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

Transcript from https://podmenti.com/t/5208771ec4262135

I want women to stop being losers. And so I'm 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 gonna talk through some actionable strategies on how to build a body that has curves. More of an hourglass figure. Let's even if I can be
Very honest with you. I'm 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 gonna be very transparent and honest with you. The pursuit of skinny is a bad thing. With devastating consequences, like you're gonna 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 gonna make them fat. But we need carbohydrates for our food, 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 gonna start looking like our bodybuilder. But that's almost impossible.
Seven to ninety eight 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 is 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 in your 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. One hundred percent. That makes me so excited.
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Doctor 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 with 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 do you want that for women?
Specifically this l 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 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
ha 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, or
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 s 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 gonna 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 gonna be sufficient over the arc.
Yeah.
Is gonna be lower, you are going to likely underconsume calories. If you are someone who thinks that they've won because they can fit into you know, you're forty and you can fit into a size whatever dress. But when you're sixty-five, you have osteoporosis.
You haven't won.
You've been you've been tricked.
Trick by who.
A society that tells us
That
Are worth
Is
Solely based?
On how small we are.
Mm.
And who are you?
Like in terms of
Why this matters so much to you as Doctor Stephanie.
What do I what context do I need to know there?
'Cause I can see you're a little bit pissed off.
Up.
Yeah, I am pissed off in a loving way. Yes. So we'll 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, uh personal trainer. So this was, you know, very young, I started having uh 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 pr I've been in practice for
twenty years. So I've seen
Yeah.
Tens of thousands of of patients over my twenty 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 T, 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 ten to call it.
thirteen percent 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
Um
with hormonal issues, my period had 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.
I
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
З 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 with your program?
And so it's I think it's so confusing for women. Maybe we lose the weight or we t 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 have clicked to listen to this conversation right now, what are they gonna leave this conversation with?
Specifically.
And how is that gonna impact their life?
Yeah.
Women and the men who love them. So this is for everyone. Um
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 gonna talk through some actionable strategies on how to do that.
I think if you're in midlife, so you're in your forties, your fifties, 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 gonna maybe
Break a little bit of your paradigm and the way that you think you're thinking about health. And how old are you?
I'm forty eight.
Mm.
Mm-hmm.
Think it's important context. Yeah. You're also a mother?
I'm a mother of two, yeah. Of two. Mm-hmm. Mother of two, and then I have a I'm have a stepson as well.
Okay. So
Um, there's lots of things on the desk here in front of us that I'd love to go through. They're all things that really, really interest me. We've also got these
Five.
Fitness myths in this envelope here that we'll reveal at some point and these archetypes here. 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, et cetera.
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 lightweight, high reps. And then there's other people that are like, that's not true. You can 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.
Right. So she doesn't do anything.
When we think about uh overwhelmed Olivia, we don't want to get her A to Z. We don't wanna get her all the way to her goal. We just wanna give her a couple of quick wins to start.
Right? Get her just A to B.
We're just gonna get her walking.
She's just gonna 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 m 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 I'll walk, right? She also calorically restricts as well.
Right. So this woman
Is my f 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. So it's just Pilates. I love Pilates. I do it twice a week. It's fantastic.

But this woman, when she starts eating a little bit, I all 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 schema 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 some bell fat because I'm skinny fat. Or maybe I'm just you know, I just have a bit too much weight on me. What is it you say to them?
You can't actually spot reduce. What does spot reduce mean?
So someone wants to reduce their bell fat. You can't just
Target bell.
overall adiposity in the body is you're gonna be strength training, 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 s oversimplified calories in, calories out, you want to be thinking about
How am I going to create a deficit? So I'm consum 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 weightlifting, 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?'Cause we he hearing that, you know, just eat less is is quite
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 gonna drive you to consume more calories. I often find when women are like, Hey, I just wanna I wanna build muscle and lose fat, or if it's just hey, I wanna lose fat
I
Personally find it easier for women specifically to do more on the calories out.
So not too much. 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.
'Cause then they have to
You know, they gotta measure, they gotta 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 gonna 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, um, 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 am this woman exorcist Emily.
So this is a just a funny word. Um
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 difficult, like 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 uh
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 I nobody talked to me with my big earphones on. Uh this was for me after I was going through um 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 gonna 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 gonna gain weight kind of mentality.
So exorcist Emily, we love her.
Um
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. Um, 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.
'Cause 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
Two, 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
Say give herself some fucking grace with her with her recovery. We just got demonetized.
We're trying to get everybody to become dolled 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 exorcist 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 Exorcist Emily, that was not a uh 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 gonna happen, it's just a 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. Uh it can be quite intense.
But it does train your resistance, your grit, your mental capacity.
To withstand.
Yeah, terrible things.
So by the end of this conversation, everybody listening is gonna be a darling Diana.
That is my dream.
Okay, that is my dream. First we should start debunking some of the myths. Yes. Um little
Envelope here. Okay.
So the first one is carbs.
Mm-hmm.
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.
Uh if you're a woman that has type two diabetes or PMOS, something like that, a temporary clawback of carbohydrates is fantastic for improving insulin insensitivity, glucose disposal. Um
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?
The carbs.
I'm never gonna 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, came by pop, and they're like, You know what, you have a bacterial infection, I'm gonna give you a script for antibiotics.
Right. You're gonna take it for the next ten days.
And then you know, 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 gonna come to the conclusion at the end of those ten 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 gonna 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 um my first book, The Betty Body, I advocate for a low c lower carbohydrate, a higher protein diet in there, but for a transient
Amount of time.
Right, until you achieve the goal of you know reversing metabolic issues or losing some weight, et cetera, improving your period. That's another thing that we actually see is menstrual cycle um regulation. But if you stay here too long, your thyroid, like so many women's.
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 s uh shedding comes out the classic sign is the lateral third of the eyebrow. We start to see the lateral third of the eyebrow start to fall out as well. The outside the outside third of the eyebrow. So the tail for most people of their eyebrow 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.
Or sleep.
Even performance
Performance at the gym in the vein of transparency and honesty. 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 gonna 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
Of total calories. So it's defined by calories here. Yes. Okay. Yeah. What's the next one? What's the next myth folder?
Oh, this one. I love this one.

Uh 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 gonna start looking like a you know, some 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 gonna be on par with Lewis Hamilton and you're gonna be a Formula One driver, right? It's just
Almost
Impossible for
I'm gonna say ninety seven to ninety eight 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 m I don't have as much testosterone.
than as you do, you have like 10 to 2x more than I do. So even if we trained the same way, I'm never gonna be able to put on as much muscle mass as you.
But a gal can continue to dream.
Right. I can continue to hope. So bulking up it's not a thing. Um I 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
uh poke through, let's say. Um, but sometimes that's why people will feel bulk. They'll say, Oh, I'm I'm getting b I started and I stopped because I was getting bulky. It's just a sort of a a swelling or an inflammation, let's say, of the muscle underneath.
Okay. Yeah.
Mm.
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
The m less calories you could take in.
And you could lose weight.
You wanna make sure that you have total sufficient calories. You don't wanna overconsume calories, but you also don't want to underconsume 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 fasts. So when I say long, I would say
twenty hours.
twenty-four hours, thirty-six, seventy-two, like these really multi-day fasts. If I
start eating a lot less calories than let's say you do.
I'm gonna have over the long term more detrimental effects.
Then 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 a hundred thousand mitochondria per oocyte, like per cell.
So they're constantly scanning the environment to see whether it's safe.
For
uh 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.
The your 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 ten
hour, eleven ish hour fast. And then you wake up in the morning and you eat.
What often happens is women try to push their they'll have a cup of coffee in the morning and then they try to push their eating window, let's say, to eleven o'clock or noon. And that ends up well, 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.
Mm-hmm. Yeah.
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.
I think that the other
reason that women are scared of lifting heavies or 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 um 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, forties and fifties who grew up in the, you know, the nineties, 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.
Maybe.
Oh, this one this one's good. This is post workout
fueling. We used to think that you only had fifteen 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 fifteen or thirty 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, ten to seventy two hours in some cases. As long as you are getting sufficient
Again.
Total protein over the course of the day, total calories over a twenty four hour period.
Totally fine.
Okay.
Yeah.
Oh pre-workout feeling. 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 um for the workout.
I don't do this.
Um, 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
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 uh for my workout. And then when I get home, that's when I have my big
Uh meal. So you have ketones before you do a workout. Yeah.
Why. In the absence of food, I would say that ketones are fuel that your body already 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 group. 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 um flavor too is the green apple. My kids have the green apple before their soccer too. I am a co owner of this company, hashtag ad. So I have to I have to disclaim that. Someone's gonna come for me.
Yeah. So in an ideal world we would fuel before we work out, but
My the constraints that I have in my life is that I just can't
In the weekend, different story. I can wake up 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, a hundred percent of the time.
So let's talk about what you do in the gym.
And why you do it.'Cause 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 uh
George.
She often goes off into like the cardio section. Mm.
And she does muscles as well, some some resistance training as well, and I go off in the other direction to like the
You know, 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 uh I do wanna I do wanna call out something that you just said and then I'll answer your question. Um you just said I go to the area that typically men go to and I do the exercises that men typically do. So just because squats and deadlifts and
Presses and pull ups are typically done by men doesn't mean that those are m male exercises. Those are fundamental human you know, motor patterns that both men and women can benefit from. Um
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 stairmaster works. I'll just get on this thing and I'll be on here for the next thirty five or forty minutes, right?
I'm not the stare, Minister.
I love the Sare Master too. It's uh a special kind of torture. It's great. Okay, so
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 gonna be working together. Is it a pull or push? Yeah. So this is um I think this is
This is from um my book, uh my upcoming book, uh called Nothing to Lose actually, because we shouldn't be losing, we should be 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 uh 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 you're these are your shoulder I like to call bread buns. So they're sitting on the side of your shoulder, the lateral delts.
below that we'll have the back muscles and the lats in particular. I like to call the lats our 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 uh muscles that make up the glutes. It's max, mead, and min glut.
Maximus, glute medius, glute minimus. And then we have the adapter group. Which is the insides of those.
And then the last the last one is the the pelvic floor.
Or may more broadly we'll say the the core muscles. So what do I need to know if I'm a woman and
I I'm thinking about building this uh
These five muscles that you've highlighted here. Are there w as it relates to how I should be training and the big misconceptions about how to train to build this.
Yeah.
What do I need to know?
For these muscle groups, you probably should be hitting something like ten sets.
Uh
Um exercises per week per muscle group. Okay, so if I do four hip thrusts. Mm-hmm.
Um that is one set of four. Correct. And that's gonna help my glutes. Correct. So you're saying that I should be doing ten sets a week. Per muscle group per week.
That's not actually that much. It's not 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 I just have two. That's all I 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. And now I you know, it's simple to say that's all you need to do. It's gonna be very difficult for you to do that because you are going to start noticing your uh range of motion, like your ability to do your range of motion is gonna be limited. You're gonna start noticing the velocity of the repetition is starting to slow down. So the your ability to sort of move the
the weight through space is gonna start slowing down, you're gonna subjectively, even though you can see that you're holding like a fifteen pound or ten pound, you know, weight, it's gonna start feeling like twenty or twenty five. Like your subjective perception of the weight is gonna be um increasing. You know, if you were to rate it out of ten,
You would rate your effort like eight
Or nine.
out of ten.
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 goals. But is my anatomy and your anatomy the same?
Our anatomy is not the same. No. So when we think about the way that we move through let's say if you and I were to squat together or you or and I were to lunge together, there's gonna 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 s stand up today is a 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 two 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 Q angle, which I believe I believe I have a
Yeah, have something. Yeah, yeah. 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 tubial tubercle and and draw it upwards. 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 uh to the patella and then the tubial tubercle. And what you'll see for women here in pink, because the pelvis is wider, the femur has to more aggressively come in medially. It has to come more to the center. So this makes women when we compare
women and men, um, it makes us more knock need.
which just means that the knees are coming more together. So this is gonna impact
Literally
Every s how we move. So it's gonna affect how we walk, how we jump, how we squat, how we lunge, how we run. And so it's important to for women to understand how we're different because often the cueing and the instruction that women get are
sort of very n they're based off of a male pelvis, let's say. And so we can run into
feeling like squats are not comfortable, that lunges are not comfortable, or we start to even uh 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 shear motions as you as you're moving. Because what ends up happening for women is as we are, 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.
Right. So that puts us at
A greater risk for ligamentus 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 the leg here.
The muscles that are gonna be helping to control the way that the hip moves it are the glutes.
So you have the glute max, but in particular the glute medius, which is often called like the upper shelf uh muscle, that's actually gonna help the femur or counteract the femur being pulled inwardly.
Mm-hmm.
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 jeans, 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 the sort of traditional cuing. Can you show me this? I can. Yeah, I'll have to take my heels off, but I'm happy to. Yes.
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 f that we're the way that we're often cued is feet are 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 in 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.
Yeah. So so that's the squat. Is there anything else need to know about the squat, the the variance between man 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 your 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 up 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 come my knee tracks a little bit inward.
Versus yours 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 stabilizers in order to make sure that I'm not putting excess shearing forces on the on the knee.
So you need to strengthen your hip stabiliser. Yep.
Okay.
'Cause I I read something about I think it was about the World Cup, the Women's World Cup, where they said that it was something like twelve women had got A CL inj 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. Uh, 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 and you and you damage it. And is that is that true that there's a connection between like your brain
And you
Mechanics.
that often result in injury. Like say I can't remember what it was, but I think someone it 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
Junk.
Your brain and your reaction time is slow.
Yeah. And you see a lot of athletes doing doing this before games because they're almost like practicing landing. And that's actually a little bit of deceleration. So what that is is basically a stick and 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 the ligaments and the tendons. And why is deceleration, why is it important even for everybody, even non 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, you know, I think that that's really important. You know, 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 m get ahead of the fall. We have the tibialis anterior, which is just

is involved in what's called uh 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 group like the side of the glutes, they're also gonna help break. So there's a couple like when you're falling, it's like you gotta get the leg up, you gotta have the toe clear.
The floor, and then if you're falling off to the side, you need the adductors and the abductors to be able to um to stabilize so that you don't trip over it.
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So let's talk about um let's talk about supplementation. Do you take supplements?
I do. I'll prefra 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'm just very, very interested in the research and the research excites me. But for 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 uh glycinate. There's lots of different kinds, uh, but glycinate's just the easiest to absorb for most people. Tends to help with relaxation, helps with sleep, helps with muscle recovery. So this is something that I love. I'll usually take one, like two hundred and fifty MIGs at lunchtime and then another one in the evening.
So magnesium for everyone. How do you remember to take them?
Mm.
I tend to habit stack them, so I always know that when I'm 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 and I 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 I'll take one there too. So you put it in the way.
Yeah.
Of other habits.
'Cause otherwise if I put it in a really beautiful supplement closet, it's just going to
Yeah, so stay there. I have to put it on my desk. And also 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 adherence is gonna go up. Right. Um what else do we got in here? Ooh, omega three. Okay.
These are so well established in the literature. They reduce inflammation, they help with cognition. Something like two to four grams a day. Yeah. I mean
It just yeah, it just helps with 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 the thing that you would most commonly reach for. If you go for fruits in the morning, you put them right beside your fruits. Okay. Yeah.
Uh what other goodies do we have in here? Vitamin D for sure. Uh D three with a K2. Uh four thousand I use minimum uh 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, reproductive hormone uh production.
Uh again, inflammation, cognition
Every day.
Every day. Every day. Yeah. Every day. I a went to the doctor and he said I was deficient in vitamin D and omega three. So those 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 it's you think that you're getting a lot of sun exposure because the temperature is
Uh amical to that. And you run their vitamin D in
It's crazy. Yeah.
Crazy.
Ooh, I'm so happy you have this one here. Creatine.
Uh, I know you just had Dr. Darren Candau on the show. He was actually on my podcast as well. For women.
You know, I think creatine used to be this um
like bro supplement, you know, like these the bodybuilders with the scary, you know, noises and the you know, weird T shirts and stuff. But the creatine is really, really important for women. The way that Dr Candau uh described it to me was he said, you know
Lifting weights the cake and this is like the icing on top of it. Right. So you're not gonna
you know, enhanced 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 a little perimenopausal hack because I am in fully 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 uh because it's a little bit harder to get if my understanding of it is 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 cre like I'm not taking the three to five grams or f yeah, for some reason I start forgetting. Um muscles look a little less swole, you know, they look a little less full. Um don't have as much energy in the tank when I'm doing like a really intense
Uh work out.
There's a performance degradation when I am when I'm not on it.
Yeah.
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 leucine or it has less than three percent of leucine, which is an amino acid that
Stimulates muscle protein synthesis. And yes.
That's true. It is a terrible driver for muscle protein, but this 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. Um and so collagen is just like
muscle is a very expensive process. So it's very expensive, you know, from a uh 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 ten to fifteen 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 there? Yeah. Collagen drinks, collagen collagens and everything. Someone's gonna figure out how to like put it in the air or something. It's good for hair, it's good for everything. It's good for fascia. It's good f I mean
Collagen is the primary compound in joints, tendons, ligaments, fascia, skin, particular type of collagen. Hydrolysed. Hydrolysed type one, two, and three. Yeah.
Okay. Yeah. Fine. What else?
Electrolytes.
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 s when you're sweating a lot, electrolytes are really great.
Okay. Yeah. So like electrolytes, don't take them all the time.
with our last puppy here. Oh, vitamin C. Vitamin C I actually like to take with the um 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. Um but good as an antioxidant, good as an anti inflammatory, helps with the absorption um of collagen as well. What about protein?
How do you think about protein? Do you do you take protein shakes or anything?
I do when I'm traveling. So
I typically in my day to day um
diet. I typically don't. I will if I'm falling a bit short, but for me, my most of my protein is coming from whole foods.
What about cardio?
Because we h we've talked a lot about doing resistance training and the importance of building muscle. Um where does cardiovascular exercises, running, sprinting, stare master fit into all of this?
It's life. It's everything. Cardios is is fantastic as well.
Um, I think that again, you know, when I think about my overwhelmed Ophelia, you 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 a longer life and spending more of those years.
A lot of women have PCOS, including my partner.
Um I was looking at the the comments on your
One
Interviews you did and one of the top comments from a woman was
For women with PCOS or insulin resistance, sprint training hit
um 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 wanna 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. We need cortisol. There's something called the cortisol awakening response where it tends to peak, you know, somewhere, you know, right 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
Uh
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 it to
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 is spiking when she's training as well. So I wanna really caution
Women
away from being scared of normal and predicted, you know uh spikes. Spikes, right? Like glucose spikes, cortisol spikes. So that that's what I would say.
Uh just to start off that conversation.
Women with P M O S used to be known as P COS, now it's polyendocrine 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 because every time she's contracting her muscles, she's actually helping
whether insulin is present 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 you're you know 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
you know, might be categorized as high intensity interval training or hit, or sprint interval training, sometimes called sit. This is like sit is basically like ten to twenty seconds.
All out.
Ovaries to the wall.
Hundred percent effort. Uh, and then you recover.
And then you do that, you know, for
Five.
Six times if you're feeling
you know, particularly you know, energetic. Uh and that can also that stress, that cortisol spike and the all the you know, 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 kinda like it becomes harder as you age, but they should definitely n s not stop doing.
Oh my gosh. Like one of the ones where we all kind of stop doing it, but it's it leads to a downwards firing. Sprinting a hundred percent. I think that everybody should be sprinting. Why?
You are gonna be increasing something called your VO two max, which is
Uh just again nerve 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 one percent per year if you're not doing anything, VO2 max is the same. So you will decline your VO2 max capacity.
Ten percent per decade if you're not actively working on it. I'll put some graphs on the screen.
That show that decline over time. Yeah.
Great. I c I can think of family members, you know
Going up the stairs or down the stairs or trying to get groceries and bringing them into the house that are huffed and puffed, right? That they're they've lost their breath from going up a flight or two of stairs. Absolutely not. It's absolutely not a function of aging. It's just a loss of capacity. There was um Can you sprint?
I sprint all the time. Yeah. But there's di I so I wanna what I wanted to say was there's a couple of different ways that we can sprint. So you can sprint in a on a track. So I used to be a track sprinter, so that's like my love. Um but you can also sprint on a cardio machine in in the gym. So in the wintertime, so I live
uh on the east coast where I can't always sprint on the track. So I will take my sprinting indoors. Um and I will do something called the Norwegian four by four on a bike.
Have you ever heard of a Norwegian four by four? I have heard of it, but please do explain. Yeah. It's a special uh 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 four by four is basically four minutes. You're s you're in my case, I do it on the bike, but it can be done on a treadmill or any cardio machine.
Eighty five to ninety five percent of your heart rate max. So you need to know what your maximum ki like the maximum heart rate that you have ever achieved. Eighty five to ninety five percent of that for four minutes.
It's a long four minutes.
Yeah.
And then you take a uh 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 fifty eight.
So they were a lot of them were n in like postmenopausal, 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 ten percent.
In two months.
Which is wild when you think about how quickly you can lose it. And you can get ten percent back in two months, which is which is phenomenal. And the other really cool thing about that study was they actually took that cohort. So that was the um we'll call them like the
the well lived or the older cohort, let's say. And they compared it to eighteen to thirty year olds and they found that the gains that happened in the older cohort were s they had mitochondrial efficiency improvements of sixty nine percent. Whereas the younger cohort, their
Mitochondrial gains were forty nine percent. 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're just pat you're over the hill, it's past your prime.
These women had maybe the gap was bigger for them, but they had so much more upside to gain.
Right, which is so that I mean that makes me so excited because it's never, ever, ever too late. Like you can like the best time to start was ten 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. We should not stop doing that as we age.
Right.
'Cause a lot of people start thinking, Oh, I sh I can't run anymore because it's not good for my hips and my knees and I've you know 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 n is absolutely inconsequential to that. So
In that 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, you know, increase that strain magnitude and strain rate on the bone, which is gonna drive that positive bone reformation. That's awesome. But yeah, it's 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? Did you like is there such a thing as jump training? Like plyos, plyometrics. Oh, is that a pl okay hundred percent. And you do that?
Yes. Even if it's just isometric holes, let's say.
Like maybe somebody can't jump, but they can stand with their e 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 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 sorts around the
the heel and attaches into the um into the uh inferior part of the calcaneus, which is just uh your heel bone. So maybe you can't quite jump yet, but you can actually this
Um
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.
w whether something's being contracted or where s w whether something's stretching and they will say, Oh, we need to remodel in order to meet the demand of this 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 you don't need a gym or anything like that.
Not at all. I've heard you say that um deceleration is important. For mobility. Yeah. Deceleration is the opposite of
acceleration. So
We think of acceleration, it's speeding up and getting fast. Deceleration 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.
Um, it's also really important for us as we age. You might trip
Um
you know, something on the floor or you know, 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 any other exercises that are like really, really simple and underrated that one can do without equipment? I have so many to show you.
So the one that I love, this is almost like a diagnosis, but then it, you know, the diagnosis almost becomes the plan, like the the care plan. Uh something that um I just call the X 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 Q angle before. This is directly challenging the muscles on the side of the hip and whether or not you can stay stable. So uh this is a great exercise. Yeah. I can show it to you.
So this is again, like I was saying, it's the prescrip it's the test, but then it also becomes the care plan. So um
Maybe what we'll do so I'll show it to you and then maybe we'll have you try to. I'm gonna be over here. 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 thirty seconds, but we'll call it.
Maybe
Mal Probably Seconds there. Uh so that's a 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 my turn. Why don't you try? Yeah.
Okay.
So on your side, toes stacked on top of each other, wrist is kinda tucked under the shoulder.
Yeah, hands waving hello.
And now try to lift to your top leg.
Oh gosh.
Call somebody.

It h 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 the the pressure of putting my foot on my other 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's actually just me being weak. Okay.
So like this.
Yeah.
And then lifting this leg up. Lifting the leg up. There you go. Okay.
Yeah.
Okay, I get it.
Yeah.
Yeah. So now you're just gonna work yourself yourself up to ten seconds, fifteen seconds, twenty seconds.
And over time you'll just be doing this at the airport. Where does this home go? Just and just on top. Anyway. Yeah, just on top. Yeah.
I think I've got more of a balancing issue. Yeah. It's also it's a really strong balance test. Yeah. This is a 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 a an entry to this exercise that's a little bit more amateur? For sure. Yeah. Well oh if there's me you can maybe instead of doing it on both
You can maybe do it on your knees.
Um, 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 um here, but it's just less less stress.
Okay. You want to try that?
See how that one feels.
I got it. Yeah, you got it. I got it. Is there anything else that you can show me that you think is pertinent to the conversation we just had? You know what, well, yeah, this one actually relates to um mobility a little bit, which we did talk about. So
In cultures where
Піл сит он на флор, іт он на флор.
Um
Yeah, the toilet on the floor.
They 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.
Um I'll y I usually won't 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. You can use a little bit of momentum if you want, um, but you're gonna see if you can get up.
Without using your hands.
There you go.
Nicely 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 um 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. What is that I do what is what what muscles am I using there?
You're using every you're 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.
Any of this that you love?
Oh good. Push ups, uh 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. Um, glute bridges, I think, are fantastic.
So many. You can pick up like a big um
Bag of cat food or dog food?
And you know, do walking lunges down your you know, wherever.

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One of the
I mean I looked at lots of the comments and a lot of them also talk about
the specific issues mothers face after they have a child.
Um I saw comments about prolapse and pelvic flaws, et cetera. Yeah.
You've had two children. Mm-hmm. What are and you speak to many, many mothers. Yeah. Um, what are the specific issues that mothers face as it relates to fitness, their work out regimes?
Their goals. Um
Resistance training, et cetera.
That I wouldn't be aware of. Yeah.
Giving birth to a child. So you know, we talked about how the
Um
The hips are different from men and women. The pelvic floor is also very different for 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 um if we were to think about so here is the uh female pelvis, we have the pubic bone here.
And then it's 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 pubocoxygeal so
Pubic.
coccyx, pubocoxygeal 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 that pu for those muscles to be able to contract and support.
Right, versus a male, uh, those PC muscles just have to deal with one. So it's mechanically much simpl simpler for a man.
And then you layer on hormonal fluctuations over the course of a you know woman as she's menstruating, if she becomes pregnant under the influence of different hormones like relaxin, uh the weight of the baby, you know, constantly pushing down, um and then birth, as I've mentioned before. Uh these can
significantly alter the strength and the ability for the for the PC muscles to um 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 want to necessarily go back to
Extremely heavy loads with lots of intensity right away because you haven't necess 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 um with the pelvic floor. So the famous exercise that everybody's probably heard of is Keegles. You've probably heard of Kegels. So those are wonderful if you're someone who has a weak uh pelvic floor.
Not so much if you just sit and contract in in your seat.
Yeah, it's it's literally like you uh for men, the way that I've often um sort of cued 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 relaxing. 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
uh neuromuscular connection to the pelvic floor sometimes is not really strong.
Often just closing your eyes or just think like just coming up.
holding and then coming down. And you can do all you can do these all day long, free, you know, no one's gonna know that you're doing it. Um so that that if you have a weak pelvic floor, that would be something that you might explore. So pelvic floher would be someone who'd be able to diagnose that and give you
A bit more counsel there. But weak pelvic floors, keegels are great. They can actually if you have if you have a tight pelvic floor where you actually have trouble relaxing, keegels can actually make things a little bit worse for you.
Um.
The battybody.
The last word on the subtitle is the word sex.
A geeky goddess guides 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 uh taboo for women is women who enjoy their sex life. And so I was hoping in that first book to give women
permission to
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 we can learn more about ourselves. I'm thinking of this one patient that I had, um
And she actually was part of the reason why I included it in this first book. She had come into my clinic, she'd come in for low back pain. It was like n the most.
Typical like I'm have
you know, mechanical low back pain, right? And so we were giving her
uh adjustments, we were giving her strengthening exercises, we were doing the rehab, all the things. Nothing out of the ordinary at her reevaluation appointment.
She said, I w like Dr. Seth, I wanna I wanna talk to you privately. I was like, Okay, fine, let's go into this room, close the door, all the things. And she said, um
Dino the real reason why I came in to see you.
I said, Yes, it was mechanical low back pain.
And she said no.
Uh it's because when I was with my husband
You know, 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 um 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
Um
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.

Steffi, what's the most um
What's the most important thing we haven't talked about that we should have talked about?
Oh my goodness.
Yeah.
When we didn't talk about GLP ones, that's all the bloody rage at the moment, isn't it? The G yeah, GLP ones are yeah, they're interesting for sure. I do think
With all
medications and I am including hormone therapy in here.
As well.
um 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 s for sure, your sleep, your mood, uh if you're experiencing some of the thermoregulatory 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 gonna 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 M H T
To add 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
We're managing your stress, recovering, doing the cardio that we've been talking about. And that recovery point you just said. What are the re 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
Uh, growth hormone and IGF one tend to surge, muscles grow when you're sleeping.
Brain cleans itself up. 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. Um
Under that I would say
If you have access to something like a sauna, that might be something that you can think of for recovery, whether that's an infrared sauna or it's a traditional finish sauna. I often call it lazy cardio. So if you don't feel like doing a really intense cardio session, get yourself into a sauna if you have access to one.
Not necessary, but really, really like there's a lot of really cool uh studies that have come out of Finland, which by the way, sauna is the only word in English that we've borrowed from Fin from Finnish. Just a little
Little fun little tidbit there, but
Um, electrolytes we've talked about. I think that if you are really pushing uh yourself and you're sweating a lot, helping to recover and replenish those, as we lose estrogen in in midlife, our ability to regulate salt also starts to decline as well.
So what if um 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 consume
The content you make.
The only other thing I would say that we didn't really go on a nerd safari on 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. Um muscle is like the popular girl at the party. She gets a lot of attention. You know, if you think about us 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 gonna 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 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 um you can bias for more tendon strength and more ligament strength. One of them is when you are lifting
You can bias what's called the ecentric portion of the lift.
So
Concentric, muscle get shorter, bones come together. Ecentric is stretch.
When you start stretching the tendon, the tendon's 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 year. You've really got to be in your butt about Pilates. You really don't like Pilates. Do you know what it is? No. It's not that. It's people confuse
Muscle endurance. So in Pilates you often have like very high reps, the muscle burns. Um it's fantastic for the pelvic floor that we were talking about before.
Phenomenal for women's health, for pelvic floor health, dot posture. Trevor Burrus But you say 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 am training four or five times a week. I'm also sprinting one.
you know, sometimes too, but mostly one time a week. I'm I'm doing tennis, like I'm doing all of these other things and Pilates brings me a lot of joy, right? I feel s 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 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 gonna end up with bone disease or a loss of low 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 Tell me about what you do with your hair. Um, 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 then. Yeah.

Uh it's pretty basic. Uh I learned this from my dermatology friends. So some vitamin C uh in the morning, some uh SPF, um, and in the evening, uh there's some kind of vitamin A. Uh I actually really like NAD.
I use a another company I ha has something called Ufin A in it, which is supposed to help get rid of senescence cells in the body. Which are like dead cells, right? Which are yeah, that's like the zombie cells that um
Uh that sort of hang around and just create inflammation everywhere.
You're almost fifty.
I'm almost fifty, yeah. Feeling good?
I feel great. I feel like I
I inhabit my body now in a way I wish I did in my twenties.
Like I was so punitive and I was so terrible to myself. The things I would
Say to myself and call myself.
Um
When I was twenty, thirty
Um
I would never say that out loud to anybody else. And so now I
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
Um
You know, it it provided me a way back home. Like it provided me a
Like it taught me how to love myself. It taught me how to be patient with myself, right? It taught me how to um forgive myself when I felt like I had failed, right? Like it re imagines uh your relationship with failure, which I think is like a really big F word.
For women.
Doctor Stephanie, we have a closing tradition on 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
Well, it's your skincare routine. No, okay.
Do you believe in God?
And why or why not?
Oh
Mm.
I do believe in God.
I believe that there is
A force.
Greater than us, greater than we will
uh ever be able to explain um 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 until we're win you know until we are willing to
Surrender?
To um
To learning the lesson?
When you're on your um
When you're in your last day and you look back at your life and you go, Do you know what I did it?
Mm.
What would warrant you being able to say that?
Then 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 gonna make me cry, Steven. They're that they're telling me um
All the ways, all the things that they have learned from me and that they're gonna take
On to future generations.
On my in my lineage.
Oh, ist das für ein gutes Vieh?
I think
All all the reasons why I do what I do.
Um
It 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 wanna deny them of their own learning opportunity, but I wanna be able to pass on
what I feel is important values that I think
make the world a better place. Like 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. Um I think it's incredibly important for so many reasons. I mean
There's been I think through I mean, it kinda says on the back of your book here, The Betty Body, through time people have thought that women were little men.
Um 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. Yeah.
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 um complicated world of uh health information.
And conflicting information and you know, I know it.
Better than anybody because my audience will often say to me th th I I r relate to all of the
Personas that you highlighted there where you've got
Uh
What was it? Which was the one that sounded like.
This one. Excuse Emily.
No, it's this uh
I get a lot of this one.
Overwhelmed of feeling. Where do I start?
Yeah. Where do I start because I don't want to fail again. 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, whatever.
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. Um because it's nuanced, it's very human, it comes from lived experience.
And it comes from as you said, you've you've you've sat with tens of thousands of patients through the care your 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 um the truth is often complicated, personal. Yeah. And it doesn't exist always in a lab. You can't always replicate it in a lab. And one of the things I learned from your work as well is that it changes through time. Yeah. I. For me, what's true for me now, thirty three years old as a man
this stage of my life with the hormone complexion I have and
The goals that I have. One thing can be true. But maybe when I'm fifty five
A different set of things are gonna be true. Um 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. A nerd. A nerd Safari. That's interesting. It used to be sort of a you know a terrible word to use. I'm like, No, I'm a total nerd. Yeah. Special category of nerd.
A geeky goddess guide to intuitive eating balanced hormones and transformative sex.
Where else do people find you if they want to learn more or message you or get in touch or come see you? Whatever like 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
thoug leaders in science and
Health and we
Try to distill what it means for uh what it means to have a well lived life. So podcasts free. Uh
probably where you're listening to this, uh YouTube and all the places. And then you can head over to my website, drstephaniestema.com.
Anything else you wanted to say?
I would say
For the woman listening, my overwhelmed Olivia's who are feeling like they don't know where to start, or my skinny fat Sophia's who are scared of lifting weights and eating like a bird, uh, or my exorcist Emily's who are still exercising their demons. Um
You're not behind.
You are absolutely enough.
And
Don't be so hard on yourself.
Thank you.
Thank you.
Uh