← The Dr. Gabrielle Lyon Show
The Dr. Gabrielle Lyon Show
Cardio vs Strength Is a Myth and the Science Proves It - Alyssa Olenick
02:03:31
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- [00:00]
A
Walking isn't enough people wait.
- [00:03]
B
Yeah, Doc, they were so offended.
- [00:06]
A
I actually know because I was sent it like a million times.
- [00:08]
B
I, I'm hearing you say and walking
- [00:11]
A
is, it's not enough for bone. It's not enough for muscle growth.
- [00:13]
B
As a geriatrician, we would see those individuals that all they did was walk. Yes, yes, walking is important, but is not going to maintain strength. And those bigger muscle fibers, yeah, all
- [00:25]
A
movement is good and it's going to be net productive for any health measure. Just moving around more is a net positive thing. But if we specific adaptations to muscle, bone, cardiovascular system adaptations, you do need enough of a stressor and a stimulus to drive that adaptation to actually get those benefits.
- [00:42]
B
Everybody knows it's not enough.
- [00:43]
A
Walking should become a baseline, not a physiological stressor for that exercise adaptation. Right. I'm sure you've heard like the new term is powerpenia. And we start to lose power. Have you not heard of this? Okay, so we start to lose power faster than we lose strength as we age. And that's like your ability to catch yourself when you fall or get up out of a chair quickly.
- [00:59]
B
Do, do you think that's because people are not training power?
- [01:02]
A
Well, no one trains unless you're an athlete in your 20s.
- [01:04]
B
You gotta do it. Exactly. I wanna touch on this plyometric component. Do you think that everyone should be doing some kind of plyometric?
- [01:11]
A
So the two things that bone responds to very well is.
- [01:24]
B
Friends. I wanted to personally let you know that our next four week Forever Strong Foundations Challenge begins July. This is back because you asked for it. This challenge is built around the same evidence based, principled nutrition and training you've come to expect from us, along with. I'm very excited. Updated content designed to help you build and preserve the one organ system, that one system that matters most for longevity, which is skeletal muscle. We'll also be hosting live events throughout the challenge, including conversations with me, members of my nutrition team and trusted fitness professionals who will help answer your questions and support your progress. What excites me most is not just the information, it's the community. Every challenge brings together people who are committed to taking ownership of their health, raising their standards and investing in their future. Now, I look forward to working alongside you as we continue to build a stronger, healthier and more resilient community. Because man, it is up to you. And let's get to work. Have you ever been confused about training? Should you do cardio? Should you do strength training? But cardio blunts your strength. Training gains. Listen this is just one example of the information that spreads and confuses people. Dr. Alyssa Olnick is a PhD that focuses on exercise, metabolism and sex differences. She did her postdoc in menopause and metabolism. Also, she's personally run 17 ultramarathons while maintaining competitive weightlifting. All right, so this girl's on a mission to help women train more efficiently and with less confusion. She's going to show us the science behind what is true when it comes to the differences between men and women in training. And even more importantly, what do we do with it. Do people call you Dr. Olenik?
- [03:35]
A
Usually I don't. I think they either get called Dr. Lissa Lenyk or like just Alyssa or Doc Or Doc. Yeah, people default to Doc list because my handle. So any of them work though, as
- [03:46]
B
long as they're not swear words, I'm in.
- [03:48]
A
That's kind of like, honestly, as long as someone's like calling me that, then I'm like, fine. I'm honestly fine with it.
- [03:53]
B
You had me at hello.
- [03:54]
A
Yeah.
- [03:54]
B
One of the things that I didn't want to do in this episode, talking about fitness is in the landscape of social media and YouTube, it's all about debunking things. And quite frankly, as you and I were chatting previously, when you're in the world of debunking, it detracts from the science and then what to do.
- [04:13]
A
Yes.
- [04:14]
B
You have been training for a very long time in a variety of sport and just training modalities. Endurance, ultra endurance, which is crazy. My husband just ran his first 50.
- [04:27]
A
Yeah, that's amazing.
- [04:28]
B
Actually he did the Boston and then Big Sur.
- [04:30]
A
Right back to back.
- [04:31]
B
Yeah. And I totally caught him on tape vomiting, if you want it. If anyone wants to see it, listen,
- [04:36]
A
there's definitely footage of me out there probably doing the same somewhere. So it's hard.
- [04:42]
B
But really what I wanted to double down on is this hybrid model of training. And I know that you do it both personally and have studied it.
- [04:49]
A
Yeah, yeah. So I kind of have this non official saying of hybrid is health. I'm sure everybody knows by now that resistance training is very important, especially if they're coming from your audience. Right. Muscle, protein, all the things. And then cardiovascular training, I think kind of was like really big and then it kind of got downplayed for the overplay of resistance training. But I think.
- [05:10]
B
Wait, the overplay of resistance training?
- [05:12]
A
I think the over correction of the lack of resistance training, I would say. And it's funny because I become known as like this cardio girl, but I am a True and true. Little meathead, honestly, at the end of the day. And I actually really got started into fitness with resistance training. But I loved endurance and cardiovascular training because I was an athlete growing up. And what I realized when I started to get into my master's and my PhD, and when you look at the exercise guidelines and all of this data and literature is like, the best health benefits come from a fitness training program that encompasses both in some capacity. And so from a both training perspective, most athletes are following a concurrent training model. They're doing some degree of resistance training and cardiovascular training and different varying percentages depending on what their goal is or whatever they're trying to achieve. But when then we look at also like the prescription for health, we see a combination of resistance training and cardiovascular training. So I, I mean, hybrid's been really trendy. I think, you know, that's gotten really popular in the last few years. It was not a thing. When I started to like, be in the hybrid space, my friend jokingly called me the queen of hybrid training. Cause I was kind of like adapting it and talking about it and doing it before. Now it's like everybody's doing it.
- [06:15]
B
And how would you define hybrid training?
- [06:17]
A
Yeah, so I was going to say I use hybrid training kind of as my trojan horse of getting people to do cardiovascular resistance training. But it's really just concurrent tr. And so most people, hybrid training is trendy. So if people want to use the term hybrid training because it makes them feel good about the exercise they're doing, absolutely do it. But hybrid training, more so in the literal sense, is taking two or more modes of fitness and trying to maximize your fitness and capacity in those at the same time. Where in the science it's more often referred to as concurrent training. It's not actually called hybrid training in any of the research done on it. It's called concurrent training. And that is essentially the inclusion of resistance training and some form of endurance or cardiovascular training in the same day, week or training cycle that a person or most likely in most studies it's athletes are doing. So concurrent training model is a little more broad of like, it can kind of adjust to goals, seasons, you know, the person or athlete at hand, where hybrid training is more so like you're truly trying to be as endurance, sleep, endurance, fit as you can be, while also being as fit as you can in strength. But there's also other ways that you can find it. It doesn't just have to be classic cardio or running and lifting. It can be multiple sports at the Same time. There's a lot of variations in it because it's just kind of made up at the end of the day. But essentially, it is just a more modern fitness term for what is concurrent training? Coming from the scientific literature, would it
- [07:36]
B
be something like the following? A newbie to training is lifting three days a week and then doing five days a week of cardio.
- [07:43]
A
Yeah.
- [07:43]
B
Would that be considered concurrent training?
- [07:45]
A
Yeah. Yeah, that would be considered concurrent training. Yep.
- [07:49]
B
When you talk about the hybrid athlete, would that. Because as I think as we sit here and we chat, you and I have been into fitness for a really long time.
- [07:59]
A
Yes.
- [07:59]
B
But the reality is, if someone is coming to listen to this podcast, they are probably interested in fitness, or maybe they've been doing it for a long time, but overall, people are not training. And as someone is sitting here thinking, okay, well, if I'm a beginner, how do I think about the foundational science and then apply that to real life?
- [08:24]
A
Yeah. So that's where I kind of like to give the disclaimer about hybrid being kind of intense. And if it feels off putting to beginners, I'm like, you don't have to identify as a hybrid athlete. It's just a model of fitness that I. It's a more friendly term than concurrent training. If you say concurrent training, no one's stopping their scroll. Right. They don't care. But if you're an absolute beginner. I have a stance in my fitness philosophy that I love beginners, and I want to get to them before everyone else gets to them and gives them all the things that distracts them.
- [08:47]
B
And usually what I tell, oh, I love that.
- [08:49]
A
Right.
- [08:49]
B
Because people are very distractible with various types of things.
- [08:52]
A
And I always, in my programs have included beginner programs because I'm like, I want you to come in and you have the fastest pathway to success, rather than, like, trying this and trying that and doing all these things. But with the beginner, everything's new, everything's overwhelming, and being less fit makes it harder. Like, I think people don't give enough credit to the beginners that it's really hard. It's a lot easier for me to go for a run. I feel a lot better than I did, you know, when I was starting out or at the beginning of my fitness or same thing for people starting in the gym. Right. Like, there is that resistance that you feel both physiologically but also mentally. Like, there's a lot of things you're trying to correct for in your life. So I usually tell beginners, don't worry about doing it. All right, you can start with a cardio program and a resistance training program. But like, what will you start with and what will get you in the gym and what will get you moving? For some people, the intimidation of lifting feels really scary. I'm like, okay, can we get you and start doing some cardio and then you can look at the weight room and see what's going on and feel comfortable in the gym and build that habit and then merge to that. For some people, I say, hey, if you have no strength, no baseline capacity, no muscle, you're going to be okay. If you don't do cardio for the first, I don't know, month or two while you build that skills and that foundation, I think there's this idea that, well, if you haven't been doing it well now you need to do it perfectly tomorrow or it doesn't count. And I don't have that philosophy. I think beginners should start where they're willing to what feels the most realistic, most accessible, but then have a plan long term to start integrating the two together. Because we know that muscle, obviously, anyone listening to this podcast knows muscle is really, really important for health. We want strength, we want power, we want bone density, we want capacity. But also we know that parameters of cardiovascular fitness are heavily tied to long term health outcomes. So how do we get you to do both in a way that's realistic for you, but then also the beginner, you don't have to think about like, well, what's that high end, even recreational athlete doing? You might never need to be there to improve your health or fitness, but can we get you to model those things in a scalable way that's realistic for you and you can do. But then also knowing that you always have the option to scale up? I think a lot of beginners are like, oh, I'll never do that thing. And then one, two, three years down the road, they're like, I want to try the high rocks. I want to try the half marathon, I want to do the powerlifting meet.
- [10:55]
B
These are all considered. Well, would those be considered hybrid type athletes? Maybe the cross?
- [11:02]
A
Yeah, I think.
- [11:03]
B
What is it called?
- [11:04]
A
The.
- [11:06]
B
The hybrid.
- [11:06]
A
The high rocks.
- [11:07]
B
The high rocks. The high rocks. That's right.
- [11:09]
A
Yeah. Hy rox are. I mean, they get a lot of slack for not being truly hybrid because they are very heavily endurance focused. It's a very endurance heavy race. I mean, it's a running race if you ask me. But most people training for that usually are doing some sort of Resistance training, because you need a baseline of strength to push that sled or to do a bunch of lunges. Right. But then you do need the endurance training on top of it. But, I mean, I love, in general, though, if anyone, once they get past that beginner stage where they're very intimidated by everything, I love saying, like, set an athletic goal. You don't have to compete in something, but you can, I think, that have the hyrox, you know, the crossfit, the power, local powerlifting, meet the local race, whatever that is. That could be a really great goal to make it fun, social, supportive. But you can always set goals like that.
- [11:47]
B
Do you have a timeline?
- [11:50]
A
I don't have a specific timeline for anyone with how fast to train for anything like that. I would say, you know, that first six months in the gym of training for any specific goal, give yourself grace in that time period of maybe first 12 weeks to six months of like, getting used to the training, the routine, adapting. But it's never too soon to start. Set a fitness goal. And honestly, I think a lot of people might find it more rewarding because if you set the goal of like, hey, I want to deadlift my body weight, Right? That's a great objective to work towards than just like, I just want to change my body, or I want to xyz, which can be sometimes not as fast of a process as we want it to be, or as quickly rewarding. And it gives you something to work towards, and it gives your training meaning. And then it. I feel like for. Especially for a lot of women, it kind of. You have to train hard enough to get to that goal, rather than so doing some of those things that spin your wheel and just kind of. I don't say waste your time because all movement is valuable, but aren't valuable in the sense of moving you closer to an objective strength or fitness.
- [12:44]
B
But also, yes, all movement is valuable. But we know from aging data that if you are heavily reliant only on cardiovascular activity, your muscle fibers change. You cannot maintain those type 2 muscle fibers. And as a geriatrician, we would see those individuals that all they did was walk. Yes, walking is important, but is not going to maintain strength. And those bigger muscle fibers.
- [13:10]
A
Yeah, and that's a big reason why I like people setting objective kind of athletic goals, even if they're not gonna compete, because then it kind of forces you to train with an adequate enough stimulus.
- [13:18]
B
You have to have a stimulus.
- [13:19]
A
You have to have a hard enough stimulus to reach the goal. But then it can add an Enjoyment factor to it, which is a big obstacle for a lot of people. But yeah, I'm very big on. You have to have a stress or stimulus greater than what your body's baseline is at. And I think that a lot of people conflate movement with exercise with training.
- [13:36]
B
That's a really good point.
- [13:36]
A
Yeah, like there's a spectrum of movement to exercise, to training. And I think that, you know, and this gets really hard because everyone's like, well everything's good. Don't shame people for what they're doing. I'm like, yeah, all movement is good and it's gonna be net productive for any health measure. Just moving around more is a net positive thing. But if we want specific adaptations to muscle, bone, cardiovascular system adaptations, you do need enough of a stressor and a stimulus to drive that adaptation to actually get those benefits.
- [14:02]
B
And that reminds me of something that I hear a lot and it's this idea of the interference effect. I'm going to read something that I pulled out and the interference effect, which is the idea that if you're doing cardiovascular activity that it's going to interfere with your muscle gains if you're doing them right within the same time period. And this has really been something that we get questions on a lot. The interference effect, which I would say has been the boogeyman of concurrent training since there was an original study. Hickinson in 1980 found that combining endurance and strength blunted strength gain in men. How should we think about that and is that true?
- [14:49]
A
So I will give people the, the quick answer they want to hear. For most people, the endurance, I'm sorry, the interference effect is not really a big deal. Really high end specified athletes or people with high training volumes, that's where that starts to become more important.
- [15:05]
B
Do we know that to be true though?
- [15:07]
A
I think from like an applicable training standpoint, most people, if they're so detrained that they're going to start to get fitter with almost anything that you give them over time. And I, you know, there's, there's been some like review papers that have discussed this theoretically. And my viewpoint on it is that, you know, you can get fit at both for a while, but eventually there is gonna be that degree of specificity that you're going to need to branch out or you're gonna probably have, you're gonna hit a ceiling. Right. Of like what you can truly achieve
- [15:34]
B
long term if you are pushing for an extreme capacity. Right?
- [15:39]
A
Yes. And that's where hybrid training is different than specified training. Right. Like a Hybrid athlete with someone who's trying to maximize both. But they're always going to be sacrificing some degree of their strength or some degree of their endurance versus the pure endurance. The guys that just ran sub two one hour marathons, they're probably strength training to support that, but they're endurance attributes.
- [15:57]
B
You know how much Kipchoge weighs?
- [16:00]
A
Oh my gosh, probably less than me. Like maybe 60 kilos. 140 pounds.
- [16:07]
B
He weighs, I think it was like 115. Okay.
- [16:10]
A
Yeah.
- [16:11]
B
For you guys listening. Yeah, we're really big into the marathon in this house. And he was like 115.
- [16:19]
A
Okay, that's even lighter than I was thinking. Yeah.
- [16:21]
B
And I might be wrong, but it was much lighter. And I think he's. What is he, six? Probably close to six tall. Very tall. And I guess what I'm saying is that it's not this weight outcome. I mean people are built to probably run a certain way. And I don't know how much resistance training he's actually doing.
- [16:45]
A
Most elite athletes are to do some degree probably to support at least, because we do have data that suggests that resistance training reduces injury risk or improves running economy. But at that extreme end of sport, you are rewarded by efficiency, size, also weight, all of those things. There's a little bit of nuance there. People take that and they go, why, if I lost a bunch of weight, I'd be a better runner. I'm like, no, they're also training incredibly high volumes. But then all the way to the other side, you have the super elite strength athletes, the strongman, the powerlifting, the Olympic weightlifters. They're probably maybe doing enough cardio to support general baseline health
- [17:21]
B
within that session.
- [17:23]
A
Or you mean no, in general in a training cycle or even a year. But they're probably not doing a ton. Right. So there's always going to be those extremes of specificity. And if you want to be an elite runner, you want to be an elite weightlifter. I'm not going to tell you that you should train for a marathon or a powerlifting meet on top of that. That's where the hybrid training kind of falls in the middle of that spectrum of like those are people who are trying to maximize both, but to the original point of the interference effect. There's always a compromise, right, of what you are. You're not going to be the fastest marathoner you'd ever be or be the strongest lifter, but you're trying to be the strongest at both that you can be simultaneously. Right. And we're seeing now a lot of people are getting very strong and very fit at the same time. You can have both of those characteristics developed. What we see in some of the studies is that I think when people think of the interference effect, they think, okay, well, it's 100% blunted. That if you do both or you do both in the same program or in the same workout session or too close to each other, it's 100% blunted. And it's not that, it's that it's probably the magnitude of the effect that you would get from that session might be a little bit less, but you are still adapting or getting benefit from it.
- [18:29]
B
But that's why I think the magnitude of the effect. I just want to pause you there because this makes me think about women in training and there's a lot of discussion about the differences between men and women.
- [18:40]
A
Yeah.
- [18:41]
B
I believe that you and I are both on the same foundational belief that it's not that the men and women are different. Clearly they're different. But it is the interpersonal individuality that really probably trumps everything. Now, that being said, are there different fiber types that would be predominant in Men vs Women? Maybe. Like maybe. But the percentage is so minuscule that it might be 2% or less.
- [19:11]
A
Yeah.
- [19:11]
B
And this just goes back to the. The statement that strength could be blunted if you're doing too much cardiovascular activity or there's this interference effect. But when we say strength is blunted, is it a 0.2%?
- [19:27]
A
Yeah, we have to put in. And I would have to try to give a. I wish I remember the actual datas from these studies that I'm referring to.
- [19:34]
B
Which ones are they? We can pull them up.
- [19:36]
A
I would have to give you guys the citations. I'm sorry, I don't have them off the top of my head. I have them pulled up in a presentation that I gave last year. But we see this magnitude of blunting. It's greater with running than cycling or non nervous system stressing type activities. Let me back up a second and talk more about the interference effect to give more context for people. The interference effect from those original studies, essentially they looked at this cellular pathway. Lifting and cardiovascular training have two different cellular pathways. These cascades are almost like someone's knocking a door, ringing a doorbell. The messenger is going to someone else. It's sending a signal. It's telling someone to do this.
- [20:13]
B
Like my house.
- [20:14]
A
Yes, exactly. And so the resistance training pathway is turned on by mechanical tension. That tension, that pulling, that stress, that strain on that pathway and it essentially results in muscle protein synthesis. Or you have also neuromuscular adaptations to strength training. When you start lifting heavier, your neurons are better at contracting more fibers. Those fibers get more powerful, they can protect, produce more force. All of these things are adaptations unique to resistance training. Then you have endurance training. And this cascade is essentially turned on by energy deficits in your cell. Essentially you start doing activity. There's turnover of glucose, ATP. All of our energy systems fuel and sense that deficit. And that deficit in energy inside of our cells turns on a different pathway. And it turns on some of these things called PGC1 Alpha, which is really important for simulation of mitochondrial biogenesis and all these other positive adaptations of aero training. But it also turns on something called ampk. And AMPK essentially is like the neighbor kid messenger that goes and then locks the door to the house. You can't get into the resistance training house essentially if you want to play on the kids and house craziness. And essentially that when AMPK is really up regulated, there's kind of this like blocking of that protein synthesis pathway.
- [21:29]
B
Now, which would be MTOR.
- [21:31]
A
Yeah, which would be MTOR. Now is the degree of what's that happening 100% every time it happens? No, I think that you can think of it almost like muscle stimulus soup. Like there's so many other things that are also happening, but there is a downregulation because you have to think muscle is a pathway where your body is taking proteins and building and it's anabolic. You're trying to build tissue where endurance training by nature is catabolic in the sense of it's breaking down fats, carbs, hopefully not proteins, but sometimes for energy metabolism. Cause in the moment it's trying just to to supply the output. They're kind of antagonist in that sense with each other. So when I say that it is blunted and or different activities can interference, that's one way that it can interfere. I'm a little bit more of the take that most of the issue for most people comes down to central nervous system fatigue. So there's carryover of fatigue from an endurance training session that then when you go to the gym, you're not able to lift as heavy or as high of percent of the when you're one rep max or your power output is slower. So therefore the net productivity of that session might be slightly lower because you aren't able to push as hard.
- [22:40]
B
I want to pause you there because I think it's really important.
- [22:42]
A
Yes.
- [22:43]
B
What I'm hearing You say is that the intensity of the endurance activity over time affects the nervous system, which all training affects the nervous system. But some training definitely seems to have nervous system impact that is bigger than others. We agree. For example, yoga might have a lower impact on central nervous system fatigue. Something like a sprint or a max effort or running to the point where your heart rate is up and you maybe get to the place where you quote bonk. There's a stressor.
- [23:22]
A
Yeah. So. And that's what we see. That's why I was trying to get physical. No.
- [23:26]
B
So this is where I think people listening.
- [23:29]
A
Yes.
- [23:30]
B
Would love to understand more. And I just want to clarify, because you said it so eloquently, I want them to understand the importance of what you're saying.
- [23:37]
A
Yeah. So it's that you're. When you're trying to do concurrent training, hybrid training, combined modes in a week, you're competing for resources within your body. Now between two different things in a training program. And one of those is that fatigue from one session to the next. Right.
- [23:51]
B
We also see physical or mental fatigue.
- [23:53]
A
Usually it's physiological so you have like less ability to contract your muscles as powerfully. Things like that. You might have mental fatigue as well. That can come with some of that CNS fatigue. I know that if I was to run before I lift, my brain state is not there to go all out maximally during that training session versus if I separate them and do them around. So there is some fatigue there. So you can have carryover both ways. Right, people? Also, if you do a really heavy leg day and then you go to do your, your speed work or your high intensity intervals, you might not be able to push those as hard because you have that carryover both ways. Right. But it does appear that modes of training like running tend to be a little bit more demanding on the central nervous system versus if you were to bike. Right. That might be a little less fatiguing or demanding on that nervous system. So you might see less of a magnitude of that blunting we were talking about earlier because there's less of that potential carryover over interference that isn't necessarily cellular as it is. You're. You can't train those things at 100 back to back, so to speak.
- [24:52]
B
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- [26:19]
A
Yeah.
- [26:19]
B
Absolute curiosity. How does one know? And I've thought about this a lot because I've studied amino acids and the amino acid fatigue. There's this idea that there is the utilization of these fuel systems change, but there would be, there's almost no way for us to be able to differentiate. Okay, so is this tryptophan, you know, serotonin ratio actually being depleted or are we looking at some kind of muscular fatigue? How does someone tell? Because yeah, you would think that someone would be able to tell if it's a muscular fatigue problem. How? From a scientific perspective.
- [26:59]
A
Yeah. So one of the ways that I liked in a more practical way so people can understand, is that for me, I think that one of the easiest ways to tell that potentially your endurance training is starting to interfere with your lifting, is that your bar speed or your weight speed starts to go down at regular weights or intensity. So like if I'm peaking for a race and I'm at the end of a training cycle, I will notice that like the same weight might move slower, it might be a little bit harder. I don't have that snap or that pop to my lifting. So that's really strength and conditioning. Like, bro, like you can get little things that test your bar speed and you could like literally quantify how fast you're moving. That, that's one way that I see that. Also like the same weight or the same output might be an effort level higher than it normally is, or you might have to drop weight to do the same perceived level of effort. So you're kind of having to adjust to that because you're not able to produce the same amount of work or force in your training session. Those are a little bit more objective. So people can say, hey, like that is happening to me. And that's not necessarily always a bad thing, right? Like when I'm peaking and training for a race that I just expect that that's gonna happen. It's not inherently bad. The fact that I'm still lifting and training and showing up during that is probably more important as a net stimulus for still, you know, supporting muscle power, all of that stuff. But I think that that's, it's a really easy way for people to see. Similarly, on the opposite side, if you do a really heavy full body or strength day or leg day, and then you try to do your hardest, fastest interval workout the next day, you might feel some of that carryover fatigue. And so just speaking to your point a little bit about metabolically, one of the things that I think is the biggest issue for most people when it comes to like interference or competition of these resources is nutrition, right? Making sure that you're eating enough to fuel these systems, especially carbohydrate, especially if you're adding in endurance to resistance training. It's a very carbohydrate heavy, demanding type of activity. And I think for your audience who's very concerned with protein and muscle turnover, carbs are protein sparing. Also, your body isn't going to want to pull from carbs to fuel anything or recover from or break down muscle tissue if they have enough of that. So it's a big piece in recovery there. And I think when I say that people think, well, overeat carbs, well, no carbs are necessary based off your activity level. The more, the more you're doing, the more carbohydrates you're going to need. So there is that competition of resources. And they're also assuming like, protein is staying same or slightly going up, depending on what you're doing. And that's kind of maintained throughout that. So I think that there's a lot of like, lifestyle factors that we can do to minimize that than having to like have biopsies and see what's going on in our cells. And for most people, you know, I usually, this is like, not to be dismissive people. I'm like, you're not fit enough to worry about that, right? Like, you will still gain fitness and still improve, improve for a very long time before most of these things start to become a question of do I need to pick, do I need to prioritize, or. The approach that I like to take is seasons. Right. Seasons of emphasis and focus that allow you to spread those resources more in favor of one mode versus the other so you can raise that floor of fitness up together without giving up the other one entirely.
- [30:01]
B
I like the idea of raising the floor of fitness for the nutrition aspect. I think it's a very important conversation. We've also had Zach Bitter on the podcast News that again, we had Lisa Smith baching on both Ultra Endurance Runners. And one of the things that they said to your point is that they focus on having enough calories, and then if they're having 5,000 calories, then if they have, I don't know, 40% of that is carbohydrates or more and 20% of protein that they hit their protein target. How do you think in terms of fuel use and just to kind of lay this out for people, Healthy muscle at rest burns primarily fatty acids. If you are unhealthy, if your muscle tissue is. What is a good word? Compromised, then you force it to burn glucose. If you are sedentary and you are overeating carbohydrates, you are in a position while you are sedentary, you are forced to burn glucose. This is not ideal.
- [31:07]
A
Yeah, yeah, absolutely.
- [31:08]
B
But as you train, what, in a healthy muscle, the more and longer that you're training, the more carbohydrates that you would utilize.
- [31:16]
A
Yeah. So energy metabolism in exercise and our muscles works on a spectrum of intensity or duration. Right. So for most people listening to this, you're probably not going to do so much endurance that it starts to kind of cross over. I don't know, but you might be. So we can get to there.
- [31:32]
B
Yeah, I mean, we've got.
- [31:33]
A
Yeah, get it all.
- [31:35]
B
Just for perspective, this podcast, which what I think is so amazing is that we have the general population who are really interested and we also have a lot of scientists.
- [31:44]
A
Yeah, that's true.
- [31:45]
B
That. Listen to this. And then we have a mix of athletes and also military.
- [31:50]
A
Yeah, that's true. And they are going very long.
- [31:52]
B
So what I love to do is I always love to explain for the layperson, then the athlete than the scientists.
- [31:58]
A
Yeah, I can absolutely do that. So when we think about metabolism in our muscle or our bodies during exercise, essentially, it works on a spectrum of intensity and time. So at rest, in a healthy muscle, healthy individual, you are using a lot more fat for fuel, you're oxidizing A lot of fat. Your body has ton of oxygen available and you need oxygen to metabolize fat. And that point is important. So we can explain later how fitness interacts with this. But then as exercise intensity goes up, both fat and carbohydrate will kind of go up. I know you just did your whole podcast with Tony Tommy Wood and you talked about fat max a little bit and some of that stuff. And so your fat oxidation and carboxidation will both go up. But at one point they will. There's this whole thing called a crossover effect. And essentially your body gets to a point where it can't keep up with doing both. Or there is this like cellular interference between carbs and fats that different signals for your body will be like, hey, okay, we can't keep up with fat oxidation right now. It's too energy costly. It's too, we don't have enough oxygen, we're moving too hard, there's too much lactate. Whatever the signal is going on.
- [32:59]
B
And then what happens?
- [33:00]
A
And then you'll switch to predominantly carbohydrate oxidation. Because carbs are really easy to break down. You can break them down both anaerobically without oxygen and aerobically with oxygen. Also, there is a lot of lactate production that starts to happen as you get more and more intense, which allows your body to keep doing carbohydrate metabolism to a point until you can't do it anymore. So the more intense you get, the more you will go to essentially a hundred percent carbohydrate oxidation. Um, and that's just when we think about the sheer relationship between intensity and that. So if you were to do a classic VO2 max test in a lab, you would go for 8 to 12 minutes running progressively harder or biking progressively harder until you couldn't go anymore. And you would see this metabolism shift across this, but it will also shift with duration. So if you were to go do like a long run or a long bike, or a long endurance rock, whatever it is, for the people listening here for that, you will predominantly, if you're doing a really long duration activity, you're going to be using a lot of fat oxidation. That's a favorable adaptation. Because you're usually not able to sustain a high intensity for long periods of time. You can usually only sustain high intensity for very short periods of time. But metabolism doesn't work in silos where you're only burning carbs or you're only burning fat. Your body can dynamically shift between them or oscillate to kind of what it needs to supply it or what's available in the bloodstream. So what you're taking in if you're eating during activity, so you will use a lot of fat during that activity. Assuming it's like slow to moderate intensity where fat oxidation still can kind of happen at a large amount, but gradually over time you'll start to deplete your glycogen levels and your muscle cells. You'll start to kind of shift towards, you know, depending on if you're taking a nutrition or not, you'll shift to preferentially using a little bit more glucose as you go, or having to rely more on fat oxidation because you don't have enough glucose available. But then usually you'll start to slow down or bonk or kind of hit that wall. So these things are kind of dynamically happening in our bodies. But the reason I brought up the oxygen thing earlier is that this differs person to person, right? This ability to oxidize fat for a long period of time during exercise or when that crossover happens or something that people might hear of the lactate threshold. A lot of these are just indirect physiological markers of talking about what's metabolically happening in the muscle and what we're can do.
- [35:09]
B
And can I ask you a question before we continue? Is this a training adaptation or is there a genetic component to how someone utilizes fuel?
- [35:18]
A
Yeah, so a good example of somebody like we just talked about the elite marathoners, right? Those guys probably preferentially are born with a ton of type 1 muscle fibers. So they're gonna be more predominantly, probably off the get go, predisposed to mitochondria, fat oxidation, all of those things. But they're probably not gonna go and become like an elite powerlifter, right? With really powerful type 2 muscle fibers. So there is that genetic component of what's the muscle fibers that you were born with, right? What are you pre like disposed to adapt to and respond to? So there is a little bit of that, right? Not all of us are going to become world class athletes in whatever modality that we want to do, right? Yeah, I wish, I really wish. So there is that little bit of that underlying genetics. But I really like to in the genetics conversation acknowledge for people that like everybody will adapt to the stressor of exercise. Like even if you're not gonna be, your ceiling is genetically determined, but your ability to adapt at all isn't something where it's like, well no, you just, you just don't adapt to anything. You might need slightly bigger stressor or More than somebody else. Like there's hard gainers in lifting versus people who might not be as cardiovascularly gifted off the get go, but with enough training you can adapt. It's just that ceiling, like we're not all gonna get a VO2 max of 90, right? Like we're all gonna hit that at some point.
- [36:30]
B
And the fuel utilization is the fuel utilization. Because there's a lot of discussion in this space that men and women utilize fuels differently. Again, I'm sure that you've heard that.
- [36:45]
A
Yeah, we can talk about that. So let me first go back to my point of that adaptation to feudalization that is trainable in everybody, right?
- [36:53]
B
Everybody.
- [36:53]
A
To the same extent, give or take, right. Obviously, some people are going to be able to become. Because you're going to have a higher V2 max, you're going to have a higher ceiling of that. And all those things like the amount of energy per minute those guys in those marathon are burning is astronomical for what their bodies can keep up with. Right? Not everyone's going to be able to do that, but everybody can shift their ability to burn or oxidize or use more fat during activity. And so that crossover point of which when those two cross over or for many people, their lactate thresholds, or we've talked, you know, a lot of people hear about zones which are just indirect measures of like physiological points.
- [37:28]
B
We had Martin Gabala on there, like, yes, zone is different for everybody.
- [37:32]
A
Yes, no, exactly. And so with training, all of those thresholds can shift and your ability to oxidize fat will remain for longer during physical activity. And that is a positive adaptation because for athletes, that preserves your depletion of glucose and glycogen in your body, which is a good thing, but also it's a marker of that underlying adaptation that is both, you know, more capillaries being able to deliver more blood and more oxygen to your mitochondria and your tissue. But also what most people care about is that you either have more or more efficient or robust mitochondria that are able to use that oxygen, because your aerobic fitness and your metabolism, they're all interlinked, are dependent on your ability to deliver oxygen and your ability to use that oxygen when it gets to the muscle cell and mitochondria are what using that for energy production. So that is a trainable characteristic. Sedentary people, both men and women, who do endurance or cardiovascular training and get those adaptations at the muscular level, there's of course, heart and capillary. No one cares about that. Everyone cares about the mitochondria. Right.
- [38:36]
B
No, we just care about muscle.
- [38:37]
A
Yes. Inside the muscle. But you can think of the mitochondria as the little engines in the muscle. Like my whole, you know, to put a pause in it, my whole approach, hybrid training, is like, build the car with the lifting and then build the engine with the cardio. Like, that's the way I think about it. So the more you have of these mitochondria, the better you are at being a fat burner or fat oxidizer. And that is positive adaptation for metabolic health.
- [38:58]
B
Totally.
- [38:59]
A
And aerobic cardiovascular output. Right. So, like, I know you guys talked about on that last podcast, metabolic Flexibility. That was my whole dissertation topic, actually, was metabolic flexibility. And it's essentially like, can you switch between carbs and fats when it's necessary? Right. Burning carbs isn't inherently a bad thing. It's just about, are you burning them when you could be using fat or at the wrong time at rest? Right. Like, that's not a positive adaptation. But the more you train, the more you're able to increase your fat oxidation at higher intensities so you can sustain a faster pace, a faster power output, a faster speed and still be using fat oxidation, which is good because then you're not depleting, relying on carbohydrate. Those elite runners, I know, we keep coming back to them, the point of which they can metabolize fat still, or their lactate threshold is so close to their VO2 max. Right. It's crazy how close that is compared to us regular people. Right. But we can still shift that forward with training, and we see that. But then when we talk about the men and women conversation, you know, there is the underlying narrative that women have more type 1 fibers and they're better fat burner, so therefore they're always better at this. And that also isn't entirely true because training status also matters for women. It's not like, I think it's, you know, pushes this narrative that a sedentary woman is somehow metabolically healthier or better than a male counterpart heart just because she has estrogen. And that's not entirely true.
- [40:16]
B
I've never even heard that.
- [40:17]
A
I feel like that's like the almost the narrative that gets pushed is like, well, you're a woman, so you're better at burning fat, and so you have more type 1 muscle fiber, so it's metabolically more favorable. But there's still a training.
- [40:26]
B
If someone is sedentary, that's a disease state.
- [40:28]
A
Yeah.
- [40:29]
B
And to your point, which I think is of interest to this community and also the scientists in this community. If Brett Goodpasture would ever come on this podcast.
- [40:38]
A
Yeah. So I did him left and right, up and down. Dissertation.
- [40:42]
B
A huge fan.
- [40:43]
A
Yeah.
- [40:43]
B
The where fat is stored within the muscle as it relates to the mitochondria. It's the athlete's paradox.
- [40:48]
A
Yeah.
- [40:49]
B
And what you're saying, what you were talking about, which I think is so valuable is that the fat location within the muscle is close. If you are training and you become well trained, then the fuel source of fat is close to the mitochondria within the muscle because it wants to be
- [41:07]
A
able to readily pull it out.
- [41:08]
B
Yep, exactly right. And that's serves individuals even if they are not training. So if someone is well trained and then they are just living a life, they are more healthy than someone who is sedentary. Where there is fat infiltration not necessarily close to the mitochondria, it is within tissue, it's within connective. It's. It distorts the muscle quality.
- [41:32]
A
So some of the earlier studies in metabolic flexibility were actually done in individuals with elevated weight status and or sedentary. They also like looked at their actual muscle physiology and the two things that biopsy or tracer studies. Yeah, tracer studies or biopsy. And essentially the two things that they found that improve this like metabolic flexibility within the muscle, which essentially just is a fancy way that your body can use fat when it's necessary to switch between the two. And there's not this like interference of carbon fat. Like it's almost like a. You can think of it as like a red light was out and carbs and fat are all stuck and they don't know who to go where. Being metabolically flexible is having like a really good crossing guard and signaling to these things, hey, we need to bring fat into the cell. Hey, we need to clear out this glucose, this needs to be oxidized, things like that. But when they individuals lost body fat, they also lose it in their, in their muscle cells and or improve fitness status. And that was directly tied to that fat oxidation at the muscular level to the point that you were making there. So. Yeah, and to go back to the female conversation, you know, there are estrogen receptors in muscle cells which do interact with, you know, the, the fat oxidation pathways and all this stuff. So there is a elevated fat oxidation in women during lower to moderate intensity exercise. Like so I think like below 70% VO2 max. But once you get kind of above 70 or so, it starts to become a lot more Intense. Obviously, everyone's thresholds are going to be different. So there could be anywhere between 40 to 60, 40 to 70. Someone can kind of cross over to that. But if you had, like, fitness mismatch, males and females, you might see a female is oxidizing fat a little bit longer or a little bit more. But then once you reach that crossover point, everybody's using carbohydrates.
- [43:09]
B
I also have to pause you to be fair, and I think that you agree, you and I are on this, is there's a lot of potential for information that we don't know.
- [43:21]
A
Yeah. Oh, yeah, absolutely.
- [43:22]
B
When it comes to women and exercise and just women in general, it's not very clear. We haven't been studying them to the level that. Because they're complicated.
- [43:34]
A
Right.
- [43:35]
B
The changes in fluctuations in hormone, it creates and complicates things. And there are estrogen receptors on muscle, but to the extent at which that plays a role, I don't think that we don't have enough bodies of literature in human.
- [43:54]
A
No. And it's mostly mouse model. Exactly. It's mostly mouse model. But to the point is that's like what people are hearing, that there's estrogen receptors. They're like, they're essentially. And that's estrogen, they're increasing mitochondria, all this stuff. And whether that's true or not, you know, one of my underlying theories I'd actually love to see tested in the literature is the interaction between women who undergo exercise training and that interaction at the muscular level versus, like sedentary to see if that's like a switch, you know what I mean? Like, is exercise needed for those interactions? I don't know which interactions for, you know, a lot of these positive adaptations we attribute to female sex, is it, you know, just female sex at baseline, or is it female sex plus the exposure to exercise training that increases that fat oxidation? Or.
- [44:33]
B
I worked on some of those studies when I was at the University of Illinois, and Don Lehman did some of the first studies on postmenopausal women.
- [44:44]
A
Yeah.
- [44:45]
B
And also women just in general with diet and exercise, meaning it was calorie controlled, isocaloric, we fed them. And then there were the exercise inputs without hormones.
- [45:00]
A
Right.
- [45:00]
B
Postmenopausal. And it was really the resistance training, which was the biggest driver. And then obviously the isocaloric diets with higher protein. Those people did better. Everything got better.
- [45:13]
A
Yeah. And because we've seen that in some of the metabolism, exercise science studies, like you'll have sedentary groups of women versus trained and the trained women always have greater fat oxidation. It's across the board. It's not just. Yeah, so you might see some of that. But honestly, that's where you know a lot of people. Okay. If there are these baseline general physiological differences.
- [45:32]
B
I mean, there are, right?
- [45:33]
A
They are.
- [45:34]
B
There's no.
- [45:35]
A
Yeah.
- [45:36]
B
I mean, women have more estrogen, at some point, they lose, probably plays a role. And to what extent, I'm not sure.
- [45:43]
A
And that's where I think the question comes from. Okay. A lot of people say, well, there's these differences. And I'm like, okay, but what does that mean for training application? Does that change? Because we also expose women to traditional training of strength or aerobic training, we see similar adaptations relative. Obviously, there's some absolute differences that we see compared to men and women. So maybe we are oxidizing a little bit more fat.
- [46:04]
B
When you're saying a little bit more, are we talking about anything that's statistically significant?
- [46:08]
A
I think that so many people blow out of proportion fat oxidation research because it's like ramps. It's like grand.
- [46:14]
B
And that is. This is all context for people because there's a lot that we don't know. But what we do know is that a good solid training program is a good solid training program.
- [46:24]
A
And that's kind of. My whole thing is like, okay, yeah. I mean, I did my whole dissertation on having women do hiit, Right. Like across the menstrual cycle. And what we found that was that aerobic fitness status mattered more than birth control use or menstrual cycle phase when it came to fat oxidation in both phases of the menstrual cycle. Right. But the women who were more fit, they oxidized more fat across the entire HIIT protocol. But we're talking like maybe 15, 10 grams of fat during that process.
- [46:48]
B
What would that translate over to in terms of. Do you translate that over in terms of calories? How could someone put that into context that is hearing that.
- [46:57]
A
Yeah. I mean, say 10 grams of fat. Say it's. That just. Absolutely. I have to go back and do the real math. That's like 90 calories. Right. Of fat. But that doesn't mean that the caloric differences. The other group just might have been using more glucose or more glycogen. Right. They might still be burning.
- [47:14]
B
So it's even less than one would imagine.
- [47:16]
A
Yeah. It's not meaningful from. And I think that's where people conflate fat oxidation with fat burning. Right. You're utilizing fat as a fuel source. But that doesn't necessarily mean that that's a net removal of like fat from your, you know, your adipose tissue that you want to shrink, so to speak. Right. Because your body's dynamic. It's going in and out of these states across the day. It's not just like your exercise training session isn't always net additive to that either. There's compensation, all of these things. So yeah, I think that the, the real question when it comes to these underlying differences that we see in women is like, yeah, they might have a little bit of that, and that might be good for ultra long endurance where we might not deplete glycogen as fast because it's so slow, low intensity. But that's also conflated by the fact that all of that is also a training adaptation. Right. So people who. There's just so much of a Venn diagram over overlap. You know, there's these baseline differences that we do objectively see between men and women.
- [48:05]
B
And what are those?
- [48:06]
A
Like, women typically have more type 1 muscle fibers, but the difference is like 49, 51. It's not like 60, 40 or anything crazy like that.
- [48:14]
B
Type 1 muscle fibers. Do you want to highlight that for people?
- [48:17]
A
Yeah. So type 1 muscle fibers tend to have more mitochondria in them. They're more oxidative, they are faster to fatigue, but they can endure longer. They're in the endurance muscle fiber where type 2 muscle fibers are more, more of your, your strength muscle fibers, your power output muscle fibers, your, you know, your ability to produce force. And men have slightly more of that. They also just have thicker, denser type 2 muscle fibers. Genetically like that, they're just because of puberty. Right.
- [48:43]
B
Like they, they get the bigger, stronger, they're the bulkier.
- [48:46]
A
Yeah. And so a lot of our baseline differences between men and women typically really do come from that heavy influence of testosterone that.
- [48:52]
B
Actually, I hadn't thought about this before, but if you were to, and I'm not recommending anyone doing this, but you do see female bodybuilders that then take testosterone and they're able to bring their physique up to what I would consider would be a very masculine type. It's a masculinization. And their size is not that much different.
- [49:11]
A
No, because we have, you know, these meta analyses that when you look at men and women from baseline, if you control for body size or lean body mass, women gain muscle to the same degree as men. We just gain. The absolute amount is less because we don't have the ability to put on that tissue.
- [49:26]
B
Do you think they do you. So I've thought about this a lot and I feel like it's a really difficult conversation in the way that just trying to think about it. For example, I will look at my husband who is just this massive human and he's running marathons. He looks at a weight and he can put on muscle. I mean, probably less now because he's so well trained.
- [49:47]
A
Yeah.
- [49:48]
B
But for me and you, I think that even if our training was perfect, it just seems as if it might take us a little bit longer.
- [49:57]
A
Yeah, I think that some of the bigger gaps for women there might be some of those difference in physiology because the testosterone is just making. Because it's so physiologically greater versus even women. But you would agree that it would
- [50:09]
B
be because I hear that people can, or men and women can put relatively the same amount of muscle mass on, but scientifically it doesn't make sense in the way that they just, just don't have as much.
- [50:20]
A
I think a big difference though too is we also have to consider like the social factor. Like I actually look at a weight and put on a ton of muscle. But I have been lifting since I was 14, 15 years old. Right. So I got a way bigger head start than a lot of women. Like I, if I had a dollar for every time a woman asked me, how do I get legs like yours? And I'm like, my dad's genetics and I've been lifting since I was 15. Right.
- [50:40]
B
Nobody asked me that.
- [50:41]
A
Yeah, I know. I'm like, I'm like, that's just the cup perfect combination of that. But you know, I do have that bonus that I'm probably more predisposed to be a strength athlete than an endurance athlete and everything that I do. But I started lifting when I was 15. I think about the women who don't start lifting until they're in their 30s, 40s. They have also the, you know, the lack of the testosterone and then potentially, you know, perimenopause is just a storm of other influences all at once. But they also don't have that training age. Right. That, that long term accumulation of that stress or that muscle that was built. Especially since so much bone density and muscle is being built in your teens to your 20s and then kind of starts to slowly Decay in your 30s on if you don't keep training it. I think that that also adds an added effect for a lot of women who are maybe starting later in life that is genuinely harder. So I think it's a mix of a few different things because the Studies, they're controlled. But also most of the studies are being done on college students. Right. Because that's the people that they're able to get into the studies. They're not necessarily doing those trials on women that are 35, 45, 50 and comparing that necessarily, it's just a bunch of college age populations.
- [51:47]
B
And I interrupted you and I'm really glad that we are talking about this because you studied women, that was your interest. What do we know the difference is between men and women when it comes to training muscle? What can you say confidently that we know versus what is still outstanding for questions?
- [52:06]
A
Yeah, so one, women don't need different training programs than men. Strength training works because strength training is a stress and a strain on your muscle and your body. We adapt similarly. I like to say that we're a different sex, but we're not a different species. Right. Like we still respond to a lot of similar things. There is some data coming out potentially that we might fatigue a little less quickly, so we might be able to do more reps, more sets, a little bit more volume in the gym, maybe lifting less weight. There could be that. I think in these studies they're controlled. I think that they think it's the underlying effect of potentially estrogen being favorable for that. But I also think that that's a good point. A lot of studies on women is that women are under trained going into them maybe compared to their male counterparts. We also see that too in low energy availability studies. How many of those women were in low energy availability before they even entered the study? It's really hard to control for all those baseline differences. But objectively, regardless of the fact that men have more testosterone and they have a higher baseline muscle bone, all of that stuff going into the game, maybe they played sports growing up and you didn't. The road to get to the results that you're looking for isn't there isn't like a sex specific protocol that that gets there other than potentially like if you can push a little harder or handle a little more than like and recover from it, then, then go for it, then do it. Absolutely. Like there's no rule saying that you can't. I just don't think we have the data right now that suggests that there's a different protocol between sexes that say, okay, well this person should do this and this person should do that. At least in the data that we have right now.
- [53:35]
B
Do we know confidently the impact estrogen has on muscle?
- [53:40]
A
So it's not as clear cut right now. The story that everyone wants to think that estrogen equals muscle. Because when we look at the data from.
- [53:48]
B
Also that makes no sense.
- [53:49]
A
Yeah, right. Yeah, yeah.
- [53:50]
B
I mean, just from.
- [53:51]
A
Yeah.
- [53:53]
B
Someone who's been reading the literature for a really long time. That makes no sense.
- [53:56]
A
And I feel like that's the narrative that's being pushed to women is like you have estrogen premenopausally, so you have muscle and then it goes away and then you don't have muscle. Like that's like the narrative that's being,
- [54:03]
B
at least from what I'm seeing, primary role is to drive anabolic adaptation.
- [54:09]
A
And then we see that when you look at the data of the perimenopause to menopause transition, estrogen doesn't seem to be the main contributor to the muscle loss. There is, it's tricky cause there's overlap with aging and other things that can influence that. And I think it's really hard for a lot of women to unpack the fact that like age and menopause happen at the same time and so many of those things concurrently. It's really hard to test that. You can't, you really can't. You can, you can do, you know, these suppression studies, but they're still not perfectly gonna capture age versus, you know, menopause. So there's this overlap here. But if estrogen had such a stimulus on that or was so robust, then we would see that when you add back estrogen that all that muscle loss was completely regained or there was this significant meaningful boost in it. Really what we see is the main driver and stimulus, even for menopausal women is the resistance training even more. Not that protein isn't important, but in the studies where they even isolate high versus low protein, it's the resistance training is the stimulus, not the estrogen.
- [55:07]
B
Not. That is absolutely true. And Don Lehman and I about talked about this all the time, that protein is so important for many things. It's non negotiable.
- [55:15]
A
Right.
- [55:16]
B
I mean you need more of it as you age. But protein alone isn't.
- [55:20]
A
It's not doing it on its own.
- [55:21]
B
It's not going to do it on its own. There's a very. As you age, it's helpful, but the protective component seems to become a bit devalued if you are sedentary. So without a shadow of a doubt, yeah, resistance training is the primary. And then, you know, we focus a lot on protein because you have to eat. So if you're going to eat, you got to get that piece right. But I want people to understand that you can't just eat a whole bunch of protein and then build muscle and even protect it. I mean, it's your best defense, but
- [55:56]
A
you have to, you have to have that resistance training stimulus. You have to maintain it. And I think the thing that potentially to your point of women underloading, like they really struggle with is I think a lot of women, at least from what I've seen, is they're afraid to load heavy enough or they've never experienced what that feels like, so they don't have anything. So, like, I grew up an athlete, right? I've been lifting since I was 15.
- [56:15]
B
I was like primary sport.
- [56:15]
A
I played lacrosse and did cross country. But I was exposed at a very early age of what my max effort felt like, what hard felt like. You know what I mean? If women don't have that context, they might not think, okay, well I should be lifting to like a 7, 8, 9 out of 10 in the gym, whatever. But that might actually, actually be like a 4, 5, 6, right? Because to them, that does feel perceptually really hard, but they've never given that relatively. So then maybe they're not getting as much of the stress and the stimulus that they actually need. And then they're frustrated because they're like, well, I'm not gaining muscle, I'm not getting the body composition goals I want, I'm not getting results. But the stress wasn't great enough to drive that. But I also then wonder, how do we get more women to understand what truly hard enough feels like so that you can have those adaptations that you are looking for from resistance training? Right?
- [57:02]
B
Most people understand that muscle has to be continuously rebuilt. That's why we train, that's why we recover, and that's why we prioritize protein. Thank you to one of the sponsors of the show, Timeline Powered by Mitopure. What most people don't realize is that the same thing has to happen inside the muscle cell. Just as we remodel muscle through exercise, our cells must continuously remodel their mitochondria to optimize performance as we age. Unfortunately, damaged mitochondria can accumulate and the body's ability to clear them out becomes less efficient. The result isn't just aging, it's declining capacity, less energy, slower recovery. Maybe you're moving slower, you're feeling tired. Reduced physical resilience. Mitochondrial renewal may be one of the most important conversations in muscle health today. That's why the science behind Timeline Powered by Mitopure is so compelling. Mitopure contains urolithin A the first nutrient shown in humans to support the body's natural mitochondrial renewal process, restoring what we lose to time. You're already training your muscles now support the cellular energy systems that power them. I won't miss a day of training, just like I won't miss a day of mitopure gummies At a time when everything feels like it is getting more expensive. Timeline cut the everyday price on mito pure, which is very amazing. And today you can get an additional 20% off the new lower price@timeline.com lion don't miss it. What about the menstrual cycle fluctuations in terms of the hormonal environment?
- [58:58]
A
Yeah.
- [59:00]
B
Is there. And I remember when I was in my twenties, I mean it definitely was much and I always trained, but there were definitely moments and days where it felt whether it was energy. And again, it can be a ton of variables. But would you say that does the change in hormones affect the caloric intake to a meaningful degree or the training to a meaningful degree?
- [59:26]
A
Yeah, I think that the influence of the menstrual cycle on performance or intake ends up being. And this is not, you know, this is really hard for people to understand. The data right now really doesn't show this like hormones change equals like muscle, like performance or output or whatever that looks like. We just don't really see that consistently in the data. But what we do see is that the hormone fluctuations can change perceptually how you feel. So to the eating standpoint, there might be an acute increase in energy expenditure in the luteal phase. It's like 2 to 12% is the range. That's something like 2 to 12.
- [60:01]
B
Let's think about what that would be
- [60:03]
A
like 50 to like 200 calories a day. Like so it's not a ton, right? It's not like, go eat a ton more. And also like, it's also there's some studies that show no effect. So it's not like this big conclusive thing. It's a. It might be increased. We do see that women habitually eat more in the luteal phase and less in the follicular phase, the early half the menstrual cycle. Whether that's because estrogen has a different effect on hunger and satiety versus the luteal phase affects digestion, slower motility, things like that, or energy expenditure. There's other things that potentially could be going at play there. But then when we think about also the changes in those hormones, really what happens is in that specifically late luteal phase into early menstrual cycle phase, where we do have studies that show, hey, there might be something going on here, decreased in performance. There's a few studies, they are smaller, but I really love them because they control for hormones and all these perceptual metrics. And when they try to find a relationship between the change in the hormones and the performance, they don't. But then they look at perception of pain, motivation. You know, all of those things that drive you to want to push hard in the gym, those are impacted by hormones. And there is that steep drop off of progesterone and estrogen into that menstrual cycle. And for some women, they're more sensitive to that. So that's like pms, pmdd, like that can drive that. But you might do the same training session in the gym and your late luteal phase and the same weight, say it's 100 pounds. If in your follicular phase it feels like an effort of 7 out of 10, well now I might feel like a 9 out of 10. And it might not be be that your muscles can't move that weight. You might just your, your effort levels, the motivation, all of those things might be impacting that. And then that's compounded by women with increased menstrual cycle symptoms that report it report also more increases of impacts on their performance. Right. So there's multiple factors going at play here. There's little things here and there across the cycle that might be more real and true. Like for example, there might be changes in like thermopath regulation in the luteal phase.
- [61:55]
B
So meaning you would get warmer, you
- [61:57]
A
would get warmer and you couldn't cool down as quickly. You might sweat more salt and lose, have more sodium loss because you might increase your sweat rate. So for women that are doing like endurance performance, that might be something where like you might want to dial in your hydration or your sodium electrolyte strategy for like an endurance event if you were in that. So I think a lot of the times when we say that there's like not one concrete menstrual cycle program, that means that there's none of these things are happening, happening. But it's not this like, oh, we changed all of these things every single week or to every hormone profile. It's, you're kind of adjusting to fluctuations. And also the individual variation is really big. There's some really cool studies coming out of these, out of Europe that's called the Fundora Project.
- [62:33]
B
What is it?
- [62:34]
A
Fundora F E N D U R A and they're testing a lot of female athletes.
- [62:39]
B
And where's that out of.
- [62:40]
A
Somewhere in Europe. I saw at the female athlete conference that's hosted by Dr. Katie Ackerman. The, their group presented to. They have, like, you can look up their website and they have all of their papers coming out of these projects. They're really exciting.
- [62:51]
B
It's Copenhagen.
- [62:52]
A
I think it might. It's somewhere like that. There's so much more sports performance research in Europe. There's a lot more funding for it. US only cares about disease. Europe will, in Australia fund a little bit more performance stuff. But it's. They, they, they've been doing these studies where in some of them, they track these female athletes for two cycles and they'll see like, where the performance changes is different cycle to cycle. Right. So it's not that you're just, I'm different from you or you're different from me or she's different from her. It's also, you could be different month one to month two. So I'm really big on like the tool set of like learning to adapt and listen, to adjust to your body because women do, like you said, you perceive it. I was a female athlete calling my mom, crying because I'm like, I don't want to have to do suicides with cramps. This feels horrific. I feel, I feel horrible. And that's very, very, very real.
- [63:40]
B
And I want to say. So I'm actually working on my third book.
- [63:43]
A
Yes. Okay.
- [63:44]
B
Amazing. Which is about strong women.
- [63:45]
A
Okay. Yeah.
- [63:46]
B
And, you know, as I'm sitting here looking at just the scope out there, menopause people are, you know, it seems very defeatist. And then also, you know, they talk about estrogen in the brain and all of these hormone fluctuations, just like you and I are talking about. And then I couldn't help but think that if our mentality was trained up.
- [64:12]
A
Yeah.
- [64:12]
B
That if our mentality was trained up. Well, you might have cramps and it might be terrible, but you still execute.
- [64:21]
A
Yeah.
- [64:21]
B
And I don't want to downplay. Listen. I had hyperemesis gravidum for.
- [64:25]
A
Yeah, you had really rough pregnancies, right?
- [64:26]
B
It was.
- [64:27]
A
Yeah.
- [64:27]
B
And my husband was active duty, so I was alone in New York city in a 600 square foot apartment, throwing up and nauseous, traveling from downtown to uptown alone.
- [64:38]
A
Yeah.
- [64:39]
B
And I still trained. And you know, and my whole point of saying is that, yeah, a guy's not going to go through that. And then at the end of the day, I was having all kinds of hormonal fluctuations but there's the biology, the physiology, and then there is the mentality. And I think that if we go through our life like you did when you started young, you train up the mentality of, yeah, it's hard.
- [65:10]
A
Yeah.
- [65:11]
B
And then you.
- [65:12]
A
And I think a lot of women, again, to my point from earlier, like, if you weren't exposed to that just because you weren't a lifelong athlete like me or doing the things that you did, like, you can still develop and train that, right? Like, I have a lot of cognitive skills for doing the hard things because I did the hard things to do it, right. Like, I just finished the worst ultra that I've ever finished in my entire life. I death marched the whole thing in and I. Any and a lot of people would have just quit. And I was like, well, I can still finish it. I wanted to quit. I said it out loud many times, but I didn't actually do it. It was terrible. But it's so funny, even three weeks later, I'm like, I'm really glad I finished that because now I know what I can do when it gets hard or when I want to quit or when I don't want to do it. And I think that so many of the messages that go towards women, and this is probably like the if there's a hill I'm going to die out of, my platform is I'm not going to talk to you like you're stupid. And I'm also not going to talk to you like you're broken and so many people are fragile or it's doom and gloom or nothing can be fixed and things might change and shift. And that's real. Right? But I really do agree that so many of the narratives talk to women like they're incapable of hand handling any difficulties or resistance. And we're so capable in everything that we do. Right? Like, a lot of women are doing similar things to, like, what you were doing being pregnant, you know, still pushing yourself. You're doing these things in other areas of your life and think about how you can do that in training and show up for yourself and still do those hard things. But also, yeah, especially when you think about the narratives around pregnancy, the menstrual cycle, menopause. Like, we just keep telling women you're weak, you're fragile, you can't do it, you're incapable and everything's downhill.
- [66:41]
B
You might have hormone changes and maybe you're hungry for an extra 50 to 100 calories or 200, but all of that, there has to be a separation of here's the emotional component to it, here's the science, here's what we know, and here's what actually your choice is, your own agency. And that's one of the reasons I was really excited to chat with you about it because as I was listening to your interviews and reading some of the things that you write that that really came across. And yes, I, yes, estrogen does play a role. And you were talking about progesterone and maybe in the luteal phase when your progesterone is high, you might be, I don't know, more risk adverse or want to train less or do any of these other things. But regardless, we still have to show up.
- [67:31]
A
Yeah. And I think a lot of people, I think they look for that reprieve and messaging that kind of gives them the permission slip to do last. And I really always like to, to remind women, like, if you are having such a terrible day that you don't want to train, you don't have to train on day 28 of your cycle. But how can we proactively rearrange your week shift where you feel good? You know what I mean? Like maximize on when you can get it and get it done rather than just writing it off as like, well, I'm broken. Let's move on.
- [67:55]
B
When you talk about nutrition and the hybrid athlete, coming back to the hybrid athlete. So up to this point, we've kind of outlined the idea of concurrent training, which honestly is what everyone should be doing.
- [68:08]
A
It really is. Because that's why I say I'm Trojan horsing everyone into health. Yeah. Tricking everyone to hell.
- [68:14]
B
You know, the. And also even our exercise guidelines have both cardiovascular activity and resistance training.
- [68:22]
A
Yeah.
- [68:22]
B
I think that those are probably abysmally low, which is 150 minutes.
- [68:26]
A
Yeah.
- [68:27]
B
Two days a week of resistance training. I'm happy that we start there, but that's not where we want to go to probably end up.
- [68:34]
A
Well, I don't think a lot of people realize that that's just the first big jump in health impacts being decreased. But it keeps going when you keep doing more. I think the fact that's left.
- [68:43]
B
What do you mean?
- [68:43]
A
So especially cardiovascular. The resistance training guideline just got rewritten and we could talk about those in a second because I'm very thrilled with the updates to that. But when we think about the aerobic training guidelines, that minimum of 150 minutes of moderate or 75 minutes of vigorous can be interchangeable 2 to 1, blah, blah, blah. Anyway, that 150 minutes of moderate to 75. Vigorous is when you start to see the first meaningful decrease in risk of death, mortality, whatever word you want to use that sounds really aggressive or just like disease risk, like onset of chronic diseases, all of these things.
- [69:12]
B
When they track people long term, 150 minutes.
- [69:15]
A
Yeah. Or 75 minutes of the vigorous. But when you scale that up to 300 minutes of moderate or 150 minutes, that's vigorous, which can be kind of hard to get to that with the vigorous activity. Kind of. The more you do, the more you kind of have to start parsing it out. And we can talk about that too. You still see another jump and decrease in those risk factors and it kind of keeps going.
- [69:33]
B
Do we know that to be true or is that EPI data?
- [69:35]
A
It's all EPI data. Yeah. So. But I.
- [69:38]
B
No offense to your husband. There's.
- [69:39]
A
He didn't want to do epidata, if it makes you feel any better. He wanted to be a physiologist. He wanted to be performance physiology. The army shows where he wants. Yeah. So it is EPI data. You're just looking at these big data sets and like finding these associations of outcomes, which is a big reason for me is like, I'm really big. That's again, coming back to my objective athletic goals is because, like, I don't really care necessarily, like, how much you're doing is good. The more you do, the more you move, the better you're probably going to have net health benefits. But I care about how are we objectively moving a parameter of fitness forward. Right. Can you do more work, parameter of
- [70:10]
B
fitness or parameter of health outcome?
- [70:13]
A
So I'm big on that. If you improve your fitness for most people. Right. Obviously there's the caveat that athletes sometimes aren't the healthiest to get to where
- [70:20]
B
they need to be. I would say that the better the athlete, the worse their health is.
- [70:23]
A
Yeah. But for most regular people, if you're improving a measure of fitness, you're probably indirectly improving a measure of health because the physiological adaptations that are required for you to become fitter are all the things that positively influence health. So I think a lot of people obsess about like, like hand grip and VO2. Cause those are always like really heavily related because they're easy to test. Right. But if you can improve your 5k time or how much you can bike for 30 minutes or whatever it is that you're trying to do, and you can either go for longer further or cover more distance or more power output in a set amount of time, I think those are a lot more easier objectives for a person to know that they actually got fitter and better. Because in order to improve that, you had to improve your fat oxidation, improve your mitochondria, develop more muscle, muscle fibers. Maybe you have more powerful type 2 muscle fibers. Right. To deadlift your body weight or two times your body weight, you have to have those adaptations that positively impact you downstream. Of course, you can take it too far. Right. And become unhealthy. But most regular people are not doing enough of that.
- [71:28]
B
So what were the past resistance training guidelines and what are they now?
- [71:33]
A
Yeah, so the past resistance training guidelines, they were just very vague. It was two days a week of full body resistance training, and then like, kind of just stopped there. Right. Cardio got the spotlight. And I think a lot of that is because historically exercise physiology has been very endurance.
- [71:45]
B
And also acsm, who wrote. Who writes the exercise guidelines, too? Is it the American College of ecsm?
- [71:52]
A
Yeah. So who has their own acsm also is. That's the. That's who just released this updated position stand coming from it, and I loved it because one. It did set the. It's still saying at least two days a week. Like, at least. Like, we really want at least two days a week. Again, if you're a true beginner and you're only gonna start with one, start with the one. But, like, make the roadmap to build. And it also does a great job of, like, speaking to that beginner of, like, everything works when you start. Start with whatever you can do, whether that's body weight, resistance bands, you know what I mean? Like, whatever you are willing to do, it's better than nothing. But I love that it started to parse out strength, hypertrophy and power and defining the those more clearly and talking about, like, how you actually achieve those versus just saying, go lift your whole body twice a week in 60 minutes to move on.
- [72:35]
B
Do you remember what they are? I could probably pull them up too.
- [72:38]
A
Oh, I don't remember exactly everything off the top of my head because there's so many different parameters. But really, like, if we're gonna break it into those three buckets of strength, power and hypertrophy, which I'm a big fan of programs, including a little bit.
- [72:51]
B
That's interesting. That's interesting that they. And they break it down into strength,
- [72:55]
A
hypertrophy and like, the. What this literature suggests is, like, best for developing those again, they keep coming back to the fundamental thing that, like, doing something is better than nothing.
- [73:04]
B
We're not talking about that. But we guys know.
- [73:06]
A
Yes, but we want to, we want to do a little bit more. Yeah, I know there's always the, they want to do more, they want to do more. So when we think about strength, you know, strength is obviously specific to what you're trying to do, right? Like you can get stronger at reps of 10, you can stronger at reps of 15. But when we're thinking about like the true characteristic of strength of like 10 text testing your maximal capacity of your muscle, we're usually thinking of that like greater than 80, maybe greater than 90% of your one rep max effort. So it's more of your traditional one, three, five rep ranges. And that's a mix of both a trainable adaptation but also a skill because strength has to be practiced to be, you know, performed. So strength isn't just an adaptation of the muscle like we talked about earlier. It's also like your neuromuscular, your neurons ability to contract and recruit more muscle fibers and, or produce more force output. And it's trained by practicing that, right? Like you kind of have to practice it to do it. So that's strength training. And there's a lot of benefits to strength training. You get a lot of muscle fiber recruitment. You're, you're getting, you want strength. Strength's really important. We lose strength as we age and you know, it's a kind of independent characteristic sometimes of muscle size alone. There is a pretty good relationship between having more muscle and being stronger. But strength can also be trained independently to something degree on its own. And it's important to train. But that intimidates a lot of people. So you can do it at like more moderate rep ranges or lifting heavy relative to like what you're willing to do. You don't all have to do one rep max powerlifting type Olympic weightlifting efforts to benefit from that. And then we have hypertrophy, which, you know, historically hypertrophy got sold as you had to do like 8 to 12 reps. And that's the hypertrophy range. Hypertrophy has a pretty big breadth and depth. It's more so tied to volume, how much you're actually, actually doing.
- [74:45]
B
So for example, how many reps and
- [74:48]
A
sets or total sets you're doing across a week of training and things like that. But the nice thing about that is like the threshold of when you start to see benefits from hypertrophy starts as little as like two to four sets a week.
- [74:59]
B
When you say benefits, how are you defining benefits?
- [75:02]
A
So people in studies who gain muscle from doing a training program, so they start to gain muscle tissue.
- [75:07]
B
So do you gain strength before you gain tissue?
- [75:11]
A
Yes, because the newbie gains will come through first. So you'll get those strength adaptations first. And that's why you get really strong the first, like, six weeks of lifting or whatever it is. But yeah, I mean, we have this, like, a minimum effective dose of, like, you can kind of get slowest 2 to 4. I'd love to see people closer into, like, 6 to 8, maybe 6 to 10, for a lot of benefit. We have some interesting studies in postmenopausal women that, like, a little bit more volume actually gives them a little bit more benefit. But the difference was like, six to eight sets. It wasn't like, crazy. It wasn't like six to 20. It was like, doing two more sets was, like, enough to give them, like, a slightly greater magnitude of benefit.
- [75:47]
B
So from the outcome of putting on muscle.
- [75:49]
A
Yeah, putting on muscle and stuff like that, so. Or strength muscle. And so sometimes doing a little bit more, you know, you need that for hypertrophy. But you can get hypertrophy across a wide variety of rep ranges. You can go all the way up to 30, as long as you get close enough to the effort level that you need, and you can go all the way down to strength. What's hard, though, is, like, once you kind of get above 15 to 20 or you get below 5, it's kind of hard to either do enough volume when it's below 5 or to what we talked about earlier, like, perception of effort. It's really hard to go really close to muscular failure or close to that fatigue point with that many reps. So if you are starting out at home or you don't have a ton of equipment, you can do 20, 25, 30 reps to. To still get some hypertrophy. But you just really do have to make sure you're taking it to an effort of like, seven, eight, or nine out of ten, or really close to, like, hey, if I did one to four reps more, I couldn't do any more. That's what's most important for hypertrophy is that proximity to essentially failure. It doesn't have to be a hundred percent failure, but it does need to be like, essentially versus strength.
- [76:49]
B
Isn't there a strength hypertrophy continuum?
- [76:52]
A
Yes. So that's kind of what we're talking about here and now it's kind of like the continuum has kind of been reclassified as they all overlap. So strength, hypertrophy and endurance all overlap. But when you get to more reps it's going to be slightly more favoring endurance. You get to lower reps. It's slightly more favoring strength. Hypertrophy can be achieved across all of these.
- [77:10]
B
So this is the 2026 ACSM position stand on resistance training. So it was published April 2026. Stu, you're welcome on the show anytime. It represents a significant Update to the 2009 position stand and takes a notably more flexible, which it did sound like individual approach compared to prior guidelines. Here is the key shift. Oh. In individualization over rigid prescription criteria. I'm not sure if I agree with that. It says that only 30% of American adults perform any muscle strengthening activities. 30%.
- [77:48]
A
And that's. That's also like self reported and stuff. That's like not really true. Formal lifting gets like factored into that. So it's probably actually lower.
- [77:58]
B
I know.
- [77:58]
A
Yeah.
- [77:59]
B
It's terrible.
- [77:59]
A
I know.
- [78:00]
B
We're changing that.
- [78:01]
A
We're trying.
- [78:02]
B
Did you know that November is National Muscle Health Month?
- [78:05]
A
I didn't know that.
- [78:06]
B
We created National Muscle.
- [78:07]
A
Really?
- [78:07]
B
We did.
- [78:08]
A
That's amazing.
- [78:08]
B
And we're gonna work on initiatives. So hopefully you will be involved in that.
- [78:11]
A
Yeah, I would love to be. That's. That's actually amazing.
- [78:14]
B
National Muscle Health Month.
- [78:15]
A
I love that.
- [78:18]
B
60% or more perform none. Okay. So prior ECSM guidelines were estimated to potentially require 20 plus hours a week of training to. I do not. That's not. There's no way that's true. 20 plus hours a week.
- [78:31]
A
That does not seem correct.
- [78:32]
B
No, no, no. Making them impractical for most adults. Okay. Minimal dose of resistance training can produce, and this is how they defined it, produce substantial strength hypertrophy and functional gains. Here it is two to three sessions a week. Eight to ten exercises, one to four sets. Okay, so it's lifting a little bit heavy. Oh, and here it says 8 to 20 reps or 40 to 70 of 1 rep max. No one knows their 1 rep max. 2 to 3 minutes of rest. Okay. Basically it said 2 days a week prior to this. Now says 2 to 3 days a week gives you 8 to 10 exercises, which is a good amount. The load greater than 80%. One rep max to maximize strength gains sets multiple sets frequency higher load. Multi set training. 3 times per week was highest ranked for strength. This is interesting. 2 times per week was highest rank for hypertrophy.
- [79:33]
A
That's interesting. But I wonder if that's just by default of the studies being done.
- [79:37]
B
Okay. They said that you can use an elastic band. Home weight resistance training, body weight training. So all in all what it does is it gives a more. It seems as if it's a little bit more specific, but also saying that there's a broader range of things that you can do. Yes. And they also emphasized periodization, which is making that less important. And the way I understand periodization is the actual training program. Is that a good way to think about it?
- [80:11]
A
Yeah. It's kind of like alternating between cycles of different focus across time. Yeah.
- [80:16]
B
It also says that this aligns with the American heart association of 30 to 60 minutes a week. That doesn't seem like enough.
- [80:28]
A
I think that. I think people can get a lot done with two full body days a week if they're done intensely enough. It's kind of like the same cardio conversation. Right. Like you just had in that last podcast is like, if you're going through the motions, it's probably not enough. But I think if you can do two days that are like, really meaningfully or three days that are like full body and they're actually taking them to strength or pushing hard. But I think that's the gap. Right. For a lot of people is they don't take those days super hard.
- [80:58]
B
It's really important to. I think that we can all agree that if we were going to pick a perfect amount, that it's probably two to three days. And let's say in my ideal world, and I covered this in the Forever Strong playbook, which I'm going to give you one if you do not have one.
- [81:15]
A
I don't have one.
- [81:16]
B
Okay.
- [81:16]
A
Yeah. I don't. I apologize that I don't have one.
- [81:18]
B
Still be friends. That's okay. But three days a week.
- [81:22]
A
Yeah.
- [81:22]
B
We have to shoot. If we don't shoot for something, we fall for everything.
- [81:25]
A
Yes.
- [81:26]
B
I like this. Now I want to ask the reverse question. We can all agree that it's. We're going to say three days a week. And do you care? When we think about the outcome, again, it's challenging. I think exercise training, muscle health, conversation from the physical aspect is so much more complicated than what I do as a physician and in nutritional sciences. It's much more complicated because my question to you would be, do we think about body parts? Do we think about functional patterns? If I squat and I have hamstring tear or I have hip dysplasia, I'm not using my glutes the way that I should be.
- [82:09]
A
Yeah.
- [82:09]
B
So the stimulus required for me, I might not be getting enough of what I need. And I know that that's a little complicated. When we think about Each individual. But how? From a health, not performance, outside of performance, from a prevention aspect for your mom, how do you think about exercises and patterns and movements?
- [82:33]
A
Yeah. So I would love, first of all, mom, if you're watching this, I would love a world where my mom resistance trained. I would love so much for her
- [82:39]
B
to do what she won't.
- [82:40]
A
She doesn't resistance train.
- [82:41]
B
Come on.
- [82:41]
A
I've tried. My dad does does though my dad 65 and he's still out there crushing it. But I know I'm trying so, so hard on that. So if she was to start tomorrow, which she will. Yes. Hopefully I got her doing some more walking uphills more, a little bit more intensity. But yeah, we're working on the resistance training. But if I was to start her from scratch tomorrow. Right. Or people starting from zero. I love getting, you know, you hear this all of the time when you tell beginners this, but then it doesn't actually mean anything when you say push, pull, hinge, squat. What does that mean to anybody? So realistically, you want to do something where you are doing a squatting pattern, bending at the knees, whether that's a leg press, a lunge, a step up, a box squat, a regular squat. Like there's, it can be from a health perspective, if you don't have a performance goal, it doesn't matter what mode you're doing, but you want something that is going to load your quads and your glutes within this parameter. And obviously a lot of people, like with squatting, they will say, I have knee problems, problems, I have hip problems, things like that. You can adjust range of motion.
- [83:39]
B
But you agree, because I, yeah, you know, as I think about this, when we say that you should squat, what is a good squat for a woman?
- [83:47]
A
I mean, I would love to see a world where every woman is squatting at least their body weight.
- [83:50]
B
Right. But, but think about this. But that's, those numbers are.
- [83:53]
A
So there's, there's no scientific data that says like, this is the minimum of what you should achieve.
- [83:57]
B
This is a problem. This is arbitrary.
- [83:58]
A
We don't know. We all of it is arbitrary. Powerlifting or, or bodybuilding got people classifying people by like their, by just like what's on average. But we don't know if there's like so.
- [84:09]
B
And that's why I ask you about the squat. Do we know that? I mean, we can say that we want leg strength for walking, getting off the floor. We know that it's, you know, for women, this is one of the largest places where they hold more of their muscle mass, is actually their legs suffer insulin sensitivity. But again, my question is, is there a reason that you think about that? Like why?
- [84:33]
A
So the one reason I really think about squatting and then hinging, which we can get to, is more like picking something off of the floor, bending at the hips is because those specifically, especially in women, load the hips and spine, which is where we see a lot of bone mineral density loss. So for me, for women, I always really emphasize. And that's why like if women are gonna go to the gym and they're just gonna overemphasize leg days and booty days at I don't care. Because that's what's probably the most important thing anyway. Right? Like, I'm fine with that. Like you get your hip thrust on you, do you girl? Right? Because to your point, there's a lot of lower body women have more lower body muscle than they do upper body muscle. Our gaps in strength and muscle, they are slightly smaller than to men's. When you think about sex differences, upper bodies are more great.
- [85:12]
B
It is not based on training because people will say, well, you know, men and women are relatively the same strength. Have you heard that they have the same relative strength?
- [85:23]
A
Yes.
- [85:23]
B
I mean, do they. If we're talking about now mass and men have more mass.
- [85:31]
A
Yes.
- [85:32]
B
Then that doesn't, I mean, yeah, so
- [85:33]
A
there seems to be a bigger gap in disparity in the upper body strength between men and women than lower body strength. But also then in the studies that show like women gain just as much muscle as men, like they'll actually gain more relative upper body strength. But I also just think that's because women typically are under training before you go into those studies. So they're are gaining more because they don't have that same training baseline going into it. But when I think about training in general for women, like, yes, I want women to train upper body, back, chest, shoulders. It's important to train your whole body. I think it's important. But if a woman ever bench pressed in her entire life, she's probably gonna be fine. But if she's not loading her hips and spine, I'm more worried about her.
- [86:06]
B
That would be hips and spine work okay.
- [86:09]
A
And one, there's more muscle in the lower body. But two, we start to see more of that bone, bone mineral density loss. Like if you go and get a DEXA for bone density to test to see what you're, you're, you're at, they're going to do a hip and spine dexa they're going to look at the greater trochanter and your hip there and then your, your lower vertebrae, because that's where more of that density loss. That doesn't mean you can't have density loss across your body. Athletic populations of women get stress fractures all over. Like it's. Bone density is important beyond just those locations.
- [86:34]
B
And that's why you want the hip hinge, the squat.
- [86:38]
A
Yeah, because I want to lower. I want to load your lower body. I want you to load either on your back or pulling up off the floor or picking up or something where you're pressing against. Like I want you to load that lower body for that reason. Because I know we haven't talked about bone a lot, but bone responds to intensity and load, right? So you need that stress and strain
- [86:56]
B
on it, for it responds to intensity and load. Give me an example.
- [87:01]
A
So the two things that bone responds to very well is resistance training or power plyometric training. Because cause it's putting a lot of force into the bone. And then in that stress signal of that force being put in the bone or the muscle pulling against it is what signals it to make more bone cells. People think bone is static, but it's actually very plastic. It keeps kind of regenerating itself or building or breaking down itself over time. And so that sends the signals to it. So something like walking isn't enough to put that much load and impact into the bone.
- [87:31]
B
I went on my friend's podcast, very dear friend, and I said, walking is not enough. And people wait. Yeah, Doc, they were so offended.
- [87:43]
A
I actually know because I was sent it like a million times.
- [87:46]
B
But that is. They're wrong. It's not enough. I'm incredibly rigorous about what holds a permanent place in my regular protocol. And thanks to one of the sponsors of this episode, Bon Charge red light face face mask. Earned it. Now let's be honest. Between running a practice recording podcast, traveling and raising two children, this is a full time job. Okay. Time is actively trying to age me, I am telling you. But I'd like to keep my skin as healthy as I can for long. But I'm not interested in spending a ton of money on trendy nonsense. What caught my attention is the sign science. Bon Charge uses red light at 630 nm and near infrared light at 850 nm. These are wavelengths that have been studied for their role in photo biomodulation, a process that supports cellular energy production and healthy skin. What keeps me using it is how easy it is 10 minutes a day, completely wireless. Wireless. You heard me right. I wear it while reading or working at night. And now you will also look like a 1980s sci fi character while wearing it. But friends, that is a sacrifice I am willing to make for efficiency and effectiveness. If you're looking for a science backed tool that fits into real life, Boncharge delivers. Go to boncharge.com that's B O N C H A R g e to save 15 on your bon charge red light face mask code Dr. Lion for 15 off. Boncharge.com and my biggest thing is back
- [89:29]
A
to our whole conversation earlier.
- [89:32]
B
If I'm hearing you say and walking is.
- [89:34]
A
It's not enough for bone, it's not enough for muscle growth. And my biggest thing is like when we think about improving cardiovascular fitness, if walking is enough to get your, you, your heart rate elevated.
- [89:44]
B
Wait a second, now you're making accommodations for. We're not, we're not doing that. Guys. Everybody knows it's not enough.
- [89:50]
A
Well, what I'm saying is that if that is enough of a physiological stressor that that is putting you into those upper thresholds, that's a sign that you need to gain more fitness. Right? Like that's kind of like a. It can be for some people really starting out. But that's a sign that over time walking should become a baseline. Not a. Should not be enough exercise. Not just this physiological stressor for that exercise adaptation. Right. So yeah, swimming, also swimming and biking too. That's offloading that. I feel like a lot of elderly populations get prescribed that. But that's not really bone loading. So we wanna make sure we're having something that is like loading that bone specifically. Especially women have higher rates of bone loss than males. They're more at risk for osteoporosis. And also there appears to be more of a rapid loss of bone right around the menopause transition.
- [90:34]
B
Cause we do know estrogen is important
- [90:35]
A
and that's one of those things where estrogen is directly associated with that. So that's a big reason for like women specifically or people starting out. And it's like not like men don't benefit from that too. Like loading your lower body is good for everybody.
- [90:46]
B
Hinge. And again because as we think about how we choose. Because now the ecsm, it's, it's a little loose in terms of. There's so much choice.
- [90:55]
A
Yes.
- [90:55]
B
Hinge you like. And what's an example of a hinge?
- [90:58]
A
So hinge is a deadlift. And again that can be elevated. That can be Something done with a machine that is a deadlift. Like, it doesn't have to be that. It could be a hip thrust. It can be a good morning.
- [91:09]
B
And you know what we'll do is we will schedule this differently. And also we'll go through that. Yeah, we should go through that for people.
- [91:16]
A
Yeah, yeah. Because I don't think they know what those. Cause people say squat and hinge or push and pull, and no one knows what that means. Right. And then, you know, I do like, let's train our upper bodies because you're gonna have to pick things up, you're gonna have to push things overhead. Yeah. Like, you're going to have to be strong, whole body. And so that would be pushing away from your chest. That's a push up bench press, a dumbbell chest press.
- [91:37]
B
A push up is important.
- [91:39]
A
It could be. It can be a great. And it can be elevated. Right. If you need to start to work your way down, I think it's a great skill to obtain. But something that's pushing you, you away or weight away from you would be an upper body push. And then you also have upper body pushes overhead. So shoulder presses, barbell, overhead press, any sort of pressing overhead. And then you can have pulling towards you. So you have your row, your lat, pull down, your pull up, anything that's pulling that weight towards your body. So similarly, it's like very similar upper body, you can either push or pull weight away from you, and upper body, you can push or pull weight away from you. And if you were to have a workout program which is four exercises in it, like three days a week, you could do one of each of those and have like a very complete program three days a week that's gonna hit most of those things from the guidelines or those minimum trained loaded enough, heavy enough, that you'll see a lot of adaptations and gains. It's a really simple way to approach it. And then you can mix in things like power, plyometrics, jumping core, things like that.
- [92:34]
B
I like that. I want to touch on this plyometric component for bones specifically, or maybe not. Do you think that everyone should be doing some kind of plyometric?
- [92:45]
A
So I have this thing that I'm calling the women's training triad actually right now. And the base, base is strength and power, and the top is aerobic training. So, like, you want to have this strong foundation and base of like muscular health.
- [92:55]
B
And how do you define power?
- [92:57]
A
So I classify power into things that are either specifically power training. And I'll define that in a Second plyometrics, jumping, hopping, skipping something where you are moving weight or your body rapidly.
- [93:09]
B
Oh, I like this. Jumping hop. Okay.
- [93:10]
A
Yeah. So I kind of bucket them all in together because I'm sure you've heard like the new term is Powerpenia and we start to lose power. Have you not heard of this? Okay, so we start to lose power faster than we lose strength as we age. And I think a lot of people have always over focused on like the classic bodybuilder pro program for hypertrophy or a lot of the strength stuff. But we lose power as we age and that's like your ability to catch yourself when you fall or get up out of a chair quickly or react
- [93:33]
B
to something or we lose strength and
- [93:34]
A
we start to lose it more rapidly. We're starting to see more data that's showing. That's your question? Yeah.
- [93:39]
B
Do you think that that's because people are not training power?
- [93:43]
A
I think it's a mix of people are not training in general and they're not training power. Yeah, because, well, no one trains unless you're an athlete and you're 20 dead.
- [93:50]
B
Don't do it. Exactly.
- [93:51]
A
Yeah.
- [93:51]
B
We do get a denervation of muscle and the neuro connection. Yeah, but people don't train power just like they don't.
- [94:03]
A
You know, there's all these people who talk about like we don't really sprint or move fast or train power. Like all that stuff seems to be reserved for athletes and people in their youth. But we can adapt and keep doing those as they age. They're actually really important. Right. So Powerpenia is the new Powerpenia is the new sarcopenia. Yeah, but I think it's important because power is, if we're talking about athletes, that's really great for improving your running performance, reducing injury risk, all of those things. Having stronger, denser bones, which are really important for people who have endurance based goals. If you're a strength athlete, being able to move weight quickly or have more power is going to benefit you because that's a characteristic of muscle that you want for the sport or whatever you're doing. But also when we're thinking about general population individuals, one, we don't want power loss as we age, especially with fall risks being higher in women and fragility being higher. But also when we look at the studies that look at bone health, we also see that it's usually strengthening combined with some sort of jumping or landing based training to put that loaded impact on the bones. And it's not to say that Strength training has no benefit without that. It does, but usually see them combined or even like really like simple things like pogo hops, like sets of ten across a year. Improves bone density in post perimenopausal women. So even little bits of impact. So I like. I kind of group.
- [95:16]
B
I have a question.
- [95:17]
A
Running, if you're okay, running isn't enough.
- [95:19]
B
But you. You would.
- [95:20]
A
There's a lot of loaded impact, which is why I can.
- [95:22]
B
And it's unilateral, isn't it?
- [95:23]
A
Yes. And it is more than walking or swimming or biking. So it's like a spectrum. Right. So but running still isn't like it's. It. There is a lot of load and impact on your bones and your body. Impact into that is really significant, but it's just still not as great as like true jump landing, you know what I mean? Versus there's a little bit more elasticity and support and that. So it's kind of on the spectrum. So running's closer to this than walking is or swimming or biking, but it's not quite. So if someone was to go from full sedentary to running, they probably would get a little bit of benefit here, but they wouldn't maximize that benefit across it. And for a lot of people, the reason I group these together is because it can be intimidating. You've never done it. A lot of women struggle with like pelvic floor stuff or people might have knee injuries. So I'm not going to tell everyone they have to go do depth jumps to height because that might not be realistic or that might not be the starting point for them. But I put these together because you can also move weight quickly. So that's kind of a little bit more into the guidelines that they talked about. Power. There is like 60 to 70% of your one rep max. Max. But you're doing it quickly, more rapidly.
- [96:23]
B
Give me an example, because that's my favorite form of cardio.
- [96:26]
A
Yeah.
- [96:27]
B
Is doing kettlebell swings.
- [96:28]
A
Yeah. It would be like kettlebell swings. Maybe dumbbell thrusters. Maybe like you take a squat and instead of doing it for heavy load, you're doing it as quickly as you can.
- [96:37]
B
Do you count that as part as
- [96:39]
A
cardio or is that a. I still count that as. I don't count anything really. That's like. Doesn't have a cardiovascular component as cardio. There's some overlap with that kind of thing, but I kind of still bucket them out because those pathways we talked
- [96:50]
B
about earlier, but I couldn't.
- [96:51]
A
Yeah.
- [96:51]
B
So there's a little bit of overlap.
- [96:53]
A
Yeah.
- [96:54]
B
If you're like. If I call you and I say, Alyssa, I'm doing cardio and it's going to be 50, I don't know, 50 kettlebell swings. And then I'm going to do 50 broad jumps and then I'm going to do. You're not counting that as my cardio.
- [97:11]
A
Not in the traditional sense. Because what happens is the, your heart rate will go. Go up because it's very central demanding and there's a lot of muscular intensity. It's hard. So there's going to be an overlap in some of that. Like your cardiovascular system is contributing to
- [97:23]
B
that exercise you don't want me to be doing.
- [97:25]
A
But you're not stimulating those pathways of adaptation. And even the VO2 max contribution of that is. It's artificially like a lot. Your heart rate will be artificially higher than the actual VO2 max contribution of that exercise. So it's not that it can't have a cardio. People get really mad. That's where my contracts come for me. Yeah.
- [97:41]
B
Martin would probably disagree with you.
- [97:43]
A
Really? I think there's an overlap there. But I think when we think about like true, true aerobic stuff, I usually like if you were to do something like that. Cause I do stuff like that too. I love throwing in like a bike or a ski or a row in it. So there's still that like traditional. Cause you can't get as much power output, like aerobically, I guess, or even anaerobically from something like a kettlebell swing as you would if you went on a row or did a max one minute effort, so to speak. So I think that I like when we. I'm not against those things, I do them. But I think that I usually like to say like, let's throw in some sort of component of like classic cardio.
- [98:15]
B
But you like this for power because we're talking about.
- [98:18]
A
But I like it for power.
- [98:20]
B
How often do people need to do some kind of power in an ideal world.
- [98:26]
A
Yeah.
- [98:26]
B
Or someone who is or has been training, for example, me. Because now I gotta start jumping.
- [98:31]
A
Yeah. You could start with like one day a week or even spacing it off. Say you lift three days a week. You could put it on a little bit in each one of those programs. Or some people do like a whole day dedicated to that. But you want to start out with less and build. Especially if you're doing like jumping or landing or plyometrics in that more formal sense. You want to start with like just like 50.
- [98:49]
B
But the goal is 50 hops in a day, every day. I think that, that.
- [98:54]
A
And then you can build or you can build in like. So you might start with like pogo hops, like really simple double leg hopping, if you haven't done a lot of this before. Because this is also a lot of stress strain on.
- [99:03]
B
On a pogo?
- [99:04]
A
No, not a pogo stick. They're just like little hops. Very, very gentle.
- [99:08]
B
What about jump rope?
- [99:08]
A
That could be a great example of that too.
- [99:10]
B
I just tried that recently. I almost totally wiped out.
- [99:13]
A
Yeah, it's hard. So it's just. You can start with really low level plyometrics, but then if you want to keep gaining skill, you can start going from like double leg hops to single leg hops.
- [99:22]
B
What's the alternating effective dose to? There's the maintaining the power that you have and then there's improvement. Improving it.
- [99:30]
A
Yeah. So the, the suggested hops or landings or whatever you want to call it in like traditional power plyometric, like jumping type literature is somewhere around like 50 to 100 hops a day. But you can build that up. But again, it takes that. That building of it. Yes, like, but even these. There's like, though some of the studies I mentioned earlier that are doing like just a couple sets of pogo hops and they're like menopausal women across a week.
- [99:53]
B
I think that's awesome.
- [99:54]
A
They were doing like, I may be like maybe at the end, like 100 hops a day, a few times a week. And it's nothing aggressive, it's nothing crazy kind of thing. I don't think we have a minimum for like, if you're doing like speed, rep, back squats. I don't think there's like a threshold minimum we have established for that kind of thing. But yeah, you just want to make sure because for a lot of people you can get injured if you just like go straight to doing what I do. And if you start doing like lateral hops to box jumps, that might be a bit little, but you can start with this. And we still see these improvements with this scene with it. And then you can obviously keep going and keep progressing from there. The thing is that I don't think we have. We have these trials in older adults where they have them do strength or power training and they do see these improvements. But there's sometimes so much of a disconnect between like performance literature and health literature that we don't have this like. Well, if you get to moderate level plyometrics, you actually have xyz health benefits from it. It's kind of. Right now you can just think of it as a spectrum.
- [100:48]
B
Okay. We talked about the strength, the power, what else? You said there was the triad.
- [100:54]
A
Yeah. So I call that like. And really I call it the women's training triad because that's just like, I've now just kind of been talking a lot more to women, but it's really just like performance for health, longevity, fitness. And essentially it's just a foundation of strength training. So strength, hypertrophy, gaining muscle, being strong, getting those training sessions, but then also having that power, that moving fast, quickly type that. I kind of group those together on that foundation. Because your strength and power can complement each other. They don't have to necessarily be thought as different. I think when I tell people they should do stuff like power based training, they're like, when am I gonna fit that in on top of everything else? I'm like, put it in your workout, between your warm up and your main sets and just include it into your training day. It doesn't have to be its own separate thing. And then good programmed cardiovascular training. And when I say that, I mean that you're smiling. Yeah, I'm just. So many people just either do in adequate cardiovascular training where it's not stressful enough, they're going for a passive, leisurely walk, their heart rate's barely getting up, there's no really stress or strain on their body, or women just do this thing where they just like drink from the fire hose of every group fitness class under the sun. Or they do a lot of like moderate intensity all of the time. Unintentional training.
- [102:03]
B
And all of that stuff is junk training.
- [102:05]
A
You mean kind of. Yeah, like it's not, it's not that there's zero benefit for health from doing that, but it's usually not specific enough to get like any meaningful adaptations past that like baseline phase of gaining adaptation from just doing it. Right.
- [102:17]
B
I used to do that. Yeah, that was me. It was just kind of low level. But you know, in retrospect, it probably was improving my VO2 max at some point. But maybe not specific how much, because that was one of my questions. The reverse question is the minimum effective dose for someone, the cardiovascular aspect for someone whose primary goal is strength.
- [102:40]
A
Yeah. So I think the minimum effective dose is getting to at least the exercise guidelines. Right. And then from there you can do more. That's where we can kind of tie in those conversations too, of like intensity versus mode. Because if your main goal is strength and hypertrophy, and you just want to do enough cardio to not die early. Do it on a bike, do it on a rower. You don't need to run unless you want to run and you enjoy running. Um, but also the intensity will, like we talked about earlier, influence some of that interference. So zone two gets a lot of hype.
- [103:10]
B
Good or bad, right, wrong and different.
- [103:13]
A
So if you do a really, really intense cardio session, it's probably gonna have that carryover effect that we talked about earlier on that strength session. So if you're gonna do a really intense cardio session, pairing it away on a day where you don't care that it's inter feared by your training session from the gym the day before because you care more about that strength or it's after or it's separated by a rest day. But that's where like kind of some of that conversation around Zone 2 is helpful too. Because Zone 2 is like less fatiguing. If you want it to do more volume and you're not wanting to interfere with strength, you can do more of that zone two because it's less totally fatiguing and kind of get more volume in there. But I'm a big fan of like, I think everyone should do at least one day a week of, of higher intensity training. Whether that's hit training, sprint interval training, threshold training, whatever it is like something that's pushing you above that. Zone four to zone five plus I think one day a week. And for many people just starting out, like you can like a lot of studies, take sedentary people and put them on bikes and have them do hit. It's not like you can't do it, but if that feels too intimidating, you could start with lower to moderate intensity activity and build up to that with time.
- [104:19]
B
Yeah, no, I, but I just want
- [104:20]
A
to start sprinting right on the road flat on day one.
- [104:22]
B
Yeah. We want to hear about what is in an ideal world.
- [104:25]
A
Yeah.
- [104:25]
B
We all recognize that it takes time to build up, but the, the end goal is you want to see everyone doing some type of high intensity interval every week.
- [104:33]
A
Yes.
- [104:34]
B
Is it a, is there a length of time is.
- [104:37]
A
I, I think it scales with fitness of it. You can start and it also depends on the duration of the interval. But I think like in most classic high intensity or sprint interval sessions, in anywhere between 15 to 30 minutes, you
- [104:47]
B
can get a lot of weight. You can get a lot with the
- [104:50]
A
rest time and warmup built in. Like if you from warmup doing your interval session rest in between. Because if you're Doing like four by four. Right. Like that's going to take a lot longer than maybe like a woman and on women and off sprint for 10 rounds type thing. Like that's a 20 minute workout.
- [105:04]
B
You're talking about 80% VO2 max. You're not talking about 90 plus hitting red line.
- [105:09]
A
Yeah. So in very, very classic sprint stuff. Yeah, you can like that 10, 20, 20 seconds and redlining. I, I like sprint interval training. I like hidden training. They're kind of like sister and brother. Right. So you can do either or of those. I just think that I would love to see a lot of people doing something that's more intense. You could also oscillate between these. Right. Like there's different benefits to like doing different intensities and training around different thresholds and moving them forward. But like if you're above that essentially lactate threshold and do we care about that?
- [105:38]
B
Why do people care about elect threshold for a normie like me?
- [105:41]
A
So from a normie, the reason you care about your lactate threshold more than anything is not because you care about your next marathon performance is because that's my.
- [105:49]
B
The one that will never happen.
- [105:50]
A
Yeah, exactly. Like I care about it because it's allowing me to run faster at a higher power output with less physiological fatigue. For you, it's just an underlying reflection of those adaptations that we talked about earlier. Because if you're able to have more mitochondria, they're more capable. You're able to clear more lactate, you're relying more on oxidative metabolism, you're having less of that interference at the cellular level that's blunting fat oxidation and with time that will shift up.
- [106:16]
B
With that, everyone should be able to know what their lactate threshold is.
- [106:19]
A
No, you don't need to know how to. You absolutely don't need to know what it is. But that's why. But we want to train. The reason I say lactate threshold is we want to train above it because there is more of a bigger physiological stressor. I think your last podcast just talked about this coming from that high intensity or stress sprint interval training. There's more of that cellular deficit that we talked about. Energy is greater, it's faster, it's sending faster signals to your body than like a really long slow zone two session's gonna have. So people who aren't training a lot of cardio, you know the exercise guidelines of like 150 versus 75. It's basically the more intense you do it, the less you have to do. So if you I say at least one because I'd love to see everyone do at least one day per week. You could probably do one or two. I don't think people need, I think four, five, six days of. Because the more days of the high intensity you do, the less quality it's going to be. You're not going to be able to sustain that output every single day. But you could do like a more classic hit day and then a more classic sprint day. You could do those circuit interval type workouts that are mixed. Yeah, like you could do that as part of that. Yeah.
- [107:17]
B
Saturdays are high intensity. We do a little bit heavier weights, but Saturdays are high intensity. And then typically we do some kind of sprint interval a few times, depending on how my nervous system is. And when I say that that sounds so just arbitrary, but like I was traveling.
- [107:34]
A
Yeah, no, I totally get it.
- [107:36]
B
But today was, you know, it's a max out effort, but it's 250 meters. It's nothing crazy and it's a throne in there for a couple. But this reminds me of something that I did want to touch up because I know we're running short on time. Nutrition for the hybrid, the hybrid athlete. And I am cautiously saying athlete because again, there are these buckets where we say, okay, well you're a lay person, a regular person, which I would consider myself in that. And then there's athletes.
- [108:08]
A
Yeah.
- [108:09]
B
But I would say for overall wellness that there are certain risks that I think are real for women. And it says hybrid athletes here. You know, the team and I were talking about this, who the relative energy deficiency in sports. What have you seen with chronic low energy availability and just muscle and hormone function, bone metabolism. Are there early warning signs that someone is in this energy deficit?
- [108:38]
A
Yeah, and I think that so many women that are pretty active will not identify as athletes. So they don't think that they're are highly active. And they don't realize that even taking like the jumps from like, oh, I'm doing the minimum to doing like the 150 to 300 minutes. If you increase that demand on your body and you don't match it with enough physiological resources, it might not prioritize hormonal health. So this isn't just a conversation for. I mean, I train eight to 12 hours a week. This is not just a conversation.
- [109:04]
B
You know what I mean? Do you?
- [109:05]
A
No, but that's like people think, well, you're crazy, you're extreme. This matters for you. Right? But even though a woman doing three to five or building up to that, like Training for their first half marathon marathon. They've never been exposed to the higher volume of endurance. They often don't match that increase with that.
- [109:22]
B
And so do you think that it is in our practice we work with a lot of people that are very physically active in strong medical. And one of the things that we see is that when they jump up their training, it's not that they're actually hungrier, they get to a point where they're actually less hungry.
- [109:39]
A
Yeah, yeah. So there is, it's interesting because you start like because the more you train or the more it's intense, sometimes you get that suppression of, of hunger and satiety. I also think it's a mix of like women are so conditioned to like be afraid of eating more carbohydrate or calories or they just have never been in a position where they needed it to fuel. So they're just kind of eating their normal diet and not realizing they need to scale it up to the activity that they're doing. You know, again, a lot of people, people, they'll be like, when I talk about the importance of carbs or increasing carbs or inter workout carbs, they're like, well what about metabolic disease? I'm like, but I'm not talking about eating past your body's capacity for that. I'm talking about matching your body's need for that. And so what happens in women is that when you have these energy deficits, so that's like chronically across time, you have these big deficits of energy that mix match between your activity level and what your body needs for physiological function. It will start to basically like downregulate and, or deprioritize hormonal function because it's a costly. And it's like it doesn't want to make a baby if there's an environment that has scarce resources. So that's where more of the, you know, we talk about the cycle training. Like a bigger risk for female health is the downregulation of the menstrual cycle. Like that is a, you know, you want to talk about increased stress in the body and cortisol and inflammation. And the women that want to get
- [110:51]
B
pregnant, that's one of the things that we have them make sure that they're eating breakfast.
- [110:56]
A
Yeah. Because there is, it's still early data, but there's data that suggests like within day deficits can also be humidly stressful or carbohydrate availability deficits can become stressful because you're not feeling that activity. So for women, I think they wait until they miss their period. And that's not the first warning sign. That is the red flag that is like the alarms going off. There is a spectrum of steps that your menstrual cycle dysfunction starts to take. And I think a lot of women, they've never tracked their cycle, they're not aware of their phases, they don't know where they're at.
- [111:24]
B
When you are talking to your community, is there something that isn't a really early warning sign?
- [111:30]
A
So most women aren't testing ovulation until they try to have a baby. But if you're missing ovulatory cycles frequency, that's a sign. What you might start to notice instead, because you might not be tracking ovulation, so you might not know, is that your luteal phase, your luteal phase is pretty standard and how long it is. It's usually like about 13, 14 days after you ovulate to your next period. If you start to notice that that's shorter or you start to suddenly have a lot lighter cycles or shorter cycles than normal because your progesterone isn't being elevated, so you're not building up that lining. Like those might don't just wait until you're missing your period entirely. If the duration of your cycle starts to really shift or even like phase to like obviously we talked about earlier, you can change month to month. But like if you start to see these acute little differences in your cycle, you might be having menstrual cycle dysfunction, luteal phase deficiency and ovulation. All these fancy terms long before your body's not ovulating, you have luteal defense deficiency and now you actually have amenorrhea. Like that is, that is the final step. And that's so I think that for so many women, they don't, you know, not everyone, but a lot of women don't even know what phase of their cycle they're in or when they're getting it. And there's period, period surprises them. So, you know, the, the first thing would be to have like some sort of cycle awareness of just knowing where you're at, what's normal for you, but then paying attention to like when those things start to change a lot. If they get really long or really short in cycle length, that's abnormal to you or outside that normal range of like, you know, if it starts, you sort of get a 20 day cycle and you get a 28 day cycle. That's a good sign. Like, hey, maybe something under the hood isn't going on or you start skipping cycles or all those little things underneath that that is worth paying attention to rather than just waiting until you don't have your period for three months. And the reason this is such a big deal to your point to the bone is like when girls and women go into low energy availability, the bone loss is incredibly significant. It's fast, it's very fast. And even so, in order to regain your cycle, you typically have to gain more weight than you lost. To get there. You have to go past that, which can be really scary for a lot of highly active women. But even up to 12 months after weight is restored and cycles restored, the bone density loss isn't fully restored. And so it's like you really don't want to dig yourself. Especially like we think about nowadays all of the narratives to girls in their 20s when bone density is peaking to like not resistance train, just do like yoga and pilates hawker walks and like under eat. And then it's like this perfect storm of like, okay, well no, like that's like, that's the opposite of what we want to be doing during this time. And it's really, I mean it's a huge risk in endurance girls, girls who are doing endurance sport. And then it's also a risk to just like sedentary women who aren't doing the typical things that you should be doing to prevent or promote bone density and loss across time. What about.
- [114:11]
B
I have two more questions before we wrap up. What about protein requirements for the concurrent training athlete? And I'm going to be very specific here. Those that are doing more endurance, so they're doing endurance and they are doing strength. Where is the evidence for protein with endurance training? Because I think that this is a misrepresented topic.
- [114:38]
A
Yeah, a lot of people think that endurance athletes don't need as much protein because they're not building and promoting muscle growth and they're not lifting. But you actually need potentially higher protein. And I think a lot of that is because your body doesn't want to really use protein, protein for energy metabolism, but it can and it will. And if you are in very large carbohydrate deficits or energy deficits, whether that's intra workout or from training chronically, how
- [115:00]
B
do you use your fuel source as you're thinking about your own nutrition? How do you think about your grams per kilogram? And then do you use branch chain amino acids or essential amino acids?
- [115:13]
A
Intro workout So I don't do, I mean I did do EAAS a few years ago. I was. Long story short, my PhD just gave me every gut health issue that you could possibly have from the stress. And so I was having a hard time with eating in the mornings and training. So that one period in time in my life I did take essential amino acids during that just so I had some amino acids available. Right now I really just prioritize getting in protein in at my breakfast before I go out for my long runs or across the week. I'm getting enough during the day.
- [115:43]
B
How much protein do you do you typically ingest in a day?
- [115:46]
A
I haven't tracked in a few weeks, but when I was tracking, I was probably getting between 120 and 140 grams per day. And I'm about 141 pounds. So that's about right. Yeah. So I try to hit somewhere in that range. I don't go over because I'd rather take that for carbohydrate. It's not really necessary. I'd rather use that energy for carbohydrate.
- [116:04]
B
What about your carbs?
- [116:05]
A
When I'm in peak ultramarathon training, I'll go up to 4, 5, 600 grams of carbs a day, especially on long run days where you're taking in a ton during it. My day to day right now where I'm doing a little bit more normal training is probably in the 3 hundreds to 400 range. I probably don't. I have. It's really hard to eat enough carbohydrate. Like it's really hard. Yeah. I would rather eat the avocado and the. And the nut butters than the carbohydrates sometimes. But yeah, for me I'm probably in the three hundreds when I'm just doing a normal training and it ramps up.
- [116:34]
B
Do you take it in? I'm very curious about where the data is for all these endurance types because we've been reading a lot because as you know, our household is very interested in.
- [116:44]
A
Yeah. Your husband's. He's drinking the Kool Aid.
- [116:47]
B
Yes. I mean, I don't know how it is for you, but when my husband is into something, he's just like, oh yeah, he's into it.
- [116:54]
A
Yep.
- [116:55]
B
You would think he's always.
- [116:56]
A
It's been his thing his whole life. Forever.
- [116:59]
B
We've been playing around with the use of essential amino acids and carbohydrates because he does use the gels to help with. Just to be able to keep going and not lose too much muscle.
- [117:11]
A
Yeah. So I think that one to add on to we talked about earlier, I Always bring like a protein shake with me so as soon as I finish my long run I drink that so I immediately have protein. I know that like post workout timing, like quote unquote doesn't matter as much as much as getting it in the whole day. But if I'm going out for a three, four, five hour run, I'm trying to get amino acids in my body right away. Typically the good you want to get some carbs in with that to restore that. But intra workout I do. I'm really big on carbohydrate feeding for endurance activity, so I get between 60 and 90 grams of carbs per hour on my long runs.
- [117:43]
B
And how fast, how do you think about your heart rate or how do you dose that out?
- [117:50]
A
So for me I really just kind of build up to it over time and then I find that the more intense it is, the less I can handle versus the slower I'm going, the more I can do. But if I'm doing like a carbohydrates you can do. Yeah, but if I'm doing a trail run that's like zone one, mostly like very easy long training run, I, I can tell that I don't need 90 grams of carbs in that training session to fuel it kind of thing. But for me I think about too not just hitting that carbs to fuel my session, but hitting those carbs so that my body isn't using protein from my muscles or my body as an energy source. Also it helps with recovery. Like if you think about concurrent training and hybrid training. You know, if you eat enough intra workout nutrition and daily nutrition after a long run, you're gonna feel a lot better when you show up to the gym Monday than If you eat 30 grams of carbs per hour, didn't hit your protein for the day, and then try to show up for that same resistance training session on Monday. So that's the way I think about it. I would love to eat a little bit. This is actually a lesson that I learned in my last, last ultra. There wasn't.
- [118:50]
B
How long is an ultra? 100 plus.
- [118:53]
A
An ultra is anything 32 miles or 50 kilometers and longer.
- [118:57]
B
Oh yeah, an ultra is. It's only 32 miles.
- [119:01]
A
Yeah, it starts at the 50k distance only, but yeah, yeah, I know it's crazy. It starts with the 50k distance. So I just ran an ultramarathon that it was supposed to be 100k but end up being like 69 miles. And the reason it was so bad for me is that I didn't have enough food. Food like I had done the, the perfect gels and the electrolytes, but I didn't have enough real food in my system, in my stomach. Part of that was I was assuming to rely on aid stations more. And the aid stations didn't have quite what I needed. And that's feedback I gave. I'm friends with the RD and he took it for next year. But what ended up happening is that I just kind of finished that thing, totally depleted and I needed more of that. You know what we see in ultra endurance is that you need a little bit of protein. You want some protein, you want. And it's nothing crazy. It's like something like 10, 15 grams an hour. It's nothing crazy that you need to get in. I do struggle with GI issues with running. So for me I have to be really careful about like the sources of protein more so fat. Like protein's kind of easy to get in and digest in liquid form. This is exactly why we use the essential amino acids.
- [119:54]
B
Exactly right.
- [119:55]
A
And it's really something I should do. A lot of gels historically in the past used to have them in there. But that was because of the way that essentially amino acids interact with the brain and fatigue and delaying that we
- [120:05]
B
talked about, we were kind of talking about.
- [120:07]
A
I have thought about that more. I got away from it the last few years, but I thought about that. I was like, I. It would be great because honestly like that I'm not, I'm not so much worried about like muscle loss when it comes to my training because I'm still resistant training during it, potential recovery. But in an event like that, especially now that it's like kind of popular to over race like ultra endurance and marathon races, that's one thing I don't do. Like, I know like we talk about muscle loss and preserving muscle. I take seasons intentionally where I really just lift a lot. I'm still always running or doing endurance training. But also I can handle a lot more without that appearance on my body because I have a. I raised the floor, but I take time to actually like build back up. What's crazy is when I was at my PhD I would do DEXs and VH maxs all of the time just because I was always participating in my studies and being a lab rat and I could watch my bone density oscillate with my training cycles. And I always had really high bone density but. But I take periods of time off. But I think about like I finished that race so depleted that energy deficit that I was in I spent that whole next week just eating as much as I could to recover, because that probably was a greater negative influence on my musculature than the peaking block where I was running 10 hours a week and lifting on top of it. You know what I mean? Like, that's probably more of where that big stress and strain comes from. So I do try. Like, right now, I'm ramping back up lifting. I'm doing a lot more. Like, I'm gonna go into an intense, intentional season of at least rebuilding that back. And that's like, my big thing with hybrid training is I, I, I call it the seasons approach, but it's how athletes train. You're not just doing a hundred percent endurance training all the time. Like, you need to spend time developing strength and in hypertrophy. And especially if you're someone who lacks that and you've never built that, you really should take a period of time actually, like, scaling back the endurance so you can create that recovery space to ramp up and build. And that's really important message for women who've neglected strength, strength training their whole life or endurance athletes who have never really strength trained. They just have always done endurance training. You know, it's really hard and scary, but, like, taking a time where you step back and you really intentionally drive up that. I mean, spend a year really lifting. Right.
- [122:05]
B
And I love that.
- [122:06]
A
Like, I love that advice. Yeah. I tell it to women, too, all the time.
- [122:09]
B
I'm like, love that advice.
- [122:10]
A
Spend a year. I call it like, send a year. Like, not like chronically yo, yo dieting and flipping between workout programs. Just spend a year eating and lifting, and it will change so much in your life for you. But you have to just give it time. Right. Because it's really. Muscle is really slow to adapt. But I really like that year of all in.
- [122:25]
B
It would be great if muscle was as easy as fat.
- [122:28]
A
Yeah. Yeah.
- [122:29]
B
It just really, for some reason, it's not.
- [122:31]
A
Yeah. So that's kind of like, to round up my whole philosophy there on all of that. Hopefully that touches on all those last little bits that are cliffhanging for people, because at the end of the day, I know we talked about endurance training a lot and some strength training. Like, I need people to always walk away from conversations with me knowing that I'm very pro lifting. I am very pro lifting.
- [122:50]
B
Well, Docliss, this has been wonderful, and I think it really creates a very great perspective for people because we oftentimes have one person that is focused on strength and one person that is focused on endurance, but you're really this perfect intersection of both. And what I love is that you do it.
- [123:11]
A
Yeah.
- [123:11]
B
It's one thing to talk about it, and then it's another to do it. And you've experimented with all of these things, and I am excited for your book and all things to come, so
- [123:22]
A
thank you very much. Yeah.
- [123:23]
B
Thank you.
- [123:24]
A
Thank you.