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Habits and Hustle
Episode 435: Dr. Stacy Sims: Workout Like a Woman Not a "Little Man" + How To Train Based on Hormones
01:04:35
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- [00:01]
Dr. Stacey Sims
Hi guys, it's Tony Robbins. You're listening to Habits and Hustle.
- [00:04]
Jennifer Cohen
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- [02:01]
Dr. Stacey Sims
Yeah, so I started as an athlete and an academic and an academic in sports, science and nutrition. And all the things that we are learning in class didn't really apply to me as an athlete or my teammates. So that really started the question of what are we doing? And as you started digging in, realizing that there really wasn't very much research on women, and even when you're looking at the textbooks and the textbook pictures of representation, they're all male, male bodies. So that was so many decades ago. And ever since then, I've been really trying to dig into both research and the application of research to get women to understand that their bodies are different. We have different physiology from birth. We have hormone fluctuations and these affect every system of the body. And we respond to training differently than men. We respond to stress differently than men. And the more we dig into it, the more we realize There's a lot of research to be done. So the research that we do have, I'm really adamant about getting it out so women can be empowered to understand what is going on. Because face it, we put as much work into our training and we take time out of our day to really work on our health and wellbeing. So it should be appropriate for us. We shouldn't be fighting the battle against our own bodies because of protocols based on male data. So that's my mission across the lifespan is to get women from puberty all the way through post menopause up to speed about what their bodies are doing and how they can modify or alter what they're doing to get the best benefits.
- [03:32]
Jennifer Cohen
Right. Because, you know, I think a lot of times a woman and a man can do the same workout, eat the same food, do all the same training, and the results are very, very different. And it's frustrating. I mean, it's frustrating for me anyway. Right? Yeah, so true. Yeah, so true. And you know, a lot of times I, I would kind of, you know, people chalk it up to genetics or that men just have more muscle mass on them. Can we, can you kind of go, I mean, this is what the podcast is about. But can we talk about what you, how you see how men should train versus women and what women should be doing across, like the evolution of the different timelines in their life? 20, 30, 40, 50.
- [04:14]
Dr. Stacey Sims
Yeah, for sure. I like to kind of start this conversation. And we look at the sex differences that exist at birth. So that's like without our hormone fluctuations from our menstrual cycle and stuff. So when we look at XX versus xy, because that's the primary area of research that we have, very binary, but that's all we have at the moment. If you are born xx, then you have more endurant type fibers. So your slow twitch, your oxidative, very aerobic type fibers, and with that comes a lot of mitochondria work. So that means your body's really able to take fatty acids in, use it, use oxygen and go long and slow. When we look at xy, they're born with more of the fast twitch glycolytic power based fibers. So good at speed, good at quick reaction time, good at doing super high intensity work, and they have to work on developing that aerobic system. So as we feed forward and see at the onset of puberty, what happens is there's another divergence where with the, what we call the epigenetic exposure or the situational change that happens with estrogen progesterone, to some extent, testosterone. In girls, we have a change in all of our biomechanics. So our center of gravity goes from being up in the chest area down to the hip area. Our hips widen, our shoulder girdle widens, but we are not told about this. So we feel un gangly in our bodies. We aren't taught how to run again, how to jump, how to swing, how to land or any of those things. You're just, well, you are. At this point, you get your period. We know girls drop out of sport, but it has to do with the fact that the actual body biomechanics of the body have changed. So when we start looking at all these trends that are out there and about doing like zone two work and improving our aerobic capacity and trying to do ketogenic diet for improving our fat burning capacity, all that's based on male data. Because being born that xx, you already have all of that capacity. What we need to work on throughout our entire life is working on that power base and the fast twitch. And I say that because we want to be able to produce power, we want to be able to run fast, to jump to land, to have good coordination. But more than that, when we look at longevity and we see this is really important in peri and postmenopausal, that we keep producing lactate for brain health. Because if we keep producing lactate from that fast twitch and that higher intensity work that we've been trying to build throughout our life, we are slowing the rate and the risk for Alzheimer's and dementia. So when we see that sex difference in Alzheimer's and dementia, it comes down to the type of muscle fibers and the metabolism that we've been exposed to throughout our life. So that's why it's like, okay, if we look from birth all the way through to the end of life, there are unique things that women need to do to keep progressing and improving their health for longevity and performance. Whereas men are more of a linear because they don't have all of these changes that women have with with regards to biomechanics and hormone exposure. So of course it makes sense that you see all this data that comes out for men, and men are scribing these protocols and they're improving that when you take that and put it into certain points within a woman's life, they're not going to respond the same way because physiologically and biomechanically they are not the same as where that data originated from.
- [07:36]
Jennifer Cohen
Biomechanics is a really big One. Right. Because even women who have. But I'll talk about that later on. But like later on in life. But I noticed I saw something about how women have more ACL issues. Right. And we have all where are the other injuries and things that women are more prone to injury wise or happen to women versus men because of our biomechanics. And then also how should we train for our biomechanics so women are more.
- [08:08]
Dr. Stacey Sims
Quad dominant just the way our posture is in our center of gravity. So this already predisposes us to change a direction injury, soft tissue injury. That's part of the reason why we see a greater predisposition and ACL injury because we don't have the hamstring strength to counter some of those cutting motions that causes an ACL tear. So when we're looking at that and what we need to do is we need to put that focus away from the knee and the lunge and all that quad dominant type work, put it posterior. So you're looking at developing the glutes and the hamstrings, a lot of extension work. And we see that when women start to do that, they reduce their injury risk and they have better posture and cutting motion. And when we're looking at things like what FIFA's put out for warmup, it's all about warming up the posterior chain and trying to get those muscles firing as a counteract to some of those cutting motions that predispose women to ligamental tears. We also see that as we get into perimenopause, there is a definitive increase in plantar fascia issues and frozen shoulder or bursa in your shoulder. And that has to do with the changing of the tensile strength in the ligaments as well as a weakening in the muscle contraction. So again we're looking at what do we need to do to prevent that. We need to keep the strengthening and the fast, faster type power based action to create a environment that reduces injury, reduces the inflammation of the tendons and allows better range of motion. So when we look at men who are in their 40s, rarely do you hear about a plantar fascia issue. You look at women in their 40s, it's one of the leading issues that make them go see a physical therapist or an osteo or a chiro. And it's, it's an inherent sex difference. Right. I can see you're like, you've probably experienced it.
- [09:55]
Jennifer Cohen
I'm laughing, crying and laughing at the same time because I've had, I'm in my 40s, I have frozen. I had the frozen shoulder for two years almost. It's finally now dissipated. And I had the plantar fasciitis. And I didn't realize that those were two things that went with my age. I had no clue until I went down. It's like I thought something was. I thought maybe I like pulled a muscle in my shoulder and the guy was like, no, you have a frozen shoulder. And I'm like, what the hell's that? Like, how does someone get that? They're like, you're old, basically, is what he said to me. Right. And I never understood, like, I get the ACL because you're right. Like, we are quad dominant, right? And women tend to do those lunges and those squats. But the frozen shoulder, I didn't understand. I did not understand that.
- [10:43]
Dr. Stacey Sims
Yeah. So frozen shoulder has to do with. We have a wider shoulder girdle because our hips have widened. But if you think about all the metrics that we've taught to do push ups, pull ups, they're all in a grip strength or, or a grip width that's based on male data mal, male physiology. Because, you know, if you go to do a pull up and you're a bit wider, like, no more narrow. So it puts a lot of strain where it shouldn't. Same with push ups, they're trying to teach you to be really tight and use more tricep. But our shoulders as women, we need to be wider. So it's just that inherent that we're. And we tend to like when we get our 40s, we're like, okay, yeah, I really, I. Most of us have a challenge and we want to accomplish. So it could be a push up or pull up or we start doing more up and push pull motions and even like lifting things, overhead groceries and all that kind of stuff. It's just the mechanics that we are not taught how to actually maximize with our wider shoulders. And you couple that with changes in our estrogen progesterone ratio, which changes tensile strength and the actual texture kind of of our tendons and our bursa and it just comes on. So I'm always trying to reteach from a young age, from puberty onward, how we move in these new mechanics to reduce injury risk at the onset of puberty, but also as we get older into peri and postmenopause.
- [12:03]
Jennifer Cohen
So what should we be doing to offset that, that type of injury in the frozen shoulder? What is a good exercise to focus on?
- [12:11]
Dr. Stacey Sims
So a lot of it is you're dropping your traps and you're pulling back. So you're doing a lot of rhomboid work. You're also looking at where you're placing to be able to use more of your back muscles when you're doing a pushup. Also back muscles when using a pull up instead of relying on the shoulders. And the same when you go to lift something up, most of the time we're lifting or hitching our shoulders. If we're thinking about dropping our traps and we're using our back muscles to pick something up and then extending through the hips to lift it up, we're reducing the load in our shoulders and in that rotation, which reduces the whole onset of injury or soft tissue damage that can perpetuate injury.
- [12:47]
Jennifer Cohen
And what about for ACL issues to kind of strengthen. What do you think is the best way to strengthen our posterior? Posterior chain.
- [12:55]
Dr. Stacey Sims
All the glute work where you're thinking about deadlifts, you're thinking about Romanian deadlifts, you're thinking about hip or glute bridges, hip thrusts, all of those things. Right. And really focusing on getting the hips strong and a lot of other things that can perpetuate it is we have weak and tight hip flexors. So really working on developing that hip flexor strength so we can lift the hip and the leg up and over instead of stumbling.
- [13:24]
Jennifer Cohen
Right. Oh, that's good. Right. And so, but we, as we get older, we talked about, you were saying, like, as you're getting to perimenopause, menopause, let's stay with that because I think my audience can appreciate that. And that's something that I feel like that's become super trendy now, too. Like, I don't remember. Maybe because I'm at that age, I'm seeing it more.
- [13:42]
Dr. Stacey Sims
Or is it something that's come up?
- [13:44]
Jennifer Cohen
Right.
- [13:45]
Dr. Stacey Sims
Definitely. Yeah, absolutely. And it's scary because the conversation has not been out there and now it's a buzzword and everybody's grabbing onto it. And there's a lot of misinformation that's being spread. And from a scientific point of view, where I've been in the whole perimenopause menopause research world for 15 or so years to all of a sudden see the conversation out there and people are misconstruing a lot of the research, or they're in one camp bucket of pharmaceuticals or one camp bucket of suffering through it, and none of it's actually right. And then there's just so much. It's just so noisy. So I'm like trying to cut through the noise and go, okay, ask me what you want to know and we're going to unpack it for you.
- [14:33]
Jennifer Cohen
Thank you. Because I think that's a great point. Because like I said, I see it. If you scroll on social media, every second post is about menopause and. Or perimenopause. And I think the problem is there is so much noise and so much information. People are very confused. I know I'm confused. Right. And I do this for a living. And I've had, like, all the same top doctors come on here and talk about it, and I'm still confused because they don't even agree with each other, you know?
- [15:01]
Dr. Stacey Sims
Exactly. Exactly. That's it. Yeah. And I'm finding that a lot of the. And I don't want to put people on the bus, but unfortunately, those with some of the loudest microphones tend to not stay in their lane. And what I mean by that is, like, if you're an endocrinologist or you're a medical specialist and you understand things like hormone therapy, then talk about that. Right?
- [15:25]
Jennifer Cohen
Right.
- [15:25]
Dr. Stacey Sims
If you're someone who's like me, who's an exercise physiologist and a nutrition scientist, understands that and environmental stress, I talk about that. I can give a high touch on hormone therapy, but I'm not gonna be a definitive person on that because that is not my area. I'm going to refer you to Jen Gunter or Mary Claire or some of the other experts that are out there who actually know the nuances of hormone. Hormone therapy and how it can be applied to you as an individual. So that's part of the confusion, too, because everyone's kind of in their silo and trying to be an expert in everything instead of saying, you know what, this is my lane. And these are the things that I know, and I can talk at a high point on some of the things I don't know. But I really want you to seek out these experts who know what it is in that lane.
- [16:11]
Jennifer Cohen
Right. I think that. I think there's so much confusion. So let's start with perimenopause. Right. Because it's before menopause, how should women be training, eating, recovering in that space for optimal results?
- [16:31]
Dr. Stacey Sims
So as a physiologist, I'm going to explain what's happening on the undercurrent of everything. So we look at estrogen, progesterone, and testosterone, and they affect every system of the body. So when we start losing the higher doses and pulses of estrogen, and we have more and More anovulatory cycles. So we don't necessarily produce progesterone. Every system gets affected, specifically bone and muscle. So we'll have women who are complaining about waking up feeling squishy overnight and they can't even open like the jar of pickles because they don't have the strength. And they're like, what's happened? That's an estrogen effect. Because when you look at how estrogen affects skeletal muscle and the feedback mechanism for strength and power development, it's in every part. It's on the satellite cell to develop more muscle fibers, it's on the nerve endings to be able to say, yep, let's create a really fast nerve conduction across the gap junction to be able to fire a lot of fibers to create a strong contraction. And it's also part of the contractile proteins itself to be able to grab together to create a strong contraction. So when you lose estrogen, you're losing the impetus for those three main points of strength and lean mass development. So when I start explaining this, people are like, shit, now what do I do? It's like, okay, well now we want to look at a nervous system response because if we can find an external stress that's going to create the same cascade feedback mechanisms that estrogen did, then we can keep progressing. And that is strength training. But it's not lightweight, going to failure type stuff. We have to take a page out of the power based work where we're looking at zero to six reps, we're doing heavy loads, we have lots of recovery between those loads because we're trying to really stimulate the central nervous system and peripheral nervous system to say, you know what, I've got to have a lot of muscle fibers and I need to be able to recruit them quickly to have a very strong contraction to withstand that stress and load. So now we can build lean mass, strength and power without estrogen. So when we're looking at perimenopause, we have to look at all the systems that are being affected and we have to look at that external stress to apply to the body to create the adaptations that we want. So when we look at it, it's all about the intensity and the quality of the work. It's not about volume. So like I said earlier, where zone two is not really appropriate for women at this point, it doesn't really do much for women at all because we, when you take away our sex hormones, we're really endurant, we're really fatigue resistant, we burn a lot of fat. So we have to look at how do we polarize it. We want to do some true high intensity work. So that's 30 seconds or less as fast and hard as you can go with two to three minutes recovery to have full recovery, to be able to do it again, you might do that two or three times. Or we do true high intensity interval training. And that is a little bit lower intensity and a little bit longer, but you're still really polarizing where when you go to do your interval, you're doing it at the intensity you're supposed to and the recovery, you're fully recovering so that you can hit that intensity again. So the three big things there are proper strength training and the intensity of your sprint or high intensity work. So like I said, it's not a lot of volume, it's the quality. Because each one of those factors affects the body in a way that will cause positive change. So strength, like I said, you know, you're going to get that central nervous system response to build bone and muscle. When we're looking at that high intensity interval training, which is not full intensity but maybe 80%, this is, causes more of a cardiovascular and a blood glucose improvement. And then when we're doing that high, high intensity sprint interval work, it causes a cascade of what we call myokines. So these are little hormone and feedback molecules that go from the skeletal muscle to the liver and the storage area of body fat. And says, you know what, we don't need to store body fat. We don't need to take these circulating fatty acids and make them visceral fat. We need to use them and store them in really active tissue. So the, the aspect of doing those three things as the mainstay during perimenopause is to benefit body composition, our metabolic health, our cardiovascular health, and then most importantly, our brain health. Because if we're doing strength training and creating neural pathway plasticity, we're doing lactate training to improve brain metabolism, then again, we are able to support the brain when it is starting to lose the receptor sensitivity of estrogen, progesterone, because we don't have those sex hormones anymore.
- [21:12]
Jennifer Cohen
So I got so many questions. Okay, so you said, you said polar. Okay, so when people, women hear high intensity training, they're thinking orange theory, they're thinking Barry's boot camp. I don't know if you know what these, I mean, New Zealand, that they have Barry's boot Camp. They're thinking of these classes that are, they're like taking you to the max and the, you know, or they're trying on the treadmills and then they're going back and forth.
- [21:35]
Dr. Stacey Sims
Mm.
- [21:36]
Jennifer Cohen
And you sweat like a, you know, you sweat like a fiend. I heard you say that. That is not actually high intensity training. Why is that not considered high intensity training?
- [21:47]
Dr. Stacey Sims
When you look at those classes, it feeds into the mentality that we've grown up with where you have to feel smashed, absolutely smashed and burnt out when you finish a class to make it worth anything. Cause it's about the quote calorie burn and the smash aspect. I think orange theory even has splat points or something like that trying to navigate how hard it is. But the length of those classes and the speed at which those movements are done is really a precursor for injury with how fast the movements are under weight. And you can't really recover well enough to hit that 80 plus percent for your interval. Because if you're looking at a 45 to an hour long class, you cannot hold high intensity for that long. That puts you in moderate intensity. Now the problem with moderate intensity is our bodies when we're perimenopausal are already under a significant amount of sympathetic stress. So this means we're tired but wired. We have a really difficult time coming down from that anxiety and that awakeness flight or fight sensation. And moderate intensity perpetuates that. When we look at what it does from a metabolic standpoint, it doesn't have a post exercise response that true high intensity does of increasing growth hormone and testosterone that drops cortisol. So when we're doing this moderate intensity stuff, we end up with a higher circulating amount of cortisol which becomes our new baseline. And we don't get any of the metabolic change. We're not going to see a dissipation of our minnow bellies or visceral fat. We're going to see an increase in that we're going to be completely tired all the time, which means we are not sleeping well. And if you can't sleep well, you're not going to invoke any change. So when we're looking at that moderate intensity work that people feel is high intensity, I feel like it's such a disservice. And what makes me angry about these classes is that they are really marketing to women 40+ and like this is just not appropriate. These women are coming wanting help, they want to do some strength training and the protocols you're throwing in there are specific for men. And you're not looking at what's happening when women hit 4:40 onwards. So when we talk about true high intensity. We look at taking a page out of Hyrox or CrossFit where they're doing every minute on the minute with for four minutes and then one minute full recovery. And you might do two or three rounds of that. And that is true high intensity work. Because each minute you're going to go as hard as you can. It might be 40 or 50 seconds, 20 seconds to get to the next one. Then you do that four times and a full minute to like come down. Maybe it's two minutes to come down, repeat that again and maybe a third time. So all up it's 20 minutes of work. And that is true high intensity work.
- [24:32]
Jennifer Cohen
And so does that. So if I were to do, or not, or anybody who was perimenopause in their 40s or over, and they think that they're doing themselves a service by going to Orange Theory five days a week or Barry's boot camp, will those classes actually make them worse off with more body fat than if they just didn't do anything or just, I don't know, just walked around the block?
- [24:55]
Dr. Stacey Sims
It wouldn't necessarily make them worse off for, as you're looking at it, comparing to someone who's just doing low intensity work all the time. But what happens in those classes and low intensity or sitting around is there's a really high incidence of being skinny fat. So that means you might look lean, but you don't have a lot of really good quality lean mass and you have low bone density. There are so many women in the past about six months that have come saying, I don't understand what's going on. I got my DEXA scan and I go to these classes. I go to boot camp, I go to Les Mills, I go to Orange Theory, I'm osteopenic and I have a very high amount of visceral fat. I'm like, okay, well, there's two things. One, you're probably not eating enough, and two, you're putting yourself under this moderate intensity load almost every day. Your body has no chance to recover and polarize and understand that it needs to step up its game to be able to answer the challenge of exercise. Because it's not getting the feedback to actually adapt. It's getting the feedback to stay tired but wired and in a stressed state, like you have to run from a bear.
- [26:01]
Jennifer Cohen
Wow. So if I want to do like a weighted vet, like if I wore a rated weighted vest and went for an incline walk on a treadmill at a low pace, would that be more beneficial? Than doing orange theory class for my. For fearing menopause.
- [26:16]
Dr. Stacey Sims
Yeah, no, I kicked this into. Because of the weighted vest. So if we look at the weighted vest, that changes your biomechanics, because like I was saying earlier, our center of gravity is down in our hips. So you're putting a weighted vest on, you're putting all the weight up here, which is not where our center of gravity is. So that changes your biomechanics. And this is why you see a lot of women are like, oh, I've got a tendon issue, I've got an Achilles issue, which then develops into plantar fascia problems. It would be better to get on that treadmill without the weighted vest, but holding two heavy dumbbells and trying to do farmer's carry. Five minutes on, two minutes off on that incline. So you're getting strength, high intensity work and then some recovery in between.
- [27:01]
Jennifer Cohen
I love that you said that. So, you know, it's really funny. I'm laughing and giggling because I get all these questions all the time and about what do I do this? Should I do what's better? This or that? That or this? And you know, weighted vests have become like, again, it's like the new tail. Like everything. There's all these, these trends that like come and go and, and you know, then all of a sudden, all the same people who are wearing these weighted vests are now are complaining of their, their foot is hurting, their Achilles is hurting, they can't walk because the weight from here is going down to your foot because it's not properly balanced.
- [27:37]
Dr. Stacey Sims
Right, exactly, exactly.
- [27:39]
Jennifer Cohen
So, okay, so then to do that, that's a better option. Okay, so then what now? I. So what is polarized training? Because you said that word too. You said polarized training is a big one.
- [27:51]
Dr. Stacey Sims
Yeah. So polarized means that you go top end capacity and recovery is really low. So when you first start doing high intensity work, you might find you need more recovery in order to hit that top end capacity. And that's fine. Women underestimate recovery all of the time. So polarized means that you're staying out of that middle zone so you can go super hard when you need to and you recover super easy. So we look at that moderate intensity stuff as it's too hard to be easy and it's too easy to be hard to invoke change. Stay out of that. You want to be hard to invoke change and you want to go easy to recover so that you can go hard again.
- [28:27]
Jennifer Cohen
How many times a week would you recommend someone Doing this type of workout.
- [28:33]
Dr. Stacey Sims
Bare minimum, we see two sprint interval sessions or one sprint and one high intensity session and three lifting sessions a week. But you can combine the sprint and the lifting for one day in the gym. So you might do lower body posterior chain work. We're doing hip thrusts and deadlifts and then we finish off with some sprints on the bike and then you're done and dusted. Or maybe you do box jumps instead of sprints on the bike as your high intensity work and then you're done and dusted. So like I was saying earlier, it's about the quality of the work that you're doing rather than the volume of the work that you're doing.
- [29:09]
Jennifer Cohen
Why is jump training so popular? Not popular. Why is jump training so important?
- [29:14]
Dr. Stacey Sims
When we look at how bones respond to stress, we need multidirectional stress to invoke actual bone regeneration and increasing our bone density. Jumping does that because you're landing and it's complete stress in all the different planes that go up through the skeletal system, which then causes a cascade response of I need to be stronger through the entire bone. If we look at just running, it's very uniplanar and it doesn't cause that multi directional stress. We look at walking, it doesn't either. Strength training does, but not to the extent of jump training. So if people can't jump, strength training is going to help improve bone density, especially the heavier work that, that you should be doing. But just plain running doesn't do it.
- [29:58]
Jennifer Cohen
What's what would be considered jump training? Like plyo jumps, like on a box.
- [30:04]
Dr. Stacey Sims
You, you can do that. When we're looking specifically at building bone, it's a landing. Not how we've been taught with soft knees, but absorbing the impact through our bones, we're not jumping really high. We might be on a low box and jumping off as a depth jump and landing kind of flat footed hard or doing pogo pogo jumping where you're flat footed and absorbing the impact through your skeletal system. And it only takes 10 minutes, three times a week at the most to invoke change.
- [30:34]
Jennifer Cohen
So don't laugh, but how about just jumping on a trampoline because you're still going that you're still going up and.
- [30:41]
Dr. Stacey Sims
Down vertically, but you're not getting the impact from the ground. Because our body moves when it hits the ground. The ground doesn't move, whereas the trampoline it moves. So you're not getting the same kind of reactive force course through the skeletal system.
- [30:59]
Jennifer Cohen
How about you're obvious you're a nutrition scientist as well. So what is your take on women in fasting in perimenopause and menopause?
- [31:08]
Dr. Stacey Sims
If I were to use the bud words or the buzzwords of fasting, I would say you do your 12 hour overnight fast. That's what you do for fasting. But when we look at it from a hormonal response, reducing stress, improving body composition, brain health, all the things that people want with fasting for women, we need to eat within a half an hour of waking up because we have a cortisol peak and we need to drop that peak. We also see from circadian research that fueling throughout the day improves sleep, but it also improves the feedback for increasing lean mass development and dropping body fat. So when we have a big hole of no food and what happens for the most part is women will start a fast and they'll try to hold their fast till noon and then they end up working out fasted. And the brain, especially the hypothalamus, is like, what's happening here? There's no fuel for this exercise. I'm going to start breaking down lean mass because I need some amino acids for some fuel and I can't support really metabolically active tissue when there's no fuel coming in. So when we start looking at what's the best way to counter the body comp changes that are happening in perimenopause. Train smart, eat, eat during the day, stop eating after dinner so you don't have nighttime snacks, and making sure that two to three hours before you go to bed was your last meal so that you can get into a deep reparative sleep. And I know sleep is fleeting for lots of people in perimenopause, so we need to work on the sleep hygiene and maybe it's adding supplements like apigenin and L theanine, maybe it's cycling progesterone to help with sleep so that you do get into that deep parasympathetic activation so that your body knows that it can change body comp because you cannot create change without enough calories and without good sleep.
- [33:05]
Jennifer Cohen
Yeah. But again, another huge trend, as I'm sure you know, is this whole idea of fasting, fasting, fasting. And I, you know, I, I don't understand how hormonal issues and, or just if someone who is, someone who is active, how do you not eat and then also be active if you're someone who doesn't move all day? Right. Okay. And I, I, I know that I think she was on my podcast, I think you did her podcast and it all, you know, she goes on about like autophagy and how it's, it's actually really important for women to be fasting in their 40s. And this whole idea like this is, it's actually much healthier to do it. And we went back and forth because, you know, I see, I can see how it is for men. I see how men respond to the fasting differently than how I've seen women respond.
- [33:58]
Dr. Stacey Sims
Absolutely. And from a physiological perspective, women have two areas in the hypothalamus that is very sensitive to nutrient density. The two areas are the arc areas. And we have what we call kisspeptin neurons that get expressed when we don't have enough food coming in. We don't have all those kisspeptin neurons being expressed. So we have a hit on our entire endocrine system. So that's not just estrogen and progesterone. It's also things like thyroid and our appetite hormones. Men have one area, so their sensitivity to nutrition density is not nearly as sensitive as it is for women. And I'd like to scope it down to calories per kg, fat free mass. We look, women need a bare minimum of 35 calories per kg of fat free mass to be able to maintain some endocrine health. Ideally want to see people up to 40. For men it's 15. When you start to drop below that 35. For women, we start to see a lot of just subclinical disturbance in endocrine and sleep and body compound. For men, when it's 15 and below, we start to see that disturbance. So there's a massive threshold difference. So when we start talking about fasting, yes, men are going to respond because their hypothalamus is not as sensitive to low calorie. But from a biological standpoint, women are more sensitive to no calories because we're the ones that are or were responsible for reproduction, for carrying a baby, having a proper menstrual cycle, being able to support the ongoing aspect of survival of the species. So from a biological standpoint, there are specific sex differences in the brain that people don't acknowledge when we talk about fasting and fasting protocols.
- [35:40]
Jennifer Cohen
And so you would Recommend maybe a 12 hour window at best. And how about protein? I mean, what's your idea? Because I know, I think I also see that you're not someone who eats animal protein. Right. You're, you're, you eat plant, you eat.
- [35:55]
Dr. Stacey Sims
You'Re not a. Yep, I'M primarily plant based. When I travel, because I travel so much, I'll use organic Greek yogurt and or whey protein because it's readily available. So that would be the only kind of animal product I put in for protein. We see that there is an age and sex difference in the way your body responds to exercise and protein. We see that when women start to hit 40 onwards we are more what's called anabolically resistant to exercise and protein. So that means that we need more protein and we need a stronger dose of resistance training to get our bodies to build and maintain lean mass. For men that starts about 50, 55. So when we talk about protein and protein intake, women really need to dial it up because that recommendation that is based on the bare minimum to prevent malnutrition is still circulating as the needs for people. If you're a sedentary person who's in bed all day every day, then yeah, the recommended of 0.8 grams per pound, that might work. But for women and men who are active and trying to rebuild and promote that body comp, we're looking at that one to 1.1 grams per pound as a bare minimum. And that is to stay healthy, maintain our endocrine system and keep building bone and mass.
- [37:19]
Jennifer Cohen
So I'm so surprised to hear that you are not an animal protein person because a you're so fit. I mean it's insanely. You're insanely fit. But I mean just in terms of the satiation piece of it, right. Like animal protein is for me is much more satiating and plant protein I found it harder to get enough of. Are you saying it's just equally is okay in terms of building lean muscle mass. Have you, were you an animal protein person then you switched or what was.
- [37:51]
Dr. Stacey Sims
When I was 15, we took a field trip to a pig slaughterhouse down the five. So that will do it. Yeah. So I'm well beyond 15 now and that was the first like four way into it. I had issues back in the day because there was no such thing as plant based. And so I've kind of fought my way through but I've been plant based for very, very long time and it's. You go through the whole you have to have complete proteins at every meal, you have to have X this, X that. But it's not about that. It's about the total amount of protein you have through the day and making sure that you have all your essential amino acids. The important part, yes is leucine content post exercise and if we look at pea protein isolate, it's just on the cusp of having enough leucine so you have a little bit of a bigger dose of the pea protein than you would the whey. But when we're talking about meal and protein in a meal, if you're taking ad nami, green peas, nut seeds, other beans, maybe some tempeh, then you're going to get your 40 or 50 grams in one meal and it's going to be a mix of all your essential amino acids and you're golden. It's just really understanding nutrition and I think that's one of the lacking points is the education around it.
- [39:05]
Jennifer Cohen
That's right. Well, because even when you said that, I'm like, well, aren't you also getting a lot more carbohydrates, a lot more fats when you're saying you're eating edamame and all these other things, like it's easier to eat a piece of chicken, let's say, than to.
- [39:19]
Dr. Stacey Sims
Absolutely.
- [39:19]
Jennifer Cohen
Right. And so, and so. But you said that what's the, what's the best sources of protein that you find for people who are not animal protein eaters?
- [39:30]
Dr. Stacey Sims
The big ones that I try to get people to put in are tempeh spirulina. Pea protein isolate. Yeah, spirulina is really good in iron and protein. And so for the supplement is pea protein isolate, we look at some of the fortified almond or coconut yogurt. So they can be highly fortified in protein as well. So there's lots of different options. But when we're looking at carbohydrate and fat, women are afraid to eat carbohydrate and for the most part they don't eat enough. And if we're looking at the plant based proteins, we're also getting a lot of fiber, which is really super important for our gut microbiome. So when we're looking at all the animal sources, yeah, they're high, high in protein, which is a great hit. But we also have to look at how are we keeping that gut diversity and also getting enough carbohydrate so it's not one or the other. Ideally it would be a mix, but for me, I've been plant based so long and through the years I've tried to put in egg or fish and I just can't do it. It's just brings me right back to my time when I was 15 at a pig slaughterhouse.
- [40:32]
Jennifer Cohen
Yeah, it's crazy. That would happen to me too. What about Stockholm? Right. Like, gross. What, what would, what would you Say, are supplements that are fundamental for women's health or just. Or are you somebody who don't believe in supplements? Because supplements, people think is food. It's not. It's a supplement to what you're actually.
- [40:55]
Dr. Stacey Sims
Eating, to the things that you're eating. Right.
- [40:57]
Jennifer Cohen
Yeah.
- [40:57]
Dr. Stacey Sims
So they're. I would say the big three would be creatine monohydrate for sure, because you can't eat 22 chicken breasts in a day to get enough creatine to support brain and gut and heart health. There's so much evidence about creatine being so beneficial for men and especially for women, even in pregnancy. So that is probably my number one omega 3 fatty acids. Really, really important, especially for perimenopausal women who are active to help with the antioxidant capacity as well as the actual cell membrane and cellular capacity and vitamin D3. Because we live in a global community of, you know, sunscreen, hats, clothing, avoiding the sun. And we live in the, you know, I live in the very, very southern part of the world, and we don't get a lot of sun in the wintertime. And vitamin D is so important for every system of the body, including things like iron and iron absorption. So if we look at vitamin D, that's a. That's the third one. So those would be the top three. And then, of course, you can add things like your adaptogens if you want. Your protein powders are good. We talk about the extremes of performance enhancement type supplements. There's no real evidence for women things like beet juice, where, you know, beet juice became a thing a few years ago for postmenopausal women. Sweet. It works well. It helps with vasodilation, it helps improve VO2 max. But for premenopausal women, including perimenopause, it has a backwards effect because we have estrogen that's tightly tied to our vessels and that's part of the nitric oxide cycle that causes vasodilation and constriction. So if you're introducing nitrates, it interrupts that system and you end up with a disconnect in what we call orthostatic hypotension or poor blood pressure control. Kate Wickham, out of. Where did she do it? She's in Copenhagen now. She did research on this, looking at the differences between premenopausal and postmenopausal women in nitrates and saw that, yes, it's beneficial for post, but not for pre. And then things like beta alanine, it may or may not have an effect for women. So it's kind of in the. There's not enough to elucidate the evidence for it to be pro women. So that's why I'm always like, okay, let's stick with the big three. And then we can do an individual basis. Did you test low for magnesium? Maybe you need magnesium. Are you on a big training block? And we need to look at how we're going to adapt to the heat or how we're going to adapt to altitude. There's some things that we can do in there from a supplement standpoint, but for the most part it's those big three and then some protein and then we can kind of pepper other things in on an individual basis.
- [43:40]
Jennifer Cohen
I heard that quercetin is really popular and really not popular. I keep on saying popular because it's popular, but it's really good. And Coq 10 and what is your. But you didn't mention those two. You're saying those are not foundational. They're like maybe a nice little add in, but not foundational.
- [43:59]
Dr. Stacey Sims
Right. Coq10 has more evidence to support it being used in peri and postmenopausal women for cellular health than it does for premenopausal women. But again, it would be one where I would look on an individual basis. How are you struggling with energy? What is your exercise performance? How is your sleep, your oxygen carrying capacity? So these are a lot of things where I'm talking about it's the individual, let's pick and choose. But not a blanket statement that everyone should use it.
- [44:25]
Jennifer Cohen
And that's what you feel about NAD as well. Yeah, yeah. Because that's very popular too, as I'm sure you know.
- [44:32]
Dr. Stacey Sims
I know.
- [44:32]
Jennifer Cohen
Yeah, yeah.
- [44:33]
Dr. Stacey Sims
And so are peptides.
- [44:35]
Jennifer Cohen
So that was my next question about peptides. It's like the, again, huge thing. What's your take on peptides? Do you believe in them?
- [44:43]
Dr. Stacey Sims
Some of them for specific healing properties. So if you look at the BPC157, which is your. Right.
- [44:51]
Jennifer Cohen
Yeah.
- [44:51]
Dr. Stacey Sims
So if you're looking at that for tissue healing, there's a lot of rodent data out there and a little bit of human research out there that shows it's beneficial. But when you look at something like WADA and informed sports saying it's a banned substance, you know, there's something there makes it work. As for the other peptides, they're kind of like floating out there with not a lot of science behind it. Yeah. So that's another one. Would be a case by case. It's like, why do you want to use it? What do you think you need it for? What are the other things that we can do to invoke the same change but for tissue healing? Yeah, maybe we'll look at the bpc.
- [45:31]
Jennifer Cohen
Right. That's the most benign one of the ones that. Exactly what we're talking about. I need to ask you about Ozempic. Right. Because it would be remiss if I didn't. What is your take on the Ozempic craze?
- [45:45]
Dr. Stacey Sims
Yeah, I think I got slammed from another podcast about talking about this, but I'm going to say it again anyway. So when we look at Ozempic, there's a little bit of a disconnect. It's starting to get a little bit better because there's more education around it. When it first came out, there was no way that there was enough education to tell people that when you start using it, the very first thing to go is lean mass and bone. So you're going to become a very sarcopenic, chalky skeleton type person and you're going to be on the stuff for life. When we start looking at Ozempic as a tool in the toolbox for losing a significant amount of weight, not our vanity pounds of 10 to 15 pounds, but that significant amount of weight that plagues two thirds of American population, yes, it can be a tool. It can help with appetite control, to dampen the noise, the food noise that happens so much around the ultra processed food and the cravings and gives you the opportunity to put healthier habits into play, like learning how to lift what are wise food choices so you finally can dampen that crazy food noise, to put in strategies to help maintain weight loss and to build lean mass. That's how I view Ozempic as having a role in trying to combat some of the obesity epidemic. I have problems when women who come to me and go, how can I microdose Ozempic because I want to lose my 10 to 15 vanity pounds? I'm like, no, we don't do that. There are other things. And maybe you are learning to live with an extra five pounds on your body, which is probably beneficial as you get older. Because we want a little bit more weight as we get older so we don't have enough reserve if we get sick. So there's nuances within it as well. I feel for people who really need it for diabetic control because of everyone now using it for weight loss. I'm interested in the research that's coming out about Parkinson's and Alzheimer's about Ozempic and the GLP ones helping with that. So that's early day research. So right now it's a tool in the toolbox and we have to really look at lifestyle to extend, accelerate that tool.
- [47:52]
Jennifer Cohen
You know, it's funny you mentioned the microdosing, right? That was my next part of the question because that's what I'm noticing. A lot of people who like people who are doing that, people in the health and wellness longevity space claim that the microdosing is really good for inflammation and all these other health benefits. And so they're microdosing and these are people who don't need to lose any weight really. Maybe like you said £5 here and there. What do you say about that? Like, do you believe, do you believe the microdosing for the inflammation and all these other longevity reasons? Is there any truth to that at all? Or is it just people just having misinformation and just jumping on the bandwagon because they're a little thinner?
- [48:38]
Dr. Stacey Sims
Yeah, I. Part of it's misinformation and part of it is people have become inherently lazy and don't want to. And I say that and I'll take full ownership of that statement. Because when we look at exercise, regardless of intensity, duration, mode, whatever it is, it's a super powerful stress that gets put on the body and the body responds in kind. So yes, you're going to have inflammation after exercise, but the subsequent response is your body upregulates its anti inflammatory and antioxidative responses. So the chronic use of exercise improves oxidation and inflammation. It also improves autophagy. So all the things that people are talking about by using pharmaceuticals for longevity or trying to biohack by using microdoses of this and peptides and stuff, you can use exercise and it's just understanding what kind and dosage is not the blanket ACSM 150 minutes of moderate to vigorous activity, which is based on male data. Right. So we have to be very nuanced in what we're talking about.
- [49:43]
Jennifer Cohen
You know, also with when it comes to Ozempic, if someone were to compound that with strength training, would that offset the problem of bone density loss and lean muscle mass? Would it actually balance itself out?
- [49:59]
Dr. Stacey Sims
You have to be very dedicated to the strength training and eating protein because when we look at protein, protein and a high protein diet induces satiation and increases our natural production of our GLP1s. So if we are looking at using Ozempic as well as strength training and high protein, you're going to get better body composition, better appetite control, better appetite hormone regulation and it's going to allow you to get off the ozempic when you get to a certain point, which is decided by you and your doctor or whatever your lifestyle choice is.
- [50:33]
Jennifer Cohen
So. Okay. And then I, by the way, I just remember something else to going back to the other part about training. We talked about menopause and perimenopause training. What about if you're not at that place? What type of training should someone actually do if they're in their 20s or 30s? That's different than when they're 40s, 50s, 60s? We missed that part.
- [50:53]
Dr. Stacey Sims
This is a time. Yeah, well, this is the time where you can play. You can play a little bit. You can try a lot of things. It depends on your hormone profile. It's like what kind of. If you're using hormonal contraception, what kind is it? Is it oral contraceptive? Is it a Mirena, is it a copper iud? All of those have different responses within the body, which is going to affect the kind of training and how you feel about training naturally. Cycling. Are you finding changes in your bleed pattern? Are you finding changes in the length of your cycle? Well, those are beginning stop gaps and warning signs that you're putting your body under too much stress. But for the most part you want to find a goal and the basic idea of periodization of both cardiovascular and strength is beneficial. If you're someone who wants to go the endurance route. Sweet. You can, but put some strength training in there. You don't have to put it your mainstay, but you want to have a strong, resilient body regardless of where you are in your life. And you can pepper it in your 20s and your 30s with different adventures.
- [51:53]
Jennifer Cohen
So. Yeah. So how do you train? Give me a day in the life of you, like, what's your day to day? What's. What kind of habits do you do beyond? I mean, obviously you look great. So I want to know what time you wake up, you're sleeping. What are all your habits and routine?
- [52:07]
Dr. Stacey Sims
My habits? Well, full disclosure, I tried my very first high rocks on Sunday here in Auckland.
- [52:13]
Jennifer Cohen
You did?
- [52:13]
Dr. Stacey Sims
Yeah.
- [52:13]
Jennifer Cohen
Was it good?
- [52:14]
Dr. Stacey Sims
It was super fun. Yeah, it was super fun. Super hot. I did end up tearing my meniscus.
- [52:21]
Jennifer Cohen
Really? Oh, no. Yeah.
- [52:25]
Dr. Stacey Sims
And I'll share the story is I was not strong enough in the posterior chain to do the sled pull and then run. And I went into it after being in the States under a high amount of stress and not having Been able to train on the sled very much. I came back, I had 10 days before the race, so that's my full disclosure. But I'm now at a point where, oh, it's all right, it'll heal.
- [52:50]
Jennifer Cohen
How long will it take to heal? Do they say?
- [52:53]
Dr. Stacey Sims
No, I haven't. I haven't seen a sports doc or surgeon yet. So I'm like, I'm doing all the rehab things that I know and I have to get on a plane next week and fly to the States and be gone for a month. So where are you going? I am going Houston and then Boston, Boston, D.C. d.C. Denver, Denver, LA, LA, San Francisco.
- [53:16]
Jennifer Cohen
Oh my God. Doing what? Just traveling?
- [53:20]
Dr. Stacey Sims
No, I wish it's not vacation. Doing some podcasts and some board meetings and some filming for a project and looking for houses.
- [53:30]
Jennifer Cohen
Oh, okay. Well then, wow. I'm so, I'm so bummed. Like, why didn't we do this in person? By the way, I don't understand why we're doing this on a computer if you were going to be coming here anyway.
- [53:40]
Dr. Stacey Sims
Because the LA trip was really fully booked until someone just canceled. So that's why we're going to try to see what we can do when I'm there in la.
- [53:49]
Jennifer Cohen
Okay, perfect. But finish your. I want to hear your hat. Your. Besides the meniscus, what else happened with your habits and your routine?
- [53:57]
Dr. Stacey Sims
My habits? Yeah. So I am a kind of person that needs to get up before anyone else in the household so I can have 10 to 15 minutes of absolute no noise because that's how I can reset and recenter. Then I'd like to do some training. Either go for a swim in the pool or the ocean a couple of days a week. Strength training definitely three to four times a week. After training, come home, have food, do the email thing, go through all the meetings, have some quiet time, get some work done. Then my daughter comes home from school, we do some stuff. Then I do some more work, then take the dog for a walk, make dinner, have dinner, have conversations and maybe read with my daughter. And then I try to be in bed by 9:30, 10:00. I get up maybe 6:37. But I'm also the most fatigued person at the end of the day and I want to go to bed before everyone else, but I make a priority. I'm like, I need to go to sleep now and I need to sleep. I might do some reading before falling asleep. Make sure it's a cool dark room because I don't like to be hot when I'm sleeping and I get very agitated if my sleep is disrupted because I'm like, I need sleep, I need sleep.
- [55:11]
Jennifer Cohen
Yeah, especially when you're active like you are. Do you train people still regularly or.
- [55:17]
Dr. Stacey Sims
No, I don't. I advise people who do train and every once in a while I'll take someone on. Especially if it's a really complex, like sticky moment where people are trying to do all the things and they're stuck. I wish I had the bandwidth to be able to get out there on boots on the ground to help more people on an individual basis. But there's only one of me at the moment.
- [55:39]
Jennifer Cohen
Right? Exactly. Can I just ask you a couple more questions and I can hopefully see you when you're here. I want you to tell. Can you tell me what you think the most underrated health tip would be and the most overrated health tip or most overrated health myth trend out there?
- [56:00]
Dr. Stacey Sims
Yeah, I think the most underrated is the intuition. I think people have forgotten what it feels like to sleep well, to eat well, to have energy, because we've been told by werewolves what we're supposed to be feeling and what we're supposed to be doing and people have lost that connection to themselves. So that intuition of actually understanding our body and using things like rating of perceived exertion without any of the tools, I think that's one of the most underrated, but one of the most effective means of invoking change. When I look on the other end of things, it's all those top end, like the 1% that you should be looking at, like peptides or fasting. Let's just bring it back to basics. How are you eating? What are you eating? When are you eating? How are you sleeping? It's like the big four is the mindfulness, the sleep, the physical activity and the nutrition. If we focus on those, then we can start to really see change is when we start going outside the box and really focusing on all the biohacking and the bro science that's out there is when we start to lose sight of where we should be and get into the overrated trends that tend to take over everybody's mentality.
- [57:15]
Jennifer Cohen
What is your take on saunas and cold plunges? Cold, you know, therapy saunas I love.
- [57:23]
Dr. Stacey Sims
I started as an environmental exercise physiologist, so I look at how the heat can invoke positive change on the body. It doesn't have to be a large dose. It could be 10 to 15 minutes in a Finnish sauna three times a week. Because we start to See massive cardiovascular improvements, blood pressure improvements included in that, metabolic changes. So we have better blood glucose control, we have better gut health, brain health. So many great things happen with the heat. When we think about cold plunge. For women, it's cool water. It's around 15 degrees Celsius, which is around that 56, 57 degree Fahrenheit. Mark, ice is too cold. And we don't get the same kind of response that men do when we get into ice. It's too strong of a stress and the body rebounds with too much sympathetic drive, too much constriction, where if it's cool water, we're going to invoke initially a vagal response, which is that. And then the body's going to get that more parasympathetic relaxation response that we're looking for for cold plunge.
- [58:27]
Jennifer Cohen
So what happens if we do the cold therapy? I mean, because I hate it, you know, but. And I won't do it, and I get a lot of, you know, slack for that. But what does it do to the body in layman's terms? Like, what does it do to a woman's body when they jump into a cold plunge? Because I think it's a woman.
- [58:44]
Dr. Stacey Sims
You're jumping. Yeah. So you're jumping into that icy cold water and you're getting that shock. And that shock is a sympathetic. So that you have your flight or fight sensation, which is your sympathetic drive, and you have that deep relaxation, which is your parasympathetic drive. For women, we get that shock and that sympathetic drive which increases cortisol, increases our blood glucose and our free fatty acids, because the body's like, ah, what is this incredible shock? I've got to get out and run away. For cool water, it's not as intense. So you don't get that sympathetic. You get the initial. And then the body's like, okay, I can deal with this. I'm going to do some vasoconstriction. I'm going to put more blood sugar to the brain so that the brain understands what's going on and stimulates what we call the vagal nerve. So the vagal nerve is what that parasympathetic nervous system is attached to. So it invokes that calming and you can stay in it, take some deep breaths. But that said, heat does so much more for a woman's body than cold plunge. So if we're looking for increased parasympathetic drive, we're looking for better metabolic control, we're getting better hormonal control. It's all instigated by sauna work, not by cold plunge.
- [60:02]
Jennifer Cohen
So a finished auna is usually 200 degrees or 210 sometimes. Right. If I have a sauna that's like this infrared that doesn't get hot enough. Like it takes forever to get to 160 and even that takes forever, four hours. Can I still. Because at the time it was everyone's like, oh, the infrared is the best sauna for your body. It doesn't warm my body. I'm like cold half. I'm shivering in my sauna. Yeah, I know, it's crazy. I mean, but do I. If I wait long enough and it gets to 165 from Lucky.
- [60:36]
Dr. Stacey Sims
Yeah.
- [60:36]
Jennifer Cohen
Do you still get the same benefits as you would in a finished sauna? If it's an infrared sauna?
- [60:42]
Dr. Stacey Sims
So the thing with the infrared is it really bypasses when the initial thermoregulation control centers. If you get to a point where it's hot enough and you get that sweat onset and you feel really uncomfortable, then you're hot enough. But you don't have to stay in there for half an hour or more being uncomfortable. You bring it up to your sweat response and then you can get out. And I think that's what people don't like. They're like, oh, I get an infrared and I get warm, but I don't sweat. I'm like, but you need that, you need that uncomfortable heat and uncomfortable sweating to invoke the change.
- [61:16]
Jennifer Cohen
No, I wish I did sweat. It doesn't get hot. These things don't get that very hot. Have you ever been in one? Like, these things are like 50 degrees much cooler than the finished saunas.
- [61:28]
Dr. Stacey Sims
My stepdad has one, but we have a finished sauna. So I use our finish and then I go to my parents house and I'm like, I'm freezing in your sauna.
- [61:36]
Jennifer Cohen
I know. I'm saying it's like a cold plunge. I mean, it's like crazy. It's so not hot. But I don't know. I mean, so you believe that the. That's kind of all hype, the infrared sauna, because you're. It gets maybe your skin a little bit warm red.
- [61:52]
Dr. Stacey Sims
Maybe you put on one of those sauna suits they sell in like Kmart or Walmart and you wear the sauna suit in your sauna.
- [62:00]
Jennifer Cohen
Or just get a new sauna and call it a day. Right?
- [62:02]
Dr. Stacey Sims
Get a new sauna. Yeah, yeah, do that. That's the best way to do it.
- [62:05]
Jennifer Cohen
Yeah, I think that's a great idea. Okay. Well, I. Again, I. Dr. Stacy Sims, you've been a delight, like I knew you would be. Thank you so much. No, you have. And thank you for being on the podcast, even though I feel like it was. It wasn't the same as being in person. So I really hope we can do it in person next time.
- [62:25]
Dr. Stacey Sims
Yeah, me too. It's great to see you.
- [62:27]
Jennifer Cohen
It's great to see you.
- [62:28]
Dr. Stacey Sims
And. Yeah, have a great day and give LA hugs for me.
- [62:33]
Jennifer Cohen
I absolutely will. And everyone should go check out Dr. Stacy Sims. What do you have? The book is called Roar, but it's a little. When it wasn't out your book, it was a while already.
- [62:43]
Dr. Stacey Sims
The second edition that was just released last year.
- [62:46]
Jennifer Cohen
Last year.
- [62:47]
Dr. Stacey Sims
And then we have next level that is specific for peri and postmenopause.
- [62:51]
Jennifer Cohen
Oh, perfect. Perfect. Okay, good. Well, then you'll come back and talk more about the peri. All of it.
- [62:57]
Dr. Stacey Sims
Yeah, perfect.
- [62:58]
Jennifer Cohen
And I hope. I hope you feel better with your meniscus.
- [63:02]
Dr. Stacey Sims
Yeah, it'll get there. It's just. There's no pain. It just catches, so there's instability, but no pain. I'll take that.
- [63:09]
Jennifer Cohen
But you're not working out. Correct.
- [63:11]
Dr. Stacey Sims
I'm not running. I went for a swim this morning. Okay, that's good, because it was a happy place, but yeah.
- [63:17]
Jennifer Cohen
Okay, good. Well, thank you again. I appreciate you. And I'll see you hopefully in a month.
- [63:22]
Dr. Stacey Sims
Yes. Be awesome. Thanks.
- [63:24]
Jennifer Cohen
Thank you.