BITESIZE | What You Need To Know About Strength, Menopause & Healthy Ageing | Dr Stacy Sims #673

0:00Today's Bite Size episode is sponsored by Thrive, the longevity supplement from Heights that I have been taking daily for the last six months to help me with vitality, cellular energy and longevity. Now there's a lot of noise in the supplement space and it can be confusing to know exactly what to take. Before I start taking something, I do my own due diligence. And for this one, I had a wonderful, enlightening conversation with the research team at Heights. You see, in our bodies, we have something called NAD, which helps to support our cells' mitochondria in producing the energy our bodies need.

0:39But with age, our NAD levels start to deplete. Thrive helps resupply your cells by combining NR, a clinically validated NAD booster, alongside coenzyme Q10, copper, and resveratrol to provide a powerful combination designed to keep yourselves thriving. If you want to give Thrive a go, Heintz are offering my listeners 20 % off their first month at www.heintz.com forward slash live more when you use the code livemore20. Welcome to Feel Better Live More Bite Size, your weekly dose of positivity and optimism to get you ready for the weekend. Today's clip is from episode 578 of the podcast with exercise physiologist and nutritional scientist Dr.

1:34Stacey Sims. Stacey is dedicated to helping active women take back control of their bodies, health and lives through science-based knowledge and practical tools. As we move into our 40s and beyond, our physiology changes in ways that can often feel confusing and frustrating. In this clip, Stacey shares why conventional fitness advice often fails women in midlife and what many of us may be missing when it comes to improving our health, vitality and resilience as we age. What would you say are some of the common mistakes you see women making as they get older when it comes to losing body fat, increasing vitality, and I guess more broadly, improving their overall health and well-being?

2:32I think the biggest thing is following traditional trends, where if we're looking at women who are in this kind of 40 plus or maybe 45 plus age group at the moment, grown up in the whole diet culture of move more, eat less, and that's what people tend to do when especially when they're trying to lose weight but if we were to switch it and say you know what I actually want you to do more high intensity and to eat more to shift your body composition it becomes a little bit of a disconnect and people can't get their head around it but it's following the traditional trends that have been so so well versed in the fitness world that really do not work.

3:19Yeah, it's interesting. As I've been researching you and the things that you talk about, it's very clear that, first of all, a big part of what you do is to help people understand that women and men are fundamentally different. They're physiologically different. They're biologically different. You, of course, have your phrase that women are not small men. But what's super interesting for me is that as women get into their 40s, you are very clear that two things need to happen with respect to movement. There needs to be resistance training and there needs to be HIIT, high intensity interval training.

4:02I want to talk about that, but I guess the way I wanted to frame it, Stacey, was to pose a theoretical question to you. I often talk about what I consider the four pillars of health, food, movement, sleep, and relaxation. If a woman, let's say 45 years old, okay, so in that perimenopausal period, is nailing her food, whatever that means, we can maybe discuss that later. She's nailing her sleep, she has low stress levels and for her movement she is walking for 60 minutes a day so her lifestyle is really good but she's not doing hip training and she's not doing resistance training is that enough for her to age well and be well if we're talking about the walking component of movement and that's what she's doing no it's not because if we're looking at walking we're We're falling into the idea that we're doing cardiovascular work, which is good.

5:08I mean, we want that. But when we start looking at what does it mean to age well, we need to look at how strong and powerful we are just to be able to carry groceries when we're 80. Think about our bone and bone density. And we also really want to examine what does cardiovascular fitness look like? because when we start getting into perimenopause onwards, because we've lost the epigenetic exposure of estrogen and progesterone and to some extent testosterone that affects every system of the body, we have to really understand what that means. Because if we think about puberty and the first expression of these hormones in a major way, we see all these changes that happen from a biomechanical and a physiological perspective in girls and boys.

6:01And girls tend to put on more body fat. They end up having less of an aerobic capacity as we compare it to age-matched or puberty-matched boys. We see so many different things that occur with brain, brain health, and mood development. And so when we get to the other side of things and we're seeing the unwinding of ovarian function, every system of the body is affected, including vascular compliance. Primarily, estrogen and progesterone together work to improve bone density. They also work to help with our blood glucose control, our resting blood glucose. It helps with how our body fuels itself at rest using more free fatty acids and having a conversation between the liver and the muscle that says, you know what, we want to use these free fatty acids.

6:58We don't want to store them as visceral fat. And we also see that estrogen is tightly tied to how our blood vessels respond to things like hot and cold, how they will constrict and dilate. So our blood pressure is very tightly controlled. When we start losing more and more of these hormones, we start to see a stiffening of our blood vessels. So we don't have as much what I call vascular compliance. So our blood vessels are very slow to constrict and to dilate. So it affects our blood pressure. We see that we have a change in how our body will fuel itself. Well, we'll see more insulin resistance.

7:42So that means that we have an increase in arresting blood glucose. If we don't do something, then we're going to end up in a pre-diabetic, potentially a metabolic syndrome type situation. So if we're thinking about walking for cardiovascular health and burning some calories, we're not optimizing the vascular compliance that we need to control blood pressure and to help with our lipid profile. So we see a really significant increase in LDL and our total cholesterol in women who are mid to late perimenopause. And it has to do with the way estrogen is no longer there working for anti-inflammatory properties.

8:24And there's a misstep away that we're having conversations within the system to really use free fatty acids as a fuel. So when we start looking at all the pillars that I agree with, because I talk about it all the time, we look at physical, then the emotional or the relaxation, parasympathetic, the sleep and nutrition, right? So if we're nailing all of those and there's a misstep and we're still not seeing body composition change, we're not seeing change in our lipids, our blood glucose, and a lot of women don't. And this is where they start falling into, well, my body composition isn't changing.

9:00so I need to up my walking or I need to eat less and there's all these things that start to play in that really create a misstep in what will accumulate into a better longevity profile so when we start pulling out all these sex differences and then we put on the sex hormones then we see this huge differentiation of the way that a person will respond to external stresses of exercise and how they will respond to internal feedback from the nutrition that they're getting in the nutrition timing and circadian rhythms. And women have been following all of these things that have been put out in the fitness and nutrition world that's been based on male data, and they're not optimizing.

9:45We see so many missteps. And if we were to pull it back and say, you know what, from a female physiology perspective, these are the things that we would like to do to improve and reach your potential. From a male physiology perspective, these are the things that we know work for you. We've seen it in the research too. So we just need to separate and divide. It's not that one is more complicated than the other. It's just we're different and we respond differently. And I don't want to take away people's soul food. I'm saying if we're looking at what optimizes a woman's body as she's going through perimenopause and into postmenopause, because what we do in perimenopause, we want to carry it through the rest of our lives.

10:26there are things that you can optimize from an external load to really create a stress resilient strong frame both mental and physical frame to carry you through to your late years of life and we also have room for soul food for me my soul food is going and riding my gravel bike for hours and hours. But that doesn't fit into HIIT and strength training. But it fits into what I call soul food, because it's good for my brain. I like being outside, seeing my friends. Yeah, there's so much there to unpack. It's kind of interesting. It sort of implies to me that even the word exercise, or even movement, perhaps is too broad, right?

11:16Because by saying one pillar of health is movement, which I say, and I agree with, okay, and I wrote a book with that in it, right? So it's not that I'm necessarily disagreeing with that. But the problem is then is that different movements, different forms of so-called exercise provide different stimuli to the body, and therefore different adaptations. So we as a society have to be more specific with the adaptation we require. Once we know the adaptation we require, we can choose the right movements or exercises to give us that adaptation. More and more, I think one of the key points I want to get across in this conversation for women is why those two things must be done as you get older.

12:07Because I think there's a lot of my audience who might fall into that category. They're doing really well with that conventional stuff. They're doing well with the four pillars, but on the movement aspect, I know many women, friends of mine who perhaps are not strength training and are not doing high intensity training, but they are walking regularly and they would probably think that that's enough. So let's go through those changes so that we can make that case. Exactly. So when we start looking at something like resistance training, Why is it so critical? And we hear conversations out there where I'm talking about we want to lift heavy loads.

12:46Other people like just regular strength training. When we start looking at what's happening in perimenopause, the very first thing that happens before we see a loss in lean mass is there's a disconnect the way our muscles contract because we have a change in some of the expression of our contractile protein. So if we think about muscle contraction as a ladder that's coming together, we have myosin and actin and they bond together to pull fibers together to create a contraction. When we start losing estrogen, we start losing the ability for myosin to hold on to actin strongly. So we become weaker.

13:29We don't have as much power. When women are talking about this, they're like, I have a really difficult time opening a jar of pickles because my grip strength isn't there. I might be a runner, but now all of a sudden my running pace is really slow and I don't know why. Their body composition hasn't started to change yet, but their overall strength and power has. Then about a year or so later, we'll start to see a significant loss of lean mass and an increase in body fat. There are two things that are going on here. One, we have that disconnect of estrogen and the way that it's affecting our muscle contractile strength, but we're also having a change in our gut microbiome.

14:11Because when we start losing our sex hormones, we start losing some of the gut bugs that are responsible for some of the ways that these sex hormones are able to be pushed back out into circulation. So we have a decrease in the diversity of our gut microbiome. And because women are tired but wired, the bacteria that grows is more of a firmacruites phyla so that means it's more of the obesogenic phyla so this encourages the body to hold on to body fat so when i bring it back down to what are we going to do to counter this because we can't counter what's happening with the down regulation of our estrogen progesterone receptors or that our ovaries are starting to wind down naturally So we look at those external stressors.

14:59Resistance training for lifting heavy loads, it's going to create an adaptation that makes myosin and actin hold on to each other strongly to be able to have a central nervous system response for really strong muscle contraction. If we look at high-intensity interval training, and we talk about it as like true polarized, we're going as 80 % to 110 % of our max, and then having significant recovery between each effort, this creates a change that allows our muscles to pull carbohydrate in and glucose in without insulin. It also creates more of a conversation with what we call myokines, which are hormones that are released from the skeletal muscle to circulate, to say, you know what?

15:48We don't need these free fatty acids to be changed and stored as visceral fat. We need these free fatty acids to be used as fuel. So it improves the way that our mitochondria are using our free fatty acids and improves our metabolic flexibility. So when we're talking about why resistance training is so important, it's all about maintaining strength and power as well as lean mass. Why is high intensity interval training so important? It gives us much better metabolic control and more feedback to reduce the buildup of that dangerous visceral fat yeah really really clear okay so when you say resistance training and lifting heavy what exactly do you mean by that so resistance training is the umbrella term of a push pull against your body meaning that you are pushing or pulling a load that is heavier than just your body weight.

16:52And this is how we increase our overall strength or power. When we're looking at lifting heavy or specific strength training, this is when we're getting in the nuts and bolts of how we do it. So if we're looking at strength training, this could be anywhere from air squats and push-ups to tire flips and Olympic lifting. When we look at heavy lifting, this is the power end where we're trying to really use central nervous system responses to increase our muscle capacity, meaning our ability to have a very strong muscle contraction, a fast muscle contraction, and a stimulus to build and keep our muscle itself and our bone.

17:37When we're looking at perimenopause into postmenopause, the two really critical things that we need to remember so that we can age well and not get old is we need to be muscle-centric and strong. So if we're looking at how estrogen really stimulates what we call the satellite cell or the stem cell of muscle, and now all of a sudden we don't have estrogen to do that, we need to find something else that's going to stimulate the stem cell of muscle to keep building muscle. Yeah. Time plays a role here, right? So let's say you're a woman, you're 40 years old, you know, you're busy with, you know, whatever work, being a mom, like the things of life.

18:26And perhaps you go for a few walks throughout the week when you can. If we have minimal time, let's make the maximum gains. Yeah. So help us think about that a little bit for the woman who's time pressed. Yeah. I mean, that's almost who I talk to every day. Women who are in their forties, they're working, they have kids, their lives are very full. I have a group of women who say they're the 5am club because that's, they have to get up and get their stuff done and be back by 6am. So fully understand that. So if we're looking at a woman who has maybe one hour a week that she can dedicate for herself and then like you said throw in a couple of walks here and there maybe after work or on the weekend we have to look and focus on that one hour what can we do maybe we can split that up into three 20-minute strength training sessions but that would require you know three separate days and maybe she only has that one hour So if I were to look at that one hour, I would structure it into three 20-minute segments, where the first one is we're doing lots of mobility work so that we make sure that we stay injury-free.

19:37So we're looking at opening the joint capsules and creating more range of motion so it's not stretching, but it's working on proprioception. It's working on in-range. It's loosening up the tendons and the ligaments. then I would do 20 minutes of compound heavy resistance training then I would finish with some sprint interval work so this would be 30 seconds as hard as you can 110 % effort and then you have two to three minutes full recovery and you might do that two or three times salt bike's great for that maybe you're doing kettlebell swings but that stimulus at the end of the mobility and the resistance training is what you need instead of a 35 or 40 minute HIIT class.

20:23So we're looking at that one hour and you can do that once a week. That's a bare minimum that's going to help create the impetus for better body composition change and brain health. Because the other thing about heavy resistance training is it works on the neuroplasticity of the brain. and when we're looking at neuroplasticity we want that because we want to be able to maintain our ability to have cognition and not experience cognitive decline yeah and then you can look at your walks maybe one of your walks with your dog you go okay well instead of just going on this normal 3k walk with my dog i'm going to take the dog and i'm going to divide that 3k up and maybe I'm going to pick up the pace for a minute or two, and then I'm going to have a minute recovery.

21:12So you take that into a HIIT session. So there's ways of looking at what you're doing during the week, even if you are time constrained. Okay. For the woman who hates gyms, right? Who, for whatever, for whatever reason, they don't like going to gyms. Okay. I appreciate you might need some instruction and there's a risk of injury and you have to build up slowly. You know, I understand all those things, but for someone who feels that they could and they want to start strength training, what are some other options for people who want to do all of this at home? Yeah. I mean, you can start with loading a backpack up and using that with air squats, right?

21:55So you can put canned goods or you can put a sandbag in your backpack. So there's ways of adding external load while you're at home. There's some really fantastic apps available now too of guiding women at home first through resistance training body weight into adding load with their body weight. And it could be buying a couple of kettlebells. It could be using sandbags. Like there's lots of things that you can do that doesn't require you to actually go to a gym. It's understanding what your environment is, how you feel about being by yourself working out, or do you need a partner to work out with?

22:33Because community is huge. We see women really gravitate, especially if they have a lifting partner or a friend who's on the same journey. See better adherence and better progression when you have community around you. So it depends on the individual, but everything is totally doable at home. It depends also on what you want to invest in. But starting out with your body weight and then adding load through a backpack or sandbags like you're talking about, a weighted vest, anything like it's going to add a little bit of external load. It's all extra stress on the musculoskeletal system that is going to benefit you.

23:10So if someone's never done any kind of resistance training, they're not going to hop into the really heavy loads right away. It could take up to six months to a year to learn how to lift heavy properly. and let's figure out where you are in your journey. And maybe it's connecting with the Betty Rocker or Haley Happens or Loretta Loves Lifting that all guide you through starting the journey. And then boom, now you feel confident to go to a gym. Yeah, I love it. And I guess the key point is if you're not lifting heavy, there are certain adaptations which you're just simply not going to get, which you probably really, really wanna get as you go through perimenopause and beyond because you've got this quite catchy phrase, don't you?

23:54Be the oldest person in the gym, not the youngest person in the nursing home. Exactly. Yep. And I like to point out the Instagram account, Train With Joan. So Joan is 72 or 73 now. She started her strength training journey in her late, was it late 60s, mid 60s? She hasn't been lifting very long, but she was facing a lot of the typical things that a peripostmenopausal woman faces, extra visceral fat gain, prediabetes, low bone density. And her daughter's a personal trainer and she's like, I want exercise. I don't want drugs. so she started strength training and now she is this phenom who started lifting late and is benching you know 55 kilos as her her bench press and she's dead lifting 100 kilos and it's just the progression that she's had and she's a really great image to show what heavy lifting can do for you you're going to get strong you're going to have really good cognitive faculties and you're going to have really strong bones.

25:07And those are the things that we're after. And for the men who are listening, even though we don't have those hormonal changes, we're still going to get incredible benefits, aren't we? Absolutely. Because as we age, both men and women, we become more anabolically resistant to exercise and protein. So the more strength training you put in, the more your body responds to building muscle and building bone, both men and women. it's just when we look at aging we see women have this definitive point in time where all of a sudden they're feeling the effects of aging and it's perimenopause whereas men age in more of a linear fashion we see a blip in their 40s and we see a blip in their 60s but it's not as overt as what's happening to women in perimenopause yeah i mean would you say that's fair to say that your message is it's one of empowerment, but it's also one of urgency.

26:03Yes, you've acknowledged Joan, so it's never too late. At the same time, why wait until your 60s and 70s if you can get the message now? Why not start in your 30s? And I say this coming from an incredible endurance background. Like I was an ultra runner, I raced Ironman, I raced road bikes, I did Xterra, but strength training is something that was exposed to me early days, but I didn't really understand the value and the power of it until I started working with Marcia Stefanik at Stanford in the Women's Health Initiative data, where we really started looking at the outcomes and longevity from DEXAs of who had more lean mass and who did strength training versus those who didn't.

26:52So it wasn't really even about attenuating any of the menopausal symptoms. It was about, let's look at the viability and the quality of life for women who entered the study when they were in their 60s, and now they're in their 80s or 90s, who's doing the best. And it was those women who were more muscle-centric and strength oriented. And I was like, okay, now let's really start getting into the strength training thing. for a woman who feels inspired but they don't know where to start what are your final words to them first find a friend because i'm sure that you have a friend who's going through the same thing and have a conversation and then you can look to either go in and get a personal trainer together but if that's a bit too daunting you can look at some of the apps that are out there one who just wants to stay at home would go with Betty Rocker one who's really confident in the gym might go with Haley Happens Fitness one who's just starting to explore strength training and wants to add some equipment might go with Loretta Loves Lifting but those are all really good and they all address different levels of fitness you can get into the communities there because again when I talk about community it's about having someone to lean into and ask questions but also to support you.

28:12And when you start your strength training journey, it's good to have that. Yes, you're going to achieve personal goals and benefits, but it's always more fun with community around you to encourage you to push a little bit more than what you really thought you could. Thank you so much for listening. This episode was the last bite size of the season. If you are a long time listener of my show, you'll know that every summer I take a break from the podcast for six weeks. Why do I do that? Well, my wife produces each week's show. I spend a lot of time researching and having these conversations. And over the summer, it's really important for us as a family to take some time off so we can really spend some quality, undistracted time with our children over their summer break.

29:01There is one more long-form conversations come next Wednesday, we finish off the season with a very special episode. Of course, I'll be back at the very start of September with the Wednesday full-length conversations and the Friday bite-sized ones. If you have enjoyed my podcast, if you've enjoyed these bite-sized episodes, I'd really appreciate your help in spreading the words. My request to you this summer is if you found my podcast useful, if you found it valuable in your own life, would you consider sharing an episode of this podcast with five different people. My goal with the information on the show each week is to inspire and empower as many people as I possibly can.

29:44And you guys can help me do that. If you help me spread the word together, we can help spread this message of positivity, compassion, and health. Thank you so much for your support this season. I hope you have a good summer and I will see you at the start of September, ready and raring to go. you