← The mindbodygreen Podcast
The mindbodygreen Podcast
631: Building lean muscle, optimizing body comp & protein timing | Jaime Seeman, M.D.
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- [00:00]
A
Welcome to the mindbodygreen podcast. I'm Jason Wakab, Founder and co CEO of mindbodygreen and your host. As the new year begins, most health advice still revolves around cutting calories and chasing the scale, rather than supporting women's long term strength and hormonal health. Today's guest, Dr. Jamie Seeman, is back on the show to shift that narrative and explain what true strength actually looks like this year and beyond. Dr. Seaman is a board certified certified certified OBGYN with advanced training in nutrition, exercise science and integrative medicine. She's also a board certified ketogenic nutrition specialist and a member of our scientific advisory board here at mindbody Green. Bringing together clinical expertise, performance science and real world experience caring for women across every life stage. In today's show, we explore how to train and fuel your body in the new year for strength, fat loss and longevity, fasted versus fed workouts and how to use fasting without harming hormones, why protein resistance training, creatine and muscle are non negotiable for women as they age and how nutrition training and hormones need to shift in your 30s, 40s and beyond. If your New Year's goal is to feel stronger, sharper and more resilient, this episode is for you. All right, so it's 9am in Nebraska. It's a Friday in December, although this is airing the first week of January. Walk me through your morning. I have a feeling you've already done a lot.
- [01:35]
B
I have. Well, today's a non clinical day because I get to be here podcasting. So this morning I got up, I went to the gym, I actually got called into the hospital to deliver a baby. So went and did that.
- [01:48]
A
Whoa, whoa, whoa, whoa. Just stop. Yeah. What time was that? It's 9:00am Oh, I got called 5:00am.
- [01:53]
B
Yeah, it was 5:00am but. And then, and then I came home, I actually had some coffee, got my girls off to school, I got on a meeting, we had a human performance team meeting for our Omaha Supernovas, our professional volleyball team. I actually got a few presents wrapped after my girls left the house and now I'm here doing this beautiful podcast. But a normal, normal, normal day. My normal is so much different. But a normal day. I would wake up at 5am, I would head straight to the gym, I would get my workout in for an hour, come home, shower. Depends on what's going on at the hospital. Sometimes I have surgery as early as 7am sometimes. So in the gym at 5am in the OR by 7am if I don't have surgery, then my clinic day starts at 9am Sometimes I'm fasted, sometimes I eat protein. It depends on what my lifting schedule is. Of course, creatine and electrolytes right out the door at the gym. And then you just never know what the day may bring. I've got, you know, a full day of clinic most days. Babies come whenever they want. I'm generally home by 5pm and hitting the ground running with my kids schedules, depending on kids schedules. And sometimes I get to do other things like, you know, I might sauna or you know, work on some emails and things like that. But I am in bed every night.
- [03:09]
A
By 10:00pm wow, so you've accomplished just, let's talk about today more in probably four or five hours than most people accomplish.
- [03:18]
B
I usually do a lot before most people wake up, but that is like the most productive part of my day is honestly like that 5:00am to 9:00am, you know, window. I'm, I'm up, my brain's going, right. I'm not tired. There's not a lot of distractions. You know, by the end of the day you don't know what's gonna happen. So I don't put really important things after 5pm like there's no guarantee. So if it's really important, it's gonna happen in that 5am to 9am hour.
- [03:48]
A
Like delivering a small child.
- [03:50]
B
Well, you know, babies are kind of rude. They come at any hour of the day or night or holidays or weekends. So we just let that happen. We can't plan for that. And that's just, that's my life and my family knows it too. And you know, I think if you have to run away from something in your life to go do that. I haven't, I haven't seen one person that was like, oh, okay, fine, go deliver a baby. It's a really cool part of my job.
- [04:18]
A
No, it's incredible. And the fact that you just, it just happened and here you are, no big deal. That's incredible. You know, you mentioned sometimes being fasted. Not fasted. That's a hot topic these days. How do you think through that?
- [04:31]
B
Okay, so fasting is just a tool. We all fast to a degree because we sleep at night. Unless you're rummaging through the refrigerator in the middle of the night. But we all fast to some degree. I think fasting can be overdone. We have to balance fasting with feasting. And when you are eating, whether it's a one hour window, eight hour window, 16 hour window. What are you putting in your body, in that, in that window, Are you getting the nutrition that your body is asking for? Are you getting enough protein? Are you getting enough energy, calories for what you're expending? What are your goals? Maybe your weight gain, weight loss, weight maintenance? Are you getting the micronutrients that your body needs? So when patients ask me about fasting, we have to say, okay, what's the goal? I like fasting because I'm really busy from 5am to 9am and sometimes it's not convenient for me to, you know, sit down and have a meal. I can, I can delay that until later. Sometimes I do choose to eat right when I get home from the gym. Get those amino acids, get the protein in there. And it all depends on what's happening in my life. You know, I just came off of doing a bodybuilding show and now I'm, you know, regaining and kind of back at maintenance. So I think we have to always put this in the context of what is the goal with the fasting? What's the appropriate window that we should be doing that? Is it a good thing? Is it a bad thing? I mean, I've seen people overdo it.
- [05:55]
A
So if someone listening wants to gain lean muscle mass and the same time lose fat and they're lifting in the morning, which I think a lot of people lift before they really start their day. Do you have a hardened, a hard rule like do you need to eat something before you hit the gym or do you just go straight in? How do you feel from an energy standpoint and what works best for you? Do I eat a little bit or a lot before or after?
- [06:25]
B
I have worked out, fasted now for, I mean, almost 10 years and I feel great. I don't have any issues with that. Some people feel better when they have, you know, a small amount of nutrition. Obviously you don't need to eat a, you know, large meal before you hit the gym. The studies really show, though, if you're going to use, let's say like a small carbohydrate load before a workout. It's actually a really tiny amount. It's like 10 to 15 grams of carbs in, in these studies, it's not that much, right? Like that's like a bite or two of an apple or banana or something like that. So I don't use any pre workouts. I literally just use creatine and electrolytes and I don't eat until after the gym. I think the most important thing to understand is when you break your fast, which is called breakfast. When you break your fast, the most important thing is that you're getting enough amino acids in that first meal, the correct amount of protein, because your body has been in a catabolic state. And now I've just gone to the gym and I've, you know, put it under more stress. So that very first meal, my body's catabolic. I'm gonna give it the Lego building blocks, I'm gonna give it 30 to 50 grams of protein with that first meal to get me out of that catabolic state and work on building, repairing, increasing lean mass. The mistake that most women make is that they break that fast with like 10 to 15 grams of protein and then they have a little more later and a little more later. The problem is they're spreading it out. We want a huge bolus of protein with that first meal and with the last meal as we go in into that fasted state again. And that's the biggest mistake that most people are making. You don't really necessarily even have to overthink the timing of this as long as you're getting it at that first.
- [08:12]
A
Meal, need to hit that two and a half grams plus of leucine exactly.
- [08:16]
B
Where, that's exactly where the 30 to 50 gram of protein comes from. Because if you're eating 30 to 50 grams, you're likely getting 2.5 of leucine.
- [08:26]
A
Or 25 grams if you have our Crossfed Way and our 2, and our 2 and our 2.9 plus grams of leucine like that. That's exactly why we spent, I don't know if I told you this, like almost two years working on a plant protein powder. And then we eventually gave up because we could not find a way to hit the leucine threshold without throwing such an insane amount of plant protein, which was like heavy metal soup.
- [08:53]
B
Yeah. And it'd be the same if you were trying to eat it. I mean, it's just not the most efficient, optimal way to get it not happening.
- [09:01]
A
So back to the window. So if someone's like they're gonna work out, they're pressed on time in the morning and they just want like a little something, you know, maybe it's a, a tablespoon of, it's like some peanut butter on sourdough, something just to like get, get, and then they work out for an hour and then they get their big protein, their protein losing load. Do you consider that all in the eating window of the first meal? If it's in with like a two hour time period?
- [09:29]
B
Yeah. I mean, technically, the first thing that hits your mouth, you're out of the, you know, fasted state. If you're just having a small thing and then going to the gym, though, you're gonna, you know, burn through that. And then post workout, protein and carbs would be, you know, most appropriate. If you're going to have carbohydrates, that's the best time post workout because muscle is the greatest disposal agent of glucose. So you're, you're getting that insulin spike, you're bringing the glucose into the muscle. You know, that's helping keep you in that anabolic state with the protein. I wouldn't have like a large, you know, fat meal and carbs after workout. That would be a, a metabolic bomb. So it's important that, you know, you're giving your body those building blocks and appropriately timing them too. You know, if, if you're going to be strategic, but don't overthink it. Like I said, but that first meal, make sure there's enough protein.
- [10:15]
A
Makes sense. And I want to spend a moment in the protein, fat, carbs, something that I've experienced personally and I'm training a lot harder. I crave carbs and I am eating more carbs than I have probably. Like, I am a sourdough machine. I eat so much sourdough bread, but I've also, I've cut down on my fat. So I used to be on. On the flip side, I was like the nut butter maniac, where every smoothie just had so much nut butter and then it was nut butter on this, nut butter in that, and then just a lot of nut butter, a lot of avocado, and I love avocados. I've increased. I don't really track macros, but I've. But. And I've increased my carb consumption significantly. And instead of having like two avocados a day, I'm probably having less than one. And I've never been more fit, more lean, full of energy, still maintaining my muscle mass. And it's like I was like, wow. I think, I think there's. Carbs are really underrated here.
- [11:21]
B
You are very metabolically healthy. You're probably very metabolically flexible. The trouble that most people get into is they, they don't know how to find the balance. So, you know, let's go to the extremes. A ketogenic diet is, you know, very high in fat, very low in carbohydrates for endurance athletes. There's actually some literature that suggests that it can be strategic and helpful to train in A ketogenic state, and then use carbs strategically for performance. Um, there's some literature and endurance athletes they've studied crossfit athletes, college athletes, for just kind of the regular person that's not training at that level. There's some evidence that can be really helpful at reversing insulin resistance quicker than, than just a caloric deficit using carbohydrates. And then let's go all the way to the other extreme bodybuilders, right? Most of them are extremely high carbohydrates and very low fat. This one, there is a minimum threshold of fat and fatty acids that are required for human life. So you can get in trouble eating really low fat for long periods of time. Flip that back over to people who are low carb. As long as you're consuming enough fat and protein, there's really no essential carbohydrate level that's required for human life. Where most people can't find that balance is the in between. Carbs and fat are energy, calories. And so you cannot overeat both of them. And most people don't know how to work that seesaw of like finding like the threshold of how. And you're kind of talking about this, okay, I raised carbs, but now I'm lowering fat. That's exactly what you're supposed to do. If you increase carbs, you gotta lower fat. You gotta, you know, equate for that energy. I think we all have some bio individuality as far as, like how we feel and how we function. And I think a lot of that too, is your metabolic state. Like I said, you're, you have probably have really healthy muscle tissue. You've got a good VO2 max. Your body knows how to handle.
- [13:13]
A
Keep on talking.
- [13:14]
B
Whatever energy you're putting into the tank. And so you're, you know, your baseline kind of, you know, fitness level matters. I think for people who aren't fit and don't have healthy muscle tissue, if you have insulin resistance, any sort of metabolic disease, you can really get in trouble eating a ton of carbohydrates. And like I said, the trouble is, is people don't know how to, you know, lower the fat if they increase the carbs. And so then they're just constantly overeating fat and carbs, you know.
- [13:42]
A
So how do you think about. For the average person, look, there's a lot of nuance here, but let's just say the average person around the macro conversation, average person wants better energy, body comp, better glucose stability. What framework do you recommend for this person, you know, they're not overweight, they're not underweight, they're, they're, they're kind of, they're healthy, but they just want to dial it in. How would you approach that?
- [14:12]
B
The first thing I look at, especially for women, is how much protein are you eating? Because as we age we get something called anabolic resistance. So we actually need more protein, more leucine to stimulate muscle protein synthesis. So if they want to maintain, they feel like they're relatively healthy, they just want to like, you know, bump up one Mario Brother level. We're going to look at how much protein they're eating. Cuz that may be a strategic way to maintain their lean tissue, to maintain wherever where they're at in their metabolic health. And then when it comes to carbs and fat, I personally, because I'm a physician, I get the advantage of, you know, I, I look at metabolic markers. What's their A1C, what's going on with their lipids, what's their fasting? Insulin maybe. I've got some body composition testing, you know, what's their visceral fat look like? Nutrition is, is a key part of that. And that's where we can, you know, kind of determine maybe you can tolerate more carbohydrates. Let's see how you feel with that. Maybe we need to drop that and we need to increase, you know, healthy fats in the diet. The type of carbs you're eating and the type of fats you're eating also make a difference. We're using a very broad term when we just say carbs and fat, you know, are you eating sourdough? Are you eating skittles? You know, are you eating blueberries? Or are you eating processed, you know, garbage in a box? Same goes with fats, you know, high quality fats, dairy, olive oil, avocados. Right. And not, you know, a bunch of processed fats and processed foods and vegetable oils and soybean oil and these types of things. So the quality matters too. When we're talking about these macronutrients and.
- [15:41]
A
I think something you said, I totally agree with, it's listen how you feel, you know, how do you feel? Do you have energy in the morning? Something that I pay attention to. Curious. Your take is my wearables. I look at my resting heart rate and my hrv, like are those, are they improving? And what I found is when diet is starting to really work for me, those numbers improve. When I go off the rails a little bit with diet, they tend to go in the wrong direction.
- [16:05]
B
Yeah. And women in particular, especially in a menstruating woman, it's gonna change from, from week to week. Like your physiology is literally changing. You're gonna be able to tolerate more carbohydrates in the diet when you have a lot of estrogen. When we get into luteal phase and we have more progesterone and less estrogen, we're gonna have a little bit more glucose instability. And so that may change how you feel even though you're kind of eating your normal diet. So those are things too. You know the wearable devices are so cool now like the biometric data we can get, you can literally use it to track, you know, your ovulation and women are using it for fertility. I mean it's just, it's so cool what we can do now. And, and I think it helps people learn about their bodies and you know, because like I said, we're all going to respond a little bit differently so.
- [16:49]
A
And we respond differently by decade. And let's start with women in their 20s and why don't we start with professional athlete? You work with professional athletes, the Omaha Supernovas. These are, these are physical specimens. These women are tall, strong, athletic, unbelievable athletes. They can jump higher, jump higher than I could in my prime. Some of these women, me too. So like how walk us through what they do, how, how their slightly different than us mere mortals.
- [17:20]
B
Well, these women are incredibly, you know, talented and amazing athletes. But one thing that we can acknowledge is that when you're young you can get away with, with bad things. I'm actually kind of surprised even being professional athletes, some of the really young girls, I'm like, you are such a good volleyball player and you're walking in here with this like monster energy. I mean you would actually be probably surprised not all of them have it dialed in, but I think that's what you know, separates the cream, you know, from the milk sometimes is the people that really understand how important that is. But let's say some, yeah, 20 something year old, you know, woman, you are hitting your peak bone mass and you've got lots of hormones from your menstrual cycles. The estrogen is good for muscles. It helps you retain lean mass. You don't need as much protein as you would need if you were 30 or 40, but you still want to be making sure you're getting that, that loosing especially if you're an athlete for sure. And from a, from a body composition standpoint, most people in their 20s don't have trouble kind of maintaining that, you know, weight that they're looking for it. It's really once they get into their years of childbearing that they start to struggle a lot more. But you're in your 20s, you're training, you're enjoying the gym. Life is fun. You know, you're, you're going through college, you can have dietary excursions and, and usually get back on course pretty quickly. You're, you're pretty resilient in your 20s.
- [18:44]
A
And what changes? And first of all, for the Monster, the, the girl, the, the women on Monster, we're gonna have to sign them up for our creatine and taurine protocol. We won't name names, but we, we will, we will send a shipment of creatine, taurine and our creatine electrolytes to these, these athletes on the supernova stuff. Let's set em straight. So what changes? Okay, in the 20s, I hear you, you can get away with a lot. What, what. Let's, let's go into 30s, 40s, 50s and beyond.
- [19:11]
B
Then this next kind of chapter in most women's life is, you know, they're settling down, they ready to start, you know, a family. And so when women go through these years of, of pregnancy and breastfeeding, it is the greatest physiologic stress that a woman will ever encounter in her lifetime. Growing a human and, and birthing it and then feeding it for, for a period of time, the nutrient depletion that can happen in a pregnancy. And breastfeeding can take up to three years to replete. And most women are not waiting three years to have their next child. That baby turns 1, and they're like, let's do this again. And that happened to me. My girls are 23 months apart. So I had a baby and 23 months later, a baby, and 23 months later, another baby. And so what happens then is first of all that now they're giving all their time and energy to these children. And so they're not working out in training like they used to. Their bodies are literally getting the life sucked out of them, literally and figuratively. And this is when most women really start to struggle, you know, with their health and with their nutrition and their inability to train, you know, consistently. And that can have ramifications on their lean tissue, on their visceral fat, on their hormones and their menstrual cycle. This is where I really, you know, if I were to take a picture of my patients, like year by year, like you can just start to see it in their faces. So I wish that what more women did was if you are at that point in your life where you're ready to, you know, start a family or, or have a child, is to get real strategic and diligent with your nutrition before you go into pregnancy and have a plan, you know, postpartum, how you know, you really have to kind of plan where you are going to fail most of the time and kind of like know where your weak spots are. And I wish we supported women better in that way. But it's, it's a tough chapter. It's a tough chapter and some people are resilient and come out okay on the other side. And some women, that is the top of the hill to the, to, to start to go down in their health. It, it can be really rough for some people. Rei Co Op knows when you're up at 4.30am on a Saturday for a long run and you're actually excited. Not everyone gets it, but we do at rei we're here for people who get outside gear up for your next run in store or@rei.com.
- [21:44]
A
Well, also everything changes. I think about, you know, we just talked about athletes and I'll speak about male athletes, not female athletes. There are so many male athletes who play at the highest level, like professionally and then they stop playing and they just like fall apart and you can't recognize them. They're grossly over like. And you can get away with so much in your 20s specifically if like you're a full time athlete, then, then when that stops or you hit your 30s, your body changes. And women have it a hell of a lot harder than men. If you don't have the basics, it's going to be rough. And we think about the basics. I'm assuming it's nutrition dialed in, your macros, your resistance training, some level of cardio. Like you need like a baseline understanding of what works for you.
- [22:29]
B
Yeah. Nutrition training, sleep, stress mitigation, those things, you know, have to be dialed in.
- [22:36]
A
So what worked for you? Like three babies in essentially six years?
- [22:41]
B
Yeah, like what is that, 50, 56 months or something like that? Yeah, yeah.
- [22:46]
A
What was, what was the greatest return on your investment, so to speak?
- [22:50]
B
You know, I say this because I speak from personal experience. That was where there was a down trajectory in my own health. I, after the birth of my three girls and having a husband who's a police officer working nights, I was diagnosed with hypothyroidism, pre diabetes. And I thought I would just like, I'll just like sign up for a Half marathon. That'll like, get my health back. And that wasn't it. Yeah. Like, I didn't have the nutrition part dialed in. And then I hadn't been weightlifting since college. I mean, you said that about professional athletes. You leave a place where somebody's telling you exactly how to train and show up on these days and suddenly, like, you're out on your own and you're like, now what do I do? And it can be, it can be a downward spiral for some people, mentally and physically. But, yes, I had these three girls. And then, and then what happens? My youngest is 10. My girls are 10, 12, and 14. And now I still got kids at home. And I'm transitioning into this, like, perimenopausal time, which is just, like, mind blowing because I felt like my girls were just like tiny babies crawling around on the floor. And now I'm thinking like, oh, my gosh, I'm. I'm only like, however many, you know, years away from menopause. And now I'm shifting everything. I'm kind of like recalibrating, recalculating and trying to be strategic about this next chapter.
- [24:04]
A
And you're in your 30s?
- [24:05]
B
No, I'm in my 40s. Yeah. My 41st birthday is just around the corner here in, in a couple weeks. Got a happy birthday, January 3rd. Maybe this will come out on my birthday.
- [24:18]
A
I'm sure you're much younger on. Whoops. If you were to look at your health. So how do, how do you think about minimum effective dose for, for women in, you know, call it 35 plus in terms of resistance training? How, how did you approach that? What really worked for you and how. What, what would you prescribe to a woman who's in her mid-30s, maybe a little older, thinking about this next phase? Like, what, what is your absolute threshold?
- [24:44]
B
You mean, like, how many, how often should they train? How long should they train for?
- [24:48]
A
Yeah, how do they approach that? Because I think a lot of people are training, but I don't know if they're necessarily training enough or maybe they're over training.
- [24:56]
B
Yeah, yeah. Most women are doing too much cardio and not enough resistance training. How often do you have to do it and how long do you have to do it? It depends how efficient you are. You can get a really effective full body workout in a short period of time, and you can do that two days per week. And, you know, if you're doing, you know, full body, most people are wasting a lot of time in the gym. I have to be very efficient so I'm, I'm there at 5:00am, I, I get the stimulus that I need and I leave. I don't spend any extra time. From a body composition standpoint too, there's a lot of evidence for sprint interval training or high intensity interval training. And it's, it's not what most women think, that they're going to this like cardio class and that, that's high intensity interval training. They're really, they're really not, they're just, they're just doing a, mostly an aerobic workout for too long and then you can get a lot of cortisol response if you're doing that for too long. So I think that women, first of all, the low hanging fruit, the more bang for your buck, is doing resistance training and trying to do it at least two times per week. You could go up to three or four, you know, maybe you break it up into two days of legs and two days of arms or something like that. But I think the minimum effective dose is getting in there and getting that stimulus at least twice per week.
- [26:10]
A
So if you're doing twice per week, full body and you're efficient, you're, you're not scrolling, you're not looking around, you're, you're rusting. Call it like 30 seconds or to a minute, not like three minutes per, you know, per set. Like, if you're really efficient, how much time you think you need to spend in there?
- [26:28]
B
Well, I think most women are confused. How many sets do I do? How many repetitions do I do? How are you choosing a weight that is going to allow you to fatigue the muscle and, and the neuromuscular fatigue required to see, you know, change in the muscle. Most women are picking a weight that's too light. They're not pushing themselves to that threshold. And that's scary for a lot of people, right, because it's like you gotta make an ugly face. Okay? Like, if you, if you think you're gonna go to the gym and like, look pretty, like we need like ugly face level. And most women aren't picking weights and challenging themselves in a way that does that. You could do it with one set if you picked, you know, a heavy enough weight or if you did enough repetitions. The reason that most people are doing like three sets of 10, the first two sets are literally designed to just fatigue you. Fatigue the muscle, put it under enough, enough fatigue that in that third set, on the last couple repetitions, like, that's where the change is. So it's not just about like completing the workout, it's completing the workout in a way that, that fatigues you. Like you feel like you can't do, you know, one more repetition. Everyone likes to debate, you know, more reps, less weight, heavier weight, less reps. I'm like, just get to the gym and do something. If you're at that level of debate, like you're a seasoned, you know, workout.
- [27:48]
A
Person and I think at the end of the day you need that fatigue. The last couple reps have to be difficult. Not to the point where you're sacrificing form in such a way you're going to injure yourself. Because the only time in like I, I injure myself. It's happened on a few occasions, I guess more than a few, probably a handful. It's, I'm getting a little too aggressive and you know, you start wiggling and moving and next thing you know, oh yeah, I probably shouldn't have done that. And so the biggest mistake I see.
- [28:17]
B
Guys make at the gym is their ego gets in the way. And I'm like, hey, you know, you would probably be better served dropping to, you know, 10 or 15 pounds off that dumbbell you're holding and doing better form, more time under tension, a slower eccentric. But most people are picking up something too heavy. They're getting their hips into it. They're right. They're trying to do barbell, you know, bicep curls and they're swinging the weight and they're not. So yes, form, form, form. It's time under tension for the muscle. And I personally like to do a slower eccentric. And what that means is it's lengthening of the muscle, shortening of the muscle. So like when you're doing a squat, you're gonna go slow on the way down and then come up a little bit quicker. So slower eccentrics I think can be helpful at being more efficient too.
- [29:03]
A
I'm with you. I've become a 10 to 20 rep person. I rarely go below 10. Cuz now I'm just focused. I form slow like I don't care. I don't wanna get injured, I don't wanna lose a day. I, you know, throw the ego aside.
- [29:15]
B
Yeah, I don't, my disability insurance isn't, isn't good enough to do anything crazy.
- [29:20]
A
And so what about 40s and 50s for women? Same, same rules. Hold or do things change slightly?
- [29:27]
B
No. When we get into perimenopause and thinking about making the transition into menopause, this is where we start to lose our resiliency, especially to dietary excursions. Periods of time where we're not active and working out, nights of poor sleep, stressors. You know, maybe your kids are going off to college. I see women going through divorce. Whether it's emotional, financial, psychological stress, it can have a huge impact on your health. And so at this stage, when we think about perimenopause now, we have to kind of. We have to start thinking about the rest of our life. Like, what is my goal when I'm 60? You know, I don't go to the gym in the morning to, like, be better at squats. Like, I. Like on my headstone, I don't want it to say, like, she was. Did the best back squat we've ever seen. I train so that I can run up a flight of stairs to deliver a baby. I train because I want to take my girls to Italy one day. I train for the older me. Put in, you know, put in the work now. And that's what women really have to start thinking about in this transition, because aging is inevitable. And you want to go into menopause with the strongest bones you can have, the greatest, healthiest amount of lean muscle tissue you can have. And then eventually, you know, a conversation about whether hormone replacement is, you know, a good idea for you, but you want to start paying attention to your circadian rhythm and what time you're going to sleep and what time you're waking up. Because women start to get more sleep disturbances, and then they're tired, and then they're reaching for caffeine, and then they don't want to go to the gym because they're tired. And there's really nothing that. That changes with human metabolism. It's that. That we start feeling a certain way and we start living a different way. We don't move as much, we don't sleep as well. So then, you know, the nutrition starts to go down, and it starts to be a downward spiral for some women during this perimenopausal transition. This is the time, though, to double down on the lifestyle stuff a hundred percent.
- [31:22]
A
So you said, you mentioned hrt. Feels like we've swung the pendulum from no HRT to HRT for everybody. There's a lot of nuance in there. Yeah.
- [31:30]
B
So my grandmother. This is funny. This is, like, the best analogy. And my grandmother had one of those, like, sand dishes with this little pendulum on it at her house, and we used to swirl it around, and it would, like, make different patterns. Yeah, we. We had the pendulum on this side, and now we swung all the way over here. But I think with time, it's going to find its like, middle ground, you know. But I'm glad that we're having the conversation. I think for, you know, a couple decades now, women have kind of been gaslit in a way about this stage of their life. That that's just normal. You're just gonna have vaginal dryness and intercourse is going to hurt and, you know, the hot flashes will go away eventually. And it was always about symptoms. And now I think the conversation is really opening up. It's about reduction of cardiovascular disease, reduction of osteoporosis. It's about longevity and optimizing metabolic health. So I love that the conversation's opening up. You're right though. The, the pendulum is swinging. We'll find, we'll find the middle ground. But for the, I think for the listeners listening, what we really know now is that the vast majority are good candidates for hormone replacement therapy. If it's something you choose to pursue, and the earlier you start it, the better. So start thinking about it before you are in late perimenopause, before you've hit menopause. Start thinking about, you know, whether this is something that will be good for you because you don't. You really, there's no lab test. You don't know what year it's going to happen or what month it's going to happen. And find a provider that is very knowledgeable because for 20 to 30 years, this, we didn't do a lot of hormone replacement therapy. And we, we do kind of have some, you know, seasons of doctors that didn't do it and don't do it and don't let, you know your provider, just say, well, that's not something I do. And, and you know, turn the other way. You know, if, if the conversation is something you want to have, find somebody willing to have it with you.
- [33:19]
A
I like how you framed it up about longevity. There's something that goes haywire with women around this time period with regards to neuro, neurodegenerative disease, cardiovascular disease. And there is a strong link between, and this is for men too, how hormone health has a direct impact on your overall longevity. So it's not just about like the symptom. It's brutal. Like, I, I'm not gonna pretend to be a woman going through menopause with all the nightmarish symptoms. And they're brutal.
- [33:50]
B
Declining levels of estrogen. Estrogen directly impacts the mitochondria, and we have mitochondria in our brain. There's about a 30% reduction in brain Energy, our brain starts to become less efficient at utilizing glucose effectively. So there's, there's brain energy changes and these changes increase our risk for mild cognitive decline and really scary things like Alzheimer's disease. And so we do, we have to think about all of our organs, not only our bones and our muscle, but our brains and ways that we can be strategic. It's, you know, anybody who's had a family member with a neurodegenerative disorder, it is very stressful for these families. And when I watch, you know, people who have gone through it, you know, part of me says, gosh, I would never want my girls to have to take on that stress, you know, of taking care of me for, gosh, for how long, you know, with the brain that's broken. So there are a lot of things to consider and, and estrogen replacement. We, we really, we don't know that. That data is, is a lot more gray as far as like the timing. Can it prevent it? You know, can it help it? But one thing we do know is that metabolic health, exercise, healthy muscle tissue, your muscles actually talk to your brain. Weightlifting increases brain derived neurotrophic factor, which is like miracle grow for, for your brain cells. We know that glucose and insulin, I mean they call Alzheimer's disease, type 3 diabetes, very important at protecting our brain. So there are things that we can do to protect our brains.
- [35:22]
A
So you mentioned the muscle brain connection. So I have to plug creatine with Taurine plus, which I always, in my mind, you were like the earliest fan. You're like, oh my God, you created this product. I've been hacking this. So can we spend a moment on creatine with Taurine plus and why you.
- [35:36]
B
Love it so much creatine? You know, people always said it was like the, like the young male supplement. The bodybuilders took creatine. And now the literature, especially for women involving brain health, shows dosages way higher than the young men were taking. So you know, young men was like 3 to 5 grams of creatine for muscle saturation. But what happens is you have to saturate the muscle before it spills over into the brain. And those dosages are like 20 grams. So I've been taking creatine for a long time and now I'm taking, I'm starting to like up my dosage and see kind of like how I'm feeling, how I'm functioning, make making sure that I'm tolerating it. I wouldn't just like go to 20 grams a day if I was A woman. But yes, I, I take the creatine with taurine. That can be synergistic in a way for, for our muscle health. Taurine is just an amino acid. It used to take them separately until Jason and Colleen were genius in putting them together and habit stacking for me. But I, I get a lot of questions on social media, should women take creatine? What if I'm perimenopausal? What if I'm breastfeeding? What am I? Pregnant? Pregnant women and breastfeeding women need more creatine too. Some of the studies in, in pregnancy actually show a decreased chance of what we call fetal growth restriction. So we grow bigger, stronger babies by having adequate creatine and actually a reduction in a metabolic disorder pregnancy called preeclampsia. So creatine is very important across our entire lifespan. I actually have my girls taking creatine because they're in the gym now and they're lifting weights. My girls take creatine, I take creatine, husband's taking creatine, I got my parents on creatine. So it, it really, it really is for everybody. I mean we eat, we get dietary creatine. But some people would say to me, well you can get it in your diet. Why would you be taking, you know, a supplement? The creatine content, the amount of like beef and steak I would have to eat to get that level of creatine isn't feasible with my current caloric intake. And then when we cook, sear, broil our meat, it actually decreases the creatine content of the food. It converts some of the creatine into creatinine. So if you want optimal performance and longevity, you do have to supplement with creatine.
- [37:52]
A
And it's multi generational now. I love it. You've got everyone in the family, creatine.
- [37:56]
B
For you and creatine for you.
- [37:59]
A
Well, it's also too, if you lean and I think a lot of, I'll generalize here, but many women lean a little bit plant forward, they're eating, you know, it's hard for them to maybe get all the protein and they're probably even more likely to need creatine because they're, they're not close to getting anything from their diet.
- [38:18]
B
Yeah, I mean anybody on, you know, plant based, vegan, vegetarian diets are at risk for amino acid deficiencies, creatine deficiency, vitamin D, zinc, certain B vitamins, There's a lot of things. So no shame to anybody listening. I'm not a, I'm not a plant Based girl. We're very. We eat a lot of animal foods in this house. You can do it. But it does require a lot of strategic supplementation.
- [38:46]
A
Yes, 100%. Agreed. So we're gonna play a new game here where we're gonna go through some, some hot topics, and we want your take. Are they worth the hype or not worth the hype? And so we're going to run through a whole host of them, probably 10, and give us your, your gut reaction and maybe a quick explainer why it's worth. Worth it or not worth it? Are you ready? You're always game. All right, mouth taping.
- [39:16]
B
If you're a mouth breather, a hundred percent. Tape your mouth shut and learn how to breathe through your nose.
- [39:22]
A
Okay. 10,000 steps for sure.
- [39:24]
B
Great data behind 10,000 steps. But remember, walking is not exercise. You still need to be lifting weights.
- [39:31]
A
Intermittent fasting.
- [39:32]
B
If it works for you, do it. But there's a hundred ways to skin a cat at home.
- [39:37]
A
Urinalysis.
- [39:41]
B
That one's gonna be low. Low for me. I don't think most people understand how to interpret their own, you know, labs and things like that.
- [39:50]
A
I'm like 100. I think, just a moment on that. I think it's incredible how many platforms offer lab testing, but I have never seen so many confused people. And I'm getting DMS of like, I don't know how to interpret this. And they just end up going.
- [40:05]
B
They come into my office with this like 500 page report and then it's.
- [40:09]
A
Like, well, actually this is an algorithm that's like a whole nother. Like how many vials of blood did they take to get all these labs? Like only eight. And you got like 500 labs. They're probably running an algorithm that's not accurate, which is a whole nother conversation. Wolverine. Peptides.
- [40:28]
B
Just peptides in general. This is the wild, wild west. I like peptides. I think peptides are amazing. I think there is a lot of cowboy stuff going on right now and people gotta be careful. I mean, China is infiltrating the US with a lot of like poor quality grade things. Gosh, know where you're getting these things from, know what you're doing. I mean, peptides are powerful. We, you, they're, we use a lot of prescription drugs that are peptides. They're GLP1, that's a peptide. Um, I think they're amazing when used the right way. But I think you have to understand too, that they probably shouldn't be taken long term and for like months on End So I think we gotta be careful.
- [41:05]
A
100% fiber and everything.
- [41:09]
B
I, I live my life lower fiber than what is recommended and I feel amazing and my gut microbiome is good so I think fiber is very bio individual.
- [41:19]
A
Okay, Chachi PT for health advice.
- [41:25]
B
Man, the Internet is, that's a tough one because I, I do. I was just talking to somebody about this yesterday. I think AI is going to be really good at making our lives more efficient and maybe synthesizing information in a way that you could like understand it. But you have to remember that AI learns from what we've put onto the Internet. And not all of that is good information. I think the vast majority of times that I've chat, GPT something I think it's usually close. So I mean we're going to have to learn to live with it. It's the next, it's the next chapter.
- [41:57]
A
For what it's worth, I have a special folder where I've uploaded all my genetics, all my history of labs, my whole supplement stack and I will ask for recommendations and generally sometimes you have to push back. You have to like know the right prompts and but like generally I'm like this is kind of incredible but you need to know again like you need the, need the curiosity. You need to know the right questions. But if you just like plug in anything to chat and just rely on it like this is the voice of God. It's, it's not infrared body blankets.
- [42:29]
B
I think infrared light is amazing. I think sauna is amazing. So if you want to have it stack and do those two things together, go for it. I think you gotta have the other things dialed in first. Nutrition, training, sleep.
- [42:40]
A
Okay. Rucking.
- [42:41]
B
I love rucking. I do the 50 mile march every year. It's not, it's not how I normally train, but I think rucking is fantastic.
- [42:49]
A
Okay. Walks after meals.
- [42:51]
B
Amazing. Always walk after your meal. It's a great way to stimulate glucose uptake in the muscle.
- [42:57]
A
We've already touched on this, but I'll just say it again. Creatine for brain health.
- [43:01]
B
Creatine every day, Every single day. For your muscles and for your brain.
- [43:04]
A
Lymphatic drainage.
- [43:06]
B
Only if you need it. I mean I've used the compression things on my legs. They are great after like a really hard training session. But I don't know if you need em on a daily basis unless you're like our professional athletes use them.
- [43:18]
A
Okay. Gummies.
- [43:19]
B
I mean, not the most ideal way to supplement because usually gummies will come with like sugars and binders and food dyes and things in them.
- [43:27]
A
Agreed. Okay. The last one, the biggest one, GLP1s.
- [43:34]
B
I think they are a good thing when used in the right way and when used in combination with lifestyle interventions. But you need nutrients, you need protein. You still need to be lifting weights. So, you know, I don't. I don't think they're gonna be the cure that we want them to be because most people don't want to do.
- [43:52]
A
The other work, go hand in hand with lifestyle. I thought it was such a huge deal that the who. Not that like I. Again, not that the WHO is the final decision maker and all things health, but I thought it was pretty incredible that they essentially said, if you're on a GLP1, lifestyle absolutely must go hand in hand, otherwise it's not going to work.
- [44:12]
B
The prior authorization for insurance companies requires that we say that the patient is been adherent to a lifestyle intervention program for six months. I mean, that's what they require to get it approved. So are people actually doing it? Yeah, I don't know. I just saw an article yesterday. They're putting GLP1 pellets in fat cats now.
- [44:37]
A
Fat cats.
- [44:38]
B
We've now transitioned GLP1s into veterinary care. Like the cats going to McDonald's and like picking up its own meals. Like, let's do put the cat on a diet.
- [44:48]
A
I'm not a cat person. I just. I can't do it. We covered a lot. Is there anything we didn't cover that you want to touch on or tell more people about where they can find you online and what you're up to?
- [45:01]
B
Yeah, you can. I'm most active on Instagram, Dr. Fit and Fabulous. I'm on Facebook. I have a podcast, I wrote a book called Hard to Kill and I love connecting with people. And I have a TEDx talk that went to TED last year. If you haven't seen it, go spend 10 minutes of your life learning about why women should be lifting weights. If you listen to this podcast, though, we may have you convinced.
- [45:24]
A
Amazing. Jamie, thank you so much. Always a pleasure.
- [45:26]
B
Thanks, Jason.