Look. Feel. Perform. Why Muscle Is the Answer to All Three After 40 with Andy Galpin, PhD

Summary

Podcast Summary

Podcast: BETTER! with Dr. Stephanie Estima
Episode: Look. Feel. Perform. Why Muscle Is the Answer to All Three After 40 (with Andy Galpin, PhD)
Date: July 6, 2026
Host: Dr. Stephanie Estima
Guest: Dr. Andy Galpin, PhD, Professor and Human Performance Specialist

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Episode Overview

This episode tackles the critical importance of muscle for women over 40, especially during perimenopause and menopause. Dr. Stephanie Estima welcomes Dr. Andy Galpin to discuss why strength, not just cardio or weight loss, is the true foundation of health, vitality, and independence in midlife and beyond. Together, they bust common myths, address the unique needs of women during hormonal transitions, and offer actionable advice on training, recovery, biomarkers to track, and the long-term mindset shift required for sustainable strength and health.

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Key Discussion Points and Insights

1. Bone Mineral Density: The Overlooked Health Metric

[00:00, 04:09]

• Dr. Galpin emphasizes the importance of bone mineral density (BMD) for women, stating it's rarely tested early enough.
  • “Bone mineral density will reach its highest amount in women in the late 20s, early 30s… We are actually in a bone quality crisis, an epidemic worldwide and no one's speaking about it.” — Dr. Andy Galpin [00:00]
• Most doctors suggest screening at 55-60 years, but Galpin recommends starting even in your 20s to set a baseline for aging.

2. Elites vs. Regular People: Talent and Habits

[05:26]

• Contrary to popular belief, elite athletes aren't fundamentally different in habits from regular people outside of their sport-specific talents.
  • “They just happen to be better at a sport than you are” — Dr. Andy Galpin [05:37]
• Success is about mastering basics and consistency, not solely innate talent.

3. Fitness Culture: The Dangers of Social Media

[07:12]

• Social media creates unrealistic expectations and controversy-driven content.
• “Because you get questions like that and you get answers and they're, they're generally designed for a controversy. Click algorithm.” — Dr. Andy Galpin [07:25]
• Real progress requires context and individualized approaches, not cookie-cutter solutions.

4. Cardio vs. Weights: What Should Women Over 40 Prioritize?

[09:16, 16:00]

• There’s no absolute right answer; both are good for beginners (“newbie gains”).
  • “You already won, you got there, you did the thing. Pick whatever you want to do. I don't really care. We will optimize way later.” — Dr. Andy Galpin [09:24]
• The priority is building sustainable habits—whatever you enjoy and can return to consistently will bring benefits and get results.

5. Neuromusculoskeletal Adaptations: What Happens in the First 6–12 Weeks?

[11:41, 16:35]

• Initial gains (strength, endurance, skill) are largely neurological—better motor control, learning, and coordination.
  • “A lot of strength development is just skill practice.” — Dr. Andy Galpin [11:58]
• All body systems (nervous, endocrine, immune, etc.) are adapting—even if visible results aren’t immediate.

6. Tracking Progress: What Matters?

[16:35, 25:37]

• Performance goals should drive tracking (e.g., can you do a pull-up, are you getting stronger?).
  • “If the goal is I want to get to my first pull up, are you getting better at pulling your body up? That is key metric number one.” — Dr. Andy Galpin [16:49]
• Behavioral consistency matters; focus on habits (e.g., did you do your reps or practice specific skills weekly).
• Indirect metrics (like HRV, heart rate, mood) are useful but secondary to actual performance changes.

7. Crash Diets, Social Pressure & The Muscle Misconception

[25:37, 29:16]

• Health is often wrongly equated with weight loss, not strength or capability—especially for women.
  • “We have always placed the emphasis on cardiovascular as health… and then muscle, that's sports and athletes and bodybuilders and people like that.” — Dr. Andy Galpin [26:34]
• Systemic adaptations (strength training provides cardiovascular benefits, etc.)—these are not mutually exclusive.

8. Fast Twitch Muscle Fibers and Aging

[29:16, 42:09]

• Fast twitch fibers (power, speed) decline unless specifically trained; losing these limits independence and resilience in old age.
  • “As folks get into these aging categories of the mid-50s, 60s and 70 years of age, a lot of those fast food fibers are gone. And the motor units themselves are gone as well.” — Dr. Andy Galpin [36:45]
• Preservation strategies: any movement helps; eventually build up to some explosive or power-based activity, but start gradual.

9. Injury, Movement Quality, and Power Training for the Aging Athlete

[42:09, 49:19]

• Recovery and tissue tolerance are key: focus on quality and progressive overload, not just more weight or intensity.
  • “You can do something. I can swing a kettlebell explosively. Fine. Pretty darn safe. That's going to get you last attention.” — Dr. Andy Galpin [42:09]
• Avoid long-term injuries by addressing issues now, even if it means stepping back for a period.

10. Fasted vs. Fed Training: Context Over Dogma

[49:19, 55:06]

• No universally right or wrong way; it depends on preference, goals, life constraints, and comfort.
  • “Neither is fundamentally automatically just always better ... Factors would be things like your GI tract ... What type of training are you doing?” — Dr. Andy Galpin [49:19]
• Women (and anyone) should base their training schedule on what’s sustainable and enjoyable.

11. Menopause, Perimenopause & Recovery

[57:29, 60:58]

• Individual experience is highly variable—recovery often worsens due to hormonal fluctuations, sleep disruption, and altered perception of fatigue.
  • “Perimenopause... it's so chaotic and so wildly different person to person. You can't fairly give generalized answers.” — Dr. Andy Galpin [57:29]
• The best approach is personalized, flexible, and self-compassionate—monitor behaviors more than short-term outcomes.

12. Long-Term Mindset Shift: Devotional Consistency Over Shame

[62:30, 69:55]

• Shift from motivation by shame/punishment to a long-game, devotional approach—focusing on look, feel, and perform.
  • “The kind of triangle we go after all the time is look, feel, perform... what do you want to be for all three of these buckets?” — Dr. Andy Galpin [64:11]
• Self-talk (positive or negative) is only helpful if it leads to beneficial behavior and mindset, not self-sabotage.

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Notable Quotes & Memorable Moments

• On Newbie Gains & Motivation:
  "Things that I don't like to do is ruin motivation with information... I would say you already won, you got there."
  — Dr. Andy Galpin [00:58, 09:24]

• On Fast vs. Slow Twitch Loss:
  “As the years and decades go on, those [fast twitch fibers] will start to die out... and that becomes difficult to reclaim.”
  — Dr. Andy Galpin [35:56]

• On Grace During Perimenopause:
  “You just have to give yourself some effing grace. You’re not going to be — it’s not a spreadsheet in perimenopause.”
  — Dr. Stephanie Estima [60:58]

• On Sustainable Progress:
  “It's not necessarily the positive or negative information. It's is this serving you? Is this creating benefit or is this creating risk and a downside?”
  — Dr. Andy Galpin [67:19]

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Timestamps for Key Segments

• Bone Health & Early DEXA Scans: [00:00–05:26]
• Elite Athlete Truths / Overrated Fitness Trends: [05:26–08:46]
• Weights vs. Cardio Dilemma: [09:16–11:41]
• Neuromuscular Changes in Early Training: [11:41–16:35]
• How to Track Progress Meaningfully: [16:35–25:37]
• Crash Diets, Systemic Misunderstandings: [25:37–29:16]
• Muscle Fiber Types, Aging, and Preservation: [29:16–42:09]
• Power/Explosive Training for Aging Women: [42:09–46:57]
• Injury, Patience, and Quality of Movement: [46:57–49:19]
• Fasted vs. Fed Training Nuances: [49:19–57:29]
• Perimenopause, Recovery, & Self-Compassion: [57:29–62:30]
• The Mindset Shift (Look, Feel, Perform): [62:30–69:55]

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Practical Takeaways

• If you’re over 40, get a bone density scan early—even in your 20s or 30s if possible.
• Don’t stress about optimizing cardio vs. weights as a beginner—consistency and enjoyment are the foundation.
• Strength training isn’t just for men or athletes; it’s vital for long-term health, metabolic function, and independence.
• Perimenopausal symptoms, especially recovery difficulties, are highly individual—treat yourself with both compassion and commitment.
• Adopt a long-game mindset focused on sustainable behavior, not quick fixes or perfection.
• Muscle is both your shield and your engine as you age: keep it, challenge it, and protect it.

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This episode is a science-based, compassionate guide for women in midlife and beyond who want to rewrite the narrative of menopause from one of decline to one of strength and possibility.

Transcript

[Andy Galpin]

Bone mineral density will reach its highest amount in women in the late 20s, early 30s. So we want to capture it then because we actually don't know five or 10, 15 years later if it's on the decline because we never caught you at your peak. We are actually in a bone quality crisis, an epidemic worldwide and no one's speaking about it. One on one. Things that I don't like to do is ruin motivation with information. And so if the person just, it took everything to get them in the gym because they were scared and they can't afford it, and they finally got a babysitter and they got the time and now they went through all that and they're being told on some stupid podcast that that's all wrong. I mean, that's the worst, I think, scenario we can come up with for, for many people in your position. So I would say you already won, you got there. You know, how many times have you gone to the doctor? And they strongly encourage you to add strength training, like almost never, right? But they may say something like, you got to start doing some cardio. Your, your heart's like, you would hear fat loss and cardiovascular health are for health and then muscle. That's sports and athletes and bodybuilders and people like that, right?

[Dr. Stephanie Esteema]

A woman walks into the gym for the first time. She's 48 and she has one hour. What does she choose? Cardio or weights? And why? Hello, my friends. Welcome back to another episode of better with Dr. Stephanie. It's me, your host, Dr. Stephanie Esteema. If you are wanting to blend the three prongs of health and fitness in terms of looking your best, feeling your best, and performing your best, I have a conversation that you do not want to miss. My conversation today is with Andy Galpin. He is a tenured full professor at Parker University and is the Executive Director of the Human Performance Center. He is a human performance Specialist with a PhD in Human Bioenergetics and over 100 peer reviewed publications and presentations. And that is what we were talking about all today. You're going to get a lot of insight on how to look your best, feel your best, and perform at your best, however you define those things. So without further delay, please enjoy my conversation with Andy Galpin. Let me tell you something that the fitness industry never bothered to tell you. Creatine isn't a bodybuilder supplement. It's not just for the bros. It's not going to make you bulky. It's not just for men. Right? It is one of the most researched, most evidence backed compounds on the planet. And ladies, especially ladies in midlife, we are chronically underusing it and we actually produce less creatine than our male counterparts. So here's what creatine actually does. It replenishes something called phosphocreatine in your muscles, which means more energy available during your lifts, faster recovery, recovery between sets, better sprints, better muscle protein synthesis over time. And the more muscle you have, the better body composition you will have. Right? And the research on women, specifically creatine, also crosses the blood brain barrier. This is going to lead to better cognitive function, better mood, better memory. These are not small things, right? And the dosing is super simple, just 3 to 5 grams per day, every day. You don't need to load, you don't need to do any of this loading phase stuff. You can take it every day, anytime before your workout, after your workout, literally. Consistency is the only thing that matters here. Qualia creatine is what I use. It is creatine monohydrate, which is the form with the most research behind it. And it makes this clean. I also love that they add some magnesium and some electrolytes in there. So you're sort of getting like a three for one, right? Head over to qualia life.com forward/better and use code better to save up to 5, 50%, 5% plus an additional 15% off. That's qualiacreatine. Qualia life.com better. What is the one number every woman over 40 should know about her body that most doctors never measure?

[Andy Galpin]

I would have to say bone mineral density. It's pretty cheap, pretty accessible. Usually, you know, typical standards say for women, depending on where you look, it's going to be like 55 to 60 years old, where they're going to recommend you getting your first bone mineral density scan. But I would actually strongly advocate even earlier than 40. I would actually advocate for you getting it in your 20s. And then you can go five years or more between the next one, 10 if you want. But bone mineral density will reach its highest amount in women in the late 20s, early 30s. So we want to capture it then because we actually don't know five or 10, 15 years later if it's on the decline or if it's not because we never caught you at your peak. And it's critical because we are actually in a, a bone quality crisis, an epidemic worldwide and no one's speaking about it. And it will adversely affect women probably 10 to 1 versus men. So it's a huge, huge issue with women's. Health and rarely advocated for, rarely discussed. And something I think is it's worth the very small amount of exposure that you get sitting in one of those machines. And it's again, pretty cost friendly and highly worth it.

[Dr. Stephanie Esteema]

Could not agree more. You coach Olympic gold medalist and world champions. What do elite athletes do that regular people almost never do and has nothing to do with how hard they train?

[Andy Galpin]

Probably nothing. I get this kind of question a lot. And what tends to separate the world's best athletes from the world's highest performers that are non athletes is they just happen to be better at a sport than you are? I mean, that's really it. Some of them are amazingly dedicated and some of them are just not. Some of them take their training and recovery and all that super seriously. And some don't do anything. They were just blessed and have probably worked hard enough over years to develop a very specific skill. And they're better than anyone in the world at it. And that can simply be the frustration of talent. There are some universal things that tends to help them that can, can be extended to humans, but there's not one thing that they are doing that anyone else isn't doing that just doesn't exist.

[Dr. Stephanie Esteema]

And I think if you are blessed with that kind of talent, this is, this is the best way to exploit it. And I know that that word might feel a little, but I think that if you are talented in that way, that you don't need to necessarily work hard. Like I always come back to this idea that, you know, mastering the foundational basics is what is going to separate most people from the masses. But if you are also genetically just blessed with talent where you don't have to work hard, like, why not exploit that? You know, which I, I, I mean, I don't know, maybe it's another podcast, but just wanted to add that in there for your, your consideration too.

[Andy Galpin]

Another podcast for sure.

[Dr. Stephanie Esteema]

Another podcast.

[Andy Galpin]

We could speak a lot about that. There's a lot in that answer.

[Dr. Stephanie Esteema]

Okay. Most overrated thing in fitness right now.

[Andy Galpin]

Probably social media.

[Dr. Stephanie Esteema]

Yes. Great.

[Andy Galpin]

Because you get questions like that and you get answers and they're, they're generally designed for a controversy. Click algorithm, you know, sort of stuff like that.

[Dr. Stephanie Esteema]

No nuance. Yeah, yeah.

[Andy Galpin]

And they're just not true. I deal with more than a few clients who we have literally unlimited budgets on. There's nothing you can't put in front of me, most likely, that I haven't seen. And sometimes we use a lot of it, sometimes you use very minimal of it, and sometimes we you know, we have the people that are making more money than anyone else in the world and running enormous companies and not just athletes. And so like again, anyone could throw something up as a clip and be like, oh, this is wrong, this is a. And I could probably find you a situation where we used it and it gave us, well, controlled study type restrictions and we saw a positive outcome. So there are plenty of things that are just straight up fake and nonsensical. That's not really how it works, though it typically is. Are you using the appropriate tool for the appropriate job and the appropriate situation and context. And then some things are far, far, far, far better on average. And then some things are marketed as like, you all should have this, but in reality it's like only for a very specific scenario. But that's that, that's how more truly what it really looks like.

[Dr. Stephanie Esteema]

You've done hundreds of muscle biopsies. What surprises you every single time you look at human muscle under a microscope,

[Andy Galpin]

man, just how similar to tartar it looks. You wouldn't be able to tell the difference.

[Dr. Stephanie Esteema]

Some carpaccio at your local, your local steakhouse.

[Andy Galpin]

It looks, I mean you, if you stack it vertically and you put it on a cracker, look pretty enticing, pretty

[Dr. Stephanie Esteema]

little garnish of cilantro and then there we go.

[Andy Galpin]

There you are.

[Dr. Stephanie Esteema]

Yeah. All right. A woman walks into the gym for the first time. She's 48 and she has one hour. What does she choose? Cardio or weights?

[Andy Galpin]

And why you could do either one. I think there would, you'd have a really difficult time making a strong, fair argument that anything besides that would be correct. If you're in that position. What we know to be true and clear, whether you're looking for changes in body composition, metabolism, energy, cognitive function, long term health and vitality and anything like that, either one of those will get you there because you have the newbie gains. You're at the beginning of your journey. Any type of exercise will get you some progress. And so what we need to be hedging towards is in that situation is what is most likely to get this person to turn this into a habit that's lasting. And one on one things that I don't like to do is ruin motivation with information. And so if the person just. It took everything to get them in the gym cause they were scared and they can't afford it and they finally got a babysitter and they got the time and now they put, went through all that and they're being told on some stupid podcast that that's all wrong. I mean, that's the worst, I think, scenario we can come up with for many people in your position. So I would say you already won, you got there, you did the thing. Pick whatever you want to do. I don't really care. We will optimize way later. But can we get you in a position where you're getting some return on your investment, you're not so sore or so ineffective or so damaged you can't come back for days or weeks. And I don't want any of those things to happen. I don't want you to start running and then all of a sudden, two weeks into it, your knee is killing you. I don't want you to start lifting weights and two weeks into it your back is killing. Like, I don't want any of these things. And I'll go back to being the saying, I also don't want you in the fear mindset that if you're not optimally exercising that it's not doing anything. I absolutely deplore the message when people advocate things like that. You know, the whole, you're doing all this wrong. If you're doing it this way, you're not getting any gains. That's just fundamentally untrue the vast majority of times, especially for the person you described. So I would step back and say you've already won in large part. Let's get moving. And if you came there cause you're motivated to finally walk, awesome. If you came there cause you're motivated to hit some weight, like, cool, I'm in for it all. Let's start there first and worry about progressing later.

[Dr. Stephanie Esteema]

Fantastic. Well, let's actually build on that. Let's talk about what neural adaptation and those newbie gains are. So whether she chooses the cardio or she chooses the weight training, describe for us what is happening from a neuromusculoskeletal perspective in the first, let's call it six to 12 weeks of her doing a new activity.

[Andy Galpin]

The systems wise physiology all pay attention. And so what I mean is, you may remember back to kind of middle school, high school that there's all these systems in the body. There's the bone is a system and your endocrine system are your hormones and the nervous system is one, and lymphatic system and immune system and so forth. One of the things that we have done probably in disservice, is to assume hell or make people assume that exercise only targets one of them, it does them all. And this, your physiology does not work in systems like that. It doesn't know, oh, I'm lifting weights. This is only supposed to be my nervous system and muscle. Oh, but now I'm running. This is only supposed to be my heart and blood vessels and lungs. It doesn't operate like that. It has no idea what you're doing. So the first six, 10, 12 weeks, everything is working. Your endocrine system's being challenged, your vascular system is adapting, it's needing to pump more blood and get it to return faster. Your immune system, I'm just go back through the list. I said it's all adapting in those first six to eight to 10 to 12 weeks. What may or may not happen is you may or not lose any body fat, right? You may or may not gain any muscle in terms of if you were to take a picture or to have some kind of crude measure of muscle size, you may not see a change there, but every part of your system is responding in some fashion, including brain health and following along there. I think probably what you're teasing a little bit is the idea that in the first month or two of lifting weights we'll see large increases in strength. And this is often coming because of neurological adaptations. But it's honestly a little bit of a dumbed down way to think about it. And I don't know if it's super helpful because it leads to that misguided concept that I was just alluding to and the fact that you're thinking, oh, I don't really care about my nervous system that much, so I'm going to do a different form of exercise because I'm really wanting to boost my metabolism or I'm really here for my heart health. And that's where I think teaching the systems based approach is a little bit concerning. For the same avatar that you're speaking of, meaning if you were to go to the gym and do a leg press machine and then the next week you go back and do the same thing again, you can probably press more weight. And that's not necessarily because you grew a whole bunch of muscle in the last week, but you just got motor control, motor learning and what we would colloquially call like the nervous system. So central and peripheral nervous system. It always gets given to the central nervous system. It's the peripheral as well. Have made some changes. We can dumb that stuff down. We could just call that skill. Like you just got a little bit better at a skill, right? Just like if you shot a basketball the first time ever and then you went back a week later and you got a little Bit better. You just got a little bit better at a very specific skill. And a lot of strength development is just skill practice. And it would be the same if you practiced a plank for the first time or really any movement. You just have to have a little bit of neural control to engage in those things. So that is the predominant explainer of strength gains in the first couple of months. But I really will push back again on this hard because this has led to people for years and years suggesting that, or even indirectly alluding to that it is the only adaptation that's happening the first couple of months. And that is fundamentally wrong. You're seeing progress in all those areas immediately from session one. But that explainer is coming from the nervous system side.

[Dr. Stephanie Esteema]

So the overall goal I think is just take perfectly imperfect action and keep at it over time. Right now I'm learning how to play tennis. It's like learning a language. Right. When are a child, we don't expect two year olds to put together paragraphs. We have one and two word sentences. And then over time that becomes more and more sophisticated. And I think, I love the idea of thinking about any type of movement as a motor skill in the same way that you might think about it as a cognitive skill as well.

[Andy Galpin]

Yeah, running can be that too, by the way.

[Dr. Stephanie Esteema]

Yeah, yeah.

[Andy Galpin]

You chose tennis as a pretty complicated sport. But if you're just learning how to squat for the first time or to jog, it's. It's the same thing. I would actually say your metaphor is stronger than you gave it credit for. It is the same thing. Learning a language, learning to play guitar is a motor control skill. And whether you're using that skill to, you know, pluck the right strings or to put your finger and your mouth and your tongue and your throat and diaphragm in the right spot, or you're using that to do that so you can do a pull up better. It's the same thing. Yeah, the expression of it's just different. It's. It is the same thing physiologically though.

[Dr. Stephanie Esteema]

So if we're thinking about how we can monitor our progress. So if we're thinking about what are some of the indications that our training, however we are applying that is working. What are some of the things that we want to think about from a systems based lens?

[Andy Galpin]

We always want to hedge towards performance. Meaning what is the outcome goal? Are you trying to get stronger than? Are you getting stronger? Let's not get lost in the plot here.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

If the goal is I want to get to my first pull up, are you getting better at pulling your body up? That that is key metric number one. And it's funny because people tend to gloss over it, but then they'll get so deep into other metrics, I'm like, whoa, whoa, you're getting stronger or you're not. Like, that is, that is the thing. If, if you want to be running, if you want to be losing weight, if you want to be sleeping better, if you want more emotional control, whatever that primary target is, that should be the primary target. That's specificity. That runs champion. From there, we walk behind it and say, okay, what are the indirect measures of that? And I'll get a little bit technical here, but we will often split them into multiple categories. Ones that are sensitive and ones that are specific. So specific, if you think about something like resting heart rate or heart rate variability, which some people may have heard of, these are non specific measures, meaning they are good indicators that some overall stress is on your system, but you have no idea where they're coming from. So they're not specific. It doesn't tell you, oh, this is a case of calories are too low. Oh, this is a case of your training is too much. Oh, this is a case of you have an infection. Oh, this is a case of you're on your period. Like, we don't know that. We'll just know you're under some stress like that. That's all it is. So they're not specific to a particular area, but they're also pretty sensitive, meaning they will give you day to day variations. And so there are good indicators to say something happened, I don't know what. And if you're running a tight enough ship, then you can be like, oh, the only thing I changed yesterday was I had more carbs at night. Okay, great. And so the metric in this case, Harvey, variability or something will have just gone up and down. And you'll know since you only changed one thing, that that was most likely to be your cause.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

It's never that true with humans, but you can get pretty close. So you can use indirect markers like that that are trying to tell you what we call allostatic or allostasis. This is the fact that, you know, kind of stress is stress, right? Your body treats all stressors, emotional stressors, environmental stressors, physiological stressors, training stressors. It kind of treats them all the same and it puts them in one bucket. And something like an HRV or any other allostatic metric gives you a rough estimate of what's the net equation are you positive? Are you negative? Did you make money? Did you lose money? Now I don't know if that was from the sales team or the marketing team or blah blah blah. I just know you made more money or you lost money. So you can go to secondary metrics like that. But again those would come after what is our primary outcome and then from there there are literally hundreds of evidence based, scientifically validated markers. You could look at whether these are, you know, internal blood based biomarkers or HRV and heart rate are actually more of almost neurological markers. And there's perform, there's tons and tons and tons of ones we can go to, but those are all specific to the situation scenario and how much specificity we need and how much precision we need or if we're just trying to get a rough sense and we're not trying to overcook somebody with data, we could pull back and do even ones as simple as perception. How do you Feel? Scale of 1 to 10, what's your mood like? Those are actually very scientifically validated and really, really strong. So we could use a ride wide range of research grade at home technology to simply let's track how you feel on a scale of 1 to 10 every day and call that good.

[Dr. Stephanie Esteema]

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[Andy Galpin]

Yeah. With most of our high performers we're dealing on years.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

Time frames between like a change in performance if ever.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

So we've got a bunch of magic baseball players I just got done meeting with just now. So that's top of mind. They're not going to increase their velocity. Right. You're already in the Major leagues. If you throw 101, you're not going to go to 102 this year. 103, like there's a limit to human ability.

[Dr. Stephanie Esteema]

Sure, yeah, sure.

[Andy Galpin]

So in that case, we're actually just trying to hold performance and just slowly go down or we're thinking about for our Olympians, can we make this progress over the course of the next three and a half years?

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

That's really what we're looking at. So you bring up an excellent point. When you get close enough to the ceiling of performance, there is really no change or it's very, very small. I would even say for those that are not on the highest level of performance. This can be true for things like weight loss.

[Dr. Stephanie Esteema]

Oh yeah.

[Andy Galpin]

The delta for that can take a long time.

[Dr. Stephanie Esteema]

Yeah, yeah, yeah.

[Andy Galpin]

So I think your point is, is even stronger there in the sense that the habits, the behaviors that we know will get you there eventually. And let's not get caught up in day to day on the scale or even week to week or even sometimes month to month. If we're really taking this as a long journey and we want this weight to be off forever and so forth. So depending on what we're actually interested in. Really good point. We would add those to the equation of what is our behavior, what is our action, are we being consistent and we'll worry about like the score later.

[Dr. Stephanie Esteema]

Yeah. And this is, this is where I think that a lot of women get it wrong. And this might be due to social media marketing. We, we're always sold. At least I always see this online, like six week shreds, eight week boot camps. There's always this really short time and it's often, you know, health and performance. If we're talking to Andy Galvin. Right. If it's always framed in this like in, in terms of losing weight or getting skinny in some way. So I think that there's like, there's a two pronged problem here, which is one, that women have been marketed this idea of lose like £7 in 7 days or whatever it is, 6 week shreds, Etc. And then the other problem is that health is often, always framed as weight loss and getting smaller in some, in, in some capacity.

[Andy Galpin]

I agree, we have to pull apart. I mentioned this quickly earlier, but I'll add one which is muscle and strength in the sense that we have very traditionally framed muscle and strength as athlete in sport. Yeah, right.

[Dr. Stephanie Esteema]

Yeah, yeah. And male. And male for sure. Yeah.

[Andy Galpin]

And we have always placed the emphasis on cardiovascular as health. Right. So when you think about this as like, oh, you know, how many times have you gone to the doctor and they strongly encourage you to add strength training. Like, almost never. Right. But they may say something like, you got to start doing some cardio. Your, your heart's too. Like, let's, let's even go back years before VO2 Max became in such high order.

[Dr. Stephanie Esteema]

Darling. Yes. Yeah, yeah.

[Andy Galpin]

You would never hear that. Right. And you would never hear a general practitioner say something about that. You would hear fat loss and cardiovascular health are for health. And then muscle. That's sports and athletes and bodybuilders and people like that.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

And so that has caused that confusion to your marketing point of saying, okay, number one, we're advocating exclusively that health is just your body composition. That's. That's it. Right. That's the only thing that matters. And you can get this done in six weeks. And so what we was led, those led to just an onslaught of crash diets and fill in the blanks, things that have happened. And, you know, our hope over the last 15 years of my career is to encourage the opposite. Not necessarily that muscle is more important, but to simply say, going back to my original point, this is the problem. When you treat and teach systems physiology. Like, you think that you can go for a run and that has no nervous system adaptation. You think that endurance exercise doesn't do anything for muscle. Like, you're out of your mind.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

How could that possibly be happening? The inverse would be true. You think you can go for some really heavy lifting and you go through a session, like, not even heavy, just like really hard strength training, and there's no cardiovascular adaptation. There's no adaptations to your blood pressure. I mean, look at the research. It's really clear strength training is excellent at lowering blood pressure chronically. Right now, is it as good as cardiovascular training? Typically not. Some cases, yes. Actually, it wouldn't be as good for VO2 max. Sure. But that doesn't mean it's zero. That's the huge mistake of saying this is not how the system works at all.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

You maybe have some slight hedges. And then certainly once you get past lowly trained or early trained people into moderately trained, and then definitely when you get up to highly trained, then the differences really start to break apart. No question. Right. Like, there's no one who could lift weights five days a week, never run, and have a VO2 max of 80. That's not going to happen. Right. Which would be insanely high if you're not familiar with those numbers. But that doesn't mean at the, at the base, at the middle, that we're getting no adaptations from those things. So that's, I think that's an important thing that I'll, again, I'll spend my career trying to argue for and dismantle.

[Dr. Stephanie Esteema]

Yes. Well, while we're talking about muscle, I actually would love to talk a little bit about fast twitch muscle fibers, if you can talk to us about that. Because I think that this is a problem with aging. I think that, I mean, just na. We naturally, everybody's very familiar who's listening to the show. You typically start to become more resistant to putting on muscle after, you know, about age 30ish, 35ish, there's that anabolic resistance that starts to set in. However, I don't think that people talk enough about the loss of fast twitch muscle fiber. So I'd love for you to explain that to the audience and why that is something that we want to be also considering as we are thinking about aging.

[Andy Galpin]

Well, so the breakdown in your tissue and your muscle, more specifically your skeletal muscle. So this is muscle that's not your digestive tract and not your heart and things like that. The muscles you think of when you think of muscle, they're generally broken up into two types, fast twitch and slow twitch. Fast twitch is certainly more explosive, but it doesn't have endurance as much. And then slow twitch are the opposite. They're very fatigue resistant, but they don't produce a lot of force. Now those are broad categorizations because they both do both. There's plenty of endurance capacity and fast food fibers and slow twitch fibers can get very fast. But just to keep things simple, we have that, that allows us to have independent function within a muscle and from muscle to muscle. As an example, think about your calf. Okay, we tend to say the calf muscle, but the calf muscle is not a muscle. It's several muscles. Okay, Just the muscles between your knee and your ankle. There's several down there. But the two most important ones are your soleus and your gastroc. They both go into your Achilles and then they both wrap around the bottom of your heel and insert in the bottom of your foot. If you've ever had plantar fasciitis or something, it's that tendon. It's where both those muscles come together. So what happens is either one of them gets contracted. It actually makes your toes point out, right? It's plantar flexion dorsiflexion. It's confusing term, but that's what it makes you do. It makes it point outwards Right. Because you're pulling on it. But where they start is in a different spot. And they start kind of on the back of your, of your shin bone, if you will. Just for simplicity, the soleus does the gastroc actually goes behind your kneecap. So the gastroc has this double origin point. And that matters when you're choosing exercises.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

Okay, we can come back to that if you'd like.

[Dr. Stephanie Esteema]

But yeah, yeah.

[Andy Galpin]

What's functionally different about them is the soleus is the slow twitch one. In humans, it's about 80% slow twitch, meaning about. If you look at the, the soleus muscle, there's hundreds of thousands of individual muscle fibers in it. 80 of them are going to be slow twitched and 20 of them are going to be fast twitch. But that number differs from person to person. We've, we've had some people that are 60, 40, some people that are 95, 5 and so forth. Other species have a hundred percent, like most rodents will be 100% slow twitch in their soleus. Like there's not a single fast twitch in there. The Gastroc is more 50, 50 fast twitch, slow twitch. But again, there's a lot of person to person variability. Some people are extraordinarily fast twitch in that and some people are extraordinarily are much more even. Your traditional distance runners and stuff tend to be a little bit more even. And your explosive jumpers, of course, are much more headshorts. Ratchet. Why this matters. If you're standing up, the soleus is the one that's going to be active most of the time. It's what we call an anti gravity muscle. It's what keeps you up and not falling over. Because it has to kind of be on with a low amount of force production for a long amount of time. You should be able to stand for hours and hours and hours without falling over. One of the biggest issues we have with space flight is the soleus gets trashed so much because it is needing stimuli to be activated for hours and hours a day. And when in space flight we can't do that since there's no gravity. The gastroc is easier to maintain because it only needs a few minutes of stimulus per day, because it's not very many hours a day. One is jumping or sprinting or explosively, you know, pointing their toes out. So the soleus is actually the bigger problem as where most of the research that colleagues and stuff of mine with spaceflight have looked at is that slow twitch. So when we go to space and when we get into sedentary activity, we have to consider the long term loss of these slow twitch fibers. But since almost any activity of daily living will activate a slow twitch fiber, because what happens is there's a very specific principle called the size principle. Aldo at Henneman gets credited for this. In the 1960s, one of my favorite scientists of all time, he, he, like, if you Google him, he looks like your grandpa who has some Werther's originals.

[Dr. Stephanie Esteema]

He's going to hand them out to you at any moment. Yeah, for sure.

[Andy Galpin]

That's Henneman for you. Like, oh, I want him to be my grandpa. He's the greatest. What that really means is when you start an activity of any kind, you will start by turning on your slow twitch motor units and motor fibers because they're more efficient, they cost less energy, and that's actually the only way you can regulate total force production is if you want more force production, then you have to turn more and more and more on. So there's an all or none principle that says when you contract a muscle fiber, it will contract at 100% of its force production. There's no other option. And so if you can just imagine if you're watching, if I take this pen and I lift it up in the air like this, and this pen weighs a few ounces, I actually am going to start with the least amount of motor units possible. And as I start to elevate it, my sensory organs say this is not enough force production. Turn more, turn more, turn more until the pen starts to move. So that's how you grade how much for I keep using force. Force is kind of strength, right? Like how much strength I need here is dependent upon how much I'm trying to overcome. So as I go to do this and lift it up, if say this pen was, you know, double the weight or 10x or 100x the weight, I would turn more and more motor units on until I realized this is enough motor units to move this pen. Whatever I'm trying to do with it, at some point you'll access most of your of your slow twitch neurons and then your body will realize I need more force production. So I'll start to engage the fast switch ones because they are much better at force production. But again, we're going to do that last because they're metabolically efficient, which means they cost a lot of energy. So when you're doing the vast majority of your tasks throughout the day, you're digesting food, you're building red blood cells and immune Cells. You're thinking you're walking, you're stretching, you're scratching your toe. You're going to use almost exclusively slow to fibers because it's just more cost efficient. One of the things that we saw happen post Covid was a whole bunch of Achilles be torn. Why? Because walking and standing went down, it was plummeted to the bottom. These soleuses became insanely untrained and bam. The Achilles started to go as almost exclusively a soleus and gastroc issue, but heavily a soleus issue because people were typically giving it low amounts of resistance for hours and hours a day. And I went to zero. And that tendon was not capable of handling high, fast, high forces and loads, especially really fast. So our fast twitch fibers in the, in the gastroc in this particular example are only activated under the presence primarily of high force demands. Which means as the years and decades go on, those things actually will start to die out. Those motor units will go away, those fibers will stay there, but they'll actually be reclassified and they'll join a slow twitch motor unit. And so you get these big patches of slow twitch fibers and called fiber type grouping with aging and stuff. So you won't lose slow twitch fibers because almost anything you do throughout the day will use those fibers and we'll keep them alive and activated. But the fast twitch fibers are only there to be used under high force demand. Again, this is not going to happen in six weeks of detraining or even six months. What we're generally talking about here is years and decades of disuse. That's when you will lose those slow touch fibers. Now you can convert slow fibers into fast fibers with training, but once the motor units have died out, the motor units are gone. And so what we see happen is as folks get into these aging categories of the mid-50s, 60s and 70 years of age, a lot of those fast food fibers are gone. And the motor units themselves are gone as well. Or they've been, they've been transferred over. And so that becomes difficult to reclaim. And so we want to make sure that we're doing something along the way that is just enough to keep them alive so that we don't lose that innovation or that capacity. And this helps then because now we can maintain strength, power and speed through aging, which you don't need a ton of it to age successfully, but you need just enough to catch yourself from a fall to be able to have the strength to survive any semblance of distraction, any semblance of an issue, any amount of wanting to live independently so you can, you know, manage your house and travel and things like that, and walk upstairs and, you know, kind of all the classic examples. And so the wine back answer to all that is if you want to have the functionality at eighty, ninety, a hundred plus years old that you have now, what's more likely gonna happen is you're gonna be limited by strength than you are cardiovascular capacity, almost surely. And so the strength limiter there is probably a proxy or highly related to the fact that you've lost too many fast twitch fibers. So all that to say get going now on some preservation tactic, and it doesn't take a tremendous amount so that you just don't lose so many of your fast twitch neurons as you age. So that was a very long answer,

[Dr. Stephanie Esteema]

but it's a fantastic one. All right, friends, there are a few major verticals that you should be investing in for better skin. First, a gym membership. We all know that training and cardio is great for your skin orgasms. Hello, obviously. And a great skincare line that makes your skin look and perform like younger skin. Now, when it comes to your face, specifically, as you age, skin tends to become thinner. It produces less collagen, the proliferation and turnover goes at a slower rate, and it accumulates more damage with time. Now, in the world of dupe culture, this is where I firmly believe in investing in the right technology and the right brands. And one skin is the first peptide proven to reverse the skin's biological age. The scientists there analyzed key aging biomarkers in human skin samples before and after treatment in the lab. And they found that the OS1 face cream that has that OS1 peptide increases epidermal thickness, supports collagen biosynthesis pathways. So for my nerds out there, this is the COL1A1 pathway. And it promoted cellular proliferation or that skin turnover. And when it comes to your eyes, which are typically five times thinner than the rest of your body, using their OS1 eye cream, which is formulated with the highest concentration of that OS1 peptide, this is going to help target the accelerated eye aging that many of us see at the molecular level. There was a recent 12 week clinical study on the OS1 eye cream, and it was recently published in the International Journal of Cosmetic science. And the researchers there found significant improvements in appearance, in hydration, in under eye elasticity, firmness, and skin barrier function. And they also noted decreases in fine lines and wrinkles under eye puffiness and dark circles. This has been a skincare line that I have been using for the better part of two years. And I swear by it for you, if you want skin that looks and behaves younger, I want you to head over to oneskin co better and, and use code better for 15% off your first purchase. I used to be, I used to be in track. So I used to be, you know, 400 relay was my race and I also did 200. But then, you know, life got lifey, had kids, got married, da da, da. All the things you stop sprinting. And I recently took it up again and it's, it's so wonderful. But you can't just zero to putting on your track. You know, after years and then getting on the track and then sprinting. You know, to your point around Covid, there is a, there is a high incidence or high, you know, risk of getting injured. So what are some, let's say, low risk of injury activities that someone might think about when they're trying to either preserve elastic recoil, preserve some of the type 2 fibers that you're talking about, and preserve the, the ability to increase that force output.

[Andy Galpin]

I'll actually go back to the very beginning of our conversation because you can do almost anything. Newbie gains are real. You can see strength improvement, power improve. All the things you just mentioned with walking. Like we, there's plenty of research that has shown things like 10 to 20% growth and muscle by cycling, light cycling, right? So you can see all the, kind of like the exercise science rules break in those situations of highly untrained. So my initial answer would be just that. Don't even worry about it. If you're just trying to get in two days a week of exercise, we'll, we'll get to this sort of secondary stuff later. Get moving. But tissue tolerance is very simple. It is the thing, right? If you want your Achilles and your calf and your foot to be more resilient, do anything that challenges them. If that's running, great. If that's foot exercises, amazing. If that's stand up paddle board, cool. If that's jiu jitsu, great. I mean, you, you name the thing that's going to use it, it'll get there. Ideally once or so a week. You'll try to have most of your joints try to do something explosive. But you know, I'm in my early 40s. I still feel really good, but I'm certainly not lifting how I was when I was a college football player. But there, there's a, can be a middle ground here, right There can be like, okay, I can do something. I can swing a kettlebell explosively Fine. Pretty darn safe. That's going to get you last attention. Maybe you can do some low level plyometrics, rudimentary hops. Maybe this is as simple as jump rope. You'll actually be stunned how effective jump roping is. Oh, yeah, fine, right? You could do a million things. There's. You could just start. So I guess maybe what I'm saying is if you're comfortable lifting with any movement, let's say three or four sets of six to ten repetitions, just try to go a little bit faster and get a little bit faster, and then a few months later, maybe go a little bit more faster. And then maybe a few months go by and you try to go a little bit. So like your power training doesn't have to be literally everything you got every single rep. If the situation you described a moment ago is true, where you're like kind of getting back into it, you're like, you're totally. Believe us, you're Inspired. It's been 25 years since you've done anything hard or explosive. Don't just give it like two or three weeks to warm up. Like, probably give it several months to slowly get going and slowly until you get more and more and more comfortable. And then you can get into cleaning jerks if you want. Then you can get into medicine ball throws or something. But you can also just start by going, all right, I'm going to control the weight. And then on a concentric portion on the machines, I'll try to go a little bit faster. Instead of kind of just doing enough to get it up, I'll try to go fast. Fine. Like, we're winning here. We're progressing. We've got years and decades. We can eventually get back to where you feel comfortable jumping and landing. We could get to plow metrics and throwing med balls and doing fun stuff like that so we can work ourselves up. In this case, even if you're doing this stuff that's quote unquote, kind of outside the power range, it's too light. Fine. Who cares? Like, we're just getting your tissue ready to move with a high reaction stretch and then contraction. And then we'll give it plenty of time, months to adapt and then progress, progress or progress our way up.

[Dr. Stephanie Esteema]

You were, it's as you're talking, you were reminding me. I remember seeing a clip of you, I guess it was several months ago now. You were on the ritual podcast and I think you said something like, I mean, it was, it was meant to be a bit salacious, but you Said something to the effect of, I would rather take a year off and completely correct an injury rather than trying to adapt that year and working through the injury. And I remember the comments section was like, you're nuts. Like, I am gonna work through my back injury. I am gonna continue with my janky shoulder, my bad knee, whatever it is. And I, I think often when we think about the, you know, the continuum, there's often the very extreme. Like, I will work through anything. Put me in, coach. It doesn't matter that I'm injured. I will continue to work through the pain. And then there's, you know, on the other end of it, which I think is actually a little bit, maybe a little bit more. I'll say it's the maturity that you gain along the way because if you don't stop, you're going to continue to get injured. But actually addressing the problem, like online, I see a lot of people saying, never do a deadlift, never do a squat, right? These are very technically sophisticated moves, but it's very rare to see somebody do them well. So why wouldn't you just pull back on the weight? Like, who cares what the weight on the barbell or whatever machine you're doing says, as long as you're trying to work on your technique and your form? Because you're going to be working on all the things that you just talked about, the force production, you're going to be maintaining, you're going to be progressing. Maybe it's not in the traditional way of adding weight or low to the bar, but you are going to be progressing in terms of your technique, which is also, in my opinion, really freaking important.

[Andy Galpin]

Yeah, I mean, look, I understand the poll, right? Sometimes you're like, it's been several months, I'm kind of going light. And it's like, sometimes I just want to go hard. I want to train. I get it. I'm not against it. Like, I would be lying if I said that I don't do the same thing very often myself. I'm currently sitting in this chair with a shoulder that's not working particularly well for the exact same mistake that you just mentioned. Like, all right, gonna have to see what you got. Like, it's the funniest. It's the stupidest thing, right? The cliches, the tropes are so bad here, but I was just trying to save a little bit of time on my warm up and just got up too Chevas and I was like, ah, all right, shoulder. I knew instantly in that second, I'm like, ah, Dang it. Like, I would not call this an injury, but this is like, all right, now I'm gonna have to give this a few weeks of. To get back. Okay, fine. So totally get it. I wanted to, wanted to press. I'm like, we're good here. Felt great. And you know, all the mistakes, it happens. You can't live. You can't be there forever. Kind of. You don't want to baby your body either. You can probably do more than oftentimes then you're giving yourself credit for. So those things are all true. But there has to be some point where you're like, okay, everything is banged up. We've been like this for years. What eventually is going to happen is you're going to be able to not do these activities anymore and then it's going to extend to the next activities, which is you're not going to be able to walk up the stairs and you're not going to be able to play pickleball or do whatever the stuff you want to do. And now we're just doing nothing. And so that's just, that's the. When I was. I don't remember the comment exactly from Rich's podcast. I do remember the Internet storm though, afterwards.

[Dr. Stephanie Esteema]

Yeah, we'll link, we'll link to it. I remember, I remember commenting, saying, andy, I just love your perspective here. I would also take a year off to get my biomechanics on properly and then continue.

[Andy Galpin]

Yeah, yeah. I mean, if you were to zoom out five years.

[Dr. Stephanie Esteema]

Yep.

[Andy Galpin]

You would not. No one would regret that decision.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

You would come back and be like, it was very hard to do someone. If someone forced me into it. Yeah, you'd go do it and then you'd be very happy for it.

[Dr. Stephanie Esteema]

When we talk about again, when we talk about Internet storms, fasted and fed training again, nutrition can be. I don't know what's wrong with nutrition on the Internet, but nobody can talk about it respectfully. Safer maybe Alan Aragon. But let's talk about fasted versus Fed training. Do you have a preference? Do you care which one? Is there any advantage one over the other?

[Andy Galpin]

All the. All of the above, all, everything in between. There are situations when there is an advantage to training fasted. There are situations when there's an advantage training fed and there's plenty of times when it doesn't matter at all. So this is one of those things where it, there's no, there's no magic here. There's no single answer. It's context dependent. It's driven by goals and environments and situations and unique physiology and age, where I think we can make some clear stances are one. Neither is fundamentally automatically just always better. Yeah, neither are dependent upon your age or your sex or your anything else. Like those are not the factors that determine whether or not we go fed or we go fasted. Factors would be other things like your GI tract. And does something make you nauseous? Is it hard to eat before you train? Is it actually hard to not eat before you train? What type of training are you training multiple times a day or a couple of times per week? Do you struggle with portion control? Do you struggle with being hungry? Those are the types of questions that impact our answers here. It's not, oh, you're a woman, therefore you have to eat. And it's absolute bonkers. None like pseudoscience. There is no, oh my gosh, you're, you're overweight, you have to fast like that. Those are not the critical factors there. So there is a lot to think about here. It's certainly a viable option.

[Dr. Stephanie Esteema]

Yeah. Well, I'll tell you, I would prefer to eat, but the time of day that I get to train, which is somewhere around 5 to 7 if I'm lucky, I can't. It's very uncomfortable for me. So I often will have a cup of coffee with. I have a higher protein milk. Like I have a cappuccino in the morning. So I put some milk in, probably, I don't know, 10 grams of, 12 grams maybe of protein from milk. So it's liquid, I can digest it, I can deal with it. I'll have ketones.

[Andy Galpin]

So we're gonna basically call that fasting.

[Dr. Stephanie Esteema]

Yeah, it's fasting. It's not. There's no carbohydrate bowl, nothing. So I'll eat afterwards. But on the weekends when I have a little bit more flexibility, I'll usually eat before. And I love to go and work out fed. I find that my performance, I find that I have a little bit more energy, I can push myself. I have a little bit more time to neural fatigue where I'm start. And this is. I'm talking about leg day, let's or back day, like a big muscle group that I'll train. So I really love to do fit. I just can't. And so my recommendation often has just been like, you know what? The one that's best is the one that you can do consistently. It's like as long as you have like the protein and the carbohydrates and the refueling in the 24 hours. Ish. After training, assuming you're training once a day, it doesn't really matter. But I would love for, I would love for you to dissect that and get into the science and the mechanisms there too.

[Andy Galpin]

Yeah, totally true. It also depends on goal. Like I said, if you're trying to compete in a very specific event, then the answer is very dependent upon that event. It depends on style of training. Are you trying to maximize for recovery and performance? Are you trying to maximize for body composition changes? Are you trying to maximize for adherence? Those are different time of day you train, as you already mentioned. How much are we trying to GLEAN those last 5 to 10%? Are we just trying to get the, the first 85, 90% those things are, are there all that can go out the window too? Like we have, I have plenty of professional athletes who don't train till 11 o' clock or noon and they still struggle to eat anything before. All right, great. And these are people training multiple times a day. Right. And they're world champions or right there on the, the, the, the block of that in their sports. So fine, we can do it that way. I have plenty that are, that are the opposite too. We have plenty of people who are fat loss people, their hormones fixed and balanced like any of the stuff here with fasting and we can absolutely do that with lots of feeding throughout the day, no problem whatsoever. So we can get there. In your case, like, okay, fine, you want some caffeine and effectively to fast. Okay, great. Like it's what I can make work

[Dr. Stephanie Esteema]

with the constraints of my life, like if I didn't have school drop off and all, you know, all the things I might be able to change around and if I didn't have work, I could work out at 11:00am Sure, 12:00pm you know, but, but I can't. So you know, what I have been able to just construct in my own life based on those constraints is I work out, fasted most days on the weekends. I try to push it so I can eat and then train.

[Andy Galpin]

Yeah.

[Dr. Stephanie Esteema]

Um, and it just works well.

[Andy Galpin]

You know, we've worked with, with some military members and we will often force fasted training on them simply because of resilience development. I need them to know that they can train, they can perform when they haven't had food for days, literally.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

So we will do that stuff because they're going to be in environments. Well, you just imagine, right, we want to train sometimes fed, we want to train sometimes fasted and everything in between.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

We've also done A lot in hospitals with surgeons and with other like EMTs and firefight and things like that. But the surgeon in particular, they can't stop to take a break every three meal, three hours to eat a meal. That. That's not going to happen. And so a lot of the times they will be on eating one meal a day because they need to be able to go through six, seven, eight hour surgeries and not be losing any cognitive or physical performance capacity, which almost always means they're going to train fully fasted. We've done the same thing. We've had some pretty crazy adventure people. We actually have a bunch of people doing this wild outdoorsman challenge right now. We've got some people doing the Grand Canyon where they're going to go rim to rim to rim in a day, and just different things like that. A lot of related hikes, and we had a guy do Mount Everest to get to base camp and stuff. So we'll do a lot of fasting there. Not for any special thing, but just the fact of going, you're very likely going to be low calorie.

[Dr. Stephanie Esteema]

Well, that's specific. Yeah. Then that's specific to their goals and their sport.

[Andy Galpin]

Exactly.

[Dr. Stephanie Esteema]

Yeah, yeah, yeah. You know what, nobody told me when I started lifting that the workout isn't actually the hard part. The recovery is. Your joints are doing the invisible work between sessions. Your tendons, ligaments, and connective tissue holding the whole system together. That's your infrastructure, and most of us have spent years ignoring it entirely. This is where incrediwear comes in. I wear their elbow sleeve when I'm playing tennis, their knee sleeves when I'm squatting, and when I recover. They're not just compression sleeves. The technology here is different. The fabric woven into them increases the circulation to the tissue, which means that your body is actively repairing between sessions, not just waiting to feel better. That means that you are going to feel less stiffness, you're going to have faster recovery. Your joints are going to actually keep up with the work that you're asking them to do. Now, of course, muscle is the engine, but your joints are the road. Okay? Take care of the road. Whether you're an athlete dealing with chronic joint pain or just somebody who wants to feel better in your body today, this is worth trying. Head over to doctorstephenestima.com incrediware and use code DrSteff20 for 20% off your order. That's drstephaniestima.com incredaware and use code Dr. Steph20. That's D R S T E P H2 0. What about menopause and perimenopause? One of the things that I. I mean, we have a big perimenopausal, menopausal audience. One of the big things that I hear most commonly from them is that their capacity for recovery is very different than what it once was. So they all. They'll also say things like, my body comp is changing foods that I used to be able to eat, I can no longer tolerate the way I used to fast or whatever. No longer tolerate. But the one thing that I find very interesting is the recovery capacity. So the same workout, let's say now, destroys them for three days. You know, like they do a leg workout, they do deadlifts or whatever they're doing. And then there's much they're sore or their recovery capacity. They go for a long run, they're much sorer for. Sorer. Is that the word? For a longer, for a longer period of time. What is happening there?

[Andy Galpin]

Yeah, kind of. By the definition, perimenopause is a collective word of everything, meaning you. I'm sorry to almost punt in the answer, but the reality of it is it's so chaotic and so wildly different person to person. You can't fairly give generalized answers like that because everything you just said to fully agree, like I can speak very specifically on this in my current household. Like I, I. Yeah, great. Totally happens. Other women. None of the same other women. It is some phases and then it changes.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

And then they can. I think the main challenge of the perimenopause window is just that it's. Nothing is consistent. You can't get a beat on anything because it's constantly changing. It's like you're in this tornado that just never gives you consistent signal, which becomes a challenge. So then knowing what to do about it is so different because you're the target is changing so frequently. So what could be happening with that stuff? It's everything. It's everything from the obvious endocrinological changes, right. Hormones are by definition moving up and down. But then it's past that. You start to see major transitions and changes with sleep. And so you start asking about recovery windows. Well, what's happening with your sleep? Right. You have everything from I just laid there for three hours out of randomness and I have no idea why I wouldn't fall asleep. And then it went back to normal and maybe then all of a sudden I couldn't fall asleep for 10 days in a row. And then I went back like, like it's, there's no beat and rhythm to it, which seems to be very challenging. Or you get the midnight or the middle of the night wakings or none of that. And you're like, yo, I feel like I need to sleep for 10 hours a day. What the hell is going on? And so huge sleep disruptions happen. That is going to be definition. That's gonna be the biggest thing that will alter your recovery capacity. And then you also have obvious, again, hormonal changes happening there. So those would probably be the two biggest places. And then on top of that, you have such significant changes in perception and cognition that things just feel harder than they actually are. Your perceived fatigue and mood are altered so significantly. There may or may not actually be anything happening physiologically, but you certainly feel worse and don't want to do stuff. So all of those things are a factor or a combination of them. And that combination can be changing all the time.

[Dr. Stephanie Esteema]

Ah, it's so frustrating because, you know, you really, I think when you actually become menopausal, it's much easier to manage that patient. Right? Like, it's much easier to deal with that. And it's hard to tell a patient, well, you know, like next five years, you know, like go back in five years.

[Andy Galpin]

Yeah, it's like this may be a year, you may be here for 10 years. We have no idea. We don't even know when it started officially. Technically. Don't know when it's going to end, technically. Well, the ending is, you know, much clearer definition there. But sure, yeah, it becomes difficult. So it's just sort of like this 2 to 10 year window where you just kind of manage the best you can. And I think the only. I know this is probably a frustrating set of answers here, but the best piece of advice we give here is this is. This has to be one on one management. Right? You just have to treat this as an N1 and you have to figure out what's working for you. And that's always the case. But it is double, triple, quadruple, 10x more the case. Perimenopause. Like you just, you just have to be able to have an individual approach

[Dr. Stephanie Esteema]

and you just have to give yourself some effing grace. You know, it's like you're not gonna be, it's not a spreadsheet in perimenopause. Like you said, some days are going to be good, some days are going to be bad. It's going to, you know, like that some days may be good, some days Maybe shit like that meme that I see all the time.

[Andy Galpin]

It's a combination, honestly, just to add one more thing, it's a combination of grace and fortitude in the sense that. Yeah, grace for sure. At the same time, if you're like year three, year four, and you're just like, ah, I don't have the motivation to work out. Like, well, at some point I give no shits about your motivation. Like, it's. At some point you have to realize the motivation is not going to come.

[Dr. Stephanie Esteema]

Yeah.

[Andy Galpin]

And you, you just have to go do it like you're a 40 to 50 year old adult. Like you, you've got to go do the work at some point. So there's a tug and pull between those two things, of course, but there's a, there's a reasonable amount of that sometimes where you just like, again, we've got to go do the things we know and it's not going to feel great. You're not getting the numbers. That's where the grace can come in. But we, we want to be careful of letting that slide into just like, well, I can't do it because my hormones are off.

[Dr. Stephanie Esteema]

Yeah, like throw it in the effort bucket. Well, this is, this is the behavioral goal, right. It's like, this is where we forget about the outcome right now and you just adhere like it's, you know, f your feelings stick to the plan. You're just, this is the plan. You're gonna follow it. Did you make it to the gym two times this week? Did you go for a walk five times this week? Did you, you know, as much as you can set up your bedroom to be restful, dark, cold, like as much as you can. Did you do that? And that's the, that's the, the best you can ask of yourself in that period.

[Andy Galpin]

Totally. And as you know, like the one probably the nasty twist here is one of the major things that perimenopause does is it makes the effort bucket. Like the size of a house.

[Dr. Stephanie Esteema]

Yeah, yeah, exactly. Like everything, everything goes in that bucket now. Okay. Okay. One of the things I, I really want to dial in for my audience is this idea of playing the long game. We were just talking about it, I like to call it sort of this devotional shift. Elite athletes always talk about this, being in it for the long game. Right. We think about athletes that can withstand the test of time. Of course, someone like Ronaldo comes to mind. But for a woman who's been motivated by shame and punishment in, in terms of health and fitness for most of her life? What does it look like for her to shift from being motivated by shame and punishment and moving into trusting her body and, like, kind of sticking to the plan? Like, what does that sort of devotional shift look like?

[Andy Galpin]

I think I'm probably not an expert in this area. I'll answer this as best as I can in the sense that I think, you know, from my perspective, obviously, performance is. Is where I go. And so I. One thing that comes to my mind when you bring this up is this is the advantage of the rise of female sports, is this can now be like, you are cherished, you are admonished, you are rewarded for your athletic accomplishments. Like, I do not care about the other side of the equation in this sense. Right. We don't. I don't care what that means with how you look or anything like that. Like, we're now just saying, hey, this is great. You are really good at being an athlete because you're an athlete too.

[Dr. Stephanie Esteema]

Right?

[Andy Galpin]

And that's all this ever has to be. The. The kind of triangle we go after all the time is look, feel, perform. And so what I mean by that is everyone wants to look a certain way or doesn't want to look a certain way.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

Some people want to look at, some people don't. They don't like the athletic look. Fine. I. I'm not here to place judgment on anything you feel like is a good or bad look. But we all have to acknowledge all of us care at some level about how we look. That's not. It's not necessarily a bad thing.

[Dr. Stephanie Esteema]

Right.

[Andy Galpin]

There's some.

[Dr. Stephanie Esteema]

I think it's a great thing.

[Andy Galpin]

Yeah. I mean, it can go bad, of course. Right. And certainly most eating disorders are going to be much more hedged towards females than males. Sure, it can happen in both sides, but it's going to be historically and probably for forever will always be hedged more towards females. So I don't think we want to run from that per se, but we seem to acknowledge that. Are you sure that's the way you want to look for healthy reasons, or is there some other stuff going on there? And so, I mean, I work with, you know, famous musicians and stuff, and they're like, they want to be skinny, like, okay. Like, they want that lean look. They don't want the athletic look. These are men. Like, oh, okay, like, that makes no sense to me, but it doesn't need to make sense to me. Right. Some people probably look at my physique and they're like, I hate that. Oh, okay, fine. Whatever. Like, yeah, okay, but then there's feel and perform. Right? And so you all want to feel a certain way. Some people want to feel strong. People want to feel in control. People want to feel high energy. They want to feel whatever and then perform. Right. You want to be able to run up a hill or ski all day, or you don't care about any of those things, and you just want to not have your back hurt when you pick your kids up from school. Like, okay, fine, so if we start to play this game, it's. Now it's just like, okay, what do you want to be for all three of these buckets? And underlying all them is actually still like, is this coming from a healthy place or non healthy place? Why do you care about feeling that way? Why do you feel like you want to be in control more? And are we getting to a mental health challenge disguised with strength like that? That may. Or like, you want to feel more in control in the gym because you feel out of control emotionally? All right, that's probably not our best answer then, Right? We probably need to go address where these things lie. Not to say again, every want, desire, physically is just unrooted psychological dysfunction. That's not at all the case.

[Dr. Stephanie Esteema]

But that's not what every leg day is, Andy. Okay, sorry.

[Andy Galpin]

Yeah, it's. It's a little bit of S M in there every time.

[Dr. Stephanie Esteema]

Exactly.

[Andy Galpin]

You're gonna do that. It's the same thing would be true for sprint repeats or something.

[Dr. Stephanie Esteema]

Right, right, right. Sprints, yeah.

[Andy Galpin]

So I think my best answer to that would be those things. The. You know, I had a conversation with the sports psychologist Lenny Wiersma pretty recently on my show, and he took this from the angle of self talk. And I'll draw parallels here, where we have the. The misguided notion here is that positive self talk is better than negative self talk. So positive self talk being defined as positive iterations back to yourself. Right? So good job. You did a great job. You're amazing. Things like that. That canal, that can actually be detrimental.

[Dr. Stephanie Esteema]

Right?

[Andy Galpin]

And then the negative self talk is like, you suck.

[Dr. Stephanie Esteema]

You're.

[Andy Galpin]

You're terrible. Oh, my God. Get your stuff together. All those things that can also. That can obviously be very positive. So the way that he frames it is it's not the positive self talk or the negative self talk that's good or bad. It is the. Is it actually helping? Is it actually making things worse? And so I would lean heavily towards that kind of idea here of saying in the case of some people, male or female, if Negative self talk around your body image is beneficial, then I'm okay with it. That's personally how I roll. Like the, when, when I look in the mirror and go, oh my God, you're getting a little sloppy. Like you, I will, you know, speak very negatively to my own self, but just like, oh yeah, gotta get it together. And that has no negative self worth or self consequence for me. Other people, you probably want to stay as far away from that as as ever possible because it's just way too close to negative emotional states and, and behaviors. I have plenty of men that I coach that are like that. We just don't get anywhere near these things because they, they cannot control that ledge. They just fall way off of it. And I'm saying this about men because like obviously women, we know this about women, right? But it's also the case of men too. We will hold back information. They'll get tons of health anxiety, they'll get optimization anxiety, they'll get orthosomnia. All right, so we got to withhold information like that. And I guess the broader point I'm making is it's not necessarily the positive or negative information. It's is this serving you, Is this creating benefit or is this creating risk and a downside? So your original question of saying like, I think my answer immediately thought of is like, this is where sports are awesome because it allows a physical expression that's not simply based on how you look, right? Let's just acknowledge the fact that you're a high level athlete even in your own right. Even if you're the worst athlete in your entire city, you're still a high level athlete for yourself. Like, who cares, right? You're just like you're athlete in your own right. All of us are. All humans are athletes, right? If you have one, a body, you're going to be an athlete at some level. And we're all just gradients of good or worse athletes. And so if you want to make a change in your physical expression and performance, we can do that. If we're doing this because of pressures and thought processes and assumptions that are a net negative, even if it's not mental health, even if it's like, oh, I have to be faster, I have to be bigger, I have to be stronger. And that's leading you to engage in dangerous behaviors like excessive training through injuries and other risks. And it's negative. So it doesn't have to just be coaxed in mental health. Although that's, that's the obvious one to think about here. So that's. That's my long wind rambling answer.

[Dr. Stephanie Esteema]

I love it and I really appreciate your time today. I know that you had. You're very constrained. So happy that you made the time to come on our show. Where can people find more about you if they want to find about. More about you and your research? And I know you have a podcast, so please plug that as well.

[Andy Galpin]

Sure. It's called Perform. It's on all the. The normal playlists and stuff. We just put season three out, so I'm not sure when this is going to air, but it's only. We typically do something like 10 to 12 episodes a year. So just a couple of seasons and give you a couple weeks at least in each one and go through that. And then you know my name on all the socials and my website, andygalphin.com is pretty easy to find.

[Dr. Stephanie Esteema]

Awesome. We'll make sure those are all in the show notes. Andy, it's been a pleasure talking to you today. Thank you so much.

[Andy Galpin]

Yeah, it's a pleasure. And it was great to finally, after all these years, get to connect.

[Dr. Stephanie Esteema]

Yes. All right, friends, welcome to the after party, where I tell you how I felt about the conversation as it was going down and my thoughts afterwards. And for those of you that don't know what the after party is, basically when you get to menopause, that's the after party and everybody wants to be invited there. So that is what this is. Okay. So Andy and I have been talking on and off for, I don't know, a couple years getting him on the show, and then he started a podcast. And so I was so happy to have him, to have a time that worked out and to have him come on here. What I really loved and I continue to admire about him is his flexibility in thinking. So there's no one right way, there's no one wrong way. There's just a. All the right ways and all the wrong ways and it's all context and goal dependent. And I think that you probably got a lot of that as you were listening through the entire conversation. So a couple of highlights for me is, and this is just me being like a total nerd is the fast twitch, muscle fiber conversation. Can we get a hell yes for Solius? 80% usually, 80% slow twitch, 20% fast, and then gastroc evenly divided for most people, 50. 50. Of course it can be different. There's bio, individuality, as you said. But I love that. I love conversations like that because then we. What we naturally navigated into was the high force demands and the force type that is required to maintain that muscle. So the talk, the talk about anti gravity and astronauts that go up in, into space losing their capacity for the soleus and having to rebuild that when they come back to a gravity environment. So just loved that. The other thing that I enjoyed in our conversation was the fasted versus fed convo. I think that this still continues to, you know, we still see these chat rooms and you still see it on social media where people are advocating for one type. And I've said this for a long time, I think like the type that you can do is, you know, and it's going to be even week dependent. Like I said on the show, like during the week I got to do it, you know, fasted and then on the weekend I can do it fed. So I really, really loved that. And the other thing that I really liked as well, it was my last question to him and he was talking about this idea that positive self talk can actually be negative and negative self talk can actually be positive. But the question that you need to ask is how is this serving you? Is the positive or negative self talk, like if it is beneficial to you, then keep doing it. And obviously you don't take it to an extreme. But I've seen, I'm sure you've seen videos of someone like Cristiano Ronaldo or I'm thinking of that sprinter, that female sprinter, she's American, where she's basically standing at the French like run down the track like you always do, you know, as fast as you can run fast, you know, so she's talking to herself and Ronaldo's saying like put it in the back of the net the way that you always do. You know, you all, you never lose, you always win. So that those are examples of like positive self talk. And then, you know, he was giving examples of like where he sees himself in the mirror and he's like, oh God, like I gotta, you know, gotta get back at it. And that has a positive impact on his behavior. So I really like that reframe. And then I think the last piece I'll share with you that I loved was the, the Triad. The Triad, if you will, of look, feel and perform. I think that that's, you know, looking, you know, however you want to look, feeling however you want to feel and performing how you want to feel. Like, I mean that's the ultimate goal, right? Is like achieving the look that you want. So long time, long time waiting for this conversation. I hope that you enjoyed it as much as I did. What was your favorite parts? What did you love? Let me know in the comments on Apple, Apple and Spotify and all the places that you listen to the show and if you feel like we are worthy of your five stars, we will gladly take them. So until next time my friend, I bid you adieu. I hope you enjoyed today's episode and now I must give you the obligatory legal and medical disclaimer. This podcast Better with Dr. Stephanie is for general information only. The advice and recommendations we discuss do not replace medical, chiropractic or any other primary healthcare providers, advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship and the use and implementation of the information discussed are at the sole discretion of the listener. Please take this information to your primary healthcare provider to make the best choice for you. Remember, I am a doctor but I am not your doctor and these episodes are meant for educational purposes only.