OK. um Shoot, I had a very important question about that, and now I forgot it. So um that covers, though, the the regular meals throughout the day, and having those 40 grams of protein in all of the carbs afterwards is just simply a meal, which is what I’m always telling people.

01:04:08.05
stacy
Yeah.

01:04:08.71
neelyquinn
like It doesn’t have to be an extra meal throughout the day.

01:04:11.55
stacy
No, it doesn’t.

01:04:13.68
neelyquinn
And that also helps with weight too, because if people feel like, yeah.

01:04:16.04
stacy
Exactly. Exactly. When you’re looking at the high profile and it’s been because the Olympics just happened, all these, what are you eating? How are you eating things? People think they have to add extra in.

01:04:26.65
neelyquinn
Right.

01:04:26.83
stacy
For a general pop, it’s not bad. It’s timing your meals. And it can be simple as taking your breakfast and splitting it and having half before your session and half after.

01:04:36.90
neelyquinn
Yes.

01:04:37.88
stacy
Right? So you’re not overdoing the calories, but you’re timing the food around when your body needs it.

01:04:43.60
neelyquinn
Right, exactly. So I’d love to talk about caffeine for a minute.

01:04:47.91
stacy
Yeah.

01:04:48.37
neelyquinn
And um because with the sleep component being so important, and with caffeine also stimulating stress hormones, what is your advice and, ah you know, and just general guidelines about caffeine for women, menopausal women?

01:05:06.45
stacy
Yeah, so caffeine’s interesting because it’s really based on your genetics. If you’re a fast metabolizer, a slow metabolizer, or if it does nothing for you. If you’re a fast metabolizer, you will find you you will start to be affected by caffeine the further you get into perimenopause because of the way that affects blood glucose. If you’re a slow metabolizer, you might find you can’t tolerate any caffeine.

01:05:31.24
stacy
So if you’re like, ah I really love coffee, but I can’t do it because of the caffeine, you can look to decaf or maybe switching to green tea, which isn’t the best, but you just have to kind of navigate those waters and see how you react to it.

01:05:45.69
stacy
Ideally not having caffeine after three in the afternoon, even if you are a fast metabolizer, because of the new responses your body is going to be having to the caffeine the further you get into perimenopause. um So it becomes an individual responsiveness to it and seeing how your body changes, then then you’re able to say, yep, okay, I know that if I have more than three cups of coffee in a day, I am completely jacked and I can’t sleep.

01:06:15.23
stacy
if I bring it down to two and I’m using those two strategically throughout the day that works for me, sweet. So that’s what the caffeine use comes down to.

01:06:23.05
neelyquinn
Okay. okay So it really is just what your body in in sort of titrate down to what you feel works best for your body.

01:06:33.80
stacy
Yeah, yeah.

01:06:36.02
neelyquinn
And I know that you can get that genetically tested like with the 23andMe, right?

01:06:41.05
stacy
Yeah, yeah,

01:06:43.25
neelyquinn
It’s super interesting. um All right. So we’ve covered a lot and I just want to make sure, oh, I wanted to ask you about birth control and hormone replacement.

01:06:55.18
neelyquinn
um I have chronic migraines and one of the things that I’ve been considering is going on birth control and I’m 46.

01:06:55.29
stacy
Yeah.

01:07:03.42
neelyquinn
And I would love to know what your thoughts are on birth control and hormone replacement therapy in general.

01:07:10.56
stacy
So two different things, completely different things.

01:07:13.03
neelyquinn
Yeah.

01:07:13.10
stacy
So we look at the formulations between the two. They’re completely different. The reason why they’re there are completely different. If we’re looking at birth control, The idea behind birth control is to have enough exogenous hormone to down regulate your natural ovarian function so that you don’t become pregnant.

01:07:30.71
stacy
So we look at the generations of the progestin all have a different response within the body. The estradiol component, you have 20 and 30 microgram doses. Both of those have a different response within the body, especially with regards to lean mass and strength.

01:07:45.32
stacy
We see a higher amount of estradiol will increase the amount of muscle tissue that’s being built, but it’s not strong. Like you don’t get that nerve response for a strong contraction.

01:07:55.33
stacy
You just build the tissue because that’s what estrogen does.

01:07:56.73
neelyquinn
Well.

01:07:59.23
stacy
um We can look at an IUD. IUD is really helpful for women who are in perimenopause, especially if they get migraines, because you’re having a little bit more progestin, because an IUD, like a marina, has localized progestin. So we’re seeing that as you get into perimenopause, late perimenopause, you’re having more and more anovulatory cycles, and so you become more quote estrogen dominant, but it’s really just have a higher amount of estrogen progesterone.

01:08:27.02
stacy
So that can trigger migraines. So using an IED can help. And that’s that’s more acceptable from a OB-GYN perspective for women that are in their late forties, because you can still kind of keep track of what’s going on with ovarian function.

01:08:38.66
neelyquinn
Hmm.

01:08:43.64
stacy
After you get put in about six to eight months later, you’ll start to ovulate. So you can still keep track. You won’t get pregnant because of the way that the IUD changes the environment of the cervix and the mucosal um mucus lining and all of the things that make it inhospitable to sperm. If we’re talking about menopause hormone therapy, they’re different compounds, even though they’re called estradiol and progesterone. They’re either um taken through a cream or a patch. Conjugated is what the oral ones are and those are the ones that have the most side effects that we find. And the journey on menopause hormone therapy is completely different because you have to dial it in over the course of three or so months. It’s not about

01:09:33.82
stacy
reducing ovarian function as it is to allow your body to have natural hormones. You don’t have a severity of disruption to your estrogen and progesterone receptors because we’re having that disruption. This is where we see really severe menopausal symptoms of hot flashes, mood, um, gut issues, body composition change.

01:09:56.38
stacy
So when we’re looking at the stuff that’s out there for menopause hormone therapy, people need to realize that it’s there as a tool in the toolbox to slow the rate of change that’s occurring in perimenopause. It’s not to replace your natural hormones to put you into reproductive state. It doesn’t help with cognition. It doesn’t help with cardiovascular disease. The whole goal of menopause hormone therapy is to slow the rate of change and to make life quality.

01:10:24.63
stacy
instead of going through all the symptomology of perimenopause and suffering. So there are two overt things that are completely different, even though they are sex hormones.

01:10:35.64
neelyquinn
And when people say, I want to do this, is it something that you say, yes, I think you should do this or?

01:10:42.95
stacy
I tell people, look, have you what are this if you’re looking at menopause hormone therapy, have we looked at all the other tools on the table? Are you doing all the other things? Because a lot of people will try to gravitate, especially in our pharmaceutical um like-driven society, towards the easy fix. where What people don’t realize is even if they are using menopause hormone therapy, they still have to put in the work from diet and exercise.

01:11:09.29
stacy
to get quality of life. So if you can put in the work of diet and exercise and sleep, maybe you don’t need this. But if you’re having really severe issues of sleep disruption, mood changes, vaginal atrophy, vaginal dryness, no libido, just really like my quality of life sucks, then that’s where menopause hormone therapy is available and should be used. Because we don’t want women to be afraid of perimenopause and amenopause.

01:11:38.89
stacy
There are lots of availabilities of tools out there to make your life really high quality, but the discussion still is in the taboo-ness and kind of in the quiet corners.

01:11:50.81
neelyquinn
Mmhmm.

01:11:50.92
stacy
So that’s why we’re like, look, there’s all these things out there, you don’t have to suffer in silence.

01:11:56.32
neelyquinn
Yeah. Yeah, it’s a very balanced approach to it.

01:12:01.33
stacy
And it is individual too. So you have to work with a physician who understands what it is for, and what your symptomology is. Because unfortunately, there are a lot of people who are given just a rote prescription.

01:12:15.05
stacy
Here, we’re going to start you on 50 micrograms of estradiol on a patch. And we’re going to give you 100 micrograms of progesterone every night. You’re good to go. But that could be too much or too little.

01:12:27.93
neelyquinn
Mm hmm.

01:12:27.92
stacy
Don’t know.

01:12:29.56
neelyquinn
Right. And then it’s just a guessing game for the next month of your life.

01:12:33.70
stacy
Yeah, so that’s why you want to work with someone who knows how to prescribe, what the different options are, who you are, what your lifestyle is, what your history is, so that they can dial it in with you instead of telling you what to do because they don’t know.

01:12:34.37
neelyquinn
Mm hmm.

01:12:48.12
neelyquinn
Yeah, so then what do you Google, like women’s health, menopause, doctor, it’s Boulder.

01:12:55.15
stacy
You can look on the International and also the American Menopause Society and they have a list of all the practitioners that are specialists in menopause. And there are quite a few really good practitioners now because of the upsurgence of awareness of menopause.

01:13:14.72
neelyquinn
That’s great.

01:13:15.13
stacy
So you could even have a conversation with your GP because your GP might know someone who’s really good and dialed in.

01:13:21.99
neelyquinn
and Okay. ah Last question, I want to respect your time, um is about supplements. You’ve talked so much about supplements everywhere.

01:13:29.51
stacy
Yeah.

01:13:32.15
neelyquinn
It’s amazing. um Are there maybe a handful that you would want to talk about real quick?

01:13:39.85
stacy
I think the big three, maybe four. Do we count protein powder as a supplement?

01:13:45.38
neelyquinn
if you want.

01:13:45.68
stacy
Because it’s a good supplement. We want whey isolate for people who can do dairy and pea protein isolate for those who are plant-based. because they have a pretty similar amino acid profiles and and good high quality leucine.

01:14:00.51
stacy
Then when we get out of that kind of thing, we look at creatine. Creatine monohydrate is super important for overall health and brain function as well as muscle function for women.

01:14:11.75
stacy
Omega-3 fatty acids and vitamin D.

01:14:15.43
neelyquinn
Okay.

01:14:15.35
stacy
Those would be the big three or four.

01:14:18.89
neelyquinn
Okay. And why create team?

01:14:22.37
stacy
So your body naturally produces around three grams from the liver a day, but women by the nature of being women have around 70% of the stores that men have. And we see creatine is involved in all the fast energetics of the body. So we think about our brain and brain function. We think about gut, gut health, gut integrity, ah muscle, muscle performance. And when we look from a clinical perspective of using just a very low dose of three grams a day,

01:14:51.72
stacy
It improves mood, it improves muscle function, it improves gut health, it improves um heart function because it saturates all the tissues in the body, and it’s a very essential nutrient for all the tissues in the body to use. um Some people say they have side effects, but you have to be careful of what kind of creatine monohydrate that you use. You want to use Crea Pure. It is ah any creatine product you you pull up,

01:15:20.19
stacy
It doesn’t matter what brand it is. If it says Crea Pure on the side, then you know that it has been created through a water wash. When we don’t see Crea pure, it’s an acid wash to create the creatine, which is what causes some of the side effects.

01:15:33.30
neelyquinn
Hmm.

01:15:34.43
stacy
Um, so low dose start one and a half grams, work your way up to three. So, you know, that’s a half a teaspoon at the most a day. It doesn’t matter when you take it and it takes about three weeks for your body to fully saturate.

01:15:46.87
stacy
And then you’re like, wow, I didn’t realize how much better I feel must be the creatine.

01:15:51.65
neelyquinn
Wow.

01:15:52.49
stacy
Yeah.

01:15:53.09
neelyquinn
Great. Okay. And then, um, omega threes briefly. Why did you mention that one?

01:15:59.72
stacy
ah As we start to get older, we start to have more oxidative issues, especially on a cellular level, because estrogen in itself is very anti-oxidative and anti-inflammatory. We see that omega-3s helps with that. So it’s another way of just helping cellular integrity to help with oxidative um or being more anti-oxidative.

01:16:22.51
stacy
and having more anti-inflammatory responses within the body, which feeds forward to helping with reducing esterified fatty acids that circulate, that then gets stored as the cereal fat, um because all of that is an inflammatory and oxidative response.

01:16:38.96
stacy
So using omega-3s really does help with a lot of those responses that estrogen used to help with.

01:16:47.74
neelyquinn
Again, we’re tricking the, more it yeah, the system.

01:16:47.67
stacy
And then when we look at Yeah, yeah, yeah, exactly.

01:16:55.18
neelyquinn
Okay. And then vitamin D briefly.

01:16:57.48
stacy
Vitamin D, um there’s so many things that are wrapped up in symptomology when we’re thinking about depression, anxiety, muscle function, iron levels, ferritin levels, and vitamin D helps with all of that because it’s a cofactor in so many different functions in the body.

01:17:14.89
stacy
And we’re in a society now where we use sunscreen and hats. We’re inside all the time. We don’t get enough vitamin D. And we know that it’s so essential, especially for women going through perimenopause when we start to have iron issues. We know that vitamin D is really essential for preventing anemia. It helps with iron absorption. It helps with iron metabolism.

01:17:38.49
stacy
We see again with muscle muscle muscle repair muscle function helps with soft tissue injuries because two of the biggest things that occur in perimenopause or plantar fascia issues and frozen shoulder.

01:17:49.94
stacy
So we would just want to be cognate of how to take care of our soft tissues and our tendons and ligaments are included in that vitamin D.

01:17:57.59
neelyquinn
OK, good to know. All right, this has been like a little hour and a quarter master class. This has been the most efficient um interview I’ve ever done.

01:18:12.29
neelyquinn
youre Yeah, yeah, I really appreciate it.

01:18:13.95
stacy
Awesome.

01:18:16.94
neelyquinn
um

01:18:16.89
stacy
No worries.

01:18:18.25
neelyquinn
i I wonder, on a personal note, I know that you had a rough you know start with all of this. And how are you feeling now?

01:18:28.59
stacy
Well, today, not so great because I’m jet lagged.

01:18:31.02
neelyquinn
OK. Yeah.

01:18:33.66
stacy
But um overall, much, much better. Even my daughters commented, over the past two years, mommy, you’ve gone from being grumpy to actually being normal.

01:18:41.83
neelyquinn
Oh.

01:18:41.83
stacy
I’m like, thanks. I appreciate that.

01:18:44.71
neelyquinn
Normal wins.

01:18:46.12
stacy
Yeah, I’ll take normal for the win.

01:18:48.01
neelyquinn
Right, that’s wonderful.

01:18:49.18
stacy
Yeah.

01:18:50.38
neelyquinn
Okay, well, thank you. um How can people support you? Where can they find your work? How do you want them to find you?

01:18:58.60
stacy
um So social media, Instagram, we post information daily. I say we because I do have a team can’t do it all. um and our website, drstacysims.com, that has a list of all the courses and books and um our newsletters and everything that I’ve been doing and how you can keep up with all of the stuff. So those would be the places.

01:19:23.86
neelyquinn
All right, but people cannot work with you one on one. It’s through group stuff only, right?

01:19:28.91
stacy
Right now, yeah, I don’t have the bandwidth. I would love to. I need to clone myself because there’s so many women where I’m like, I really want to help you. I just can’t give you the time that you need.

01:19:38.24
neelyquinn
Yeah, yeah, that makes sense.

01:19:39.44
stacy
Yeah.

01:19:39.94
neelyquinn
Well, thank you for making yourself available to my audience. We really appreciate it.

01:19:42.96
stacy
You’re welcome.

01:19:43.85
neelyquinn
Thank you so much.

01:19:44.28
stacy
Yeah. No worries. Been great chatting.

01:19:47.04
neelyquinn
Yeah, you too.