Most Replayed Moment: This Is The Best Exercise Protocol For Women!

Summary

The Diary Of A CEO — Most Replayed Moment: This Is The Best Exercise Protocol For Women!

Host: Steven Bartlett (DOAC)
Guests: Dr. Stacy Sims, Dr. Vonda Wright, Dr. Rhonda Patrick, Dr. Lisa Mosconi, Leah (Caregiver/Host)
Release Date: May 8, 2026

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Episode Overview

This episode presents a dynamic roundtable of leading experts exploring the optimal exercise strategies for women, particularly through the phases of menstruation, perimenopause, and menopause. Drawing from cutting-edge research and years of clinical and athletic experience, the panel dismantles common fitness misconceptions—including the pitfalls of chronic cardio, the importance of strength training, and the social and hormonal factors influencing women’s health. With a particular focus on how female physiology demands individualized protocols, the discussion blends practical advice, evolutionary biology, and candid personal anecdotes to deliver empowering, actionable guidance for listeners.

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Key Discussion Points & Insights

VO2 Max, High-Intensity Training, and the "Norwegian Protocol"

• VO2 Max Training Simplified: VO2 max increases don’t require frequent, grueling workouts (01:09–01:38).
  • Dr. Stacy Sims: “In the sports science world, it's always been the 4x4. The Norwegian 4x4: four minutes on, four minutes off … once a week at the most.”
• Sprint Intervals for Women: Brief, all-out exertion followed by complete recovery is highly effective.
  • Dr. Vonda Wright: Shares her own protocol—30-second sprints to peak heart rate, 2–3 minutes recovery, repeated four times, adaptable beyond treadmills (01:40–02:43).
  • Dr. Stacy Sims: “That's all you need.”

The Dangers of Chronic Cardio & Running Trend

• Balance is Critical: Solely focusing on high-frequency endurance running (e.g., daily marathons) sacrifices essential strength and hormonal health (03:16–04:55).
  • Dr. Lisa Mosconi: “If all you do is running, then that is definitely not the best way to be … running, 58% of runners have a luteal phase defect.”
• The Pitfall of ‘Skinny Fat’: Visibly thin long-distance female runners might still have high visceral fat due to inflammation and hormonal disruption (05:09–06:23).
  • Dr. Stacy Sims: “...on the outside like super lean, but they have a really high percentage of visceral fat because of the inflammation, the low energy intake and most likely estradiol suppression.”

Evolutionary and Biological Foundations

• Evolutionary Perspective: Female bodies evolved to downregulate reproduction and store fat in energy-deprived states (06:32–07:12).
  • Dr. Stacy Sims: “If it was low calorie, menstrual cycle would stop … Body fat would come on because there weren't a lot of calories.”
• Modern Stress vs. Ancient Stress: Chronic stress today keeps cortisol and inflammation chronically high, compared to episodic spikes in ancestral environments (08:04–08:42).

Overtraining, Under-recovery, and Social Media Messages

• Population vs. Demographic: Most women aren’t overexercising, but fitness-conscious women (especially listeners) may under-recover due to high ambition (09:00–10:23).
  • Dr. Stacy Sims: “I like to frame it where women are under recovering, not over training.”
• Pushback Against Willpower Culture: Harmful social media narratives blaming women for body composition are called out as socially constructed and unhelpful (11:52–12:18).
  • Dr. Stacy Sims: “It's not your fault. These are the things … that have come into play ... But now we have tools to offer you.”

Perimenopause, “Adaptive Stress”, and Training Quality

• Adaptive Stress Defined: Smart, purposeful training triggers positive adaptation—muscle building, insulin sensitivity, and metabolic health—without chronic overload (13:05–14:53).
  • Dr. Stacy Sims: “[High intensity] then creates a eventual epigenetic change … that's going to allow that glute 4 protein … to open up and have glucose come in, reducing insulin resistance.”

Training Protocols During the Life Span

• Polarized Training Model: Alternate high-intensity (zone 5), strength work, and low-intensity recovery; avoid chronic moderate-intensity (zones 3-4) except for sport-specific needs (16:05–18:27).
  • Dr. Stacy Sims: “If we're looking at polarizing, which is top, top end and low recovery end, then with the top end we get the signal cascade of improving body comp, improving insulin sensitivity … otherwise, you’re just exacerbating inflammation.”

Summary of Weekly Exercise Prescription (18:33–19:39)

• 2–4 days/week: Progressive, heavy strength training (few reps, compound lifts, explosive work)
• Several days/week: Low-intensity continuous movement (e.g., brisk walking)
• 1–2 days/week: Sprint intervals or high-intensity sessions (Zone 5/6)
• Optionally: 4x4 VO2 max interval day

Dr. Vonda Wright: "I layer on behaviors. Because if I say all of this at once, nobody's gonna do anything." (19:40)

Lifestyle Pillars Beyond Exercise

• Sleep as Foundation: No health/physique improvements possible without quality, adequate sleep (19:45–19:52).
• Nutrition & Activity: Motivations differ—address each independently.
• Mindfulness & Community: Social connection and nature reduce stress, bolster overall health (19:52–20:36).

Menopause, Strength Training, and Brain Health

• It’s Never Too Late: Strength training benefits even those starting older (21:16–21:35).
• What Counts as ‘Heavy’?: Lifting ‘heavy’ is relative—aim for 70–80% 1-rep max, about 5 reps per set (21:59–22:41).
  • Leah: “So that you can usually do about five reps before you hit failure. And that is what they consider lifting heavy.”
• Women Underestimate Strength: Social conditioning discourages challenging weights; true benefit comes from progressive overload (22:41–23:16).
  • Dr. Stacy Sims: "Women have been so conditioned to do 10 to 15 reps to get quote 'toned' ... you're underestimating yourself in so many facets."

Long-term Health: Future Planning & the Caregiver Burden

• Disconnect to ‘Future Self’: Studies show we emotionally perceive our future selves as strangers, hindering long-term planning (23:50–24:28).
• Women as Caregivers: Midlife women juggle children, hormones, and aging parents, often at great personal cost (24:45–25:25).
• Brain Health & Lactate Production: High-intensity work boosts lactate, a key fuel for the aging brain—critical for dementia/Alzheimer’s prevention, especially for women (25:25–26:48, 27:18–28:19).

Social and Cultural Factors

• Changing Stimulation Across Generations: Older women may have had less cognitive challenge, resulting in less neuroplasticity—a risk factor for dementia (27:27–28:19).

  • Dr. Lisa Mosconi: “Neuroplasticity … you're creating pathways in your brain to make you healthier but more resilient to dementia.”

• Modern Stressors & Technology: Excessive phone use and chronic stress are new obstacles to brain development; classic activities like reading at night boost neuroplasticity (30:09–30:40).

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Memorable Quotes with Timestamps

• Dr. Stacy Sims on training intensity & recovery:
  “If we're looking at polarizing, which is top, top end and low recovery end, then with the top end we get the signal cascade of improving body comp, improving insulin sensitivity …” (15:36)

• Dr. Lisa Mosconi on comparative risk for women:
  “It is very rare to see that in a man. Meaning the number one reason why I will see low testosterone is … men are taking testosterone … It is very rarely my brain is not sending out the signals …” (11:24)

• Dr. Vonda Wright on adaptability:
  “People always ask me, what does heavy lifting mean? … It's relative. My heavy is not going to be Stacy's heavy …” (21:47)

• Leah on women's multigenerational (caregiving) stress:
  “We’re in this, like raising kids, going through our own hormonal upheaval, and then watching our mothers, our grandmothers … and the way society is set up, women become the caretakers of their parents, generally the oldest daughter …” (24:45)

• Dr. Stacy Sims on self-compassion through education:
  “It's not your fault. These are the things that have come into play … But now we have tools to offer you …” (12:18)

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Timestamps for Important Segments

| Timestamp | Topic/Segment Summary | |-------------|--------------------------------------------------------------------------| | 01:09–01:38 | The Norwegian Protocol: Effective VO2 Max training made simple | | 03:16–04:55 | Downsides of chronic cardio/running focus for women | | 06:32–07:12 | Evolutionary reasoning for women’s hormonal sensitivity | | 09:00–10:23 | Overtraining vs. under-recovery distinction in female athletes | | 13:05–14:53 | Adaptive stress: Why strong stimuli (not just volume) matter | | 16:05–18:27 | Polarized training model explained: why avoid ‘medium’ intensity | | 18:33–19:39 | Example of a realistic, weekly training regimen for women | | 19:45–20:36 | The hierarchy of sleep, nutrition, activity, and community | | 21:16–22:41 | Menopause adaptation and what counts as "lifting heavy" | | 25:25–26:48 | High-intensity exercise, lactate, and preventing dementia in women | | 27:18–28:19 | Generational differences and neuroplasticity for brain health | | 30:09–30:40 | Modern lifestyle, technology, and the future of neuroplastic resilience |

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Practical Takeaways

• Less is More: Short, intense intervals and fewer weekly sessions can be more effective than chronic cardio—focus on quality not quantity.
• Strength is Key: Heavy, challenging strength training is vital through all female life stages (reproductive, perimenopause, menopause, postmenopause).
• Recovery Matters: Under-recovery—not "over-training"—is a prevalent risk for ambitious, health-focused women.
• Community & Sleep: Social connection, sleep, and cognitive engagement are as important as exercise for long-term wellbeing.
• Long-term Mindset: Building habits today—especially brain, muscle, and social health—pays off in elder years, even if your “future self” feels distant now.

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For listeners, this episode offers a science-backed, compassionate playbook for women’s healthiest, strongest, and most resilient years—at any age.

Transcript

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[Dr. Rhonda Patrick]

I hear a lot about VO2 maxes, so I thought but we should all be driving our cardiovascular performance up to get a high VO2 max.

[Dr. Stacy Sims]

Well, that's where the intensity is. Yeah, I think it's.

[Dr. Vonda Wright]

That's the only one.

[Leah (Caregiver/Host)]

I mean, and correct me if I'm wrong, but my understanding after reading and watching everything is doesn't take that much

[Dr. Stacy Sims]

to build VO2 max. No, it doesn't. It's that high intensity that's a little bit uncomfortable where you're pushing at that max for, you know, about four minutes to build that VO2. In the sports science world, it's always been the 4x4. The Norwegian 4x4, four minutes on, four minutes off, four minutes on, four minutes OFF.

[Dr. Vonda Wright]

But that's not three days a week.

[Dr. Stacy Sims]

No, not at all.

[Dr. Vonda Wright]

The Norwegian protocol is once a week,

[Dr. Stacy Sims]

once a week at the most. Right.

[Dr. Vonda Wright]

And the other sprints, just to give you. I tend to give my examples because it makes it more real. But when I'm doing sprint intervals, I do it the 30 seconds on and then complete recovery. Meaning for 30 seconds I'm taking my heart rate as high as I can get it and then I'll completely recover, which takes me two to three minutes. I just happen to do it on a treadmill, but the reality is you can do it on anything. It's a heart rate function, not an apparatus function. So for me, on a treadmill, after I'm done warming up, you can't do it cold or you'll hurt something. After I'm done warming up because I'm a really short person. I punch the treadmill up to 11 and I am just working so hard. I don't fly off the back, but that gets my heart rate up really high, about 186. Everybody's top heart rate is different. And then I completely recover and I do that four times.

[Dr. Stacy Sims]

That's all you need.

[Dr. Vonda Wright]

It doesn't take that long and you feel so good when you're done.

[Dr. Stacy Sims]

So I can't run at the moment. This morning I did explosive kettlebell swings.

[Dr. Rhonda Patrick]

Why can't you run at the moment?

[Dr. Stacy Sims]

I have a torn hamstring and meniscus, so I can't run at the moment.

[Dr. Rhonda Patrick]

Running is in run clubs have come in strong. It's back in. Are you at all concerned with the fact that people are running all the time and doing resistance training less? Because running is cool. Like cool now. It's how people date. It's. Yeah, it's. They're not going to nightclubs.

[Dr. Lisa Mosconi]

It's the sacrifice of other things. It's like we said about Pilates, you know, if all you do is running, then that is definitely not the best way to be. It's not the healthiest for your whole body. It's not that you're unhealthy, but we're really talking about how are we optimizing your body, your hormonal health for a variety of different goals. But also if we look very micro running, 58% of runners have a luteal phase defect. That means that the second half of their menstrual cycle is not going to be able to last as long as we want it to. Likely due to what Stacy was talking about earlier. This relative energy deficiency coming back to the brain. The brain signals it not as strong to keep that corpus luteum. What happens after the follicle alive? And a lot of women, I still have my period, so I'm okay. But if we're using our cycle as a vital sign, we can actually say the rate ratio of energy balance is not great. And it's often because we're doing it at sacrifice of other things. So if you're doing the strength training three times a week and you're running however you're spacing out your other days, that's such a healthy balance. It's hard that you're going to be in a bad position with that and

[Dr. Stacy Sims]

you'll actually improve your running more so than if you were to run every day or every other day. Because if you're getting strong through full range of motion, then that feeds forward to better running economy. Then you can vary your pace without getting injured. But for people who are running every day and they're shuffling and they're getting stronger in their strong muscles and weaker in their weak muscles, then it perpetuates this.

[Dr. Vonda Wright]

And they're in my clinic.

[Dr. Rhonda Patrick]

Yeah, people are very keen on doing marathons and half marathons at the moment and got a couple of friends that are doing a lot of marathons at the moment and they're very, very, very skinny.

[Dr. Stacy Sims]

Oh, welcome to my world of Texas.

[Dr. Rhonda Patrick]

Yeah. Is that healthy? I'm not even sure if that's the right question. Or one can judge from just looking, but being extremely skinny in that regard, being that sort of marathon runner, phys,

[Dr. Stacy Sims]

There are some that are naturally predisposed to that. So. Naturally predisposed, having really good running, economy running, biomechanics, having a leaner body. And this is what we were talking about the Olympics earlier, where you can see the ideal body type for that particular sport. And then there are those like me who build muscle naturally. It's pretty easy. So I'd never be a skinny little runner. And my running economy is a little bit off because of where I build muscle versus not. So not everyone is meant to be a long distance runner and there are some that are meant to be long distance runners. So if we're talking about your friends who are like super skinny, are they economically viable for being a long distance runner? Possibly, but we also have to look, are they male or female? What is their injury rate, what is their fueling? And then for me, I'd want to see the dexas of the women that are just training long distance and super skinny, because most of the time we see a higher visceral fat in and around the organs as we're talking about, even though on the outside like super lean, but they have a really high percentage of visceral fat because of the inflammation, the low energy intake and most likely estradiol suppression.

[Dr. Rhonda Patrick]

And that's the skinny fat thing you talked about earlier. Is there an evolutionary lens on this? I always think about this when we're having these conversations. Like what, what used to happen thousands of years ago?

[Dr. Stacy Sims]

We talk about the evolutionary biological theories and there are a lot of sociologists that will counter what I'm getting ready to say, so I'll apologize in advance. When we look at original hunter gatherer type communities, the male body was designed to go out to find the calories. The woman body was designed to stay and take care of the offspring. And make sure that home was set. If it was low calorie, menstrual cycle would stop because you didn't want to reproduce. In a time of low calories, body fat would come on because there weren't a lot of calories.

[Dr. Rhonda Patrick]

And so the equivocal in the time now is that I'm not eating enough or I'm burning more than I'm consuming.

[Dr. Stacy Sims]

Exactly.

[Dr. Rhonda Patrick]

So I'm in a calorie deficit in some way.

[Dr. Stacy Sims]

Exactly.

[Dr. Rhonda Patrick]

Okay.

[Dr. Stacy Sims]

In an energy deficit. So with the male body, and we see this, their brain and hypothalamus is not as sensitive to those nutrient deficits as much as a woman's body. Because we have menstrual cycle and menstrual cycle function, a man will lean up and get more cognitively focused in times of low calorie intake. So this is what we see with fasting data and we see with restrictive diets. And that was. We need to bring it back to that biological lens. Low calorie. I have to go find the calories. I have to be fit to go find the calories. Low calories. I need to not have to eat as much. So I need to store fat and I can't have a baby because we don't have enough calories. And then stress, when we add modern stress onto that, that's a comprehensive addition of cortisol and addition of inflammation. And that also perpetuates body fat.

[Dr. Rhonda Patrick]

I mean, like stress 10,000 years ago would have been like a lion.

[Dr. Stacy Sims]

Oh yeah, it's a lion.

[Dr. Lisa Mosconi]

But it's episodic.

[Leah (Caregiver/Host)]

Right. We had stress and that this is a natural stress response. We have to have them to survive.

[Dr. Stacy Sims]

But these were episodic stresses.

[Dr. Lisa Mosconi]

Well, and your hormones would change for a very specific purpose that you would then go do. Your body would free up glucose from your liver. You're getting it ready in your bloodstre, so you can go run from the lion. And then things would shift back to normal. And what's happening with chronic stress is you're getting all the hormone shifts because your body's really getting ready for the lion. Except it's just that bad meeting you had and then you're just sitting there longer and you're not using that glucose up.

[Dr. Stacy Sims]

Exactly, exactly.

[Dr. Rhonda Patrick]

Are women increasingly over training?

[Dr. Vonda Wright]

I think the problem in this country is not maybe in the women who are really intentional, maybe there are some that are over exercising. But if we look at a population, nobody is exercising enough.

[Dr. Stacy Sims]

Exactly.

[Dr. Vonda Wright]

I mean, I would take. People ask me all the time, tell me the first thing people need to do, I'm like, I'll take anything. I mean, I'll take getting off the couch with any method, whatever makes you happy.

[Dr. Stacy Sims]

I'll say, get off the couch and do 10 air squats. Thank you.

[Dr. Vonda Wright]

That's enough.

[Dr. Stacy Sims]

Yeah, that's enough resistance training.

[Dr. Vonda Wright]

So. So in the crowd that's like, I'm going to invest in my health every day. That is not the majority of people.

[Dr. Stacy Sims]

Yeah, that's my bubble.

[Dr. Lisa Mosconi]

Yeah, but.

[Dr. Stacy Sims]

And they, the people who listen to

[Dr. Lisa Mosconi]

your show though, might be a different demographic, we have to acknowledge.

[Dr. Stacy Sims]

Right.

[Dr. Lisa Mosconi]

Than population of America. I mean, like a lot of people who listen to your show, Stephen, are interested in health and their body and achieving certain goals. And so certainly, you know, I have practiced fertility in North Carolina and in Austin, and I see a completely different patient population. You know, in Austin, Texas, which is a very fit area. Women are constantly over training. But to Stacy's point earlier about this maybe evolutionary what happens, women go into this hypothalamic dysfunction even before. It's what we call like amenorrhea. Hypothalamic amenorrhea is essentially where the brain, where the hypothalamus is shuts off, says can't reproduce right now. XYZ reason no FSH and LH are coming out. You're not ovulating, you're not making estrogen, you're not going to get pregnant.

[Leah (Caregiver/Host)]

So you're more likely to survive.

[Dr. Lisa Mosconi]

Yeah. So it's a survival mechanism.

[Leah (Caregiver/Host)]

Pregnancy is dangerous, as in hunter gatherers.

[Dr. Lisa Mosconi]

But there's state modern medicine acts like you're perfect or it's turned off. And the reality is there's all these shades of gray in between where these different chronic stressors and your insulin resistance and your inflammation and you're over exercising and you're under fueling come in and make it so. The high hypothalamus is not responding correctly. And that's what we're trying to get people to intervene there before it gets too bad. And I see a large number of women who do fall into that zone where they are trying their hardest to be healthy. But what they are choosing to do is actually having a negative impact on their hormonal health and how their brain is interpreting their hormones and you. It's very rare to see that in a man. Meaning the number one reason why I will see low testosterone is purely because many men are taking testosterone or because of other exogenous factors like marijuana use. It is very rarely my brain is not sending out the signals to cause my testicles to make testosterone.

[Dr. Stacy Sims]

I like to frame it where women are under recovering, not over training. So if we're under recovery, then it makes it more acceptable to fuel. And I always want to bring it back to it doesn't matter. Like, because I come from high performance, I'm going to use those words where it's like, you're not recovering enough. We want to focus on recovery on these days. We want to make sure that you're eating and fueling around so it's never over training. It's always under.

[Dr. Lisa Mosconi]

But the balance is wrong. They're not recovering.

[Dr. Stacy Sims]

So what do you say to all

[Leah (Caregiver/Host)]

the voices on social media that are just yelling at mostly women and telling them it's just a matter of willpower and you don't have the body composition you deserve?

[Dr. Vonda Wright]

Well, you swipe left and don't talk to those.

[Leah (Caregiver/Host)]

That's me. Right. But I mean, I'm talking to the woman in Ohio who's feeling defeated and stumbles across someone screaming at her on the Internet that her body composition that she's not happy with is her fault.

[Dr. Stacy Sims]

I hate that. Because it's a construct of society. Right. Especially Western society. This is where we have to educate. It's not your fault. These are the things that have come into play and lined up to create this situation. But now we have tools to offer you that to take one step out of that situation, and let's see how many more steps we can get you away from the situation to improve your health.

[Leah (Caregiver/Host)]

Yeah.

[Dr. Rhonda Patrick]

And are the rules of exercise slightly different once you've entered perimenopause?

[Dr. Stacy Sims]

So this is where we really need to look at how we can use exercise and some environmental stress to create a really strong adaptive stress and really strong recovery stress.

[Leah (Caregiver/Host)]

Stacey, can you explain adaptive stress? Because I'm thinking of the 10,000 people who follow me who will be like,

[Dr. Stacy Sims]

you have no idea what adaptive stress is. So if I go and I do some resistance training, some heavy lifting, I want to create a stress on my body that's going to then have a signaling cascade to repair the muscle in a stronger way than when I think.

[Leah (Caregiver/Host)]

Because lifting the muscle damages the muscle.

[Dr. Stacy Sims]

Yes. And it creates a series of feedback mechanisms that make it repair stronger than when you first went in. So that's an adaptive stress. And we're looking at what levels of stress we can put. So it's a training stress or what levels of stress we can use through exercise to really, really create an environment that improves our health. So if we talk about sprint interval training, the 30 seconds on and the two to three minute recovery. The reason why we want that super high end stress of our heart rate is it then creates a eventual epigenetic change. So it's that environment that's going to create a change within the muscle that's going to allow that glute 4 protein that I mentioned earlier to open up and have glucose come in, reducing insulin resistance. Also with that really high, high heart rate, we're having a lot of stress on the muscle that's going to release some myokines, which are little hormone signals that then will go to the liver and say, wait a second, we don't need to store visceral fat, we need create non esterfied fatty acids which can then go into our skeletal muscle to be used in the mitochondria as fuel. So we want to have the stress that's strong enough to create these cascades of feedback mechanisms to improve our overall health. If we stay in that moderate intensity zone, we aren't creating a strong enough stress to create that signaling.

[Leah (Caregiver/Host)]

What are we doing?

[Dr. Stacy Sims]

We are exacerbating inflammation or exacerbating cortisol. Now cortisol isn't the demon, but when we have an elevation of it, and especially in perimenopause, when we're sympathetically driven and we already have a higher level of baseline cortisol, if we are continuously in this moderate intensity zone, we never get a signal to allow that to drop. So if we're looking at polarizing, which is top, top end and low recovery end, then with the top end we get the signal cascade of improving body comp, improving insulin sensitivity, as well as getting growth hormone and testosterone responses which then feed back to drop cortisol.

[Dr. Rhonda Patrick]

So am I right in thinking the solution if I'm perimenopausal is to do high intensity interval training for short periods of time?

[Dr. Stacy Sims]

So we look at the quality of the training, not the volume of the training. So if we're in our reproductive years, then yes, you can do the moderate intensity stuff because you have estrogen and some of our other hormone feedback signals that are going to drop cortisol. It's going to allow your body to recover and repair.

[Dr. Rhonda Patrick]

And when you. What makes quality training? What is quality training?

[Dr. Stacy Sims]

So this is your polar. So you have a very specific session that you're going to do. So for Vonda, it's your 30 seconds on as hard as possible, two to three minutes recovery. Do that four times at your session.

[Dr. Rhonda Patrick]

Okay, I'm going to try and summarize this, see if this is a test. See if I understood all of this stuff. So if I do a lot of volume, but I play in that sort of medium intensity range, I'm basically just like stressing out my body in all the worst ways.

[Dr. Stacy Sims]

Exactly.

[Dr. Rhonda Patrick]

Like the inflammation, it's just not good for my body necessarily. If I don't do vigorous enough exercise, then that's also bad because nothing's gonna break and therefore build. Nothing's gonna adapt, nothing's gonna grow. If I do it for long periods of time, really anything for long periods of time, that's also stress. But the key thing to do is to do shorter, higher intensity exercise that will cause my body to adapt, but won't put it into that inflamed, stressful state.

[Dr. Stacy Sims]

And you also have to pepper in some lower intensity work. So this is your flexibility so that you have recovery, you're getting blood flow circulating, you're tapping into some mitochondrial at work so that you are still getting benefit of exercise, but it's not in that modern intensity. So that's what we mean by polarizing. So if we were to talk in like the zones talk that everyone talks is out there, right?

[Dr. Rhonda Patrick]

We're looking at what is zones.

[Dr. Stacy Sims]

So if we're talking about heart rate and the way that your body works, we have zone one, which is just sitting around, you know, like you're.

[Dr. Rhonda Patrick]

Yeah, we're in zone one.

[Dr. Stacy Sims]

Zone two is the bro science kind of thing where you're like, let's, let's work in this zone two area where we're working.

[Dr. Rhonda Patrick]

I was in zone two. When you're talking about menstrual cycles.

[Dr. Stacy Sims]

Yeah, there you go. That's it. A little elevated. Your heart rate's elevated still a little bit. Have a conversation. For women, it's good for recovery stress release. For men, it's good to improve metabolic flexibility. When we're looking at zone three, four, that's the area you want to stay out of, unless you're specific, specifically training for something that requires you to be there. So that would be your half marathons, your endurance races, that kind of stuff.

[Dr. Rhonda Patrick]

Everyone wants to stay out of zone

[Dr. Stacy Sims]

3, 4

[Dr. Lisa Mosconi]

during training.

[Dr. Rhonda Patrick]

Because that's the medium range, right?

[Dr. Stacy Sims]

Yeah, that's medium range.

[Dr. Rhonda Patrick]

So you want to jump into zone five, hang around for five, six.

[Dr. Stacy Sims]

Yeah.

[Dr. Rhonda Patrick]

Okay. A couple of minutes and then get out of there.

[Dr. Stacy Sims]

Yeah.

[Dr. Vonda Wright]

But in a week, this is what.

[Dr. Stacy Sims]

Yeah, it's cross the week, let's be clear.

[Dr. Vonda Wright]

So two to four days a week, you should be lifting progressively to lift heavy, meaning Heavier weights, fewer reps. Right. One compound lift a day, plus the augmented lifts that go behind it. Right. So you're warming up first. Then you're gonna do one lift and then you're gonna do your jumping or your balance work. The other days of the week you will do preferably low intensity doing anything. Walking briskly down the New York street could count as that. It's continuous motion. And then a couple days a week, add in your sprint intervals, your really high zone, 5, 6, high intensity. And then when you've got that, you can add in your 4x4 VO2 max on one of the other days. Because it sounds like a lot, but when I work with non pro athletes, I layer on behaviors.

[Dr. Stacy Sims]

Absolutely.

[Dr. Vonda Wright]

Because if I say all of this at once, nobody's gonna do anything.

[Dr. Stacy Sims]

I always describe it as. We have these pillars, right. First we have to nail sleep. Doesn't matter who you are, you have

[Leah (Caregiver/Host)]

to same cause you cannot sleep is non negotiable.

[Dr. Stacy Sims]

Yeah. You cannot invoke any kind of metabolic or body composition change without adequate sleep. Also improves stress resilience. Then we look at nutrition and physical activity. The behaviors that go with both of those are somewhat independent. You have some people that are more motivated to do physical activity and some people who are more motivated to change nutritional habits. Most of the time they're two different personalities. So we have to look at what comes next. And then we also have, which isn't lesser importance, but often neglected, is the mindfulness and community. So this is being out in nature, it's connecting with friends. Might be going to group exercise class, it might be just having coffee. But that is really, really important for parasympathetic and whole. Like whole being. Exactly.

[Leah (Caregiver/Host)]

So there's a new book out coming out called Joy Spann. I don't know if you've spoken with her. So she's a gerontologist and works with the very elderly. And she has a very specific, you know, what determines who's going to kill it in that last decade of life. And that community part, using your brain, you know, having interactions with human beings seems to be the key. And if you don't keep that going through this 40s, 50s, 60s, when you get to 70 and 80, you're not gonna have a great end of your life.

[Dr. Rhonda Patrick]

And what about the last phase then? So someone's postmenopausal. Does their exercise recommendations change at all?

[Dr. Stacy Sims]

We like to start the habits early and continue them through. If you haven't started, it's not too late. As we're seeing like with Liftmore and some other of the older age researches coming out, it's never too late to start. We just have to be very careful of how you start to have support and phase you into these different exercise modalities.

[Dr. Rhonda Patrick]

Is it the same exercises though? Meaning, you know, the three days a week, the mobility, the strength.

[Leah (Caregiver/Host)]

I am firmly postmenopausal and I am doing all these things, but it's different.

[Dr. Vonda Wright]

People always ask me, what does heavy lifting mean?

[Dr. Stacy Sims]

Right? It's relative.

[Dr. Vonda Wright]

It's relative. My heavy is not going to be Stacy's heavy. Or I should say it the other way, Stacy's very heavy. It's not going to be my heavy.

[Leah (Caregiver/Host)]

In Liftmore, the authors describe the one rep max. And so one rep max is like safely, what is the heaviest you can do one rep, you know, so for a bicep curl, what is the heaviest weight I can do one to fail. You know, I'm going to fail after this one. And for me that was about £20 with good form.

[Dr. Stacy Sims]

Exactly.

[Leah (Caregiver/Host)]

Safely with good form. And so I could nail 20. And so then they took them down to about 70, 80% of that, which for me was about 15, 16 pounds so that you can usually do about five reps before you hit failure. And that is what they consider lifting heavy. And that seemed to really resonate with my followers to understand what that meant.

[Dr. Stacy Sims]

And there's so many women that underestimate their strength, see them and they gravitate towards the 10 pound dumbbells. It's like, put that away, go to the next one, do a couple of lifts with that and then ideally I want you to put that away and pick up the next one because that's going to challenge you. Because women have been so conditioned to do 10 to 15 reps to get quote toned and not really put in the work they need to to build muscle and to get the benefit out of strength training. And I, I'm always telling women, you're underestimating yourself in so many facets. Don't cheat yourself with the strength training

[Dr. Vonda Wright]

as well because people have to remember what we're training for now. It's different than I had a woman recently say I was taught to do biceps curls 5 pounds 30 times. Well, after 30 times, not only are you bored, but you'll probably be at failure 30 times. That will build endurance. I am training to be as strong as possible and when I have strength down, then I start playing with tempo so that I could build, replace some of the explosive muscle fibers that I'm Going to lose over time.

[Dr. Rhonda Patrick]

To your point, Rhonda, I've just been writing my book in Cape Town, as I told you before we started recording. And one of the studies that I read about while I was writing the book was a study done by a guy called Hal Hirschfeld and his colleagues, where they asked. They put people in these MRI scanners and they asked them to think about a famous celebrity. And then they ask them to think about themselves today. And then they ask them to think about themselves in 10 years time. And in 10 years time, the same brain regions lit up as if they were thinking about the celebrity. Which kind of led them to conclude that in our brain we almost see our future selves as a bit of a stranger.

[Dr. Vonda Wright]

Yes, that's right.

[Dr. Rhonda Patrick]

And so when we think about long term planning, this is in part why a lot of this advice is often most effective when it's put in the context of like short term performance or cognitive benefits. Because we really do struggle to like, care about ourselves at 90. And I think we all kind of think we can just figure it out later.

[Leah (Caregiver/Host)]

I think what's different for women, especially in menopause, is because we're also taking care of our parents in so many ways. You know, we're in this, like raising kids, going through our own hormonal upheaval, and then watching our mothers, our grandmothers, our aunts age and we. The way society is set up, women become the caretakers of their parents, generally the oldest daughter. And I have to give full credit to my sister who lives in the same town as my mom and as a nurse. So she really is bearing the brunt of taking care of mama because I'm living this life. So thank you, Leah. If you're watching, it is such a tremendous stress, you know. And so our motivation, my sister and I, is like, we don't want to do this to our daughters.

[Dr. Stacy Sims]

Yeah, exactly. The other thing I want to bring in is the brain health component, right? We talk about Alzheimer's and dementia. And one of the reasons I really preface doing high intensity work is the lactate production. Because we're finding more and more research coming out showing that part of the development of dementia and Alzheimer and the plaque is a misstep in brain metabolism. So when we're looking at brain metabolism and the brain uses a lot of glucose, it also uses lactate. Now for women, we have less of the glycolytic or lactate producing fibers and we tend to lose those with age. Men are born with more, tend to hold onto them more. So it's not necessarily as big an issue for lactate production. Men need to spend more time in the low intensity, being able to produce more of our fat burning capacity. But for women doing that high intensity work and being able to produce lactate to then allow the heart and the brain to use that preferential fuel feeds forward to reducing the misstep in this brain metabolism component that occurs. And it's such a sex difference. We're seeing a change in glucose metabolism in and around perimenopause into menopause. So it's that lactate production that I is kind of the offshoot of the high intensity work that's super important for brain health as well as when you

[Leah (Caregiver/Host)]

look at glucose metabolism in the brain, I'm talking specifically coming out of Arizona and from Lisa Moscone's work, and they looked at glucose utilization in the brain, especially the forebrain through the transition. It's wildly different based on what phase of perimenopause, menopause and postmenopause that they're in. And it's absolutely astounding. And they're seeing patterns that can give clues that may be the women who are headed towards the dementia route versus those who aren't.

[Dr. Rhonda Patrick]

And women are significantly more likely than men to develop dementia and Alzheimer's largely because they have certain unique biological risk factors and also because they live longer.

[Dr. Stacy Sims]

And the sociocultural component, I keep bringing it up because I work stress. Yeah. But also, if we're looking at women who are 80, 90 years old now, their upbringing to this point is completely different than ours. Meaning that the job availability and the brain stimulation they had when they were in their 40s, 30s, 40s, 50s, completely different than what we have now, better or worse. So they didn't have necessarily opportunity to be scientists, lawyers, medical doctors, so they didn't have as much stimulation of brain and implications on that neuroplasticity. So we're seeing a higher episodic issue of dementia and Alzheimer's in older women now because they didn't have the same lay down effect that we have now as 50 year olds, 40, 50 year olds and this and the stimulus we have for neuroplasticity.

[Dr. Rhonda Patrick]

Oh, so okay, like you're laying down

[Dr. Lisa Mosconi]

brain pathways and neural fibers. So neuroplasticity, think about it like the bone, but you're creating pathways in your brain to make you healthier but more

[Dr. Rhonda Patrick]

resilient, more resilient to dementia. But they're also going to have stress

[Leah (Caregiver/Host)]

built a stronger brain younger.

[Dr. Rhonda Patrick]

Are they not going to have more stress if they're working, maybe hours and

[Leah (Caregiver/Host)]

fascinating study, and this one shot me out of a cannon emotionally was if you choose to become a caretaker of a parent with dementia, you have a 60% increased risk. Now there's a genetic component, but when they took the genetics out of it and they feel like it's the stress of caregiving for that parent, you are signing your own death warrant. Because now you are increasing your risk of death.

[Dr. Rhonda Patrick]

Yeah. Because I'm right in thinking that women are still both caregiver and now in the corporate world.

[Dr. Stacy Sims]

Yes, yes, that's right.

[Dr. Rhonda Patrick]

So it's both.

[Dr. Stacy Sims]

Yeah. Stress from both ends, lactate production for the win. But you have to have an active

[Dr. Lisa Mosconi]

plan to combat this.

[Leah (Caregiver/Host)]

Right.

[Dr. Lisa Mosconi]

We're not going to live in a world that is stress free. If you're a woman in the world, you are likely to have a caretaking role in some fashion, even if you are chasing other dreams. When it comes to professionally building good brain pathways is wonderful as far as a way to help start from a higher standpoint before you have brain loss. However, we've just like we've said on these other tangents, the brain is that too. We need to think about active ways we're going to combat what is happening in today's world naturally. And some of the factors are modern society that put us into this pro inflammatory state. But we need to think about making lactate what's important for us. And it really is a plan. This whole I'm gonna figure it out when I'm 90 and the problems in front of me is too late for these medical problems.

[Leah (Caregiver/Host)]

So. And back to your point about neuroplasticity, we're not reading as much. We're on our phones and so not in my house. Yeah. And so as a culture, there's this worry that all this time on the phone and these dopamine hits and. But not creating stories in your head and reading for pleasure at night. You know, a lot of women are on their phones now before bed. Rather than developing that neuroplasticity that we get from storytelling, what you just listened

[Dr. Rhonda Patrick]

to was a most replayed moment from a previous episode. If you want to listen to that full episode, I've linked it down below. Check the description. Thank you.

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