Women’s Fitness Expert: What You NEED To Know About Dieting & Exercise | Dr. Stephanie Estima

I want women to stop being losers, and so I am on a mission to really undo the genuinely terrible advice that most women have been given as it concerns their health and their fitness. So we're going to talk through some actionable strategies on how to build a body that has curves, more of an hourglass figure. But Stephen, if I can be very honest with you, I am pissed off because we've been sold a lie that our worth is the number on the scale. And I've seen tens of thousands of patients over my 20-year tenure. And right now, a lot of online dialogue is, "I want to be toned. I want to have the Pilates body. Be as small as possible so this is where I get a little fired up because I also have personal experience struggling with my own weight and my own worth. I was trying to become what I thought was the right thing. And I had massive problems afterwards. So I am going to be very transparent and honest with you. The pursuit of skinny is a bad thing. With devastating consequences, you're going to end up with bone disease like osteoporosis. So there's lots of things on the desk here in front of us that I'd love to go through. We've got these five fitness myths. Yes, so one of them, for example, is a lot of women are scared to consume more carbohydrates because they think it's going to make them fat. But we need carbohydrates for our mood, our sleep, even performance at the gym. And then there's also women are scared that if they're lifting heavy weights, that they're going to start looking like a bodybuilder. But that's almost impossible. 97 to 98 percent of women don't have the hormonal environment to bulk. And then we've also got these archetypes here. So there's four archetypes that women identify themselves in their fitness journey. And the most common woman that I see skinny fat Sophie. And we'll talk about what this means. So let's talk about what the women listening should understand about hormones. How do you think about fasting a new menstrual cycle? What are the specific issues that mothers face as it relates to fitness? I mean, there's lots of things that I'd love to talk about. 100 percent. That makes me so excited. Guys, I've got a favor to ask before this episode begins. The algorithm, if you follow a show, will deliver you the best episodes from that show very prominently in your feed. So when we have our best episodes on this show, the most shared episodes, the most rated episodes, I would love you to know. And the simple way for you to know that is to hit that follow button. But also, it's the simple, easy, free thing that you can do to help us make this show better. I would be hugely grateful if you could take a minute on the app you're listening to this on right now and hit that follow button. Thank you so, so, so much. Dr. Stephanie Estima, why is it you do what you do? Like, ultimately, what is it you're trying to change in the world or what impact do you trying to have? And who are you trying to have it for? Well, I am on a mission to really undo the genuinely terrible advice that most women have been given as it concerns their health and their fitness. And what I mean by that is for the vast majority of health and fitness goals for women, it's all about becoming smaller. It's about becoming skinnier. It's about losing weight. It's about dropping a dress size. Stephen, if I can be very honest you, I want women to stop being losers. I want them to stop trying to lose all the time. And instead, what I would love for them to do is to shift their focus from losing and focusing more on what they have to gain. So how much muscle can they gain? How much bone density can they gain? How much connective tissue capacity from their joints, their tendons, their ligaments, can they gain? Can they work towards building a body that they love and trust and enjoy living in? Why don't you want that for women? This is specifically this losing, gaining thing. We've been sold a lie that our worth is the number on the scale, which is, by the way, you know, when you're weighing yourself, this is really just a reflection of your relationship with gravity, no more, no less, right? But we are told that when we fit into a certain dress size, that we are now worthy, that we will somehow have arrived. That is not the full experience of being women. Women can be strong. Women can be capable. Women can be competent. And you can't do that when you're starving yourself, when you're over exercising and you're not prioritizing your recovery or treating recovery like it is something that you have to earn. So are you saying being skinny is a bad thing? I'm saying that the pursuit of skinny at all costs is a bad thing. So right now, a lot of online dialogue is, you know, strong is the new skinny. I don't want to pit those two things against each other. But I do want to, like if you are obese, you are much better not being obese, right? But it is the pursuit of skinny at the sacrificial altar of everything else. So if you are somebody who values being slim, the likelihood that you are going to pick up heavy weights or weights that challenge you with enough effort and intensity is going to be lower. The likelihood that your bone density is going to be sufficient over the arc of your life is going to be lower. You are going to likely under consume calories. If you are someone who thinks that they've won because they can fit in, you know, your 40 and you can fit into a size, whatever dress. But when you're 65, you have osteoporosis, you haven't won. You've been, you've been tricked. Tricked by who? A society that tells us that our worth is solely based on how small we are. And who are you? Like in terms of why this matters so much to you as Dr. Stephanie? What do I, what context do I need to know there? Because I can see you're a little bit pissed off. Yeah, I'm pissed off in a loving way. So let's say it that way. I have professional experience in this and I also have personal experience in it as well. I have an undergrad in neuroscience and psychology from the University of Toronto. When I was pursuing that, I became a fitness instructor, a personal trainer. So this was, you know, very young. I started having my first exposure to seeing firsthand how people were setting goals for themselves and having a difficult time achieving it went on to the Canadian Memorial Chiropractic College in Toronto, Canada. And then I was in, I've been in practice for 20 years. So I've seen tens of thousands of patients over my 20 year tenure and the same pattern kept showing up over and over and over. And then personally, I also, you know, just being a woman living in this society grew up also struggling with my weight, trying to control my, what I ate, trying to do lots and lots of cardio, to keep my weight down into what I thought was the ideal body type. I competed in a figure competition, which was really the first moment for me where I really felt like the science failed me because I had followed everything to a tee, do lots of cardio, restrict your calories, you have to earn your recovery. The day that I got up on stage, I was 11% body fat. So just, just for context, you know, women have about 10 to call it 13% essential body fat. And if you go beneath that, then you start to get into a lot of trouble. So I was right at the bottom range of that. Most women, a healthy body fat percentage is something like, call it 18 to 25%. I had lost my period for two months before, I think it was two or three months before I stepped on stage. I ended up with hormonal issues, my period, I had, it took a long time for that to regulate again. I gained all the weight back that I had lost. And I felt like a total failure. And I felt like the science had failed me. And it caused you a lot of pain. I hated myself. Like full stop. I looked in the mirror. I hated what I saw. I would pinch, I would pick. It was like, I wish this, I wish that, I wish, I wish. The other thing I'll say is the weeks before I stepped up on that stage, people were coming up to me and showering me with compliments. People were like, Oh my God, you look, you look amazing. What are you doing? What's your program? And so it's, I think it's so confusing for women. Maybe we lose the weight or we, we go on this health journey, which is often just code word for getting smaller. And we, we get showered with these external compliments. And at the time, I was starving because I was not eating. I was completely overworked. I wasn't sleeping. And I didn't have my period. Like I was not the picture of health. But everybody was telling me how amazing I was, how amazing I looked. So I think that's where we get it. We, we, we hitch our worth to what the outside world tells us, rather than thinking about who we need to be and how we need to show up for ourselves first in order to be able to give to everybody else but also just unhitch ourselves from other people's expectations of us. And for the women and for all the people, I guess that I've clicked to listen to this conversation right now, what are they going to leave this conversation with specifically? And how is that going to impact their life? Yeah. So this is for women and the men who love them. So this is for everyone. I think for women, maybe you have been doing like the good girl thing, like I was doing, you're doing the things that you thought you should have been doing, but you still don't have the dream body or the body composition that you want. We're going to talk through some actionable strategies on how to do that. I think if you're in midlife, so you're in your 40s, your 50s, and maybe you're finding that you used to do those strategies. And now they're not working for you as well or as much as they once did. We're going to maybe break a little bit of your paradigm in the way that you think you're thinking about health. And how old are you? I'm 48. I think it's important context. Yeah. You're also a mother. I'm a mother of two. Yeah. Of two. Mother of two. And then I have a step-send as well. Okay. There are all things that really, really interest me. We've also got these five fitness myths in this envelope here that will reveal at some point and these archetypes here. Yes. Where do you believe the best place to start this conversation is? I think that maybe we can talk about the archetypes because I think that it sets the stage for allowing women to identify themselves in their fitness journey, however that is. Okay. My first overwhelmed Olivia, this woman wants to do the right thing. Okay. So she is on social media and within a couple of minutes of going on social media, she sees someone saying plants are trying to kill you. Olivia, you should never have plants. They're terrible for you. And she keeps scrolling and then she comes upon someone else who says actually plants are great for you. They have lots of fiber, they have lots of phytonutrients, etc. So she's like, oh, okay, that's weird. Let me look up some fitness stuff. And then same thing with the fitness. Some people say you don't want to get bulky Olivia. So you need to do light weights high reps. And then there's other people that are like, that's not true. As long as you're bringing the muscle close to failure, you will build muscle. So she's getting the, I like to call it infobesity. It's like so much information. It's too much information that she ends up getting like, you know, it's like analysis paralysis. And this woman, I have a soft spot for her because she just is so scared to start something else and fail at it because she doesn't want that to reinforce her own schema, her own perception of her being a failure. So she doesn't do anything. When we think about overwhelmed Olivia, we don't want to get her A to Z. We don't want to get her all the way to her goal. We just want to give her a couple of quick wins to start, right? Get her just A to B. We're just going to get her walking. She's just going to have a goal of racking up five to seven thousand steps in a day. So she feels like she's a winner in some vertical of her life. And then you start to layer in more things with her as she goes along. The second one is probably my favorite, the most common woman that I see, skinny fat Sophia. So the technical term for skinny fat is T-O-F-I thin on the outside fat on the inside. This is a woman who doesn't present as obese, but her body composition, she's starting to see a loss of maybe bone loss, a loss of muscle because she is not, she's very afraid of heavy weights. So maybe I'll do some Pilates, some yoga, maybe a walk, right? She also caloricly restricts as well. Right? So this woman is my, is like personally, she's my favorite woman because when we start giving her a little bit more food, and we start giving her just a little bit heavier weights than the two pound weights that she's been lifting, you know, in her Pilates class. And by the way, I don't want Pilates people to come for me. I love Pilates, but it's just not the main strategy for muscle building. I love Pilates. I do it twice a week. It's fantastic. But this woman, when she starts eating a little bit, this is what she always says to me. I can't believe I'm losing fat. I can't believe I'm losing weight by eating more. What is this trickery? What is this magic? So I love this woman because when we get her to see the light, it's actually just, it's just a beautiful thing to have all her schemas sort of rearranged in terms of what she thought was possible for her. Okay? This subject to fat. Yes. If someone comes to you and they say Stephanie, I would love to lose some belly fat because I'm skinny fat. Or maybe I'm just, you know, I just have a bit too much weight on me. What does it you say to them? You can't actually spot reduced. What does spot reduce mean? So someone wants to reduce their belly fat. You can't just target belly fat. So the way that you're going to reduce overall adiposity in the body is you're going to be strengthening, which we've talked about. But you will probably also need some kind of caloric deficit. So when we think about that very famous somewhat oversimplified calories in calories out. So you want to be thinking about how am I going to create a deficit? So I'm consuming either consuming less calories on the calories inside. Or I'm eating the same, but I have more output. So I'm doing more cardio or I'm doing more weight lifting or I'm doing more walking or I'm doing something where my calories out surpass my calories in. Is there an easiest way to do that? Because hearing that, you know, just eat less is is quaint. I hate it. It's it's yeah, not great. Yeah. And it doesn't it doesn't work in the long term either. Yeah. You can temporarily reduce your food. But at some point your hunger hormones and your body is just going to drive you to consume more calories. I often find when women are like, hey, I just want to I want to build muscle and lose fat. Or if it's just, hey, I want to lose fat. I personally find it easier for women specifically to do more on the calories outside. So not too, yeah. So doing more exercise, more daily movement. I think that the calories in is totally doable. People do it all the time. I just find it's hard for most women to stick to long term. Because then they have to, you know, they got a measure. They got to do all the things. So if you can figure out what your maintenance calories are, and then you can surpass that with maybe more walking or something that's not going to ratchet up your hunger hormones or your cortisol levels, let's say, I think that that's often, I think, it's a healthier option, personally, because you're also making sure that you're getting in sufficient substrate sufficient calories so that you can actually build, you know, you can build muscle bone density, collagen, et cetera. So that's our skinny fat Sophia. Up next, I was this woman. I sometimes still end this woman, exorcist Emily. So this is just a funny word to really describe the intensity that this woman puts out at the gym, right? So this woman, you have no problem getting her to the gym. She is the woman at the squat rack. There's no problem getting her to the gym and getting her to work very, very hard. What her issue is, and this was me for years, is that she still has some of the skinny fat Sophia attitude towards food. So there's a mismatch with her between how much effort she's putting out with her exercise program and how much energy is coming in with her food. She's still under eating because she's scared of gaining weight. I was exorcist Emily. I was, you know, had the hoodie on wearing the earphone. Like, nobody talked to me with my big earphones on. This was for me after I was going through a divorce with my, I had very young children at the time. They were five and three. So I was, I was grieving that and I was still adhering to this idea that I had to punish myself, that I was going to go to the gym and crush it and then follow that with insufficient calories afterwards because I still had that, well, I can't eat a lot. I'm going to gain weight kind of mentality. So exorcist Emily, we love her. And then the pinnacle, if you will, is the dialed-in Diana. So this is the woman who has maybe made peace with some of her demons. Enjoys movement knows that it's a way for her to tend to herself. You know, food is not a punishment. It's not, she doesn't restrict calories because she ate too much. She fuels to nourish her lifts, to nourish her recovery and for pleasure because I think a lot of us, a lot of women have forgotten that food is, is pleasure. It gives us joy and happiness. My sourdough bread in the morning gives me lots and lots of pleasure and I will not give it up for anything. So this is sort of the, this is where we want every woman to be able to get to, we want her to dial in both her exercise program, her nutrition program, and to give herself some effing grace with her recovery. You can swear. Yeah, her fucking, her fucking, to give herself some fucking grace with her, with her recovery. We just got demonetized. We're trying to get everybody to become dialed-in Diana. Yeah. And also just know, so if you've been listening to these descriptions, like, oh, I got a little bit of the exercise Emily, I got a little bit of that rage or grief or something, but then I also sometimes have analysis paralysis. Like you will also oscillate through them and that's completely normal as well. Yeah. When you were talking about exercise Emily, that was not a, it wasn't a light season of your life, was it? No, it was very dark. And it was the, it was the lifting that got me through it, truthfully. Yeah. It's, you know, sometimes when we think about resistance training, it's literally training your resistance. It's not a question for, you know, if something bad is going to happen, it's just, it's a matter of when. So I think something, you know, voluntarily putting yourself in a situation where you are making yourself uncomfortable, you know, going to the gym and moving your muscles to failure is not, you know, it's not fun. It can be quite intense, but it does train your resistance, your grit, your mental capacity to withstand, you know, terrible things. So by the end of this conversation, everybody listening is going to be a dialed-in Diana. I, that is my dream. Okay, let's do that. That is my dream. Yeah. First, we should start with debunking some of the myths. Yes. What's six myths in this little envelope here? Okay. So the first one is carbs. And so the, so all the ladies who are listening, we have to heal our relationship with carbohydrates. You can restrict carbs temporarily, and for certain populations, that's a wonderful idea. If you're a woman that has type 2 diabetes or PMOS, something like that. A temporary clawback of carbohydrates is fantastic for improving insulin insensitivity, glucose disposal, but diets like a low carb diet or a ketogenic diet, which I am a big fan of for certain populations, and even for a temporary amount of time, I think what a lot of women did with the carbs is once they started losing weight on a keto diet or a low carb diet, they said, "Oh, you know what the problem is?" It's the carbs. I'm never going to go back. And the problem with that is that if you were sick, you had a bacterial infection, you went to your doctor, they did a swab, and they're like, "You know what? You have a bacterial infection. I'm going to give you a script for antibiotics." You're going to take it for the next 10 days, and then you'll come back for a checkup, and we'll see how you're doing. You do that. You follow the protocol. You take the medication. I don't think anybody listening, or at least I hope anybody who's listening is not going to come to the conclusion at the end of those 10 days. Do you know what I need to do to never get sick again? I need to continue taking antibiotics for the rest of my life. No one is going to do that. But somehow, for carbohydrates, people made the illogical conclusion that you should never have carbohydrates ever again. And for women, what I noticed, so I'm sure we'll talk about my first book, The Betty Body. I advocate for a lower carbohydrate, a higher protein diet in there, but for a transient amount of time. Until you achieve the goal of reversing metabolic issues, or losing some weight, et cetera, improving your period, that's another thing that we actually see as menstrual cycle regulation. But if you stay here too long, you're thyroid, like so many women. What's the symptom of the consequence of your thyroid being malfunctioning? Yeah. I would say you're always cold. So your hands are cold. You're always cold. You might have very, very heavy bleeding. So your menstrual cycle during your bleed week, so that first three to seven days, let's say, when you're on your period, hair shedding. So hair starts to actually fall out. Hair is not necessary at all for survival. So when you don't have sufficient calories or sufficient balance of macros, your body is going to sacrifice the things that don't matter at all to your survival. And a lot of women will start to say, hair shedding comes out. The classic sign is the lateral third of the eyebrow. We start to see the lateral third of the eyebrows start to fall out as well. Which mean the lateral third? Outside third of the eyebrow. So the tail for most people of their eyebrows starts to get really sparse and thin as well. So there's lots of common signs and symptoms, but we need carbohydrates if not for the thyroid, but for our mood, our sleep, even performance performance at the gym in the vein of transparency. And honestly, I don't always get to eat before I train, but on the weekends when I do and I have some bread and I have some omelets or I have what my breakfast and I go and train. Fantastic performance enhancer. A lot of women are scared to consume more carbohydrates because they think it's going to make them fat. And this is really comes down to this CIM or carbohydrate insulin model of obesity, which has kind of largely been like disbanded. There's not a lot of evidence to support it anymore, but there's a lot of people online that will scare you and think, well, if you have carbs, your glucose levels might spike. And that, you know, the way that it's often presented is that is the worst thing that ever could happen to you. But there's such a thing as too many carbs. Correct. Yes. I think that the problem is not that the carbs were the problem. It's the overconsumption of carbs, the overconsumption of fat, the overconsumption of total calories. So it's defined by calories here. Yes. Okay. Yeah. What's the next one? What's the next myth in your folder? Oh, this one. I love this one. This one is women getting bulky. Women are still scared that if they engage in a program of progressive overload, which is to say that you are maybe you are lifting heavy weights, maybe you are doing more volume, meaning you're doing more sets or more repetitions, that somehow you are going to bulk up as if to say that they're going to start looking like a, you know, a physique competitor, a bodybuilder. It is the equivalent of saying, well, if you drive to the store to get some groceries that you are going to be on par with Lewis Hamilton, and you're going to be a formula one driver, right? It's just almost impossible for I'm going to say 97 to 98 percent of women don't have the hormonal environment to bulk. There are a few genetically gifted outliers that absolutely can, but for the most part, women cannot bulk. We do not have as much, I don't have as much testosterone than as you do. You have like 10 to 20x more than I do. So even if we train the same way, I'm never going to be able to put on as much muscle mass as you, but a gal can continue to dream, right? I can continue to know. So bulking up, it's not a thing. What I will say though, actually, what I will say is some people when they do start lifting weights initially, they will start to feel a little thicker, right? Because the muscle is a little bit more swollen. There's also a layer of fat that usually sits on top of the muscle. So as you begin to lose body fat, your muscles will begin to poke through, let's say, but sometimes that's why people will feel both, they'll say, oh, I'm getting I started and I stopped because I was getting bulky. It's just a sort of a swelling or an inflammation, let's say, of the muscle underneath. Yeah. Oh, long fasts. So I will call myself out here as well. I used to believe that this was the key. And this was when I was in my skinny fat Sophia era when I was in my exorcist Emily era, where I thought that the more you could fast, the less calories you could take in and you could lose weight. You want to make sure that you have total sufficient calories. You don't want to over consume calories, but you also don't want to under consume them either. But fasting doesn't actually teach you how to eat when you are not fasting, right? So I think that a lot of people overly rely on long fast. So when I say long, I would say 20 hours, 24 hours, 36, 72, like these really multi-day fasts. If I start eating a lot less calories, then let's say you do, I'm going to have over the long term more detrimental effects than you might. The female body is just more sensitive to whether nutrients are coming in or not so that we can figure out whether or not we want to direct our energy to, you know, being able to get pregnant that month. Our ovaries, when we sort of look at the density of the mitochondria in them, it's something like 100,000 mitochondria per oocyte, like per cell. So they're constantly scanning the environment to see whether it's safe for a woman to get pregnant. And so if you are fasting all the time, you run the risk of sending a signal that it's not safe, that these are famine conditions, and that you should not be producing an egg because that would be terrible because if you got pregnant, there's not enough food to feed you or the baby. So it shuts off your menstrual cycle as a way to stop you having a baby. Yes. So you can still fast, but the way that I like to fast is sort of pull the food, you know, call it two to three hours before you go to sleep. That's when you cut off the food. You sleep for eight or nine hours. That's like a 10 hour, 11-ish hour fast. And then you wake up in the morning and you eat. What often happens is women try to push, they'll have a cup of coffee in the morning, and then they try to push their eating window, let's say, to 11 o'clock or noon. And that ends up, it becomes more difficult, I'll say it that way. It becomes more difficult for you to get in sufficient calories, sufficient protein, sufficient carbohydrates, and fats in a restricted eating window. Yeah. Okay. So this is related to the bulky myth. I think a lot of women are scared of lifting heavy, partially because they've never done it. So it's foreign. And I think that the other reason that women are scared of lifting heavies are scared of getting injured, which to be fair is a valid concern. I think that in the era of, you know, again, social media can be a blessing, it can be the greatest thing ever, and sometimes it can be a vehicle for misinformation. And I think now we hear muscle mommies and lifting heavy, and I think that for women, at least in my cohort, you know, 40s and 50s who grew up in the, you know, the 90s, the Kate Mosses, and the asking a woman who is very comfortable with a cardio machine as her vehicle for exercise, to now move into the, you know, the free weight section of the gym, the deadlifting platforms, even the machines, can feel really intimidating. So there are lots of different ways that you can build muscle it doesn't have to just be heavy. There are other ways that you can progressively overload the muscle, which is to say that you are applying sufficient intensity and effort every single time, whether it's heavy weight, or it's more volume, or you're increasing the density of your workout, meaning you take less rest, so you're a little bit more tired, like you can, there's a lot of different ways that you can make a workout harder. It doesn't always have to be heavy. Okay. Yeah. Heavy. Oh, this one? This one's good. This is post workout fueling. We used to think that you only had 15 minutes to like knock back a protein shake, right? After you've done a workout. After you've done a workout because you need to replenish the glycogen and you have to start muscle protein synthesis and I would say that this is largely false. Your muscle protein synthesis is not just limited to the 15 or 30 minutes that are immediately after the workout, right? Your muscles are building little protein factories over the next, you know, depending on how trained you are, 10 to 72 hours in some cases. As long as you are getting sufficient, again, total protein over the course of the day. Total calories over a 24-hour period. Totally fun. Okay. Yeah. Oh, pre-workout fueling. Okay. I would say in an ideal world, everyone would have some food before they train. So a little bit of protein, a little bit of carbs, just to start raising some blood sugar to have some available substrate for the workout. I don't do this most of the week. So when I work out during the week, I'm typically at the gym around six-ish in the morning. And I don't like the way that it feels when I eat that early in the morning and it sort of feels like I have a brick in my stomach. So what I typically do is I will fuel with ketones. I have ketones for my workout. And then when I get home, that's when I have my big meal. So you have ketones before you do workout? Yeah. Why? In the absence of food, I would say that ketones are fuel that your body produces ketones, right? It's a fuel that your body already knows what to do with. Especially when it's a big muscle, so if you're doing a leg day, let's say, or a back day, it provides you with the neural drive to continue going. So you get into that sort of sympathetic state. That's my favorite flavor too is the green apple. My kids have the green apple before they're sock or two. I am a coroner of this company, #at. Yes. I had to disclaim to that. Yes. Someone's going to come for me. Yeah. So in an ideal world, we would fuel before we work out. But the constraints that I have in my life is that I just can't in the weekend different story. Later, I can have a long coffee with my boys, you know, have breakfast, head to the gym. And then, you know, I always know that when I do have food, my performance is better in the gym. Better. Always 100% of the time. So let's talk about what you do in the gym and why you do it because you've clearly got a big focus on muscle being important. Yeah. I train with lots of women. I actually trained with a colleague of mine this morning called George. She often goes off into like the cardio section. And she does muscles as well, some resistance training as well. And I go off in the other direction to like the, you know, the platform. Yeah. Like the men, the stuff that men typically gravitate towards. Yeah. And I'm wondering what you think all women should be doing in the gym. Like, is there, if you think about a seven day workout regime, what do you think is optimal in those seven days? Yeah. There is, I do want to, I do want to call it something you just said and then I'll answer your question. You just said, I go to the area that typically men go to and I do the exercises that men typically do. But because squats and deadlifts and presses and pull ups are typically done by men, doesn't mean that those are male exercises. Those are fundamental human, you know, motor patterns that both men and women can benefit from. But to your point, there is typically more men doing those things that are more comfortable doing those things versus someone who's like, Hey, I can figure out how a stair master works. I'll just get on this thing and I'll be on here for the next 35 or 40 minutes, right? I love the stair master. I love the stair master too. It's a special kind of torture. It's great. In terms of what I think people should be doing, if she can aim something like three or four days a week of strength training, yeah, it would be alternating upper body and lower body. And then we would be thinking about what muscle groups are we going to be working together? Is it a pull or push? Yeah. So this is, I think this is from my book, my upcoming book called Nothing to Lose Actually because we shouldn't be losing, we should try to try to be gaining. And these are the, these are the muscle groups that I want women to be thinking about. If their goal is body composition and they are trying to build a body that has curves, you can't spot reduce, but you can definitely spot build. Like you can put curves where, you know, they weren't before. So what I've done in the book is I've outlined muscle groups that I think women should be focusing on in order to help develop in more of an hourglass figure. So we have starting at the top, we have the deltoid muscle group, which are, these are your shoulder, I like to call these your bread buns. So they're sitting on the side of your shoulder, the lateral delts below that will have the back muscles and the lats in particular. I like to call the lats are angel wings because we have, you know, it helps sort of create that V as the back widens. You have a, the appearance of a slender or slimmer waist moving posteriorly, we have glutes. So there's three muscles that make up the glutes, it's max meat and men, glute, max mass, glute, medias, glute minimus. And then we have the ad doctor group, which is the inside of those, the inner thigh muscles, yeah. And then the last, the last one is the pelvic floor or more broadly will say the core muscles. So what do I need to know if I'm a woman and I'm thinking about building this, these five muscles that you've highlighted here, are that, as it relates to how I should be training and the big misconceptions about how to train to build this, what do I need to know? For these muscle groups, you probably should be hitting something like 10 sets of exercises per week, per muscle group. Okay. So if I do four hip thrusts, that is one set of four, and that's going to help my glutes. Correct. So you're saying that I should be doing 10 sets a week, per muscle group per week. Yeah. That's not actually that much. No. And this is why I was saying before, the two times a week that the ladies that are like, I just have to, that's all I can give you, you can still have incredible results. As long as you are taking the muscle close to muscle failure, which is to say that you can no longer perform the repetition anymore. You don't have to take it to failure, but as long as it's one to three repetitions from failure, that's all you need to do. Now, you know, it's simple to say that's all you need to do. It's going to be very difficult for you to do that because you are going to start noticing your range of motion, like your ability to do your range of motion is going to be limited. You're going to start noticing the velocity of the repetition is starting to slow down. So your ability to sort of move the weight through space is going to start slowing down. You're going to subjectively, even though you can see that you're holding like a 15 pound or 10 pound, you know, weight, it's going to start feeling like 20 or 25. Like your subjective perception of the weight is going to be increasing. You know, if you were to rate it out of 10, you would rate your effort, like eight or nine out of 10. And men and women, because they have different anatomies, should be doing slightly different exercises? I think that that's more a matter of preference and goal. But it's more anatomy than you and that's me the same. Our anatomy is not the same. No. Think about the way that we move through, let's say if you and I were to squat together or you weren't and I were to lunch together, there's going to be some differences in terms of how we look. And so we'll pull up some props here if we can. So this is a female pelvis. And this is this little guy who doesn't want to stand up today is a male pelvis. So when we sort of look at the difference between them, the female pelvis is wider and it's more shallow, the male pelvis is more narrow. And the reason that we have more of this sort of if you sort of look at the tube, this looks like a little bit more like a heart shape. And this looks a little bit more like an oval shape. And the reason for that is to allow a baby to pass through. Why this is so important is this is going to shape the stressors that happen in our knees and our ankles. So in particular we have something called the cue angle, which I believe I have something here. So here is the cue angle. So what a cue angle is is basically you take a measurement from the hip and you draw it all the way down to the kneecap or the patella and then you take like another little line from the tibial tubercle and draw it upward. So that's just for all the nerves that are listening. If you want to measure this, it's the anterior superior iliac spine all the way down to the patella and then the tibial tubercle. And what you'll see for women here in pink, because the pelvis is wider, the femur has to more aggressively come in immediately, it has to come more to the center. So this makes women, when we compare women and men, it makes us more knock-need, which just means that the knees are coming more together. So this is going to impact literally how we move. So it's going to affect how we walk, how we jump, how we squat, how we lunge, how we run. And so it's important for women to understand how we're different, because often the queuing and the instruction that women get are sort of very, they're based off of a male pelvis, let's say. And so we can run into feeling like squats are not comfortable. But lunges are not comfortable or we start to even shy away from some of these motions because we don't think that they're meant for us. You just need to know how to adapt your training so that you can support some of those sheer motions as you as you're moving. Because what ends up happening for women is as we are or let's say lunging or squatting, as the knee comes down, we will start to see more shear forces being placed through the medial or through the inside part of the knee. So that puts us at a greater risk for ligamentous injuries. So in the knee, the big one is the ACL that we often worry about. So as you're getting tired, you need to be aware that you're gonna have a tendency for that knee to come in. And there's nothing wrong with the knee coming in as long as you have muscles that can kind of support it. If I were to grab this back here so we can sort of think about superimposing it, if we were to look at the leg here, the muscles that are gonna be helping to control the way that the hip moves are the glutes. So you have the glute max, but in particular, the glute medius, which is often called like the upper shelf muscle, that's actually gonna help the femur or counteract. The femur being pulled inwardly, yeah. So we do have different anatomical differences that women need to be aware of so that we can bias training that will provide mobility and stability for us. So that's another reason why, I mean, yes, glutes look amazing in genes, but it's also because they are providing such a driving force of stability for the spine, for the knees, for the ankles, literally for the entire body. - And so with squatting men and women should squat differently. - Yeah, not all women and men should squat differently. There are women that can squat in these sort of traditional queuing. - Can you show me this? - I can, yeah, I'll have to take my heels off, but I'm happy to, yes. Do you wanna do it now? - Sure. - Yeah, okay, let's do it. - So tell me how the anatomy of a woman and a man determines how we should be squatting. - So I'll say first that you have to play and see what feels good for you. So there's gonna be some women that are gonna be able to squat, just like the traditional cues that I'm about to give you. Most women prefer a little bit of a wider squat and I'll show that. So the typical squat, the way that we're often queued, is feet are a hip width apart, toes facing forward, and then we're gonna come down, and then I'm just like, I can't actually get, I'm trying, I'm collapsing my chest at this point. So for women, what a lot of women find is more comfortable and they can actually get the range of motion that you just demonstrated, is taking your feet a little bit wider, and then you're gonna turn the feet out. So because the female femur tends to sit a little bit more spun inwards or internally rotated, now with this external rotation, we can actually just get by all of that and we can come all the way down into a squat. So and we can hang out here, like I can, we can probably do the rest of the podcast, like this if you'd like. - I'd rather not. I'd rather not. - Yeah. - So that's the squat. Is there anything else that needs to know about the squat, the variants between men and women with squatting? The other thing that you can think about, whether it's a squat with two feet or a lunge or a split squat with one, is with a woman, when she's coming down, when she's decelerating, like she's coming down into the, into the lunge or into the split squat. Everything, and you're, this is true for you as well. Everything is gonna be internally rotating. So the femur, the leg bone is coming in, the tibia is coming in, the foot on the inside, you're actually rolling onto the, you're flattening out the arch, it's called pronation, which everybody says is a bad thing by the way, but it's, you need it to be able to load the spring. And then for women, like if you and I were to squat with the same leg forward, you'll probably be able to see that as I'm coming down, like my knee tracks a little bit inward, versus your stays a little bit more straight. There's nothing wrong with that. It's just a matter of whether or not I have sufficient control with my hip stabilizer muscles in order to make sure that I'm not putting excess shearing forces on the knee. - So you need to strengthen your hip stabilizer? - Yep. - Okay. - The beach. - 'Cause I've read something about, I think it was about the World Cup, the Women's World Cup, where they said that if something like 12 women had got ACL injury, injuries in the lead up to the World Cup. - Yeah, so when we're thinking about why that happens, it usually happens when the athlete is tired. So if it's leading up to the World Cup, they've probably overtrained, they're not recovering, and then it can be just that they're training one day and she takes a weird step. The shearing forces happen just before her ligaments and her tendons are able to stabilize it and you damage it. - And is that true that there's a connection between like your brain and your mechanics that often result in injury? Like so, I can't remember what it was, but I think someone was a sleep doctor telling me that when you're under slept, one of the reasons why you get so many injuries is because when you do like jump, your brain and your-- - The reaction time is slow. - And you see a lot of athletes doing this before games because they're almost like practicing landing. - That's actually a little bit of deceleration. - Okay. - So what that is is basically a stick in land, right? So they're jumping and they're holding it so that the forces are not dumped into the joints, but rather absorbed into the connective tissue. So the ligaments and the tendons. - And why is deceleration, why is it important, even for everybody, even on athletes to do that? - Well, if you are not an athlete and you're just somebody who doesn't want to fall and break a hip, I think that that's really important. If you're thinking about falling, what you need to be able to do is get the hip flexor up in front of you, right? And then stop the fall. So there's a couple muscles. So we have the hip flexor muscle that has to come up quickly in order to get ahead of the fall. We have the tibialis anterior, which is just this muscle in the front of the tibia that is involved in what's called a dorsiflexion, which is just nerd speak for toes come up, right? So you need to be able to clear the floor and then you need to have glutes to sort of absorb and break, right? And then we were talking a little bit about the hourglass figure before, when we were talking about the adductors or the inner thigh muscles. One of the things that the inner thigh muscles will do is they'll actually pull the leg back underneath you, right? So they'll also help to stabilize that fall. And the adductors or the outside muscle, like the side of the glutes, they're also going to help break. So there's a couple, like when you're falling, it's like you've got to get the leg up, you've got to have the toe clear, the floor. And then if you're falling off to the side, you need the adductors and the adductors to be able to stabilize so that you don't trip over it. One of the smartest things a business can do is build like a bigger company, without actually hiring like one. But the problem we all face is that most companies don't have every skill in house. So when I look at the businesses seeing real success today, the consistent pattern with all of them is how quickly they move. They bring in specialists with skills and emerging areas to keep themselves ahead. Even in our company, we spent the last year pulling in talent across areas like AI native strategy, no code builds and product workflows. And we find this talent for a long time, partner, Fiverr Pro. Their premium service only shows you vetted talent, so you've always got the safeguard for anyone you pull in to help you with a complex project has the skills that you're after and will deliver to the same high standards as your internal team. 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Not only are they our sponsor and a company I have invested in, it is the only coffee I drink now. Actually, this morning when I came to work, I put a Cometilla, one of these web worlds, which is another one of my favorites from France. If you want to try your own Cometilla, they reserved a certain amount for driver's ear listeners. Just go to Cometilla.com/doac, and you can get $20 off if you use the code Doac check out. So let's talk about supplementation. Do you take supplements? - I do. - I'll pre-frame this by saying that I am a special category of nerd. So I take a lot of the foundational supplements, and then there are other ones that I take because I am just very, very interested in the research and the research excites me. But I would say for the general population, for women that are listening, if they're thinking I got a supplement, there's a couple of sort of tier one, we'll say supplements that we want to be thinking about. So I will find my magnesium first. This is our tried and true bestie, okay? So I love a magnesium glycinate. There's lots of different kinds, but glycinate's just the easiest to absorb for most people. Tends to help with relaxation, helps it sleep, helps with muscle recovery. So this is something that I love. I'll usually take one, like 250 megs at lunchtime, and then another one in the evening. So magnesium for everyone. - How do you remember to take them? - I tend to have it stack them. So I always know that when I am preparing my lunch, I actually keep my magnesium right beside my salt and my pepper. So as I'm like salting my food, I'm like, oh yeah, there's the magnesium out of take it. And I have another bottle upstairs in my bathroom. So as I'm getting ready for bed, I'm putting up my hair, I'm doing my skin, whatever, I will all take one there too. - So you put it in the way of other habits? - Because otherwise, if I put it in a really beautiful supplement closet, it's just going to stay there. - I have to put it on my desk. So when I travel, it's on the hotel desk. - Yeah, you're already doing something else. So just put the thing next to the thing you're already doing and your compliance and your team. here and it's going to go up, right? What else do we got in here? Ooh, omega-3s, okay. These are so well-established in the literature, they reduce inflammation, they help with cognition, something like two to four grams a day. - I didn't know you needed to keep it in the fridge. I've been keeping it in a hot cupboard for the longest time. - Yeah, I mean. - Plenty of spoils. - Yeah, it just helps with spoilage. So you can pop them in the fridge and then same kind of thing, like habit stacking. So as you're opening up the fridge, put it in front of, you know, the thing that you would most commonly reach for. So you go for fruits in the morning, you put them right beside your fruits. - Okay. - Yeah, what other goodies do we have in here? Vitamin D, for sure. D3 with a K2, 4,000 I use minimum per day, I would say, most people should be taking that. They call it a vitamin, it's not really a vitamin. It's more of like a pro hormone or a pre-hormone. So this is really important for sex hormone and reproductive hormone production, again, inflammation, cognition. - Every day. - Every day. - Every day. - I went to the doctor and he said I was deficient in vitamin D and omega-3. So there's more. - You know how many, even if you live in a sunny, I can't tell you, I've had patients who live in, you know, Florida, let's say, where you think that you're getting a lot of sun exposure because the temperature is amicable to that and you run their vitamin D and. - It's crazy. - Yeah. - Crazy. - Ooh, I'm so happy you have this one here. Creatine, I know you just had Dr. Darren Candle on the show, he was actually on my podcast as well. For women, you know, I think creatine used to be this like, bro supplement, you know, like these bodybuilders with the scary, you know, noises and the, you know, weird t-shirts and stuff. But creatine is really, really important for women. The way that Dr. Candle described it to me was he said, you know, lifting weights builds the cake and this is like the icing on top of it, right? So you're not gonna, you know, enhance performance. You're not gonna build strength if you're just doing the creatine, you have to be pairing it with the mechanical signal of resistance training. But I think every woman can be taking five grams, three to five grams of this every single day. - How much are you taking? - I take five. - Sometimes you take a bit more than five. - Sometimes I take a little bit more than five. So when you have been, and this is, this is the little perimenopausal hack because I am in fully in the throes of it right now. There are nights where I don't sleep well. So taking a higher dose of creatine that day will help with your cognition, your awareness and your alertness. So something like a 10 gram dose because it's a little bit harder to get my understanding of it as it's harder to get across the blood brain barrier. So you need a higher dose in order to facilitate that. But yeah, 10 grams. - And what impact has it had on you? Have you noticed an impact? - When I haven't slept well, yeah, definitely, if I take it in the morning, it definitely wakes me up. I would say that when I am not taking regular, like I'm not taking the three to five grams, or for some reason I start forgetting, muscles look a little less full. You know, they look a little less full. Don't have as much energy in the tank when I'm doing like a really intense workout. There's a performance degradation when I am not on it. And then collagen, I love this one because it gets so much hate online. So we're going to go against the grain and talk about how great collagen is. A lot of the criticism for collagen often comes from this idea that, well, it's terrible, it doesn't have any loose scene, or it has less than 3% of loose scene, which is an amino acid that stimulates muscle protein synthesis. And yes, that's true. It is a terrible driver for muscle protein, but that's not like the whole goal for women is not just muscle, right? We have other tissues that go to the gym alongside our muscle that train, like our tendons, our ligaments, our joints. And so collagen is just like muscle, is a very expensive process. So it's very expensive, you know, you know, from a mechanistic point of view to create collagen. So taking collagen is great for what I like to call the JTL, your joints, your tendons, and your ligaments. So I will typically take something like 10 to 15 grams of this a day. People will probably come at me, I put this in my coffee sometimes, which I know the heat, I get it, but if I don't, I won't take it. - There's so many collagen products out there at the moment, isn't that? - Yeah, yeah, yeah. - Collagen drinks, collagen, collagens and everything. Someone's gonna figure out how to like put it in the air or something. - Yeah, right, yeah. - Is that all of the fact? They're saying it's good for skin, it's good for nails, it's good for hair, it's good for everything. - It's good for fascia, it's good for, I mean, collagen is the primary compound in joints, tendons, ligaments, fascia, skin, hair, nose. - Keep your particular type of collagen. - Hydralized, hydrolyzed type one, two and three, yeah. - Okay, yeah. - Fine, what else? - Electrolites, I take electrolytes not as consistently, again, in the vein of transparency and honesty, I typically will take this on a very heavy cardio day. So I have recently taken up tennis, I'm terrible at it, but being outside tennis, you're in the heat, you're running left and right and you're doing it for hours on end, you know, you can, when you're sweating a lot, electrolytes are really great, yeah. So like electrolytes, don't take them all the time, and with our last puppy here, oh vitamin C. Vitamin C, I actually like to take with the collagen because it can enhance its absorption, and then this is just a general antioxidant that I think, you know, there's no harm in taking vitamin C, right? It's water soluble, you take too much, you pee it out. But good as an antioxidant, good as an anti-inflammatory, helps with the absorption of collagen as well. What about protein? How do you think about protein? Do you take protein shakes or anything? - I do when I'm traveling. So I typically in my day-to-day diet, I typically don't, I will if I'm falling a bit short, but for me, most of my protein is coming from Whole Foods. - What about cardio? Because we've talked a lot about doing resistance, training and the importance of building muscle. And where does cardiovascular exercises running, sprinting, stammer to fit into all of this? - It's life, it's everything. Cardio is fantastic as well. I think that again, you know, when I think about my overwhelm, Dophilia, you know, she's online and she has people that are saying things like, you should only lift weights and walk, and then there's other people that are doing, you know, the chronic cardio and the people who are kind of overdoing it that and not doing enough weights. I sort of think about her as we start this discussion. So we want to be thinking about cardio, not as a punishment for what you ate, and not because you're trying to get skinny, but because we want to have other goals around our health span and our lifespan. So living in longer life and spending more of those years healthy. - A lot of women have PCOS, including my partner. - Yeah. - And I was looking at the comments when you're, one of your interviews you did, and one of the top comments from a woman was, for women with PCOS or insulin resistance, sprint training hit often backfires because it spikes cortisol and insulin. Many of us do better with strength training plus zone two until hormones stabilize. I would love to hear more tailored guidance for PCOS. - Yeah. So the first thing I want to dismantle in that comment is that cortisol spikes are bad. It really, context really matters. So without, so I'll just say it this way, without cortisol, you won't wake up in the morning. You know, we need cortisol. There's something called the cortisol awakening response where it tends to peak, you know, somewhere, you know, right around the time that you wake up, and then it sort of looks like a ski slope and it, you know, gradually exits the chat, right? So cortisol is a normal process. A cortisol spike is a normal process. Just like when you train. So when she was saying like, I train, when I do resistance training, if she were to be monitoring her hormones, she would see both a glucose spike and a cortisol spike when she's training because though to be able to train with enough intensity and effort, you need to be, you need to get into something called sympathetic drive. You need to be in like stress physiology. So her cortisol spiking when she's training as well. So I want to really caution women away from being scared of normal and predicted, you know, spikes, right? Like glucose spikes, cortisol spikes. So that's what I would say, just to start off that conversation. Women with P-M-O-S, it used to be known as PCOS. Now it's Polyander Cran metabolic ovarian syndrome. Her body typically behaves more like someone who is diabetic, like a type two diabetic, where she has issues with glucose disposal. She has issues with insulin sensitivity. So specific recommendations for someone who has PCOS is absolutely she should be training 'cause every time she's contracting her muscles, she's actually helping whether insulin is present or not for her to pull that glucose into the muscle cell and to be able to make energy. So that's really fantastic. I also think that whether you have PCOS or your type two diabetic, I think that zone two cardio is fantastic. Again, for endurance, but you can also benefit from the very high intensity cardio that might be categorized as high intensity interval training or hit or sprint interval training sometimes called sit. This is like sit is basically like 10 to 20 seconds all out, ovaries to the wall, 100% effort, and then you recover and then you do that four, five, six times if you're feeling particularly energetic. And that can also, that stress, that cortisol spike and the physiological cascade that happens from that is going to make you stronger and a better glucose disposal agent, right? which is what she wants if she has PCOS. over the long term. - Are there any particular exercises that women and people generally tend to stop doing as they age because it's kind of like, it becomes harder as you age, but they should definitely not stop doing. - Oh my gosh. - What are the ones where we all kind of stop doing it? But it leads to a downward spiral. - Sprinting 100%. I think that everybody should be sprinting. - Why? - You are gonna be increasing something called your VO2 max, which is just again, nerds speak for how much oxygen can you take into the lungs and distribute to the cells, right? That along with, we've all heard the stat, muscle declines 1% per year. If you're not doing anything, VO2 max is the same. So you will decline your VO2 max capacity, 10% per decade, if you're not actively working on it. - I'll put some graphs on the screen that show that decline of a time. - Yeah, great. I can think of family members, going up the stairs or down the stairs or trying to get groceries and bringing them into the house that are huffed and puffed. They've lost their breath from going up a flight or two of stairs. - But they think they say that that's just getting older. - Absolutely not. It's absolutely not a function of aging. It's just a loss of capacity. There was-- - Can you sprint? - I sprint all the time. Yeah. So what I wanted to say was there's a couple of different ways that we can sprint. So you can sprint on a track. So I used to be a track sprinter. So that's like my love. But you can also sprint on a cardio machine in the gym. So in the winter time, so I live on the East Coast where I can't always sprint on the track. So I will take my sprinting indoors and I will do something called the Norwegian 4x4 on a bike. Have you ever heard of a Norwegian 4x4? - I have heard of it, but please to explain. - Yeah, it's a special kind of torture. I hate it up until the moment I get on the bike. And then when I'm doing it, I'm like, okay, I'm gonna do this. And then when I'm finished, I'm like, I'm so proud of myself. So a Norwegian 4x4 is basically four minutes. You're, in my case, I do it on the bike, but it can be done on treadmill or any cardio machine. 85 to 95% of your heart rate max. So you need to know what your maximum, like the maximum heart rate that you have ever achieved. 85 to 95% of that for four minutes. It's a long four minutes. And then you take a, you take a three minute break and then you do that again four times. Hence the name four minutes four times. Lots of really cool studies on looking at VO2 max capacity. There's one that I'm thinking of where they looked at women. The average age of the women were 58. So they were, a lot of them were in like post-menopausal, let's say, and they put them on a sprinting protocol. What they found was that in a period of eight weeks, they were able to increase their VO2 max by 10% in two months, which is wild when you think about how quickly you can lose it. And you can get 10% back in two months, which is phenomenal. And the other really cool thing about that study was they actually took that cohort. So that was the, we'll call them like the, the well-lived or the older cohort, let's say. And they compared it to 18 to 30 year olds. And they found that the gains that happened in the older cohort were, they had mitochondrial efficiency improvements of 69%, whereas the younger cohort, their mitochondrial gains were 49%. So all that to say, a lot of people will frame aging as it's like, well, now you're getting wrinkles, now you're getting old, and now you just pat your over the hill, it's past your front. These women had, maybe the gap was bigger for them, but they had so much more upside to gain, right? Which is so, that means that makes me so excited because it's never, ever, ever too late. Like you can, like the best time to start was 10 years ago, fine, but the second best time is today. Like you're not behind. You can totally do it now. - One of the top comments in your recent video as well was someone saying, jumping or hopping is a good way to strengthen your bones and knees. You should not stop doing that as we age. - Right. - 'Cause a lot of people start thinking, like, I can't run anymore, because it's not good for my hips and my knees and I've had injuries and stuff like that. So running is one of those things that people stop doing, 'cause they're scared of joint issues. - Yeah, I think the old adage of use it or lose it is really, really key here. Like if you stop doing it, you're gonna definitely stop your ability to, like you're not gonna be able to do it, right? Your body is going to prioritize the things that it does. So if you want to be able to jump, you want to be able to sprint, you want to be able to squat. Age is absolutely inconsequential to that. So in that particular comment, if somebody wanted to improve their bone density, yeah, for sure, you can strap on a weighted vest, do some plyometrics, add some weight to your jump. Like that's gonna increase that strain magnitude and strain rate on the bone, which is gonna drive that positive bone reformation. That's awesome. But yeah, if you don't jump, you're gonna lose your ability to jump. - Do you jump? - I do it all the time. Well, sprinting is jumping, right? - Is there such a thing as jump training? - Like plios, plyometrics? - Oh, is that what pliker? - 100%. - And you do that? - Yes. - Cometric holds, let's say, like maybe somebody can't jump, but they can stand with their heels elevated so that the Achilles tendon and the calf, like the gastrocnemius, is contracting. Just to give you a little bit of a visual here, so what I'm talking about. Maybe one of the most famous tendons in the body is the Achilles. It is the extension of the calf muscles here and then it sort of wraps around the heel and attaches into the inferior part of the calcaneus, which is just your heel bone. So maybe you can't quite jump yet, but you can actually, this mannequin is doing a really good job. They're just coming up on their toes, contracting the gastrocnemius and this is called an isometric hold. So that tension in the muscles and in the tendon, we have these little mechanoreceptors that sort of detect stretch. So they will detect that whether something's being contracted or whether something's stretching and they will say, oh, we need to remodel in order to meet the demand of this activity. And then you can progress to doing little hops. You can progress to doing jumps, et cetera. - Very easy to do. You don't need to jam or anything like that. - Not at all. - I've heard you say that and desaleration is important for mobility. - Yeah, desaleration is the opposite of acceleration. So we think of acceleration that's speeding up and getting fast. Desaleration is coming to a stop. So in order to come to a stop without dumping all of the forces in your joints, again, the tendons and the ligaments need to be able to absorb that kinetic energy. And from a sport perspective, your ability to decelerate so coming to a complete stop and then changing direction, so change of direction training is actually more predictive of whether you'll go pro than your vertical jump, your acceleration speed or if you're doing things like beep tests or whatever. It's also really important for us as we age. You might trip on something on the floor or in the corner of a rug or you might lose your footing on the stairs. You need to be able to get your foot in front of you and then be able to stop the motion before you fall. - Are there really other exercises that are like really, really simple and underrated that one can do without equipment? - I have so many to show you. - Okay. (laughs) - So the one that I love, this is almost like a diagnosis, but then the diagnosis almost becomes the plan, like the care plan, something that I just called the ex-plank, it's very difficult to do, but it is a test for stability and mobility of the hip. So we were talking about the cue angle before. This is directly challenging the muscles on the side of the hip and whether or not you can stay stable. So this is a great exercise. Yeah, I can show it to you. - So this is, again, like I was saying, it's the test but then it also becomes the care plan. So maybe what we'll do, so I'll show it to you and then maybe we'll have you try it. - Show me, I'm gonna be over here. - Yeah, okay, okay. So you're basically gonna come into a side plank, so where your wrist and your shoulders are all aligned, toes are facing forward, hand comes up, and then you're going to lift the arm up, and you're gonna try and see if you can hold this for 30 seconds. It is not easy, and so this is really testing the stability and the mobility of your hips. It's also testing the integrity of your ability to stay abducted, which is what my leg is doing right now. So if someone has a timer, hopefully I'm close to 30 seconds but we'll call it maybe, Mal, probably about 30 seconds there. So that's a really great test for anybody to do. And it's also, there's core work, there's shoulder work, it's a really whole body workout. - Okay, yeah, my turn. - Why don't you try, yeah, see. - Okay. - So on your side, toes stacked on top of each other, wrist is kind of tucked under the shoulder. Yeah, hands waving hello, and now try to lift to your top leg. - Oh gosh, okay, let me just cause somebody. I'm just, I'm just, I mean, if you want a friend. - Okay, I'm gonna tuck my, my feet hurt. - So in this case, if you're not able to do it, this becomes the thing that you train. - I mean, the pressure of putting my foot on my, the foot and putting all the weight on this foot here. - Okay. - Maybe I'll put my foot on the mat. - Yeah, yeah, like maybe you need a little bit of grip. - Yeah. - That's no better. I think it sucks, you just may be in the week. Okay, so like this. - Yeah. - And then lifting this leg up. - Lifting the leg up, there you go. - Okay. - Okay, I get it. - Yeah, yeah. So now you're just gonna work yourself up to 10 seconds, 15 seconds, 20 seconds, and over time, you'll just be doing this at the airport. - Where does this arm go? Just in case. - Just on top. - Anywhere. - Yeah, just on top, yeah. - I think I've got more of a balancing issue. - Yeah, it's also, it's a really strong balanced test. Yeah. This is one of those exercises that literally tests almost every system in the body. So I love it as a diagnostic. - Okay. - Is there like an entry to this exercise that's a little bit more amateur? - For sure, yeah, and well, if you can maybe instead of doing it on both feet, you can maybe do it on your knees. So I'll demo that real quick. So if you wanna just come here, so you're stacking the knees on top of each other, and then you can do it this way. - Okay. - So there's still, you're still having to recruit the glute mead here, but it's just less, less stress. - You can. - Wanna try that? See how that one feels. - I got it. - Yeah, you got it. - Okay, take care. - Is there anything else that you can show me that? You think it's pertinent to the conversation we just had? - You know what, well, yeah. This one actually relates to mobility a little bit, which we did talk about. So in cultures where people sit on the floor, they eat on the floor, they toil it on the floor, their fall risk is literally almost zero. So I think as North Americans or Western, we can do more sitting on the floor. So one of the big tests, I usually want to start on the floor, but I'll have if it's an elderly person, maybe they're sitting on a chair, can they stand up, unassisted, like without using their hands? And this is the hardest part of the test. So what you'll do is your feet crossed, and we'll do it with both feet to see, without using your hands. So you can use a little bit of momentum if you want, but you're gonna see if you can get up without using your hands. There you go. - Well, that's awesome. - Nice and done. All right, let's get back down. Let's try to cross our feet the other way, the wrong way. - The other way? - Yeah, I know, 'cause you always typically cross your feet one way, right? So I don't do this one as well as I do the other one, so I'm working on it as well. So again, no hands. You can use a little bit of momentum if you want, and you're gonna come all the way up. That one was not as pretty. Yeah, there you go. - Okay. - This is really loud. - What is, what is, what muscles am I using there? - You're using every, you are recruiting mobility in your ankles, you are recruiting your quads to be able to extend your knee, your glutes to extend your hip, like it's the whole leg. - Mm, great, thank you so much. We're done. - Yeah, awesome. - Thank you. Any of this, that you love? - Oh, good. - Then you can do that equipment at home. - Push ups, body weight squats, which I think you should eventually progress to weights, but so many people have terrible techniques, so you can actually have a fantastic workout with just your body weight. Glute bridges, I think are fantastic. So many, you can pick up like a big bag of cat food or dog food, and do walking lunges down your wherever. - If you know me, and if you've listened to this podcast before, you'll know how obsessed I am with sleep. I've been on a bit of a journey with sleep. I see it as the single most important thing that I have the privilege of having control over. And that's exactly what our sponsor eight sleep are. It's a very, very intelligent piece of material to sleep on. Here's what the eight sleep pod does. It monitors your body while you're sleeping. And with their AI, it adjusts the temperature for you using billions and billions and billions of hours of sleep data. And members have reported up to a 34% deeper sleep and falling asleep up to 44% faster. Me and my fiance, Melanie, sleep on different parts of the bed, and it adjusts my part of the bed to my body and her part of the bed to her body. So if you wanna learn more about this pod, go to eightsleep.com/steven. That's code Steven for $500 off from now until July 12th. Big opportunity, I'm not kidding, give it a try. For every founder, there comes a point in building a company where your job shifts. From being the person inside your business, actioning everything to the person responsible for absolutely everything. The only way I've been able to make this shift across the different companies and teams I'm responsible for is by knowing that the right systems are in place to manage everything. Systems that don't need me in order for them to work. Our sponsor pipe drive is one of those systems, an easy to use intelligence CRM tool for growing sales teams. My teams use it and have for the last decade because it's genuinely the most effective way to run a sales operation. Through one dashboard, you get every deal visible and every stage of the sales process is clear. And what needs to happen next is all there in real time. When a system like this works, you don't need to be in every conversation to know exactly if your business is moving forward where and what the blockers are. Over 100,000 companies are already running their sales on it. So if you'd like to join them, sign up at pipedrive.com/ceo where you'll get an exclusive 30 day free trial instead of the usual 14 days. No credit card is needed. That's pipedrive.com/ceo. - One of the, I mean, I looked at lots of the comments and a lot of them also talk about the specific issues mother's face after they have a child. I saw comments about prolapse and pelvic floors, et cetera. - Yeah. - You've had two children. What are, and you speak to many, many mothers. - Yeah. - What are the specific issues that mother's face as it relates to fitness, their work at regimes, their goals, resistance training, et cetera, that I wouldn't be aware of as much as not given birth to a child? - So, you know, we talked about how the hips are different from men and women. The pelvic floor is also very different from men and women as well. So just from a-- - What is the pelvic floor? - The pelvic floor is like a hammock of muscles that goes from the pubic bone. So if we were to think about, so here is the female pelvis. We have the pubic bone here. And then it's like a sling of muscles that come around and then attach to the coccyx or what's known as the tailbone. And these are called the pubocoxagile, so pubic coccyx, pubocoxagile muscles or PC muscles. And they're different than, let's say, your quadriceps or your glutes because they are literally working all the time. They are working to keep your organs in the pelvis so that they don't just fall out. And for women, this is another area where we are different because we have more-- I mean, first of all, we have more openings, right? So if you think about the sling of muscles for a woman, you're gonna have a hole at the urethra at the opening of the vulva into the vagina and then also the anus. So there's three holes. And so already, you have less surface area for those muscles to be able to contract and support, right? Versus a male, those PC muscles just have to deal with one. So it's mechanically much simpler for a man. And then you layer on hormonal fluctuations over the course of a woman as she's menstruating, if she becomes pregnant under the influence of different hormones like relaxin, the weight of the baby constantly pushing down, and then birth, as I've mentioned before, these can significantly alter the strength and the ability for the PC muscles to absorb load appropriately. So for women who've had babies, first you have to obviously be working with your OBGYN or your midwife or whoever is managing your care plan to be able to clear you for exercise. And once they do, you don't wanna necessarily go back to extremely heavy loads with lots of intensity right away because you haven't necessarily yet completely healed, right? So this is where we get into thinking about, okay, so what are some ways that we can connect with with the pelvic floor? So the famous exercise that everybody's probably heard of is Kegels, you've probably heard of Kegels. So those are wonderful if you're someone who has a weak pelvic floor. Not so much if you-- - Would you sit and contract and you see? - Yeah, it's literally like for men, the way that I've often sort of queued men is like imagine you're like zipping up a zipper, like you're just kind of coming up and you're sort of holding it and then you're relaxed that you don't necessarily have to move and jump, but you're literally just sort of connecting as much as you can. It's hard because our neuromuscular connection to the pelvic floor sometimes is not really strong. But often just closing your eyes, I just think like just coming up, holding and then coming down. And you can do all these all day long free, you know, no one's gonna know that you're doing it. So that if you have a weak pelvic floor, that would be something that you might explore. So pelvic floor physiotherapist would be someone who'd be able to diagnose that and give you a bit more counsel there. But weak pelvic floors, kegels are great. They can actually, if you have a tight pelvic floor where you actually have trouble relaxing, kegels can actually make things a little bit worse for you. - On your book, The Betty Body. The last word on the subtitle is the word sex. A geeky goddess guide to intuitive eating, balanced hormones and transformative sex. - Yeah. - Why did you include transformative sex? I included it because I think just like all of the myths that we've been talking about today about bulky and carbs, I think that the other thing that has been really taboo for women is women who enjoy their sex life. And so I was hoping in that first book to give women permission to want to desire it, to figure out if there wasn't, if there was low desire or low libido, what maybe some of those causes were, and what are some of the ways that we can learn more about ourselves. I'm thinking of this one patient that I had. And she actually was part of the reason why I included it in this first book. She had come into my clinic, she had come in for low back pain. It was like the most typical, like I'm have, you know, mechanical low back pain, right? And so we were giving her adjustments, we were giving her strength thing, [BLANK_AUDIO] as we were doing the rehab, all the things. Nothing out of the ordinary. At her re-evaluation appointment, she said, "I want to talk to you privately." I was like, okay, fine, let's go into this room, close the door, all the things. And she said, "Do you know the real reason why I came in to see you?" And I said, "Yes, it was mechanical low back pain." And she said, "No." It's because when I was with my husband, getting on top of him while we were being intimate, was really hurting me. My back was killing me, my pelvis was killing me, my joints felt like they were rubbing on top of each other. I mean, I was lucky enough that this patient trusted me enough, and we had enough rapport for her to basically say, "Yeah, I want to ride my husband, and I can't. I couldn't before, and now I can." And so I think that there is a quiet taboo, we'll say, around women not enjoying sex, and I want to give women permission to. So whether you have low back pain and that needs to be corrected, if there's a hormonal input to that. Okay. Stephanie, what's the most important thing we haven't talked about that we should have talked about? Oh my goodness. When we didn't talk about gelp1s, that's all of the value range at the moment, isn't it? Yeah, gelp1s are, yeah, they're interesting, for sure. I do think with all medications, and I am including hormone therapy in here as well, at the risk of getting shot down by some people, is I think that we often marry ourselves to what we feel the benefits might be, and we will divorce ourselves from the possible side effects, right? Hormones are going to help with your, for sure, your sleep, your mood, if you're experiencing some of the thermo-regulatory problems, like the night sweats and the hot flashes and all the things, but it's not going to go to the gym and lift weights with you, it's not going to build a healthy plate, it's not going to set boundaries with your boss, you know, like those things, you have to do those things, right? So there's this beautiful opportunity where we see more women taking MHT to at, or hormone replacement therapy, menopause hormone therapy, to blend that with lifestyle medicine, you can't, it's not, there's no easy button here, you know, you have to also put in the work. And lifestyle medicine, meaning? Training, managing your stress, recovering, doing the cardio that we've been talking about. And that recovery point you just said, what are the recovery protocols that you think all women should be doing? The best one that I can tell you is sleep, which can be a challenge in perimenopause, I understand, but that is where you have things like growth hormone and IGF1, tend to surge, muscles grow when you're sleeping, brain cleans itself, sleep is, sleep is the number one thing that everybody should be prioritizing. That's wonderful, that's like sort of tier one, like if there's like an S tier, sleep is an S tier. Under that, I would say, if you have access to something like Esanna, that might be something that you can think of for recovery, whether that's an infrared Sanna, or it's a traditional finished Sanna, I often call it lazy cardio, so if you don't feel like doing a really intense cardio session, get yourself into Esanna if you have access to one. Not necessary, but really, like there's a lot of really cool studies that have come out of Finland, which by the way, Sanna is the only word in English that we've borrowed from Finnish, just a little fun little tidbit there, but electrolytes we've talked about, I think that if you are really pushing yourself and you're sweating a lot, helping to recover and replenish those, as we lose estrogen in midlife, our ability to regulate salt also starts to decline as well. So what should we have talked about that we didn't talk about as it relates to the most pressing questions you get asked by the people that can assume the content you make? The only other thing I would say that we didn't really go on a nerd safarion is the joints, tendons and ligaments, so like the connective tissue capacity. We've talked a lot about muscle, I love muscle, I train muscle. Muscles like the popular girl at the party, she gets a lot of attention, you know, if you think about a superstar like, I don't know, like Beyonce or something, right? She's beautiful to look at, the pump is great, all of that, but if you put Beyonce on a rotting stage, or you put her on a stage that can't handle her, she's just going to fall right through it, and then you have no concert, right? So I think that the forgotten tendons and ligaments and joints, we have to be thinking about those as we age, because you can't squat if you don't have good knees. How do I get great ligaments and tendons? So the way that you encourage them to become stronger over time is how you train in the gym. So there's a couple of different ways that you can bias for more tendons strength and more ligaments strength. One of them is when you are lifting, you can bias what's called the eccentric portion of the lift. So concentric muscle gets shorter, bones come together, eccentric is stretch. When you start stretching the tendon, the tendons like, I'm being stretched. Okay, we have to now create more tensile strength to be able to meet that demand. Okay, so stretching. So stretching under load. Okay, not just stretching. Pilates. Not Pilates. No. So Pilates, again, love Pilates. Do it twice a week. You really got to be in your bonnet about Pilates. You really don't like Pilates. Do you know what it is? No, no, no, it's not that. It's people confuse muscle endurance. So in Pilates, you often have like very high reps. The muscle burns. It's fantastic for the pelvic floor that we were talking about before. Phenomenal for women's health, for pelvic floor health, that posture. But you're saying it, Pilates isn't enough to build sufficient muscle mass. That's the main point. And that's where I think that people were like, how dare you talk about this? Like, I love Pilates. I do Pilates. I'm probably in your Pilates class. However, I also, I'm training four or five times a week. I'm also sprinting one, you know, sometimes two, but mostly one time a week. I'm doing tennis. Like, I'm doing all of these other things. And Pilates brings me a lot of joy, right? But I feel, I always say, I feel so happy after Pilates. I don't know why it makes me really happy. But some people are doing just Pilates. Yes. So if you are just doing the Pilates, that's where I fear that you're like, look at me. I'm slim. You know, if you're I'm able to fit in this dress now, but then what you're not doing is you're not loading your bones appropriately. You're not building sufficient muscle. Your tendons and your ligaments are weak. And you're going to end up with bone disease or a loss of load capacity when you're older. What's the most popular question that women message you with on Instagram? Usually it's, tell me about your skincare. Tell me what you do with your hair. Or, you know, what your workout outfit is. All those little questions. But it's, how do I gain muscle and lose fat? That's the big one. So tell me about your skincare routine. Yeah. It's pretty basic. I learned this from my dermatology friends. So some vitamin C in the morning. Some SPF. And in the evening, there's some kind of vitamin A. I actually really like NAD. I use another company that has something called your lip and A in it, which is supposed to help get rid of senescent cells in the body. Which are like dead cells, right? Which are, yeah, there's like the zombie cells that sort of hang around and just create inflammation everywhere. You're almost 50? I'm almost 50. Yeah. Feeling good? I feel great. I feel like I inhabit my body now in a way I wish I did in my 20s. Like I was so punitive and I was so terrible to myself. The things I would say to myself and call myself when I was 20, 30, I would never say that out loud to anybody else. And so now I feel really proud of myself. You know, I got into weight training, just like a lot of women who are watching. They want to look better, build muscle, lose fat. That's why I got into it as well. But I stayed with it because of, you know, it provided me a way back home. It provided me, like it taught me how to love myself. It taught me how to be patient with myself, right? It taught me how to forgive myself when I felt like I had failed, right? Like it re-imagines your relationship with failure, which I think is like a really big effort for women. Doctor Stephanie, we have a closing tradition in this podcast where the last guest leaves a question for the next, not knowing who they're leaving it for. And the question left for you is, what's your skin care routine? No. Do you believe in God and why or why not? Oh, I do believe in God. I believe that there is a force greater than us, greater than we will ever be able to explain that protects us, that gives us the lessons that we need to learn. And it will continue to present the same lessons to us over and over and over again and to where we, you know, until we are willing to surrender to, um, to learning the lesson. When you're on your, um, when you're on your last day and you look back at your life and you go, do you know, I did it. What would warrant you being able to say that? That my family is around, I see my, I've met my grandchildren, maybe even my great-grandchildren, that they're all around my bed telling me, oh, you're going to make a Christ even. They're telling me, um, all the ways, all the things that they have learned from me and that they're going to take onto future generations in my lineage. Why is that so important for you? I think all the reasons why I do what I do, um, it's, it's, it's for my kids. Like, I want my kids to have a better life. I want to shortcut some of the learnings for them that I had to learn the hard way. And that's not to say I want to deny them. their own learning opportunity, but I want to be able to pass on what I feel is important values that I think make the world a better place. I just want to leave the world better than how I found it, and the way that I want to do that is through my family and the work that I do here. Thank you. Thank you for doing all that you do. I think it's incredibly important for so many reasons. I mean, there's been, I think through, I mean, it's kind of says on the back of your book here, the Betty body, through time people have thought that women were little men. And that's what you write on the back of your book. It says women are not little men, but that's how we treat our bodies. And it's great to have voices like you that are so backed by science, so eloquent, that are out there demystifying what is a incredibly complicated world of health information and conflicting information. And you know, I know it better than anybody because my audience will often say to me that I relate to all of the personas that you highlighted there where you've got. What was it? What was it? What's your song about this one? Exorcist Emily. No, it's this. I get a lot of this one. Overwhelmed, I feel overwhelmed. Where do I start? Yeah. Where do I start? Because I don't want to fail again. Yes. Yes. So many overwhelmed Olivia's in part because one of the upsides of there being so much information out there now is that people are getting, you know, they're not having to go to some expensive doctor and they can go on an AI, they can go on a podcast whenever. Right. Right. But with science evolving over time and with lots of different voices, people are filming often, I think, feeling more overwhelmed than ever with what they consider to be conflicting information. And I think you do a wonderful job of demystifying that. Thank you so much. Because it's nuanced. It's very human. It comes from lived experience. And it comes from, as you said, you've sat with tens of thousands of patients through the career you're career in practice. And things aren't always so simple. They're not always as simple as they are easiest to sell. And I think things that sell are often simple and reductive. Yeah. But the truth is often complicated, personal. Yeah. And it doesn't exist always in a lab. Yes. You can't always replicate it in a lab. And one of the things I learned from your work as well as that, it changes through time. Yeah. Are you for me? What's true for me now at 33 years old as a man, the stage of my life with a hormone complexion I have and the goals that I have, one thing can be true. But maybe one on 55, a different set of things are going to be true. And I think that nuance is super, super important. If people want more of your work, I know you've got a book coming out at the top of the year next year called Nothing to lose. Build the dream body you want today, gain the strength and mobility you'll need tomorrow. And you've got this current book here called The Betty Body, which I'll link below, subtitled a geeky goddess. You use the word geeky a lot. And nerd. And nerds so far. That's interesting. Used to be used to be sort of a, you know, a terrible word to use. I'm like, no, I'm a total nerd. Yeah, a special category of nerd. A geeky goddess guide to intuitive eating balanced hormones and transformative sex. Yeah. Where else do people find you if they want to learn more message or get in touch or come see you? What do they, where do they go? My podcast. Not quite the reach that DOAC has, but we are, I have a podcast called Better, with Dr. Stephanie. So I do solo episodes there where I go on my little tangents about tendons and ligaments and all the things. And then I also interview what I would qualify as the world's thought leaders in science and health. And we try to distil what it means for, what it means to have a well-lived life. So podcasts free, probably where you're listening to this, YouTube and all the places. And then you can head over to my website, Dr. Stephanie Steema.com. Anything else you want to say? I would say for the woman listening, my overwhelmed Olivia's were feeling like they don't know where to start. Or my skinny fat Sophia's who were scared of lifting weights and eating like a bird. Or my exorcist Emily's who are still exercising their demons. You're not behind. You are absolutely enough. And don't be so hard on yourself. Thank you. Thank you.