The Truth About Women’s Metabolism, Muscle & Fat Loss at Every Age | Abbie Smith-Ryan, PhD

Summary

Podcast Summary: The Truth About Women’s Metabolism, Muscle & Fat Loss at Every Age | Dr. Abby Smith-Ryan, PhD

Introduction

In this enlightening episode of The Dr. Gabrielle Lyon Show, host Dr. Gabrielle Lyon engages in a deep conversation with Dr. Abby Smith-Ryan, a renowned exercise physiologist and nutrition expert from UNC. The discussion centers on debunking myths surrounding women's metabolism, muscle, and fat loss across different life stages, particularly focusing on the perimenopausal period. Together, they explore the science behind women's unique physiological changes, effective training methodologies, and the crucial role of nutrition in optimizing health and performance.

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1. Women’s Representation in Research

Dr. Smith-Ryan highlights the historical underrepresentation of women in scientific research, especially concerning physiological studies beyond menstrual cycle-related topics.

Dr. Abby Smith-Ryan [04:04]: "There's a lack of education on how to study women... they're just left out."

She emphasizes the necessity of inclusive research practices that account for hormonal variations and life stages, enabling more accurate and applicable findings for women.

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2. The Impact of Perimenopause on Body Composition

The conversation delves into the significant changes women experience between their late 30s and 40s, transitioning into perimenopause, which affects both physical and mental health.

Dr. Abby Smith-Ryan [00:41]: "The data was showing us that between kind of late 30s and into 40s, there's this pretty big change in body composition and both physical and mental health."

Dr. Smith-Ryan's research focuses on understanding these changes to develop strategies that help women maintain optimal health during this transitional phase.

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3. High-Intensity Interval Training (HIIT) for Women

A substantial portion of the episode is dedicated to discussing the benefits of HIIT, its applicability to various populations, and how it can be tailored to women's unique physiological needs.

Dr. Abby Smith-Ryan [08:19]: "HIIT is very effective and time-efficient... we've done that in cancer patients, we've done it in OA, we've done it in very obese individuals, and it seems to work for males and females."

Dr. Smith-Ryan explains how HIIT can lead to rapid improvements in VO2 max, muscle quality, and fat oxidation, making it an excellent choice for women seeking efficient workouts that fit into busy schedules.

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4. Muscle Quality vs. Muscle Mass

The discussion differentiates between muscle quality and muscle mass, emphasizing that HIIT can enhance both without necessarily increasing muscle size excessively.

Dr. Abby Smith-Ryan [20:05]: "HIIT can increase both muscle size and quality... muscle quality is often the bigger target."

She introduces non-invasive methods like ultrasound and CT scans to measure muscle quality, underscoring the importance of functional muscle over mere quantity.

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5. Nutrition’s Role in Training and Recovery

Nutrition emerges as a pivotal factor in optimizing training outcomes and recovery. Dr. Smith-Ryan advocates for adequate protein intake and balanced fuel consumption around workouts.

Dr. Abby Smith-Ryan [56:46]: "You should actually start each meal with about 30 grams of protein... prioritize fiber and then carbohydrates that are starchy."

She addresses common misconceptions about fueling, advising against over-reliance on carbohydrates and highlighting the benefits of protein for muscle synthesis and recovery.

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6. Addressing Misconceptions About Aging and Strength Training

Both Dr. Lyon and Dr. Smith-Ryan confront the myth that it's too late to build strength and muscle as women age, advocating that it's never too late to start resistance training.

Dr. Abby Smith-Ryan [47:36]: "The biggest misconception is that you can't gain strength and muscle no matter what age you are, which is really important. Like it's never too late to start and we should be empowered by that."

They encourage women to engage in progressive resistance training to maintain muscle mass, bone density, and metabolic health, regardless of age.

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7. Overcoming Barriers to Effective Training

The conversation touches on the psychological and practical barriers women face in maintaining consistent training routines, such as fear of injury or misconceptions about muscle gain.

Dr. Abby Smith-Ryan [42:45]: "Some people are scared, especially women, of like, oh, I shouldn't be able to lift that much weight, but that's normal and we want that heavy load."

Dr. Smith-Ryan emphasizes the importance of progressive overload and dispels fears about excessive muscle gain, promoting a balanced approach to strength training.

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8. Future Directions in Women’s Health Research

In concluding the discussion, Dr. Smith-Ryan expresses excitement about advancing women-specific health research and developing tailored exercise guidelines.

Dr. Abby Smith-Ryan [72:04]: "We need good solid recommendations for exercise in women. I actually don't know if they'll be that different, but I would really love to see some of that data."

She advocates for collaborative efforts to accelerate research in women's health, aiming to provide nuanced and effective health and fitness strategies.

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Conclusion

This episode of The Dr. Gabrielle Lyon Show offers a comprehensive exploration of women's metabolism, muscle, and fat loss, particularly during the perimenopausal phase. Dr. Gabrielle Lyon and Dr. Abby Smith-Ryan provide valuable insights into effective training methodologies like HIIT, the critical role of nutrition, and the importance of inclusive research practices. Their discussion empowers women to take charge of their health and wellness through informed, science-based approaches tailored to their unique physiological needs.

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Notable Quotes

• Dr. Abby Smith-Ryan [04:04]: "There's a lack of education on how to study women... they're just left out."

• Dr. Abby Smith-Ryan [08:19]: "HIIT is very effective and time-efficient... it seems to work for males and females."

• Dr. Abby Smith-Ryan [20:05]: "HIIT can increase both muscle size and quality... muscle quality is often the bigger target."

• Dr. Abby Smith-Ryan [47:36]: "The biggest misconception is that you can't gain strength and muscle no matter what age you are... it's never too late to start."

• Dr. Abby Smith-Ryan [56:46]: "You should actually start each meal with about 30 grams of protein... prioritize fiber and then carbohydrates that are starchy."

• Dr. Abby Smith-Ryan [72:04]: "We need good solid recommendations for exercise in women... I would really love to see some of that data."

Transcript

[Dr. Gabrielle Lyons]

Has anyone ever told you you lift like a girl? Probably not, but that doesn't stop people from saying you should lift a certain way because you're a woman. But is that actually true? Or is that just another myth holding women back from reaching their full potential? Today we're diving deep into the science of women's metabolism, strength and longevity. With one of the top researchers in exercise physiology and Nutrition, Dr. Abby Smith Ryan will break down the real differences between men and women when it comes to training, whether cycle based workouts actually matter, and the biggest mistakes women make when it comes to fitness and health.

[Dr. Abby Smith Ryan]

The data was showing us that between kind of late 30s and into 40s, there's this pretty big change in body composition and both physical and mental health. And so we're really trying to understand some of the things that are happening in that space.

[Dr. Gabrielle Lyons]

So if you've ever wondered whether you should be training differently or eating differently or more protein, if your hormones really are to blame, then this episode is for you. Dr. Abby Smith Ryan, welcome to the show.

[Dr. Abby Smith Ryan]

Thanks so much for having me.

[Dr. Gabrielle Lyons]

And on a Sunday, no less. So thank you for all your time.

[Dr. Abby Smith Ryan]

Yeah, I can't believe we made it happen. So appreciate the time.

[Dr. Gabrielle Lyons]

Yes. And hopefully not the last time we make it happen.

[Dr. Abby Smith Ryan]

That would be great.

[Dr. Gabrielle Lyons]

One of the reasons why I really wanted you to come on is because you have spent a lot of time and energy in the body composition in the exercise fizz space, and there are a lot of controversies and I don't even think that controversies is the right word, but there's a lot of information floating around and at the end of the day, people want to have a better body composition and they want to perform better. I don't even want to say prevent injury, but they want to perform better. And that's really what led me to some of your work. So thank you.

[Dr. Abby Smith Ryan]

Yeah, I always thought body comp was kind of boring, but it's so important.

[Dr. Gabrielle Lyons]

You are currently at UNC and tell me a little bit about your background as to how you ended up where you are and really what your lab is focusing on now.

[Dr. Abby Smith Ryan]

Yeah, so I've been at UNC for 14 years and currently I serve as the associate chair for research and I direct the applied physiology lab. And really my background is as an exercise physiologist, so that's where my training is. But during my doctoral work also really paired it with sport nutrition. And then coming to a place like UNC really translated that more into, I wouldn't say clinical populations, but overweight, obesity and Cancer, osteoarthritis, to really take that physiology and apply it to help people feel better.

[Dr. Gabrielle Lyons]

And what are some of the things that you're working on now?

[Dr. Abby Smith Ryan]

So over the last about five or six years, a lot of my work has translated mostly into perimenopause. And that's not because I'm of the age of perimenopause, but really because the data was showing us that between kind of late 30s and into 40s, there's this pretty big change in body composition and both physical and mental health. And so we're really trying to understand some of the things that are happening in that space and trying to understand and help those women.

[Dr. Gabrielle Lyons]

Would you say that women have been somewhat left out of research in terms of studying them?

[Dr. Abby Smith Ryan]

Yeah, it's funny, when we look at the literature, there's actually a lot of old research on things like red, silver and menstrual cycle dysfunction. So they haven't been left out in that space, but very much from a scarcity mindset of like not enough of fuel and the side effects. And then when we start to look at female only studies and or women characterizing where they're actually at in their life stage, there's very little research there.

[Dr. Gabrielle Lyons]

And is it because that. It's just really challenging because the female cycle or even lack of, you know, it's, it's easy to say, for example, that someone is, okay, you're 45 years old, I know that that individual is 45 years old. It's much more difficult to say this woman's LH. Is this all 45 year old women have a hormone profile of this? We're no longer comparing apples to apples, right?

[Dr. Abby Smith Ryan]

Yeah, I mean, I think everyone will say it's a little bit harder, which is a bit of a cop out.

[Dr. Gabrielle Lyons]

Okay, I like that.

[Dr. Abby Smith Ryan]

I mean, I think it takes a little bit extra resources and a little bit more time. But honestly, I think it really stems from there's a lack of education of how to study women. And so they're just left out. Meaning there is no guidance in the space of physiology of how to track menstrual cycle. What does it mean? And even, especially as a woman is in their mid-40s, that hormonal status is changing. So that variability makes it harder to do research and is often considered a limitation. But that's what we need to study. Right?

[Dr. Gabrielle Lyons]

Well, and I think that the next question that I would have is, does it matter?

[Dr. Abby Smith Ryan]

What do you mean does it matter?

[Dr. Gabrielle Lyons]

Does it matter? For example, would a woman's cycle impact her performance outcomes? Does it impact her body composition? Would that be something that we say okay, we need to study it or perhaps it maybe has minimal effect?

[Dr. Abby Smith Ryan]

Yeah, it's a great question. I think at a minimum we need to characterize it. We need to state where they're at and what some of those scenarios look like which we didn't used to do. And I'm even guilty of that. Like our early studies don't say anything about the age or the menstrual cycle status. And so I think some of it does matter. When we start to look at and what we know about sex based differences in physiology, things like muscle fiber type and fatigue resistance and blood flow, those things will impact our outcomes. I think we don't see as much of an effect in a group level but it does matter individually and I think that's more, I mean we're women and I think a lot of women need not validation but they've experienced things or things change across the menstrual cycle. And so more data to understand or to provide some onus on that of here's what's actually happening.

[Dr. Gabrielle Lyons]

Do you think that there is the. Do you think that the ender inter variability has to do with a sex based difference? Again, this is a really broad question. Is it a sex based difference or is it that, you know, for example, my husband has been extremely physically active his whole life. He has a ton of type 2 muscle fibers and let's say I was someone who typically focused on endurance. Maybe I was more leaning towards type 1. Would it have to do with do we know what sex based differences the impact of those are versus just training and lifestyle?

[Dr. Abby Smith Ryan]

Yeah. So one, I like this question of. I think there's a lot of debate about sex based differences and I would say who the fuck cares? Because like really, I mean yeah, yeah, you know, like I don't need to be compared to a man. I need, we need to understand like how do we help women and they're all different. I actually think there's some really great data on these sex based differences and the best way I like to describe it is a woman's gonna perform high level no matter where she's at in her menstrual cycle status. But I do think there's some contributions that might vary and even muscle fiber types that are different. And so from a physiology perspective how I would interpret that would be perhaps so a lot of my work is with high intensity interval training. Perhaps our rest interval needs to be slightly different to see the Same adaptation that the research is reporting in mental.

[Dr. Gabrielle Lyons]

Wow.

[Dr. Abby Smith Ryan]

So will we see adaptation? Yes. But if we want to hone it in, we might need to alter some of those approaches.

[Dr. Gabrielle Lyons]

Tell me more that I love high intensity interval training, and I think that we both have very busy schedules. I mean, bring it on. That, you know, you get a lot done.

[Dr. Abby Smith Ryan]

You sure do.

[Dr. Gabrielle Lyons]

In a short period of time. Tell me a little bit about what high intensity interval training is, what you've seen for men and women.

[Dr. Abby Smith Ryan]

Yeah. So a lot of my work started here because of that reason. It's very effective and time efficient. And, you know, we all hear like, we don't have time for exercise. Well, everyone has time for 20 minutes, 10 minutes, totally. And it's very effective on many aspects of body composition and cardiometabolic health. And so some of our initial work is really focused on 10 sets of one minute on, one minute off. Not because it's the best approach, but it's very easy for someone to go, you can do anything for a minute versus a lot of the original really great work is 30 seconds at a percentage of your body weight. People have a hard time doing that. But at that same time, that one minute on, one minute off is, I mean, go hard for a minute, something you couldn't do for a minute and 20. We've done that in cancer patients, we've done it in oa, we've done it in very obese individuals, and it seems to work for males and females. We also have some really interesting data in an animal model that genetically bred mice that have a paradoxical response to exercise, meaning they gain fat and lose muscle.

[Dr. Gabrielle Lyons]

That I. That is wild, right? How is that even possible?

[Dr. Abby Smith Ryan]

Well, it happens in humans too. What they just then, you know, it's often those that. Those are the people that say, oh, you know, you need to count your calories or you're not exercising. Right.

[Dr. Gabrielle Lyons]

Wait, wait, wait. So there are individuals that would train and have a paradox response to exercise?

[Dr. Abby Smith Ryan]

Well, yes. The hard part in the lab is you can't control everything. So we looked at it in a mouse model.

[Dr. Gabrielle Lyons]

And for the listener, mouse models are very easy to control. You control their entire environment, what they eat. They're living in sterile environments. It's very challenging to translate that to humans. But it is a basis for where science often starts.

[Dr. Abby Smith Ryan]

Yeah. And I am not an animal researcher, but partnered with a geneticist. And it seemed like that HIIT response when putting mice through HIIT training, they actually then responded like they should. If you take a genetically bred mouse that gains fat and loses muscle. They actually were able to gain fat or sorry, lose fat and gain muscle with hit, especially in women. So that was enough data for me to say, okay, using this model as we go on is a really good model if we want to. To try and look at some of these physiological adaptations.

[Dr. Gabrielle Lyons]

And did that. And now you've done that in humans.

[Dr. Abby Smith Ryan]

We've done it and we did it before that in humans and continue to use it as a really good stimulus for lots of different changes in muscle body fat. Not as much depending on there's a nutritional component there as well as things like insulin sensitivity, fat oxidation for the high.

[Dr. Gabrielle Lyons]

Have you ever spoken to Martin Gubala?

[Dr. Abby Smith Ryan]

Not directly, but a huge fan of his work.

[Dr. Gabrielle Lyons]

We love Martin, he's amazing and we talk to him a lot about high intensity interval training. He is, for those of you listening, he's just, I would say he's the ultimate OG in high intensity interval training. And the. I want to highlight a little bit about how one could make this effective and, and as how it would also work. So for example, if we have someone listening to the show who has never done high intensity interval training, could you make a recommendation as to how one would begin?

[Dr. Abby Smith Ryan]

Yes, and I love this question. The very first study I did at North Carolina was interval training in overweight and obese men and women.

[Dr. Gabrielle Lyons]

Perfect.

[Dr. Abby Smith Ryan]

And our ethics committee basically said, you can't do this, they won't be able to do it. Like physiologically speaking that's not true. And so we finally got it through and in reality it's all relative to where someone is starting. And I say that like we have done it in bone marrow transplant patients before transplantation, meaning anyone can do it. It's all relative to fitness. So someone that's starting out, if we do it in a very non scientific way, essentially we would start, try and aim for five to six times of one minute hard, one minute rest. And that could be a standstill, it could be an active recovery. That one minute ideally is something that you could not sustain for a minute and 20. It's hard enough for you where you finish and you're like, oh, I really need a break.

[Dr. Gabrielle Lyons]

And would we say that it is, you know, just taking some of the science out of it? I know it sounds weird, but. No, because my mom, let's say my mom, my mom is 72 years old. I recently posted on her that she was 74. She was very upset and I said, listen Lenny, you look great for 74, but even better for 72 and if we were to say, I need you to do high intensity interval training, I want you to go at 80%, your VO2 max.

[Dr. Abby Smith Ryan]

You don't have to do that.

[Dr. Gabrielle Lyons]

Okay.

[Dr. Abby Smith Ryan]

Yeah. So we've done it both. We've actually done this similar protocol within a family medicine clinic to see how feasible is it for people to do at home. And the biggest translation is if you come to the lab, we would do it descriptive based on VO2. If you do it at home, it might be slightly less that we would prescribe. So it just take a little bit longer to see effects. But as you know, with Dr. Gabala's work, really after one or two sessions, there's metabolic adaptations, which is really important, particularly for someone like myself. I want exercise to feel not easier. Like if you're doing it right, it should be hard, but when you're done, life feels better and easier. And with hiit, those adaptations are so much faster. And so for someone like your mom, it's going and doing an exercise that brings your heart rate up and like I said, doing something that you couldn't sustain for longer than a minute. And that could be, you know, a lot of times we worry about joints. Could be on a bike, it could be stairs, it could be any method that just elevates heart rate more than you could doing more of a sustained exercise.

[Dr. Gabrielle Lyons]

And for some people, you know, you're talking about cancer patients and before they do bone marrow transplants, it could literally be sitting down and standing up from a chair, walking. Yes, these things. And it really is individual.

[Dr. Abby Smith Ryan]

Absolutely.

[Dr. Gabrielle Lyons]

Does one have to push harder than that? So for example, let's say some of the initial work is the Tabata style where it's 30 seconds on. I mean, when you go all out, you cannot, I personally cannot go a hundred percent, which is, I know, different than high intensity. I cannot sustain that for a minute.

[Dr. Abby Smith Ryan]

Yes. And I think it's good. So I think this also brings in some of the sex based differences. Now you brought up the example of, you know, maybe you had more endurance background, but a lot of times women do tend to have more type 1 muscle fibers, more oxidative.

[Dr. Gabrielle Lyons]

Do we know why?

[Dr. Abby Smith Ryan]

Do we know why? I don't know why. I mean, some of it is, is more, it's maybe not direct, but also related to fuel utilization, hormones. It's not a cause and effect though.

[Dr. Gabrielle Lyons]

Would we say that if a woman and a man were to train similarly, would you then negate the fiber type differences? So I guess the bigger question is, are we talking about untrained individuals?

[Dr. Abby Smith Ryan]

No. So I would say to answer your first question, can chronic training overcome some of our baseline genetic differences? Absolutely. That's why we train. But women tend to be more fatigue resistant and have more type 1 fibers. And so it goes back to your all out. I'll use myself, for example. I was probably meant to be an anaerobic athlete, but I was an endurance athlete. You were? Yeah, I ran cross country and track in college. But I can't go all out. I have one pace and I could go forever. Well, it's fast, but I also can't, you know. And so something like a tabata style, I could do that again and again, but it's about the same pace that I would go for a minute. Some of those oxidative adaptations vary essentially. Also you have to think about a minute is slightly different adaptations than 30 seconds. When we talk about energy systems, if we talk more about cardiometabolic health, a lot of times that slightly longer exercise bout can result in some of these mitochondrial changes, fat oxidation changes that might be better for insulin sensitivity, glucose regulation.

[Dr. Gabrielle Lyons]

Hydration is so important. And we typically recommend half your body weight in ounces, which makes a lot of water to drink. I struggle to drink straight water, so adding in element has been key for me for a number of reasons. I don't get enough electrolytes in my food and when I am drinking just water, I swear I don't seem to recover as well. Element has been great for me and my family. With a thousand milligrams of sodium, 200 milligrams of potassium and 60 milligrams of magnesium, I have less headaches, muscle cramps and you know, it tastes great, especially with iced tea. Get your free element sample pack with any [e-mail] DrLion also try the new Element Sparkling, a bold 16 ounce can of sparkling electrolyte water. And you can try it totally risk free. If you do not like it, they will refund you, no questions asked. I will also say they have a very high reorder rate. Head over to drinklmnt.com doctorlion and what I'm hearing you say is that there may be some benefit to doing more. Is that what you're saying? That there may be some benefit to doing some more endurance? Or we shouldn't even define it that way because when people say endurance, yeah, I know that they are thinking zone two, 45 minutes. And I, I see you nodding your head and meaning that you we are probably very much in alignment. I do not believe that people need to be doing that. From the data, there are multiple ways to improve fat oxidation, endurance, mitochondrial mitogenesis, all without doing 100%. Zone two is having its crazy in the spotlight moment.

[Dr. Abby Smith Ryan]

Yeah. I shouldn't admit this, but I was on a podcast and someone was like, what do you think of Zone two? I was like, I don't know what that is. Like, what do you mean by Zone two? Moderate intensity? Yeah, no, I think people should do moderate intensity, you know, kind of low intensity duration exercise if it's good for their mental health and they want to, you know, add some, some exercise. But that is not. I actually think it's harder on the joints.

[Dr. Gabrielle Lyons]

I agree with you completely. And that is probably music to people's ears that they do not have to do long bouts of quote endurance type training with to not to. They are still able to get the same adaptation with high intensity interval training.

[Dr. Abby Smith Ryan]

Well, yeah. And that, honestly, that's why we've continued to study hiit, because the best way to describe it is if I was just going to do endurance training or zone two, it may take me 12 to 16 weeks to see any sort of cardiovascular benefit. And that's if I'm doing it right. Most of the time people are still too low of an intensity, whereas with hit we see changes in three weeks.

[Dr. Gabrielle Lyons]

Tell me what changes you see.

[Dr. Abby Smith Ryan]

We see improvements in VO2 max and a lot of times people think that's just related to fitness. But VO2 max is the number one indicator of cardiovascular health. So a lot of times that's what we want. Quality of life, functionality. We see improvements in muscle. Actually, our lab was one of the first to show that HIIT can increase.

[Dr. Gabrielle Lyons]

Muscle quality or amount?

[Dr. Abby Smith Ryan]

Both. It does depend on the mode. So for instance, our work was with biking and obviously that places a bigger load on the the quad muscle. And so we saw improvements in muscle size, but more importantly muscle quality, which we know is often the bigger target.

[Dr. Gabrielle Lyons]

And when we define muscle quality, I think in the literature that it's defined by strength. But are we talking about muscle biopsies and actually looking at the tissue?

[Dr. Abby Smith Ryan]

It's a good question. So we do mostly noninvasive work and there is a way to measure muscle quality of strength over the amount of muscle. We use a couple different approaches, one being ultrasound. And the best way I like to describe it is would be a low muscle quality would be more similar to like a rib eye fill of fat, infiltration, connective tissue versus a fillet, leaner tissue. And you can do that with ultrasound. We also Use a technique called pqct, which is basically a CT scan of the quad.

[Dr. Gabrielle Lyons]

And mri, which, those are the gold standard. So MRI for sure, most people don't use ct, so that is certainly more advanced. And then ultrasound for the listener, it seems to be there's a variation depending on who uses it. Right. It's user dependent, technician dependent, but I think that's amazing.

[Dr. Abby Smith Ryan]

Yeah. And a lot of my work's fairly beginning was to look at the reliability of that technique and validity. Meaning is it actually measuring what it's supposed to be measuring and how sensitive is it? So, like, when we think about a lot of these changes, we're understanding if it's actually a real change or if it's coming from measurement error. And we've got it where it's coming from change.

[Dr. Gabrielle Lyons]

That's tremendous. And that is so incredible when we're thinking about how do we make the world healthier and what are the actual tools? How do we make exercise more prescriptive?

[Dr. Abby Smith Ryan]

Absolutely.

[Dr. Gabrielle Lyons]

When you are. Because I know also previously you've done work on dexa and I do want to circle back to The DEXA imaging vs CT vs MRI vs using ultrasound, looking at muscle quality. I want to finish up really quickly with hiit. When someone is improving, would they. Once it becomes easy to do that minute of biking, how can someone self adjust?

[Dr. Abby Smith Ryan]

Yeah, well, two things. This goes back to your other question. If someone is doing HIIT every day, that means they're not doing it. Right. Like you really should only be able to do it. I mean, I would say max three times a week and there's good data to say that too much is not good. And every day, I mean, think about it. Some days we're more tired, which is a good.

[Dr. Gabrielle Lyons]

I don't know what you're talking about. And then you pan to the multiple energy drinks from every single company you could ever imagine.

[Dr. Abby Smith Ryan]

Yeah, I mean, some days you might not be able to do as many intervals and you adjust that way. Your body's still adapting. And that's the best part about it, is no matter how fit or unfit, you can still do it. And so it's more of self regulation. It's great to measure your heart rate if you can. Another good way is breathing rate. So it goes back, like do something that you couldn't do for a minute and 20 or a minute and a half. And that's a good intensity.

[Dr. Gabrielle Lyons]

So the listener's gonna be doing this. They're gonna do it three times a week and they're gonna do it for 10 minutes. Is that fair? One minute on or are you go with 20 minutes? Where's the amount of time for the outcome of. Can we pick body? So could we pick body composition? VO2 max? Would it be fair to pick all of those?

[Dr. Abby Smith Ryan]

Yeah, I mean, I think my key outcome is usually VO2 max. Cause that's telling us then there's cardiovascular adaptations, which is what we' and we've shown that something like five or six bouts is enough. But even if someone starts with four bouts, if they're really sedentary, a week, four minutes, so eight minutes total, they'll see some benefit. Now working towards that, 10, so 10 minutes of work, but it's a 20 minute workout, tends to be a really good sweet spot. Doing that a couple times. We have data showing twice a week over three weeks will show adaptation. And other labs show that even one or two sessions will result in some of those changes.

[Dr. Gabrielle Lyons]

And if you were to think about the hierarchy of importance, would you say that that would be critical as opposed to, you know, and I don't want to say as opposed to resistance training because we're clearly laying out that this is not time intensive and that if you want to improve your cardiovascular health, you can do high intensity interval training. You could do it twice a week. For the more untrained you are, the bigger the benefit you're gonna get the more trained you are. Obviously you're gonna probably have to push yourself, but I think everyone can do that. The outcome you look at is VO2 max. What would be the secondary outcome?

[Dr. Abby Smith Ryan]

Yeah, so I mean, I think that's the. We are also seeing some support on muscle as well as some initial work that shows that maybe there's a reduction in visceral fat, which is hard to. It goes back to just the mitochondrial changes. We often don't control diet, high level, we control kind of acute feeding because of feasibility. Right. Obviously diet plays a big role in body composition. And I like to create studies that have a very translatable and feasible outcome. And so by just making some small changes around hiit, we do seem to see some changes with a loss of fat, particularly around the abdomen. So the visceral fat as well, and some slight improvements in muscle size and quality. And that's without HIIT or resistance training. Would I recommend not to do resistance training?

[Dr. Gabrielle Lyons]

No, we have seen that too. Obviously. I am not in the space of academia anymore. I mean, I still work and collaborate on studies. But we did see that when I was doing research, we saw improvements in muscle hypertrophy with high intensity interval training? Not. And that is separate than resistance training. Yep.

[Dr. Abby Smith Ryan]

Which is it? When we think about barriers, anyone can do hit, you don't have to have access to a lot of equipment. And so it's a really good way to add into training. Now, if you have body composition goals, it would be beneficial to add in resistance training. But hiit is a great. You know, I would say it's hard to lift heavy every single day. And so hiit is a good way to kind of integrate within your daily routine.

[Dr. Gabrielle Lyons]

Was there anything surprising in the research that you found that was unexpected in looking at high intensity interval training?

[Dr. Abby Smith Ryan]

Yeah, one thing comes to mind. That first study we did where our ethics board said you couldn't do it, we did a little survey of enjoyment. So here are these untrained, overweight, obese men and women, and they significantly enjoyed it. And the more they did it, the more enjoyment they got. And to me, as a physiologist, it was really important to see what if you teach them what it feels like to be hard and that it's a good feeling, they actually start to enjoy it. And I think you can start to feel the benefits. Like, you walk up the stairs and you're not as winded, you can get out of bed easier. And so that enjoyment piece, you and I both know sometimes it's really hard to get motivated to go do the workout.

[Dr. Gabrielle Lyons]

Are you kidding? I'm already bitching about. So tomorrow morning maybe you'll join me. 6:45, we will hit the gym. And I'm already bitching about it. I already know. I already know. I don't want to get up to do it.

[Dr. Abby Smith Ryan]

Well, I will absolutely join you. I'm glad you said that. But no one ever finishes a workout and says, oh, I wish I didn't do that. And so it's that piece of that adrenaline and those endorphins that people actually feel, which I think is great. So we can increase that. And then the other thing that I've seen is we've literally had to wheel people to the bike. So like individuals with osteoarthritis or like I mentioned, bone marrow transplant patients, we saw that if you can increase VO2 max prior to transplantation, it actually improves mortality rate. So it directly helps with success. We've published that. And then those OA individuals, it actually reduces pain. So a lot of times people say, oh, I can't bike, I have knee pain. But in reality, because of the strength of the muscle and the range of motion, there's Some metabolic changes that helps with inflammation over time and reduced pain in these kind of non functional individuals.

[Dr. Gabrielle Lyons]

And you mentioned something earlier that it really is, it's interesting because high intensity interval training, you provide the stimulus and the benefit actually is pretty acute. It happens quickly. Meaning you'll see changes, I don't know, immediate and two to three days later. Is that fair to say?

[Dr. Abby Smith Ryan]

Absolutely. And I think the hard part, I mean coming from a distance runner like you want to finish a workout and feel exhausted now hiit you do. But it's hard to believe 10 minutes will do that. But in reality there's not a lot of caloric expenditure. There's a lot of glycogen utilization within the workout. But a lot of the changes come within the 24 to 48 hours after.

[Dr. Gabrielle Lyons]

Two things here you often see people will do a high intensity interval training workout and maybe they'll go to Barry's bootcamp again. But one thing that you said, that if you are able to do these things multiple times a week, you are not doing it hard enough.

[Dr. Abby Smith Ryan]

Well, it's just maybe not. Interval training like boot camp is not quite the same as concentrated high intensity interval training. That doesn't mean there's not benefit but.

[Dr. Gabrielle Lyons]

Always benefit from a intensity standpoint. Because what you're really talking about is exercise intensity.

[Dr. Abby Smith Ryan]

Right.

[Dr. Gabrielle Lyons]

And if you are working intense enough, you are not going to be able to do this multiple times a week.

[Dr. Abby Smith Ryan]

Right. And nor should you.

[Dr. Gabrielle Lyons]

Nor should you. And that's one other reason to thank one of my all time favorite products, Mitopure, which is made by timeline. If all companies operated with such scientific rigor and integrity, the entire supplement landscape would be changed. And why I love and have used Mitopure forever is because I trust their science and I felt stronger and have more endurance since being consistent with Mitopure. Now Mitopure is a precise dose of a postbiotic urolithin A. It works by promoting an essential cellular cleanup process that clears out dysfunctional mitochondria AKA your cell's battery. It's the only urolithin A supplement on the market clinically proven to target the effects of age related cellular decline. From my perspective, it is the ultimate in muscle and whole body health supplement. The current human data supports its benefit for muscle health, strength, endurance and frankly, I wish I had come up with it myself. And timeline is offering 10% off your order of Mitopure simply by going to timeline.com lion that's T I M E L I N E.com lion you mentioned glycogen utilization, which is a storage form of glucose. Many people I think by unintentionally counterbalance any weight loss goals or progress they can make because they finish those workouts and then they will pound smoothies or a lot of high carbohydrate food. I'm curious as to your thoughts on that because we are using some glycogen doing these high intensity interval trainings. But do we need to post training fuel in a significantly different way?

[Dr. Abby Smith Ryan]

Yeah, I actually think of it differently because I feel like most people go into exercise under fueled because they're trying to exercise to lose weight, which then can impact adaptation. But yes, if our goal is body composition and muscle, we don't want to refuel. I mean we want to refuel, but it doesn't have to be all carbohydrate. That those changes to muscle glycogen result in some of those mitochondrial changes for the better helps with that glucose regulation. Do you want some carbs? Absolutely. Should it be all carbohydrates? No, I mean that's where some of the amino acid and the nutrient timing work. Where we've spent some time comes in. How do we optimize that?

[Dr. Gabrielle Lyons]

Do you think it matters if it's very close to post workout versus within that 24 hour time frame?

[Dr. Abby Smith Ryan]

I feel like this is a hot debate right now, which is so funny. So I think, and I'll have a bias of a lot of our work is showing that pre exercise nutrition, particularly for women, is maybe more optimal, but we have to look at the bigger picture. A lot of that post workout fueling one, it depends on the duration of your workout, the intensity and when your last meal was. So if someone goes into exercise fasted, which I would not recommend.

[Dr. Gabrielle Lyons]

See I train fasted all the time. You do and I've trained fasted my entire training career.

[Dr. Abby Smith Ryan]

Well then we need your secrets.

[Dr. Gabrielle Lyons]

Yes, I'm happy to share them. Yeah, always.

[Dr. Abby Smith Ryan]

So if you then are fasted, then you'd want to fuel more quickly after your exercise so that you can then replenish your stores or at least I think more of it from a protein synthesis side, you have amino acids available. Yeah.

[Dr. Gabrielle Lyons]

And I was talking to Don Lehman about this and based on his work and kind of the collective data, so far from our perspective, as long as it's. Unless someone is totally untrained or perhaps has a lower protein diet, the anabolic window, it just seems that it might not matter as long as you're getting it in within that day.

[Dr. Abby Smith Ryan]

I guess I don't know that literature. It seems that what I have seen is within a couple hours is most optimal, but again, it's not. It does depend on when they ate last. And I think about more practically speaking, and maybe you can speak to your experience, but if you train fasted and don't eat for several hours, someone who chronically trains, you're not going to see as much of an effect, but you'll probably be more sore. So then are we trying to optimize recovery? And so I think it comes down like, will you be fine? Absolutely. Especially if our goals are I'm at a space where I want to optimize body composition or I don't get to train as much as I want. And really the response is why wouldn't you eat? You need to eat anyways. Will I add an added smoothie? No, but I'll add a meal so that then my nutrients are available when I need it.

[Dr. Gabrielle Lyons]

Do you think that there is. And again, I know that you're doing a lot of this work right now. Again, the discussion we hear a lot and I think in our spaces, men and women, where are they the same and where are they different? Let's say postmenopausal women who now potentially, it's so difficult, we just have to say that, listen, we are trying to make it black and white, but the reality is, let's say someone is post menopausal, does that now make her equal to her male counterpart at that age? And it doesn't, it's just, it's, it's so challenging.

[Dr. Abby Smith Ryan]

It is challenging and everyone has different goals. And so, I mean, I think with women, what I run into and what we're seeing is that many of them aren't fueling because they have this desire to lose fat mass. But what it seems is if we have some protein or amino acids prior to exercise, in comparison to fasting or carbohydrate, they have, they, they feel better, they can do greater volume, greater intensity. So it's more of an indirect effect. Whereas a lot of times women come under fueled and then they don't feel very good and they have a hard time recovering.

[Dr. Gabrielle Lyons]

And that makes a lot of sense. Do you see individuals, they say, you know, I'm looking at some of my notes here. Many individuals say I hit menopause and now I've gained weight. And I think that some of your research shows that it really is focused on lifestyle and perhaps less of metabolic changes. Can you speak to that?

[Dr. Abby Smith Ryan]

Yeah, I mean, that's what we're Trying to figure out now, there is a very real data that shows that women hit menopause and they do gain weight. And we're trying to see what kind of weight. And it does seem to be, yes, they gain fat mass, but more, I think, importantly, they lose muscle. And so when we start to think about approaches to that, how do we handle it? And also thinking, I think, more from a practical standpoint, chronic exercise seems to help with that, meaning the sooner you can start to train, the better. And I say that because a lot of women, I mean, we all feel guilty when taking care of ourselves.

[Dr. Gabrielle Lyons]

I do not. I don't.

[Dr. Abby Smith Ryan]

Oh, good.

[Dr. Gabrielle Lyons]

You do not want to talk to me unless we've gotten some training done. We're just not. We're not gonna be friends.

[Dr. Abby Smith Ryan]

Well, maybe it's not guilt. Like, yes, I'm going to prioritize my training, but we have a lot of other needs that are pulling at us. And so prioritizing our exercise can help us in the long run. And it does seem that something's happening in that perimenopause window.

[Dr. Gabrielle Lyons]

Yeah, I agree, and I want to. And I actually really struggle with this because I worked on some of the early studies in the early 2000s with Dr. Donna Lehman. This is the kind of the first group looking at. He looked at perimenopause post menopause. These were largely untrained individuals, and we couldn't find a difference in terms of when diet and exercise were controlled. Again, they were new. They were able to lose comparable amounts of weight, maintain lean mass. We were using DEXA again for the listener. DEXA is not sensitive. It's an extrapolation of all lean mass, and skeletal muscle mass is a portion of that. And I personally want to believe, and I'm sure that, I don't know, maybe we'll find something, because some women go through menopause and everything changes. And then some women go through menopause and they're great.

[Dr. Abby Smith Ryan]

Yeah, yeah. I mean, so very preliminary. What we're trying to. And what we're seeing now is trying to understand some of these metabolic rate changes. And is it driven by muscle size, quality, hormones, exercise? This is very early, but a lot of it. Those women. We've seen women with resting metabolics, rate of 500 calories, which is crazy. And when you ask, is it accurate.

[Dr. Gabrielle Lyons]

Do you think those are accurate measures?

[Dr. Abby Smith Ryan]

We're also adding doubly labeled water to try and get that accuracy. So there is some variability, but it's very different than what you would expect for Someone in that size and it seems to be more driven by their lack of eating, meaning like they might be fasting for most of the day, which makes a little bit of sense. I don't think it's the only thing. But I take that in a way of we should be fueling our bodies. And if the less you eat, your metabolic rate might come down. And I think we see more of that behaviorally because body composition is changing. But it speaks to something we said before. How can we optimize it? One of the things that we know, mitochondria are the best way to help with that metabolic rate. And we be if we become very efficient, meaning if we do zone two training forever. Your mitochondria are very efficient. And so doing things that make them less efficient, things like interval training. We look at a lot of high intensity resistance training. Just stimulating the muscle and the mitochondria in a way it's not used to can help with support that metabolic rate.

[Dr. Gabrielle Lyons]

That is fascinating when you are thinking about, you know, one of the things I love about your science and your work is you do make it very translatable. So it's not mechanistic data and then trying to make broad generalizations, but really trying to translate good work to the world. If you were to say, okay, ladies, listen up, you've gained central body fat or men. Because men, you guys, you know, you're not exempt to this. And you said, I want you to do this kind of training program. Let's take an untrained individual or even we say untrained or even beginner training that now needs to push themselves. I've heard you mentioned high intensity interval training. I also heard you mention high interval resistance training. So I want to talk about that. And then straight up resistance training. How would you think about putting it all together?

[Dr. Abby Smith Ryan]

Gosh, I mean, this is very simple. But doing something is better than nothing, always. Yes. So and adding HIIT training, interval training twice a week, and then resistance training at least three times a week is where I would start.

[Dr. Gabrielle Lyons]

Do you care if it's full body split? Do you care if it's compound movements? You care if it's machines? Where, where are you at?

[Dr. Abby Smith Ryan]

I mean, I think if we're starting, it doesn't matter. But yes, you want to hit the larger muscle group. So think about your quads and your like big movements are where I would start. Um, we need to remove barriers for people that are training. So adding a stimulus to the muscle is the first place to start.

[Dr. Gabrielle Lyons]

Perfect. What about. So what about high intensity interval resistance training.

[Dr. Abby Smith Ryan]

Yeah. So high intensity resistance training. The only difference it is is it's in what that is. It's progressive resistance training. So the load is usually 6 to 8% or 6 to 81 RM 6 to 8%. So like you can only lift a weight 6 to 8 reps is the load that you want with short rest. So about 30 seconds in between each exercise or each rep. And the reason that we do that is just time efficient and it's heavy. So we see a lot of people. Obviously the first six weeks are usually neuromuscular changes of people.

[Dr. Gabrielle Lyons]

And what does that mean for the listener?

[Dr. Abby Smith Ryan]

That just means you should. If you have never lifted weights, you should expect to see increases in strength and load quite quickly. It's your body's ability to lift that weight, kind of activate those neurons. It's not morphological, it's not necessarily coming from the muscle itself. I think sometimes people are scared, especially women of like, oh, I shouldn't be able to lift that much weight, but that's normal and we want that heavy load.

[Dr. Gabrielle Lyons]

So they're afraid to. What you're saying is that the tissue changes don't happen, so the morphological fiber type changes don't happen, but the ability to generate force and lift those weights. You said neuromuscular. And for the listener, is that the brain connection to the muscle?

[Dr. Abby Smith Ryan]

Yeah. And I mean, one thing to think about, a lot of people are worried about lifting weights because they're going to gain too much muscle. Wish I could have that. I know.

[Dr. Gabrielle Lyons]

I'm still trying. Can we please end this? We have to. Never again on any other podcast or any women, you will not get bulky ever.

[Dr. Abby Smith Ryan]

I wish we would.

[Dr. Gabrielle Lyons]

I'm trying.

[Dr. Abby Smith Ryan]

I know.

[Dr. Gabrielle Lyons]

I'm still trying.

[Dr. Abby Smith Ryan]

I guess I gotta start fasted exercise.

[Dr. Gabrielle Lyons]

So is my producer Matt. He's still trying to put on muscle over there. That is the, the first six to eight weeks are. Is that again? And the idea of muscle memory, it is not that, is it?

[Dr. Abby Smith Ryan]

No, it's your brain's ability to recruit more muscle fibers, essentially. And so the more trained you are, the more motor units you can kind of attract to allow those muscle fibers to contract, which will allow you to lift a heavier weight. And that's a good thing. That means you can carry more groceries or more children. Or more children. Absolutely. And those happen. Like if you've never exercised or resistance trained, those will happen quickly. Now if you're someone that lifted when you were younger and then start again, then it maybe is not six weeks, maybe it's closer to three to four. And I say that because a lot of times people will start lifting and then pick one load and keep that load for a long time.

[Dr. Gabrielle Lyons]

Is that a mistake?

[Dr. Abby Smith Ryan]

It's a mistake. If we want to maximize the effect of our workouts, we want to progressively load the muscle which also indirectly helps the bone.

[Dr. Gabrielle Lyons]

And what you're referring to is progressive overload. And then I'm sure that there's also progressive stimulus whether it's. And I was talking to Dr. Jordan Shallow about this and he really opened my eyes to this idea that it is. It doesn't always have to be load because eventually you're not going to want to squat more than £250. I mean, maybe, but you might risk.

[Dr. Abby Smith Ryan]

Worried about your back and your joints.

[Dr. Gabrielle Lyons]

And you might risk getting injured. Man, women have it rough. From joint pains to pregnancy, it's one of the most challenging times for the female body. And there are a lot of demands placed on the body with the growing needs of the baby. 95% of women in the perinatal stage have nutrient deficiencies. Most prenatal vitamins include the bare minimum nutrition based on outdated guidance and stale research. Needed offers better nutrition products. And there are so many supplements out there it can be hard to know which one to choose. And Needed is a great option. It's recommended and used by more than 4,000 women's health experts from nutritionists to midwives, functional medicine doctors, obgyns. It was clinically developed based on insights from collective practitioners over years. Their products offer the form of nutrients your body can use, dosed at optimal versus bare minimum levels. They also go above and beyond with third party testing. They test every batch to ensure the safest product. Needed offers wonderful nutrition for women from conception to pregnancy to motherhood to menopause. Which man, there seems like there are a lot of problems that come with that. So there is so much that you can't control. Let's control what we can. And nutrition is one of those things. Kneaded's prenatal multi is available in capsules and easy to take vanilla powder that's perfect for nauseous moms or those with pill fatigue. Kneaded offers premium supplements for every stage. Supports egg quality from lactation to conceive to breastfeeding moms, sleep, stress support, the list goes on. And if you are perimenopause or menopause, they have stuff for you too. Head over to needed. That's ThisIsNeeded.com and use the code DRLION for 20% off. Head over to ThisIsNeeded T H I S I S N E E D E D and use the code DrLine for 20% off. Your first order. What is one of the biggest misconceptions from aging perspective? I was going through much of your work and I really focused on your work regarding women. But you do look at both men and women and is there a training misconception midlife that people continue to perpetuate that maybe holds them back from their goals?

[Dr. Abby Smith Ryan]

Yeah, I mean a lot of my early work we studied an older group with males and females with resistance training and HMB and which is a leucine metabolite. It is. And I think the biggest misconception is that you can gain strength and muscle no matter what age you are, which is really important. Like it's never too late to start and we should be empowered by that.

[Dr. Gabrielle Lyons]

You guys hear that? Which is an interesting statement. So it's not that, you know, people are doing it wrong, they're just not.

[Dr. Abby Smith Ryan]

Doing it at all or not doing it with enough of a stimulus. You have to have I, you know, sometimes you have to lift something heavier than what your normal day to day looks like. And then once that's easier, you've got to continue to progress that load and load.

[Dr. Gabrielle Lyons]

Does it matter if someone lifts heavy or and obviously heavy is all relative. Tell me about that.

[Dr. Abby Smith Ryan]

Yeah, I love this question. And actually a study I hope to do is the, the messaging right now is lift heavy weights. But for everybody, you think, I mean that's the messaging. But I think I have a little bit of a problem with that of what does that mean? And I think people could be intimidated and it could be harmful like if you lift too heavy. I'd like to know what that means threshold stimulus is. And really, I mean that's a lot of it of what is your baseline strength and how do we have a slightly heavier stimulus than what's your baseline strength? And then we could continue to, to provide that stimulus. Or for someone that trains regularly, like I don't always progressively overload. My goal is to maintain muscle and, and sometimes increase it depending on where I'm at in my training cycle. But it's not largely a lot of load. It's volume, it's intensity driven.

[Dr. Gabrielle Lyons]

I am number one surprised that this is still controversial. It's a bit surprising when you look at the various groups. I would say that we probably both agree that when you find data and it comes from multiple groups over a period of time, we now have a collection of literature. From what I've seen, the collection of literature doesn't indicate that we have to lift heavy weights to still make progress. And even in the geriatric world, you look at some of Stu Phillips work, it is not about the heaviness of the load, it's about the increase in stimulus.

[Dr. Abby Smith Ryan]

Yeah. Which can also be. And you're saying this, but can also be tackled with volume.

[Dr. Gabrielle Lyons]

Absolutely.

[Dr. Abby Smith Ryan]

Which is important.

[Dr. Gabrielle Lyons]

Do we believe or do you think that we will ultimately find differences between men and women? And again, perhaps when women are younger it's maybe there is, you know, from a protein perspective, when children, when our kids, we have young kids, when they eat protein, they're very anabolic, whether it's 5 grams or 10 grams. Again, we don't do muscle biopsies on kids, we're not studying kids. But what we can see from the interpretation of the literature surrounding them is they're very anabolic. Less intervariability, whether it's a male child or female child. Where do you think the differences are that we know from a scientific perspective versus where we think they are? It's a great question and a heavy one.

[Dr. Abby Smith Ryan]

What's that?

[Dr. Gabrielle Lyons]

It's a heavy question.

[Dr. Abby Smith Ryan]

I mean, so we actually have a paper in review trying to look at this with more non invasive measures of protein turnover and breakdown, which is not the best way to do it.

[Dr. Gabrielle Lyons]

Why not do more invasive?

[Dr. Abby Smith Ryan]

I don't want to do biopsies and I don't.

[Dr. Gabrielle Lyons]

I do not blame you. I still have PTSD from that.

[Dr. Abby Smith Ryan]

Well, and a lot of women don't want to do that. I mean a lot of men, and honestly, yeah, women tend to be a bit more resilient in the lab.

[Dr. Gabrielle Lyons]

You hear that guys?

[Dr. Abby Smith Ryan]

And we are seeing some things that there's not huge changes across the menstrual cycle.

[Dr. Gabrielle Lyons]

I would agree with that.

[Dr. Abby Smith Ryan]

But there are some things happening. For instance, if you are rebuilding the uterine lining or with some of the potentially fuel use, does it actually end up with needing more protein? I wouldn't tell a woman to change the amount of protein across her 30 days, if her days, you know, across her cycle. But there are some things with recovery coming out, like maybe in the luteal phase of recovery is a little bit longer or sleep is not as good. So then that would be a question about maybe optimizing the timing of the nutrients around the training. Would it be different nutrients? Probably not. Most people are under fueled and not appropriately fueling anyways.

[Dr. Gabrielle Lyons]

And that's an interesting perspective. I want to know what you mean by under fueled? Because right now we have what, 70% of the population is either overweight or obese.

[Dr. Abby Smith Ryan]

Yes. So, I mean, and I can't wrap my head around that. I can, but when you, like when I see participants in the lab and day to day and when we look at diet analysis, obviously there are lots of.

[Dr. Gabrielle Lyons]

She's in North Carolina, so that's a.

[Dr. Abby Smith Ryan]

There are lots of troubles with that. But people don't eat during the day or they have very carbohydrate centric processed foods, so they're not getting all of the nutrients that they need. And it's not just protein, it's fiber, it's vitamins and minerals. And so then when they go to train, they don't have the appropriate fuel, which then can impact recovery, protein synthesis, et cetera. So it's a lot of times just making sure there's fuel like protein, like carbohydrate around exercise, so that when they need it, it's there versus many windows. And there's some data that shows going for several hours without fuel does potentially lead to some, I won't say hormonal imbalances, but there's a lot of things physiologically that makes sense. If you don't have fuel and you're up moving around all day, then.

[Dr. Gabrielle Lyons]

Well, one of the things that I think that we can say that a lot of the evidence points to is if you cannot manage your blood sugar, you will have fluctuations in cortisol. Is that necessarily a bad thing? If you're increasing your cortisol to generate more gluconeogenesis, then, well, you might really make bad choices and you might take the nutrients away from, say, protein synthesis or various other places. So, again, I think it's probably very complicated. The other thing that I thought that you said was really interesting is that individuals have, I don't want to say.

[Dr. Abby Smith Ryan]

Poor diets, but low diet quality. Low quality.

[Dr. Gabrielle Lyons]

I love that that's positive. Low dye quality. And that definitely would make sense to think about when it looks at the totality of that individual's ability to recover. Absolutely. Again, we. I think you and I talk a lot about macronutrients, but again, there are other micronutrients, other bioactive ingredients that probably play a role in overall body composition. Again, I say that cautiously because nutrition and exercise physiology, it's a new science.

[Dr. Abby Smith Ryan]

Yeah. And it's complicated. I know you had Dr. Heather Leidy on, who's done a lot of the quality. She's awesome. But the quality of the diet has a huge Impact. How do you control for that? Well, I mean, gosh, if we knew, we would all be rich. Right. But that diet quality around exercise tends to have. I mean, it makes sense. It will impact maybe exercise volume if you're able to push through. Maybe not. But then on that recovery element, which could indirectly impact body composition, muscle mass.

[Dr. Gabrielle Lyons]

And do you look at a lot of the recovery if someone is training hard and under recovering? Is that something that you've looked at?

[Dr. Abby Smith Ryan]

We are. Recovery is such a kind of funny term. We're trying to look more at recovery because it's an under science or under research area.

[Dr. Gabrielle Lyons]

Really?

[Dr. Abby Smith Ryan]

Yeah. Because when you think about it, it's impacted by so many things outside of an intervention. It's impacted by sleep. You mentioned cortisol, which is a funny, like, I mean, a hot. A hot topic. And then how do you define recovery? It could mean a lot of things, especially in the female space. It's under researched.

[Dr. Gabrielle Lyons]

Hmm. And I can appreciate that because there's things that we can change in our life and there are things that we, we can't change. You had mentioned that women. And I don't know if you've mentioned, but I've heard you say that women chronically seem to under eat, especially maybe in that transition of menopause or during menopause. Is that a fair statement? I don't want to put words in.

[Dr. Abby Smith Ryan]

Your mouth, but yeah, no. And there's data that shows one of the greatest increases in eating disorders is now in that perimenopause space.

[Dr. Gabrielle Lyons]

And would you say that again? I have notes here that chronically undereating protein has been a problem and can affect body composition. Do you have thoughts about how women should design diets to actually build and maintain muscle and overall body composition?

[Dr. Abby Smith Ryan]

Yeah, I mean, yes, there's. You should actually tell us that science. I mean, it comes back to some of that feasible approaches. Yes. Should we improve our entire day to day diet? Absolutely. That's also a very deep behavioral science. And so one thing we've tried to look at is, well, can we make small changes to the fuel that we eat, eat around exercise to maximize those benefits, both body composition and metabolically. And it does seem that having some amino acids, whether it's in a. Usually we're not eating whole foods right before exercise due to some challenges in digestion, but some protein or amino acids prior to exercise tends to help with some of the effects of the workout.

[Dr. Gabrielle Lyons]

That's interesting. Do you mean in terms of performance or soreness or, you know, again, because I'm someone that has always trained fasted. I. I don't know if I eat, but I'm not training for performance per se.

[Dr. Abby Smith Ryan]

It's both. But I also think, and I'll be honest, like, there are days that I train fasted, not I try not to train fasted if I'm lifting weights.

[Dr. Gabrielle Lyons]

But how come?

[Dr. Abby Smith Ryan]

Why do I train fasted?

[Dr. Gabrielle Lyons]

Well, why would you not want to train fasted?

[Dr. Abby Smith Ryan]

When I look at the science and I look at, I want to have amino acids available for when I break down the muscle. And I'm also not one person, when I get done with my workout, I'm usually off to like, help my children. I'm not like, gonna have a meal anytime soon. So some of it is just optimizing. Will I see negative side effects? Probably not. I also am not trying to get that extra edge. I'm just trying to maintain or like. So it's just maximizing the little time that you have. And so when we look at more of a untrained or moderately trained population, it does seem that having protein prior to exercise helps with energy expenditure up to an hour after. So increases energy expenditure, increases fat utilization after exercise, which does not always mean fat loss. Right. And helps with training volume, which makes a lot of sense to me. Meaning, have you ever done a workout, fasted and got like dizzy or felt it is, but you keep pushing, which a lot of people then your training volume is lower. So then indirectly we've seen increases in strength and body composition. I don't think it's always a direct response. So it's almost like, why not? If you're training to maximize body composition and by having some fuel beforehand, you know, you probably will feel better, have a greater volume, and you have greater energy expenditure after.

[Dr. Gabrielle Lyons]

Why would that be? Is it just because your ability to perform more?

[Dr. Abby Smith Ryan]

Some of it. But we've even tried to control for volume. Trying to maximize or control volume during the exercise. We're trying to understand some of that now. Is it because you're still digesting some of the protein? Is it like a thermic effect approach, maybe? I would find that hard to believe with just amino acids because it doesn't take a lot of metabolic rate. Or is it because you're kind of refueling the amino acid pool? I actually don't know.

[Dr. Gabrielle Lyons]

It would be interesting. And then how do you guys measure energy expenditure? Is it a metabolic cart or is it.

[Dr. Abby Smith Ryan]

So our early work is using metabolic cart. Now we are using a tool called microdialysis. So and we're using Doubly labeled water to microdases. Yeah. It doesn't give us energy expenditure. It gives us kind of fuel utilization. So more fat oxidation, which allows us to understand what type of fuel you're burning. And then doubly labeled water gives us more of a. It's the gold standard for energy expenditure.

[Dr. Gabrielle Lyons]

Yes. And that's exciting that you guys are going to be utilizing that. That's amazing. When you design a diet for body comp. What does it look like?

[Dr. Abby Smith Ryan]

Oh, my goodness.

[Dr. Gabrielle Lyons]

And is that a fair question?

[Dr. Abby Smith Ryan]

Yeah, it is. I wish it was that easy. I mean, we could probably need your insight here. But in reality, when I have a body composition conversation, it's starting each meal with about 30 grams of protein, obviously depending on the individual. Yeah, I know. Speaking to the choir. And then I say follow it up with some sort of vegetable and our fruit. So prioritizing fiber and then carbohydrates that are starchy. So non. Fruits and vegetables are really going to be based on how much exercise someone is doing.

[Dr. Gabrielle Lyons]

Essentially you earn your carbs.

[Dr. Abby Smith Ryan]

Yeah. And I mean, I don't like to think of it that way because we still. Carbs are delicious.

[Dr. Gabrielle Lyons]

Not if I'm cooking.

[Dr. Abby Smith Ryan]

But it's more like what do you need? And those carbohydrates you're getting from your fruits and vegetables and your water content. And so trying to do that as a minimum of three meals a day. Most of us need to eat more than that. Which comes back to that conversation of people under fueling. Very few people are having 30.

[Dr. Gabrielle Lyons]

Shocking. And it's hard for me to understand that.

[Dr. Abby Smith Ryan]

Yeah.

[Dr. Gabrielle Lyons]

Because the listener is probably thinking under fueling. I thought the majority of us are eating too much and maybe it's over consumption, but it's under nutrition undernutrition for sure. And that perhaps it's the nutrient density is too. The nutrient quality is too low, but the caloric density is too high because you know, you're not going to build muscle and change body composition without amino acids where. I mean, it's just not going to happen.

[Dr. Abby Smith Ryan]

Or without. Most Americans will have a little bit for breakfast, maybe a little bit more for lunch. I mean, Don Lehman's work, you know, where everyone then throws down at dinner and then consumes a lot of their calories then. So it's even spreading those nutrients out.

[Dr. Gabrielle Lyons]

And I have here that your research, if someone were to look at your research and try to translate that, that the protein recommendation is greater than or equal to 1.6 grams, 1.6 grams per kg a day. Of protein in active women.

[Dr. Abby Smith Ryan]

Yeah. So that was translated from Dr. Mark Tarnopolski's work looking at some sex based differences and I think it's a good starting point. Like if you're a female based on some of, you know, even if it's smaller muscle or muscle mass or whatever it may be, 1.6 is a really good starting point.

[Dr. Gabrielle Lyons]

Would you say greater than or around 2.0 grams per kilogram is better? I'm looking here for postmenopausal women, I.

[Dr. Abby Smith Ryan]

Would even say for perimenopause.

[Dr. Gabrielle Lyons]

I agree. I agree as well.

[Dr. Abby Smith Ryan]

And that goes back to most perimenopausal women are trying to prevent fat gain.

[Dr. Gabrielle Lyons]

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[Dr. Abby Smith Ryan]

And so somewhat of a hypocaloric or, you know, matching goal is what we want. And anytime you do that, you want to slightly increase the protein intake and.

[Dr. Gabrielle Lyons]

Probably also for men as well.

[Dr. Abby Smith Ryan]

Absolutely right. Yeah.

[Dr. Gabrielle Lyons]

You know, I. I think what you have done is a really good job. We both feel very passionately about making the world better and, and whether it's a male or a female, the reality is women are understudied. They weren't even required to be in research until 1993. And there's just a lot of questions and people don't know where to turn or what to think. From my perspective, I think that good lifestyle habits, regardless whether you are a man or woman, there's probably less of a difference. And perhaps if you are some elite athlete or, you know, there may be a more evolved conversation eventually about how do we do things that are women specific. But from my perspective, I feel like we're not there yet. I don't know if you feel like we are or there are things that we know. Even when it comes to osteoporosis. Men get osteoporosis too.

[Dr. Abby Smith Ryan]

Absolutely. Yeah. I think my passion that fell with the female space is really because one, they really want the information and they don't have it. So does it need to be different than a male's. It needs to be different in the way we deliver it and how we meet their lifestyle. There are also a lot of mental health changes. And think about just. Women are CEOs of their household, meaning, like we need to give them the information that will also impact their spouses and their children. And sometimes it's in a slightly different way of like, you could tell a man to eat 30 grams of protein and they may have a better idea of what that looks like because of our environment, where a woman might think, that's way too much for me and how do I do that? And so I think it's just taking the science and putting it in a way that makes sense for a woman who is juggling a lot of things as well as we know in that perimenopause space, there are a lot of physiological and psychological changes that impact maybe how we interpret things or to kind of enact things.

[Dr. Gabrielle Lyons]

Have you looked at the influence of hormones or hormone replacement on training our body composition?

[Dr. Abby Smith Ryan]

Not. We haven't published any data. Our last few studies have said no hormone therapy and just looked at hormones naturally to help us understand that. Some of our new work, because so many women are now taking hormone therapy based off the, you know, kind of the. The back end of the Women's Health Initiative, most of the data I have not done, but have a big interest in it and you and I have chatted a little bit about the impact of hormone therapy on body composition, which is partly also why I'm passionate about it. Like even if a woman takes hormones, it is not going to override the lifestyle approaches. But I think that's where we lack. And hopefully what I can contribute is okay, well what do we need to do exercise wise to be able to stimulate muscle changes and bone changes and metabolic changes even with that hormone metabolic kind of perturbation.

[Dr. Gabrielle Lyons]

And that makes a lot of sense because again when we give individuals progesterone or estrogen, even testosterone, we don't see it change body composition drastically.

[Dr. Abby Smith Ryan]

Yeah.

[Dr. Gabrielle Lyons]

And especially if they are not doing the lifestyle component pieces, it, it doesn't make a difference.

[Dr. Abby Smith Ryan]

Yeah, I agree. I, I would ask you, do you see any changes on maybe like their motivation to exercise or their sleep, like indirect effects?

[Dr. Gabrielle Lyons]

Absolutely. When. And you know, if you look at some of the body composition literature and even the standard guidelines, hormone replacement therapy is not considered a treatment for body composition. Yes, but what you are saying in terms of sleep, we know progesterone affects sleep, you know, even estrogen and some of these testosterone, testosterone metabolites, all help with joint pain recovery. But again, does this translate directly to body composition changes? I think as we begin to study it more probably. But where we are right now, I can't say that that's true.

[Dr. Abby Smith Ryan]

No. And I mean I think it's more of an indirect effect of like can they now have greater volume or maybe better recovery or a lot of women, like you said, deal with pain or even just no energy to go do the exercise. But that adds so many different layers of variability when doing, you know, a controlled trial, which I know you've had conversations about and. No, I mean, I think we need more work. But my first stance would be let's not wait for the work. Like we need the lifestyle behavior changes. That's what's going to be the biggest stimulus on body composition.

[Dr. Gabrielle Lyons]

What about the advanced trainee, the person who is totally already well trained, what are they going to do to maintain body comp.

[Dr. Abby Smith Ryan]

That's a good question. I wish we had the answer. I mean it, it's those people that those small changes are going to make a big difference or I mean the best part about science and knowing science is to, to use your own body as an experiment to some extent. Yeah, yeah. So like maybe it is altering their nutrition slightly different if they've already consumed a high protein diet. There is some interesting data that shows about a 60% deviation in a young muscle is needed to see improvements in muscle size.

[Dr. Gabrielle Lyons]

What does that mean? That's interesting.

[Dr. Abby Smith Ryan]

So like if someone's consuming, let's say 1.3 grams per kilogram per day of protein, which is within the recommended norms, maybe now they need to go up to 2 grams per kilogram for that deviation.

[Dr. Gabrielle Lyons]

Oh, that's interesting. I would love to see that. That is, I mean it makes sense and I, I would just, I would love to see that.

[Dr. Abby Smith Ryan]

I haven't seen it done in women. Okay. But that would be the thing a lot of times, and I am guilty of this as a scientist too, of what does the data show. But ultimately everything we do is weighing our risks and our benefits. You know, and in reality modifying your dietary protein and, or fiber and micronutrients, there's very little risk to that which could benefit an individual.

[Dr. Gabrielle Lyons]

Where, if you could wave a magic wand, where would you ideally like to see the collective research group go for answers?

[Dr. Abby Smith Ryan]

Like what type of answers?

[Dr. Gabrielle Lyons]

So I think, I don't know, I left it kind of open ended so that you could pick, you know, for me. I know, I'll give you what I would love to see.

[Dr. Abby Smith Ryan]

Yeah, okay. I would love. You want to go first? You want me to go first?

[Dr. Gabrielle Lyons]

Are you ready?

[Dr. Abby Smith Ryan]

Yeah.

[Dr. Gabrielle Lyons]

Okay, then you go.

[Dr. Abby Smith Ryan]

Okay. This is probably because I'm a physiologist, but we need good solid recommendations for exercise in women. Do I think they're gonna be different? I actually don't know if they'll be that different. But right now all of our recommendations are based on men.

[Dr. Gabrielle Lyons]

Is that true? Yeah, tell me about that.

[Dr. Abby Smith Ryan]

Like, I mean, maybe it's been research in males and females combined.

[Dr. Gabrielle Lyons]

So for example, the ISSN will say, okay, here are the general guidelines, which is International Society for Sports Nutrition or.

[Dr. Abby Smith Ryan]

Well, yeah, so ACSM and NFCA will make our exercise regulations. Well, they're just very broad. And so when we start to look at some of the nuances related to muscle mass and bone mass, will it need to be different in males and females? Right now I don't know if it will be, but I would really love to see some of that data and to say, okay, if you are a middle aged female and you're seeing changes in body composition, would you see benefits from zone 2 training or high intensity resistance training or HIIT training and that be a bit more specific. Right now our guidelines say, you know, do 150 minutes per week of activity or 75 minutes of high intensity, throw in a little resistance training. But I think we need to narrow that for males and females, but I, I think we can do better so that it's not so confusing.

[Dr. Gabrielle Lyons]

Do you imagine it be somewhat of a flowchart? Would it look like you are a perimenopausal woman who has always been athletic with no pre existing conditions, you need to be doing high intensity interval training. This. Do you know, if we were to kind of think about how we would do that?

[Dr. Abby Smith Ryan]

I mean I think it would be training. Age will definitely have a role, but I do think their goals will matter and outcomes. I think some of it you would tell everyone to do high intensity interval training, but maybe a bit more prescriptive depending like you mentioned, there are a lot of women that have been active but continue to gain fat mass. So what do we do for those people? Like I feel like we need to help them versus exercise becoming frustrating or those are the people that then work out even harder and then end up with injuries and then unable to train.

[Dr. Gabrielle Lyons]

Have you thought about a solution for that?

[Dr. Abby Smith Ryan]

I mean I think this is maybe pessimistic, but I feel like we don't have that foundational work. So my initial solution is let's start with what we think would work kind of for everyone and to start to see is there any difference so that we can start to target some of those harder responders.

[Dr. Gabrielle Lyons]

And do you believe that it's inter variability that is it based on age or is it based on the individual?

[Dr. Abby Smith Ryan]

I mean I don't think it's based.

[Dr. Gabrielle Lyons]

On age, I think which is amazing and I would guess that many of the listeners or if you guys are watching this, you might feel that it really is based on age and it's again, you're never too old. You're also never too young, right?

[Dr. Abby Smith Ryan]

Absolutely. And I mean menopause is natural aging, like that is aging. But there's a lot of things going on that seem to be more than age. And those are the things like how can we tackle some of those? And you're absolutely right. Like a lot of the data seems that the sooner you start the better. But if you start, it's never too late. And I think that's important. Especially when we look at our 20 year olds and early 30s. Like there's a lot you can do now that actually will have a big impact when you are in post menopause.

[Dr. Gabrielle Lyons]

When you say prescriptive, do you think that there are ways of training that are a bit understudied or that we're not exploring more, for example, plyometric.

[Dr. Abby Smith Ryan]

Absolutely. And you don't want just people to go do plyometrics.

[Dr. Gabrielle Lyons]

No. You. I mean, unless you want a really busy ER or a busy surgical suite. Yes, Go right ahead.

[Dr. Abby Smith Ryan]

Yes.

[Dr. Gabrielle Lyons]

You know, because I was thinking about this as I think about what you were talking about, this prescription and what do we need to do to, number one, improve performance and also allow people to continue to train over. Over a lifetime.

[Dr. Abby Smith Ryan]

Absolutely. And I, like, I. I recently injured my calf, and I should have done some plyometrics.

[Dr. Gabrielle Lyons]

I did, too. How did you. Let's. Let's.

[Dr. Abby Smith Ryan]

I don't even want to tell you the story. I was just bouncing over to tie my kid's shoe, even though I just ran five miles. But it's that ability or our loss of ability to recruit our type 2 motor units as we age, our. Our larger motor units, our larger muscles, which. Plyometrics. Like, I should be doing more plyometrics. But how do we integrate that in a way, like even and maybe never stop? Right.

[Dr. Gabrielle Lyons]

And that would be interesting to see if there was some kind of roadmap, because, you know, I was talking to my friend Mark Bell. He's in his. Do you know Mark?

[Dr. Abby Smith Ryan]

Everyone knows Mark.

[Dr. Gabrielle Lyons]

What's up, homie? We are. We're all very good friends. And he sprints. He runs. And he said, you know, better do it now. Yeah, I don't want to lose it.

[Dr. Abby Smith Ryan]

Absolutely.

[Dr. Gabrielle Lyons]

And he's a big dude.

[Dr. Abby Smith Ryan]

Yeah. Which I wish I sprint. Like, just. How do you fit that in at 5 in the morning? You know?

[Dr. Gabrielle Lyons]

But if you stop doing it, how do we incorporate number one? I've asked myself, is it necessary to be explosive? I don't know if we would consider sprinting explosive, but I would. Okay, great. And then if we've stopped doing it, which I have, how do we do it without getting injured?

[Dr. Abby Smith Ryan]

Yeah. And what's the. I always like to ask, like, what's the minimum threshold? A lot of people want to know, how do we optimize? But with a lot of this, too. Like, what's the minimum I can do at this phase in life? Now there's like. And then what is that prescription? If we want more, how do we progress? And then, you know, what's too much? Because too much of this is also not good.

[Dr. Gabrielle Lyons]

Jump rope. I mean, I'm afraid to. I've got a jump rope sitting in my garage. I'm like, oh, man. You know, this is probably really important because most people, as they age, they step off of a ledge and they fall.

[Dr. Abby Smith Ryan]

Well. And, I mean, we're in a Space that really, I don't want to say idolizes, but we want to look better. We also want to feel better. And I can probably look better without sprinting. And so it's like, how do we incorporate that?

[Dr. Gabrielle Lyons]

That's a really good point. Do we train for aesthetics versus do we train for, I don't want to say injury prevention, but long term maintenance.

[Dr. Abby Smith Ryan]

Of muscle span, that's what we should be training for. It's hard to do that. Have you ever seen those memes of like, how do you take care of yourself and sleep and grocery shop and work and train? Like, well, how do we do it in a way that fits in our lifestyle, that optimizes health and injury prevention?

[Dr. Gabrielle Lyons]

Would you say that? And you said that you're trying to figure out where to put that plyometric piece in there. I haven't seen a ton of good data that I understand of how one can do that or from an aging perspective, have you?

[Dr. Abby Smith Ryan]

No, but I mean, honestly, that's partly why we stick with the high intensity interval training model as a starting point, because that type of training does help with recruiting those larger motor units. Is it the only way? Absolutely not. But I feel like that's a good first step where you, again, minimum amount of time, that's getting the maximum amount of benefit. I have not seen a lot of.

[Dr. Gabrielle Lyons]

Plyometric data and I was looking and it just seemed that it's a bit underwhelming because I think, okay, well, how are we going to protect bone? And does it have to be something different? We know that muscle and bone pull together, right? And that generates force, which then seems to generate use. None of us want to break a hip, at least not today. But what do we actually have to do to do that? And do we have to do jumping?

[Dr. Abby Smith Ryan]

Well, I think it depends too. Like, sounds like you and I need to do some more jumping or sprinting.

[Dr. Gabrielle Lyons]

Girl, I'll meet you out there. I just recently hurt myself again. Doing what? Personally, I like to lift heavy. And I am, as you know now a very small human. Maybe I'd be pushing 110 and I'm five foot one. I wanted to, for whatever reason, push a heavy sled. I didn't really warm up and it was probably close to 350 pounds. And man, was it fun.

[Dr. Abby Smith Ryan]

Yeah, I was gonna say.

[Dr. Gabrielle Lyons]

And I did not warm up. And then I was throwing these, you know, the bags cause fun. And the next day I could barely move. And it's still recovering now. And it was just so stupid. What muscle my Calf, it is killing me. I totally strained my calf.

[Dr. Abby Smith Ryan]

I did the same, but not lifting 350 pounds.

[Dr. Gabrielle Lyons]

Technically, I was pushing and I, you know, the human body thrives off of challenge and it's also how we maintain our capacity through life, our faculties, physical and mental and understanding. How do we design a life where we can push ourselves without getting injured? I say that cautiously while maintaining performance.

[Dr. Abby Smith Ryan]

Well and knowing that we will get some injuries, but how do we optimize it? And that's where a lot of the nutrition and dietary supplement work comes in of how do we then accelerate that?

[Dr. Gabrielle Lyons]

What are you most excited about coming up for you?

[Dr. Abby Smith Ryan]

I'm really excited about this conversation of women's health. Meaning, like when we recruit for a study, I have like 300 women that want to participate. Now, they don't always fill in that inclusion criteria, but I think the time is now and I think there's a lot of good funding. Research isn't cheap, but there's conversations about funding, whether that will actually come to fruition. So I'm just excited about the opportunity and there's more groups doing it. And I'm a big believer that if we all come together, we can accelerate research because it is so slow.

[Dr. Gabrielle Lyons]

Do you think that with the highlight of Women's Health it's going to swing people too far? You know, it just seems in, in the scientific community, and I think that we've both experienced this, is there becomes a ton of excitement and then we overshoot.

[Dr. Abby Smith Ryan]

Yeah. I've seen two things. One, I've seen there's actually more barriers to doing work in women's health because they say it's not high quality enough, it doesn't meet the right standards and therefore it's not published. So it's actually pushed us back a little bit.

[Dr. Gabrielle Lyons]

And can you explain for the listener a little bit about what you mean by. Because I think it's an important point.

[Dr. Abby Smith Ryan]

Yeah.

[Dr. Gabrielle Lyons]

The idea of high quality data and why they would publish versus not publish doesn't have to be anything deep.

[Dr. Abby Smith Ryan]

But yeah, I think it goes back to our. Where our conversation started. Women weren't originally included in research because there's a menstrual cycle or changes in hormones which adds a level of variability. Well, how do you account for that? It does take extra time and money, but sometimes those granularity pieces aren't necessarily needed. But if you don't have all of those things, there's an extra level of scrutiny when publishing data that says, oh, you're studying women, you didn't do all of these things, it shouldn't be published when in reality that's throwing the baby.

[Dr. Gabrielle Lyons]

Out with a bathwater.

[Dr. Abby Smith Ryan]

Absolutely. And it's been quite frustrating. And I also see this space of research is very competitive of, you know, like, if someone gets a grant or publishes it. But in my view, like, there are so many questions that are needed and we are so far behind. We need to change the space to say, like, we can all come together and there's enough space for us all. And I think if we can swing the pendulum the other way of saying yes, there will be some limitations in the research, but this is one step forward. Let's make sure we're not all answering the same questions and let's kind of accelerate the space.

[Dr. Gabrielle Lyons]

I think that that's absolutely tremendous. And there's that saying that if you want to go fast, you go alone, but if you want to go far, you go together.

[Dr. Abby Smith Ryan]

I love it.

[Dr. Gabrielle Lyons]

Dr. Abby Smith Ryan, thank you so much for spending your Sunday with me and I'm really grateful for your poise and desire to help share. So thank you so much for coming on.

[Dr. Abby Smith Ryan]

I'm so grateful for the chance to be here and for all your work.

[Dr. Gabrielle Lyons]

If you found this conversation valuable, make sure to share it with a friend or loved one. Leave a review and hit subscribe so you never miss an episode of the Dr. Gabrielle Lyons Show. And if you're ready to put this knowledge into action, we've put together a protocol just for you. Check out the link in the description below and it's totally free.