Ep. 552 How To Train Smarter In Midlife: Dr. Andy Galpin on Strength, Recovery & Longevity

Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. This is a podcast that was recorded at Unimonia in November of 2025, and I was really excited to connect with Dr. Andy Galpin. He's a scientist and tenured professor with a PhD in human bio-energetics and an MS in human movement sciences. He spent over 13 years running the biochemistry molecular exercise physiology lab in the Center for Sports Performance and is now the executive director of the brand new Human Performance Center at Parker University. We discussed a variety of topics, including the science and reality of perimenopause and menopause, specific changes to strength training protocols for women in middle age, the role of HRT in peptides, the impact of GLP-1s, including concerns with food noise and metabolic health, how to get patients to take action, grounded perspectives on finding balance in life and responsibilities, bone health, physical activity, children in crisis, VO2 metrics, and so many other topics, including concerns around underfueling and intermittent fasting. This is one of these truly invaluable conversations. I am so grateful for the work that Dr. Galpin is doing. He is so down to earth and I know that our discussion will resonate with the everyday wellness community. Andy Galpin, such a pleasure. I'm glad we finally got to connect and get this done. Absolutely. In terms of looking at women as they are navigating perimenopause and menopause, knowing that estrogen decline accelerates muscle and bone loss for women after the age of 40, how can resistance training help counter these changes and what does the research say about this? Well, those are two good but separate questions. Fundamentally, it's the most effective protocol we have that is available to everybody. So when you start thinking about questions like that and you really get into endocrine changes, this area gets complicated, right? And so you're naturally going to say if we have endocrine changes and we won't call them problems, right? They're normal things that happen. Then the immediate most specific direct answer is endocrine replacement. But that has its own whole host of decisions and lots of factors there. And so if you're saying what's the most effective thing I can do, I would say pay attention to that side. But what's something everyone can do that comes with no consequences, that comes with no decision tree, that can be scaled. This is when resistance exercise is there. So to me, if the conversation of HRT and other hormone therapies is on the table, fine, that is independent of the choice to strength train. Nothing else outside of pharmacology is going to have even more close to the impact that can have on bone mineral density. Then you start tapping into all the other myriad of physiological benefits that are associated with exercise broadly, but more specifically strength training or resistance exercise. You pick your poison here, you pick your pain point, you pick the thing you hate or don't want, and I could probably show you extensive evidence, numerous randomized control trials, meta-analyses that will show strength training if it doesn't directly impact it, at least have a secondary, a tertiary benefit to it. So to me, it's, I like to, trying to phrase the answer that way because these are not competing interests. This is an absolute no-brainer. Should be on the table. Let's meet you where you're at. Let's find all the things that are going to make it more practical, realistic, beneficial for you. And then other things that are more complicated, those are secondary decisions. Well, I think you bring up very good points. I think that in many instances, when we're talking about strength training, more often than not, no one is having the discussion about the need and the necessity of hormonal replenishment therapy, peptides, anabolic, all of these things in conjunction with strength training. So, I apologize for cutting off. I don't know if you're going with this, but you want to hear something wild. In this moment, as we're sitting here, I counted yesterday, there were 270 different talks this weekend. Do you know how many talks are on strength training? Zero. 270. Peptides, spirituality, all these things, 12 talks, 15 talks, 25 talks of the 270. Zero on strength training. So, we wonder why we have to continue to repeat these messages because they're not getting out there. People are either not interested in them, which I don't believe, or it simply is just falling down the like, oh yeah, yeah, yeah, but more importantly, where's the new tech? Where's the new thing, right? That is getting the interest of the wellness and health space. So, it's a really big challenge for the person who is not a lover of this space. You have a real job, you have other things. Like, for you and I, it's fine because I'm going to strengthen anyways, right? It's what I do. But for the average person, we have to make sure that first and foremost, before we're worried about your peptides, we're way more worried about this thing that solves, improves everything else, but is not being communicated. So, I mean no offense to the people here that organized this. I certainly wasn't intentional or any of those things. But that's the landscape. So, I'm very much appreciative of your question and really overall what you're doing for women in particular in this age range because this is the uphill battle that we're facing is, this is the conversation people don't want to have, they're not having enough of, and then it becomes really, really, really hard then for the average person at home trying to figure out what, you know, I'm interested in my health. I want to do something. I just don't know what to do. Do I buy this? Do I buy that? Do I buy this? I'm hearing this thing. Let's not forget about the thing that's right in front of us. That is going to have the most impact of all of them. Well, and what we're really speaking to is novelty. What do humans like? They love novelty. They love newness. They love the sexiness of, you know, gadgets and let me be clear. I mean, those things can be fun. But when we get down to it, it is the foundational elements to health that need to be the focus. And then we layer in the rest of it. And I think in many instances, it's not a sexy thing to talk about, but yet it's a necessary thing to talk about. Yeah. And I think it's the most necessary thing to repeat, to continue to come back to. Like, you have to always bring that up. It's like, you know, talk about something else, back to strength thing. Talk about something else, back to strength thing. It's got to be there as part of the equation. What are your thoughts? I mean, because I brought up the peptide piece, I would imagine, you know, with the rise of GLP ones, I hadn't planned on bringing this up. What are your concerns as a scientist about people that are appropriately given GLP ones, might just use that caveat and think to themselves, I finally lost the weight. I don't need to worry about strength training. Yeah. So I appreciate you freezing the question like that, because that's an easy one to answer. That's the wrong place to be. Right. So the broader question of GLP ones in general, look, if I presented some data yesterday, but the annual spend on sleep right now is 600 billion, it is continuing to decline in terms of sleep total sleep time. So it's one of the few health metrics that has an X on it. In fact, it's not even X, it's a weird asymptote, because the spend is growing massively, but yet the effect is arguably getting worse. Sleep is getting worse. When it comes to something like obesity, though, it's actually a different story. Because GLP ones, it's the first time in our known history where we're actually seeing some, holy crap, something that's working on a global scale. Now, like people like you and I, and probably immediately cringed at them, because we're like, man, like we're lifestyle people, like you need to be eating better, and you need to be moving. And now you're just taking a pill to fix it. But the rally of it is, it's working for millions and millions of people. And for the first time, we're seeing progress in one of these major, major health categories, right? Mental health is still in the decline. Fine, we'll do it that. There's other ones, but body fat, which is potentially one could argue the single worst thing that anyone can have with their health is improving. So when it comes to GLP ones, you have to caveat that, right? If we're using it that way, where it is well prescribed, managed. And then that results in me not exercising. It's still hard, right? If you lose 100 pounds, and you don't exercise, I can't argue that you didn't make the right choice. You did. The loss of 100 pounds will make you live a better life. And if that means you're not exercising, you're still healthier. If I can get you to exercise, now we're going to keep winning. But the reality of it is, that's how big of a deal being obese is. It's really a death sentence in every aspect that you could ever possibly hope for. There's no bigger central cause of health problems in there. At the same time, then the goal would be, okay, can we get to a spot where we recognize if we're using it and then A, B, and C are happening? If we can fix those, now you actually have huge, huge potential benefits across the board, and strength training, other nutritional things. Oftentimes, that also comes with, again, mental health and therapy and counseling. There's lots of things that are associated with that. But you put those packages together, and now something like GLP Ones went from the devil to, okay, I'm okay with this. I think having a very balanced, pragmatic perspective and really meeting patients where they are is necessary, first and foremost. I think what I sometimes see are individuals that have spent a lifetime struggling with food noise, and Terzapatite, the second generation, GLP One, and also GIP, Game Changer for so many people. But I still worry that of course, the issue around loss of muscle mass, especially because that accelerates after the age of 40 is sometimes lost in the messaging. And yet, the things that I think about with patients are things like the 50-year-old that's in the hospital that can't get off a bedside toilet, because they've lost so much muscle mass, and that's at 50. And we know all the research demonstrates about frailty. Frailty leads to falls. Falls lead to bad things. And so, it brings us back to this really important conversation about strength training. When you are thinking about how you approach these conversations with women at this stage of life, what are some of the most important kind of basic tenets to strength training that you think are important for them to understand? Yeah, so let's, can I give you a few more caveats with my answer there? I am not a middle-aged woman, so you might be surprised to hear that. But I do live with one. And many of the people that we coach are, in fact, most, I don't know the numbers I might have, but the vast majority of the females that are in any of our various programs are middle-aged. Menopause gets you to make changes. Six thousand women a day go into menopause. Oh, yeah, I'm sure. So whether it's sleep disturbances, or it's performance, or it's recovery, or energy, or cognitive function, any of the reasons that women come to any of our stuff, we have plenty of female athletes, professional athletes, but the bulk of our females are, it's menopause, or menopause-ish related things that are there. So I can speak to this from a scientific perspective as well as my lived experience, and I'm bringing that up to say the step number one that you'll see in science is not the step number one in real life. It's just not. The reality of it is whether you're talking about menopause, perimenopause, step number one is can you actually help them to take action? So the reality of it is if that action is simply having a consult with an endocrinologist, fine, if that is starting to pay attention to sleep, if step number one is getting the motivation to care, like these are the real, and I know you know this, but this is where I think scientists and even other practitioners who are actually not working with people, not at a high level, I'll have three consult, like no, like you work with dozens and dozens of people a day, you'll start to see like okay, step number one is getting them to have the motivation to even do something, and even the ones that know it, that were former athletes or were healthy, it's just crushing. It can be crushing to them to just like want to care, the app, the just is gone, like you just want the one to do it. So if that carrot can be strength training, dope, if that carrot can be sleep, fine, if that carrot can be let's just, I don't really care what that step is, and scientifically you won't see any rationale to say it's got to start with supplements or it's got, you'll see they all work, right, so whether it is weight loss or it is, again, hormone therapy or something else, fine, let's get a win, and let's meet you where you're at, that is the biggest key with this population. If we can get them to manage symptoms, if we can get them, I'll keep going back to sleep for multiple reasons, conflicts of interest, I have a sleep company, but more importantly, because you'll see everything manifested in sleep, right, whether you're talking about body composition stuff or motivation or nutrition, when the sleep stuff falls off, mental health, you're not, you're not winning with anything when sleep starts to get there, and we know that is one of the biggest physical challenges that come associated with perimenopause, is all of a sudden you see these wild changes in sleep and it's not like magnesium three and eight, like that's not, that doesn't solve you, like it's like holy hell, I slept and then I didn't sleep for three days, and I'm like what the, it's because the storm, it's insanely inconsistent, so for a male or somebody not in the perimenopause window, you can have these like, well try this blue light blocker, because things are consistent. The, the menopause storm is what's saying like, hey these things don't work because we're, we're all over the place, and so that's the lack of understanding, I think in this space with personal trainers or physical therapists or the dieticians even, that are again not dealing with like volumes, and they really haven't lived this experience in saying okay, you have to deal with the chaos, and realistically, I'll go back to it, what is the motivation we can get to want them to feel like they can even, like there's even light at the end of the tunnel, and then where can we start, so I will always argue for starting with sleep, because that impacts so many different things, and it is so wildly changing, and then if we can get nutrition, we can get training, we can get other stuff on top of that, that's where we will play the most. Transparently, I've always told my patients that if I can't get you to sleep through the night, I can't get you to do a lot of other things, and so I wholeheartedly agree with you, and in fact, I would argue if I can't get my patient to sleep through the night, I can't get them to lose weight, because what is the biggest pain point for middle-aged women in most instances is weight loss resistance, and so the sleep piece is so important. Yeah, we're actually running a trial right now in my lab, we're doing the first ever study where we're looking at sleep at a high fidelity, so we're using some of this advanced technology, we can run full medical clinical grade sleep studies on people every night from home, and that technology now is compressible, so we're the only ones that have FDA approved for sleep quality and things like that, so what that means is we can run this kind of testing every single night, and so we're looking at this level of accuracy and fidelity in sleep every day across the cycle, and so there's this ongoing conversation that's always been the background of like, well, the sleep change throughout the menstrual cycle. Well, if you were to ask any female, they're going to be like, uh, yeah, yeah, clearly, but we actually don't have any good data on that, and so the double question on top of that is, okay, is it sleep or is it energy, or is it fatigue? Those are not the same thing, and so if you were to ask perceptually, everyone would say yes, certain phases, and some women, it impacts a lot, some as a minimal impact, but on aggregate women say my energy changes throughout the cycle, so the question is, is it your energy or is it your sleep, and if it is your sleep, is it specific to the phase, or is it not specific to the phase? We actually don't have that, and so we're testing the sleep every day, we're testing hormones every day, we're testing perception every day, and we're going to have data to say if it is physically related, because we're not testing phase by saying, oh, you're a woman, so therefore your cycle is 28 days, and you have like day 14, like we have no idea, so we're going to directly test that on every individual person, and so we will know exactly what their hormone concentrations were throughout their phase, and we'll know the sleep data on that specific day. Now, every time I bring that up, everybody goes, what about menopause? And I would love to do that trial in menopause or perimenopause, but the funding for that is like really, really challenging, so right now I'm, I apologize, but that is currently in young, healthy, non-on hormone based, based worth controls, because we have to standardize everything for study one, but this is an interesting question, because like we don't, we don't have a lot of information on that specific answer, and so we don't know what is happening, and we don't know what's causing it, and so because of that it's really hard for us to give you solutions, and that's ultimately where this stuff goes. We have to understand, number one, what is your, in this case, sleep look like? Two, great. Why is that happening? Because I know, if I know now why that's happening, I can give you way more specific solutions, and the specificity of solutions are what matter, because now you're less, less likely to waste time and money on grabbing random things to try, because I can say, look, for you and your situation, this is why this is happening. It's not related to your sleep, it is related to your sleep, it's this specifically related to sleep, in this specific way, therefore you need to only go buy this, or you need to go do this, or we need to work on this, or have thousands of solutions we've used over the years, but it's that level of precision that we hope to get to, because that will actually help people solve problems. So I don't remember your initial question, but I got to hear. No, this is fascinating. I'm so glad we, we had this tangential conversation, because I would imagine, as a woman who used to have a regular menstrual cycle, that it's going to be the luteal phase where women are going to be probably, this is my guess, as a woman who used to still menstruate. The luteal phase, probably the week, seven to ten days prior to men, to menses, that's where I think when progesterone, we have less circulating progesterone, that would be my thought, plus or minus, you know, that first week of the follicular phase, when you're menstruating and they may have, you know, other symptoms that they're experiencing. Yeah, I mean, of course you have, especially if you have a heavy bleeding cycle, then yeah, we have oxygen carrying capacity that we have to pay attention to. You lose sufficient amount of blood, you're going to feel tired. But yeah, the interesting question is outside of that. There, so yeah, we're going to have to see, I actually genuinely do not know how these data are going to shake out. So where this can be fun is, it actually doesn't matter from our perspective of maybe what you said is true. Great, maybe it's not true. Fine, we can at least now go back to people and say, hey look, if you're selling, if you're feeling these high levels of fatigue at certain phases of your cycle, don't worry about your, it's not your sleep. Start searching other places. And that's all we can say, like it's very unlikely to be your sleep, in this particular case, of course still sleep, all that. But in terms of like searching out solutions, this is maybe energy. So now we need to start talking about, okay, potentially you're at a lower energy state. So now maybe you need to eat more calories during this cycle if you're feeling more fatigued. I have no idea, right? But this is like the type of stuff that we could ask next. Or maybe we want to do different things with cognitive demand. Or there's different types of supplements we can use because the fatigue is, again, coming back to it in this theoretical case, is not coming from changes in your sleep quality, architecture, fragmentation, stability, like all these things. Maybe the other way. We have no idea. Or if it isn't, it's not like, okay, it is specific to sleep and now we have a different set of solutions to deploy in that area. So hopefully we can get part one of those answers in the next year. I think that's fascinating. And I can only hope that in the future there will be more funding for middle-aged women so that that can be studied. You know, there actually is quite a lot. There's a ton of, there's actually, people say this all the time. They're like, oh, there's no research on women's health. There is loads of research on women's health. It's not, it's, everything's understudied. For sure. Don't kill me, of course. There's way more research than people think. I don't know why this narrative is out there. It's the wildest thing. People are like, there's no research on women. There's so much research on women's health. We need more always. The middle-aged range in both men and women is wildly understudied. We do studies on university kids because of all the reasons. And then you can get lots of funding for aging. Aging is 60 plus. What you can never get money for is 30 to 60. Never. Now you can get money for menopause. You'll get that because that's a question right there. But anything outside of that, you're like, there's a death. So this middle-aged range, and you brought this up earlier, this is actually when the problems at 70 started. And we, like, we actually have applied for multiple NIH grants many years ago for this. And you just, like, you get, you don't even get reviewed because you're just like, it's not aging. So it doesn't go to the National Institute of Aging. And age won't take it because it's not a disease. And then, okay, great. Then I have to replicate it in my 18 to 25-year-old college kids. So it's the middle age that's the problem. Second thing to note on that, do you know what the most, so this study I've told you about that we're running, this is year three. And do you know why that it's on year three? It's not money. We have money. We can't get women to do the study. No. That's exactly what it is. We can't get women to enroll. So the single biggest problem we have with women's health research is women won't do the studies. Is it perception of, is it that they perceive that it's an inconvenience? It's not perceived it is. It's a huge inconvenience. It's a lot of work. And you're also taking care of your kids. But it's for the science. And you're also taking care of your company. And you're like, I can't go do this study. I got to do this every day. I got to do this over here. It's way too much of a burden. So for all the folks that are like screaming more women's research, like, hey, I'm on board. And yeah, funding is always, you'll never talk to scientists, whoever says, I got too much money to spend. Of course, the biggest barrier is we need women to actually be in studies. That is the biggest challenge that we face is like we recruit and recruit and recruit for years. And this is honestly, I mean, a little bit of the like, behind the scenes stuff. As a science, like, for example, the Zo, my, my student running the study, she didn't want to run a study for four years. She wants to graduate. So she's like, great, if I just did this in men, we would have done in six weeks. But this is going to take us four years of women. And so students don't want to volunteer for that because they want their lives to move on. I don't want to be a master student for seven years. It's a two year program. So it's really hard to get students that want to run these projects. You have to 10x, if not 20x the cost, because it's going to take so much longer. Because our pool of people is smaller and all the restrictions, and then on top of that, it's all of the things. But we're having a really hard time getting women to volunteer for studies. It's super challenging. It's really interesting. I guess I hadn't thought about that piece of it. Nobody ever does. I always bring that up and like people get mad, but I do it because like people want this stuff. Scientists want it too. Like I could give you an unending list of scientists who want to study women's health. But they go, yeah, my career would be over. I won't publish anything. Nothing will get done because it's so hard because we have a hard time getting women to enroll. So don't blame us. It's not us at all. We're trying. What we need is more incentives, and we need to make it easier for women to be in the studies. That's the challenge. Because we get this all the time too. Countless women are like, I'll be in studies. I'll be in studies. I'm like, great. And then they go two weeks in, they're like, ah, my kid got sick. I got a, all right, well, studies over for you or whatever. So there's just so many responsibilities there, and again, not to offend, but generally women on average have more family responsibilities than men have on average. And you're trying to be a professional and run companies. And it's just, it's just harder for those reasons. So that is the honest reality of why some of these things and more money always helps for sure. But that's the true challenge. It's interesting. You, you touched on something a few minutes ago that I want to come back to. And it makes me reflect on a conversation I had with Dr. Lisa Mascone on the podcast. She was talking about how, if there's a dearth of, as you were mentioning, a dearth of focus on people between 30 and 60 for the most part. And yet a lot of the sequelae that comes out of things that are occurring in middle 30s is 60. You know, I think about brain function as one of them. You know, the brains that we have in our 70s, 80s and 90s are made in our 30s, 40s and 50s. And so my hope is that as we're having this conversation on the podcast, it makes people realize why it's so important to be doing research on individuals that are in this middle age range, because we could better understand what's transpiring at this kind of time in our lives, we're becoming more vulnerable. Yeah. So this is another really interesting thing. Brain plasticity and skeletal muscle plasticity almost don't end. Bone does, though. And so what I'm saying that is, if you are past that window, you're 60, it's not too late. We've done studies on 90 plus year olds in our lab, right? We've done training studies on 70 year olds and 80 year olds. Yeah, of course, you have some diminished. In fact, some of the research suggests it's 80 plus for muscle growth, muscle strength. But they all still get really strong. And I saw Al all add a lot of muscle. And so we really don't have that much of a limit in terms of when you have to start or if you've waited too long, that you can't start strength training, and then it won't result. We have all these like wild things that are being said right now, especially when the menopause, menopause stuff of like, Oh, you can't gain muscle because you don't have testosterone after menopause. I'm like, what? That's against every study that's ever been done in that field, like insanely wild claims. So to be really clear, men and women have an enormous ability to grow muscle throughout all of life. It's never too late to start strength training. More recent evidence says the same thing about brain cognitive function. We don't end plasticity. Bone is different, though. Your bone that you will have as an adult is primarily for women determined by what happened between ages like seven to 12. And I'll repeat that. The bone mineral density quality you have as a 40 plus year old was determined by what happened between like seven and 12. So if you want to fix women's health, bone health specifically, we have to get young girls moving. This is rarely a nutrition issue. It can be in some situations, but this is almost always a physical activity issue. This can be sport. It doesn't have to be sport. It can be weightlifting. It doesn't have to be. It can be gym. I don't care, but they have to be moving. Now, if you go on to the mid 20s to early 30s range, that's when that young girl's bone mineral density will actually peak. So the most amount of bone mineral density you will have in your life will be peaked in that late 20s to early 30s range for females. And I'll just skip males for now. That said, it only goes down after that. So best case scenario, we help every young girl in the world be as physically active as possible, six to 15. Second base best case scenario, we get them in their late 20s and get them strength training. Why? That'll help preserve the moment of dense they have. Third worst scenario is anytime past that, we get them to strength train. You will not recover your bone mineral density. It will not happen. You can grow muscle. You can grow brain cognitive function. You cannot grow bone mineral density very well. You can. Just not very well past that. And so I hope the message there is if you did weight and you are listening and you're 50, don't go, well, I'm screwed, I guess. No, it is very, very effective. The most effective thing you can do is strength training for the most part. If you have a medical thing, talk to your MD, is pharmacology there? But from lifestyle medicine, strength training. But if you can walk backwards and you are that 60 year old who heard this and you have a 25 year old daughter, wrangle her neck. We got to get you going now. I don't want you to look like this when you get to my age. So we can have these interventions that get there. But it's really important because if we have missed the strength training or the muscle, we've missed the metabolic, we've missed the cognitive, we're okay. We can always start. But we have to get going on bone as much as we possibly can. I think that's an important message because I'm not sure that I've heard before that that vulnerable time period of six to 12 is when we really need to get young women moving. That's the most critical thing. In fact, there's data on type two diabetes. There are data on obesity. There's a beat there are data on depression. In the sense that what you did in that range will predict those outcomes as an adult. So young girls that are more physically active have lower instances of depression as adults. You have like 30 to 40% less likely being type two diabetic as an adult. So this does not mean you continue to play sports. This is when you are physically active, when you are nine, you are lowering your chances of being type two diabetic when you're a 40 year old. Why aren't we talking about this more? And I say this respectfully, I talk a lot about peak bone mass, peak muscle mass, the role of oral contraceptives and depopravera on bone in teens and young adults. But I don't think the message about getting kids other than get your kids moving because it's good for them. But the conversation about bone in particular, I don't think I've heard before. A couple of reasons. Number one, it's hard. Number two, it's 30 years to 60 years delayed gratification. So get a 12 year old motivated for something that'll help them when they're 60. They're like you're old. Zero chance, right? Get you motivated to do something that'll change how you appear six weeks from now. It's a whole lot easier. You don't see bone is a number two problem, right? So one problem, number one is there's no when you don't feel better when your bones are better per se. You only feel bad when they get worse. If I change your metabolism, if I change your sleep, you'll feel better now, or you look better, right? So I always say that there's three things people care about in our space, how they look, how they feel, how they perform. Your bone doesn't do hardly any of those, or at least perceptually, it's a hidden thing. And again, almost only does it impact you when it's bad. The average person get them to care about bone is like a real challenge for these reasons, and it's totally understandable. The other part of this is it's hard for parents right now to conceptually understand why it's such a bigger deal to emphasize physical activity in kids than it was in our generation. I mean, think about it. Did your parents, did you have to send your boys, did you have to go out of your way to make sure they're physically active? No. You just kicked them the hell outside. Like get out of my house, you're terrorizing me, go outside. And like the door's locked, come back in six hours. The world doesn't work like that anymore. Why? Physical activity in adults is down. Do you know what happens when you aren't physically active? Your kids don't become physically active either. So when you are on your phone and you're not being active, so more sedentary adults leads to more sedentary kids. Number two, do you know the average amount of days that children get physical education in the US per week? I think it depends on the school district. It does on average. One. One to two. This is not recess. Every school does recess multiple times a day, but physical education on average, and it's actually pretty true across the world, is one to twice per week. So your kids aren't active at home, they're just not living active lifestyles. You can't send your seven-year-old to tell them to go to the park that's three miles down the road. You can't do that anymore. You think you'll get arrested. We could do that. They're not getting physical education in schools. They're also living in a physical environment where when they're bored, they're going to grab a device. When we were bored, you had to figure out how to play on the stairs in your house. You had to do these things. So it's not your fault as a parent. We just simply live in a different world than we've ever lived in, and we have to come to that reality. What that means is you have to engineer way more physical activity in your kids than your parents ever had to do for you. You have to make this happen because they're not getting it, or your parents didn't have to do that to you because you were going to get it. So on top of all this, if I said to you right now, Cynthia, we're not going to teach your kids to read in school, and let's just expect them to be good professionals. You'd be like, insane. If you don't teach a kid to read, don't expect them to be literate. If I don't teach a kid how to move, how do I expect them to be physically active with their adults? You know what happens when you don't know how to move well as a kid, and then you start a physical activity or an exercise program as an adult? You know what happens? You get hurt. Why do people stop going to the gym? Right out of the time, I get hurt. We didn't teach them to read. We didn't teach them to write. Now we expect them to be lawyers. You're out of your mind. So when we remove physical education, physical memory, physical education is teaching you how to move your body the right way. It's not recess. It's not playtime. When we took that out of schools, or took it twice per week, to once per week, and now we're not physically active on our own, sport participation is the lowest it's ever been, by the way. So when kids are not playing sports, they're not being taught how to move in schools, and they're not living active lifestyles. And then stunner, they're not active adults. I mean, this should be a crisis. It is. It's never, like no one talks about the children crisis. There was one talk this week, or this event on children nutrition. So I'm like dope. But like sorry to offend anybody, but how many conversations have we had about fucking seed oils, and we're not paying attention to kids not moving? Like you want to change health in our country? Kid, this is the problem that's leading the whole thing. And then we're over here and messing around with tallow. Like, my God, like what are we doing here? One strength training talk this weekend, nothing on children, nothing on nutrition. And this is what the epitome again, no offense to this weekend. It's not, you know, all love to eudaimony and stuff. But you get the point here. If you were to do a podcast on children exercise, you'd have probably the lowest viewership you've ever had. You do it on fat loss. Goes the roof. Well, it's what people value right now. Yeah. And I understand, right? Like if I'm the average person, I don't care about kids like exercise, like what do I like to say that? Like, I help my brain fog go away, listen to that one, I can just like a supplement. So I don't blame people at all. I do the same thing when it's outside of my field. It's like, I don't really care about that. That's why my truck to work. Like, whatever, right? Like just, I just want to pay my taxes. Like I don't really care about so I don't get people and not everyone's in health and fitness like we are. So but yeah, like, I get pretty fired up when we're way off track on this one. But yeah, like this is this is what will change or help save human life is this is this is our problem area. But I'll stop now. No, I think that it's an important conversation to have. And certainly my listeners will be thinking differently about this moving forward. Certainly myself as a clinician, I'm like, wait a minute. I think that sometimes we live in our little bubble, like I have always had very athletic kids, my husband played college lacrosse. And so it's just always been a part of what we do. But I acknowledge that's not what many other people are doing. And it was interesting. I was having a conversation. This is tangential with my personal trainer, Linda shout out to Linda. And she said, I was asking her, I said, how do most people move that you train? And she said to me, Cynthia, I don't think I realized how many people never learned basic calisthenics, basic movement patterns that I took for granted as a child that my parents took for granted as a child. And now I have 40, 50, 60 year old clients that don't know how to move their hips, they don't know how to move their shoulder girl, like she just said, you know, they don't know how to move their ankles. And because they have been so sedentary for so long, we are starting really basic, we are going back to, I can't even start with body weight exercise, definitely not, I'm going to mobility work. And then if I think they need to see physical therapy, I refer them out before we even start working together. If you're in perimenopause or menopause and are feeling more fatigued, dizzy, lightheaded, struggling with headaches or noticing your workouts feel harder than they used to, electrolytes may be part of the missing piece. As estrogen declines, we lose some of the fluid regulating and vascular protective effects that hormones once provided. 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This guy's ranting up here. He's not answering any questions. No, no. I think these conversations, these organic conversations are so important to have. And so I so value that you share that because it's going to put that on my radar and hopefully the radar of most of my listeners. When we're talking about like beginning a training program, let's say someone's ready, mentally they're ready to start. This is someone who has not been physically active. What are some of the basics that you like to start with? So I remember your... This was your original question. And the way I started with that personal preference one is because the way I like to frame this answer, I don't want perfect being the enemy of good. I don't want you thinking, I have to do these five training sessions per week. And if I can do that, I'll do zero. So my honest reality is if you can do 20 minutes one time a day, that's better than zero. If you can do that twice, take great. Like how much more can I take? Give me three? Awesome. Now can we slide that from 20 minutes to 40? Great. Like I'll take as much as you give me. You give me two hours a day, seven days a week, I'll take it. But if all you give me is one, there is a lot of research on one day a week. It is effective. It's not as effective as two or three, but it is better than zero. So I really want to make sure that because that is the meeting where women, where they are, right? And that was the one, and I started on that like motivation thing, right? Because you're like, sometimes if you're at Perry menopause, like one day a week is just the most that's going to happen. Like that's it. They're just like the all you can get out of it. And I want people to know that as a win. That's not a fail. That's a win. You got in the gym once, we won. I'll take all that. Because these reasons, I like to recommend whole body training. I do not like as much body part splits here. Simply because the fact that you're likely to missing your next training sessions high. Motivation or other reasons happen. Great. So I want to make sure that most of our muscles and joints really and movement patterns are at least touched as often as we possibly can. So maybe you're not doing a maximal load or fatigue or any of those things. But we're moving in ways, we're establishing good movement patterns. My hips know how to work. My neck knows how to work. My toes, most of my major muscle groups are moving. That's fantastic. What this can look like, it really doesn't matter that much. If you'd like to do lower repetitions, say sets of three to five to even six or seven repetitions per set. Great. You want to do more of that middle range, eight to 12 to 15. Fine. You want to do high range, 15 plus 30 plus. We have lots of research support for muscle growth. Those are equally effective. Longest effort and consistent Z and things like that are there. If you're at that training stage, that's probably also going to come along with strength development too. If you're very highly trained, there's a difference between training for muscle growth versus strength. They do start to split. But the beginning of training or if you're like fairly lowly trained or under trained, and you're going to train once or twice, those can be done at the same time. You also might even get some cardiovascular benefits and they've been getting very moderate ones, but something's going to be there. So from a strength training perspective, do the big movement patterns, do the big exercises, try to get consistently in. But the biggest key for this situation is when you're in the gym, try hard. I'm not patronizing there. I'm legitimately saying the effort matters far more than any scheme I give you. If you're in there for 20 minutes and you're training really hard, that is going to be so much more impactful than any other thing I gave you and the effort is moderate to low. And so if you're like, I got in, got the thing done, and I trained three times a week, and my effort's three out of 10, and say, fine, let's go to one week and give me seven out of 10. Give me good solid, because if you don't do enough to actually induce stress on the tissue, you don't induce adaptation. So if we're trying to set habit and behavior, then I'm cool with low effort, just get in. We're trying to establish rhythm and consistently, that's a good reason to do that. But if you're actually trying to make changes, effort can be there. And notice, I was intentional when I said seven out of 10. You know, I don't have to have you at 10 out of 10. I don't have to be at nine out of 10. I would like seven to eight is a pretty good number for most people. That's defined totally different for every person. But that's kind of where I want you to think. I want you to think the next day, I did something yesterday, but I don't want you waking up being like, I can't move for four days. That that's a problem as well. At the same time, I don't want you waking up the next day, be like, did I actually like yesterday or not? So we probably played not enough stimulus there versus way too much. The next day, I want you to two out of 10, a three out of 10. Okay, like, okay, I did something yesterday. But sometimes I forget about it. Sometimes I don't. But that's kind of, I mean, I can give you exact numbers. But what I'm trying to give you is the more realistic honest answer, which is that, like, there's got to be effort there. And if a certain repetition scheme, or style of training, if you do better when you're lifting by yourself, because you need quiet time, great. If you do better being a group activity class, sweet, here for it. Don't really care. If this is the barrier we're at, do the group fitness class. Do that. I don't really, really care. Once you're on like level two, three, where we're like, yeah, I consistently trained four times a week. I'm now trying to get better results. Now we can have conversations about, well, this rep scheme is a little bit better than that one. But for that initial question, let's get something, let's be consistent. And when you're consistent, try hard. And that's going to take us for the first, you know, two years if we need to. Well, I think the barrier for so many people is they work with someone, no hate on any personal trainers out there. But the things that patients will share with me along the lines of, if I can't go five days a week, then they're telling me I'm going to get no benefits. Or I'm told I only can lift heavy and I don't understand what that means. So I appreciate that you're talking about this nuance, which I think is so important for listeners to hear. There's so much wild stuff around menstrual cycle and menopause exercise right now that, I'll try to say this kindly, you're just putting up barriers. This idea that women have to lift heavy, like out of your mind. We have plenty of randomized controlled trials. You get progress with light weights, you get progress with heavy weights. The idea that women have to eat protein at a certain time, like insane. These are not based on any human evidence. In fact, we've done fasting studies in my lab. Women grow plenty of muscle fasting. That can also be a terrible idea for women to fast. Like there's no special recipe with these things. So like I've heard all kinds of things like women have to lift a certain weight during a certain phase of their cycle. Completely wild, absolutely untrue, tons of research on that. Hopefully that's gone. We don't have to answer that question anymore. Awesome. That they have to lift heavy or they can't lift heavy. None of those things are true. Special interval range or heart rate, none of those things are true. Special style, like I don't know. The reason I like scientifically we're so mad about that is number one, you're just not representing the current evidence, which is always irritating. But two, it's doing exactly what you mentioned. It's putting these barriers are being like, oh, well, I don't have it in me mentally today to do max effort. And that's the only thing women worked for women. So I'm not going to exercise. Like you just put up a huge barrier that's fundamentally wrong. And then two, you just made that person's life worse. You made it harder. Let's not do that. We should be focused on the empowerment. Yes, we want to know like what specifically works for you. But that is an individual human question. That's not a you're a female, therefore you can exercise this way. Or you have to exercise way like that is like, like as wild as we can possibly get. So we want to have conversations when an individual trainer or coach says, this program is better for you. If that's based on your data, your background, your experience, your pain, your medical history, then that is absolutely the right case. But if it's based on the fact that just because you have a certain chromosome, now I'm like, okay, what are we doing here? Like we're making problems that don't exist, and you're creating difficulty and confusion in a field. That doesn't need to be there. I think listeners now understand why I very much wanted to have this conversation with you, because I think this needs to be stated. I think there's so much confusion. And I have to believe that a lot of people are well meaning, but there's 100%. Thank you for putting that out. Yes, like it's, I just not calling anybody like that charlatans or anything. It's actually, they're trying to give women better options, right? But when it's packaged a certain way, and that may not be the fault, by the way, of the person giving the information. It's the fault of the interpretation, or it's the way that the media put it out there. So like as a scientist and as a public communicator, I get misrepresented constantly. So I'm very sympathetic to that person. I really appreciate you saying that because I don't mean to take shots at anybody doing that. But to the listener, if a certain program that you heard works better for you, hell yeah, sweet. But if it's making you like worse, then we probably have a million options from a physical exercise and nutrition standpoint that could work for you. And where do things like zone two training and high intensity and real training fit in when you're thinking about this population? Like I would imagine someone that is going from being very sedentary to just going to body weight exercises as a starting point, you're probably saying like just walk, don't even worry about these other things. I think zone two is insanely overblown. I don't care if you're at zone 2.3 or 1.79, like these are not important. If you are a very high level endurance athlete, then these things start to matter. Zone two, I don't think is actually majorly like special. But there like specificity does matter. For the average person, the intermediate level person, I don't think they matter really at all. We don't use zones like that hardly ever. We will pay attention to data. We'll do different things like nasal breathing versus mouth breathing and we'll regulate effort and intensity. But the zone itself is, and this is where some of my good friends, and I very much disagree on this particular point. So we have some folks that have done some really crazy, like a friend of mine Ross just swam around Iceland. It's a thousand miles. It took him five months. So we've done some wild things like this where like, hey, high level endurance, we've had plenty of people that I coach have done ultramarathons and even just like 5Ks and stuff. And so okay, you're getting years and years and years into training, then this stuff starts to matter. But for the average person, if zone two makes your life better, awesome. If it's creating a barrier, then don't worry about it. That is the easiest way I can say it. So we don't have any rationale, again, to think that high intensity is magically better for women or it's super important in menopause or you shouldn't do it or anything like that. There's just no rationale. There's no mechanism for us to think that we don't have any control trials on that. I've coached loads of people. I know loads of practitioners. I don't really see any high level practitioners. We're saying we're seeing this in the field as a thing. So when we don't see it in the field, we don't see it in the mechanism. We don't see it in the control trials. I just don't have any reason to think that there's a special zone that you can do, have to do or can't do. So if you like intervals better, awesome. You hate them? Fine. We can do other stuff too. Hopefully this, because you're playing a game here of like, I like to give more options. But then as the listener sometimes that feels like I have too many options, now I don't know what to do. Correct. So some people like to give like more specific guidelines, not because I actually believe it, but because it's easier as a listener to go, oh, they said do the four by four. Cool. Now I have an example of what to do. So if you're using those in public communication as examples, so that people listening can go stuff something to try, I'm fine with that. But when we push that too far to say, oh, four by four is the optimal way to improve VOTMACs, then I'm like, all right, stop. Like stop, that's not how it works at all. I want to unpack this. It was part of my prep, but since you opened that Pandora's box. Yeah, far away. So I just did my VOTMACs recently, and that was an unpleasant tree, which if anyone's ever done a VOTMACs training, it's pretty unpleasant, which is why I will hopefully not need to do it for 10 years. Every year. Really? Yeah, at least every year. Why not? It's one of the most important health metrics you can have. Why would you not do it every year? Right, you guys do it every year, right? Every three months. Wow. Okay, so let's unpack VOTMACs. Why is it important? And how can we improve those metrics? Because we obviously want to be above the frailty line, and I think a lot of my listeners like to hang on to numbers. They're like, oh, I want to be above that frailty line. So what are the things I need to do to improve that number? Yeah. So Dr. Ryan Green, Monarch Athletic, says every three months, get it done. You don't necessarily have to do it that frequently, but he probably tell you that. When we start looking at a VOTMACs, we have to start thinking about there's central and peripheral components to that, meaning it is both a bring in and utilize oxygen problem as well as can I transport that, get that into tissue, and then use it in muscle. And so your area of limitation will actually determine a little bit of how you train for it. Again, if we walk all the way back to the beginning, specificity is the core principle for exercise adaptation. So if you want to get better at shooting free throws, shoot free throws. If you want to get better at picking up a 500 pound barbell, pick it up one time. Like that's the most specific. So from a VOTMACs perspective, practice bringing in and utilizing oxygen. That's all you have to do. If you do that, you'll get better at bringing and utilizing oxygen. That's as simple as it can be. So what does that look like? If you want to practice doing that for a long time, 30 minutes, 60 minutes, 90 minutes, great. You'll get more efficient at bringing and utilizing oxygen. If you want to practice doing that really, really hard for a short amount of time, you can do that too. We've had extensive evidence for many, many years now. If you directly compare lower intensity steady state to maximum intervals, depending on the training age of the person, you'll see equivalent VOTMACs adaptations. And so you can do a combination. You can do some low intensity, some high intensity. You can do one or the other. It's entirely context dependent, because you have things like, what's your overall exercise volume? What's your total stress load? What's your overall energy expenditure? Where are we at calories? All of these change our equations. So if you look at any of the programs we've done, and we've done VOTMACs thousands of times, you would see everything from nothing but lower intensity stuff to nothing but intervals to wild combinations in between, because it's based upon the context and the situation, the problem. If you like lower intensity more, and you're more likely to skip your high intensity sessions, great. I'm probably going to give you a program that's more lower intensity based or the opposite. If you're telling me, I don't care, I'm a robot, I'll do whatever it takes, but I have time limitations. Great. I'm going to higher intensity intervals, because it's much shorter. I can get it done there. Sometimes though, it's really hard to get motivated to take yourself to a maximum heart rate. Yes. Three times a week. That's really hard. So if I'm like, I did one of the intervals, and I am short on time, but like I just don't have it in me, I can get to 80%. Well, if you do 80% for 30 seconds, we didn't do enough. I didn't do enough work. I didn't get you getting enough fatigue to stimulate adaptation. So I'd rather you go into the lower intensity thing and zone one, two, three, like I don't care at all what those things look like. If you like to do those by running, great. If you like to do those by swinging in kettlebell, fantastic. If you like to do those in boxing, awesome. The mode in which we get to that oxygen exchange doesn't really impact VO2. It impacts things like, can you do it frequently? Are you getting too sore? Are you causing injuries? But the actual cardiometabolic demand is the same. It does not know nor care if you're out of breath because you're swinging kettlebells and pushing sleds, or you're defending a choke because Hannah Gracie is trying to take your back, or if you're walking up stairs, it does not know and does not care. So VO2 max is not muscle. It's central. It isn't almost exclusively driven by oxygen demand. And so exercise choice, wide open, frequency, wide open, intensity, style of training, all these things are wide open. All you care about doing is putting the entire system together in a way that you will do consistently, that you will not get hurt, that you don't induce burnout. And I'm not even talking about cognitive or emotional burnout. I'm talking about if you do maximum heart rate, maximum effort every single day, there are few humans who will keep that up for very long. Physiologically, you'll tank. So you can't peg the throttle red every single day. That said, I have a current client of mine who literally trains three times a day. He's not an athlete. He's done over 5,000 berry spook camp classes in 10 years. He does berries every single day, and then multiple training, like on top of that, right? He's the first person I've ever seen him, like, okay, like he kind of hangs on. But most people, if you do intervals or tobottas, or whatever protocol you want, you can't do those every day. You're gonna, you can for three weeks or six weeks, or you're, but you're gonna hit a wall. You can do a lot of lower intensity stuff. So if you want combinations of I want to do some walking and nasal breathing, great. And then I'll do intervals once a week. Fine. Hate intervals, but I'll lift some weights. Cool. Like we can get there so many ways because it's non-specific. You need to challenge your cardiovascular capacity. Ideally, to boil that all down, if it's up to me, I would say one day a week doing something lower intensity for longer duration, probably not walking, like probably something that's actually putting you in a place where you can't breathe or like you can't speak. Then I would do something that is a higher, higher heart rate. And then on top of both of those, I would try to be as physically active as we can. Steps, standing desks, more active lifestyle, like as much as we can there. That will stack stuff too. If you do that, you're covering your bases. And then from there, you want to sprinkle in more of the intervals. Could you like them better? Cool. You want to do more, now you can play personal games there, but one day a week of maximal effort is not going to physiologically burn that many people out. One day a week of steady state is not going to toast your overall metabolic need. When we get volume of endurance exercise too high, we start running into energy problems. It's not going to disrupt sleep that much. It's going to mess up those things. So you have a system there that you can kind of always fall back onto that's going to induce adaptation. And that is like fairly plug and play for most people. I'm excited to tell you about a foundational health supplement that is backed by some incredible science. This marine super molecule is called AstraXanthin. 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I'm really impressed with AX3 and I'm super excited to share this particular podcast interview with AX3's co-founder and CEO. AX3 has also generously offered a 20% discount on your very first order when you visit AX3.life and use promo code SYNTHIA20 at checkout. Again, that's AX3.life and use code SYNTHIA20 at checkout. My family and I are actually taking AstraXanthin to see if we can drop our LP little A. Stay tuned. If you're a woman in midlife or beyond, you'll probably notice those changes in energy, strength and recovery just don't feel like they used to. And what's frustrating is that for many women this happens even when you're eating well, lifting weights, prioritizing protein and doing all the right things. You're not lazy, you're not unmotivated and you're not doing anything wrong. A big part of what's changing actually starts inside your cells. As we age or mitochondria, the energy producing structures inside our cells become less efficient and when mitochondrial function to clients, it can show up as lower energy, slower recovery, reduced muscle strength and feeling less resilient overall. This is a normal part of aging physiology and it's one of the reasons midlife can feel so different. And that's why I've added Mytopure gummies from timeline nutrition into my daily routine. Mytopure is the only clinically proven form of urolithin A, a compound shown in human clinical trials to support mitochondrial renewal. In simple terms, it helps your cells do a better job of making energy and when your cells have more energy, your body is able to support strength, endurance and recovery as you age. What I appreciate most about Mytopure is that it's foundational, not flashy. This isn't a stimulant or a quick fix. It's a daily habit that supports how your body actually works at the cellular level. And the gummies make it easy. They're just two sugar-free gummies per day. They're vegan and cleanly formulated. They're independently tested and certified for quality. And if supporting your energy, muscle health and overall resilience as you move through perimenopause and menopause is important to you, Mytopure is worth considering. You want to go to timelinenutrition.com slash Cynthia and use code Cynthia Thurlow for 20% off your order. Again, that's timeline.com slash Cynthia and use code Cynthia Thurlow for 20% off your Mytopure gummies. What are some of the common signs that your clients will report to you or cause you to suspect that they're overtraining? I think there are people who are very aware and then there are people that will just like you mentioned your three times a day berries, boot camp guy. He's nuts. Yeah, that's unusual. But what are some of the things that are red flags for you? So true overtraining is extremely rare. And so what ends most people are experiencing are what we call non-functional overreaching. So these are, you're putting yourself in a position of non-beneficial physiological changes. There's still adaptations, but if you want to think of those maladaptations, fine. True overtraining is really, really difficult. True overtraining is a situation that takes three to six months to come back from. You're talking about long term, many, often sometimes years of endocrine disruption, like really nasty stuff. So those are pretty rare to see. We do see loads of this sort of shorter term ones. Unfortunately, stress is like allostatic load is the scientific way we would, our allostasis. It's non-specific, meaning this could look like changes in appetite in either direction. Weight gain, weight loss. This could look cognitive changes, mood, word recall, brain fog. It could be none of those things for women, of course, like the easiest red flag ever. Like you know what I'm going with that one. Amen, Aria. Amen, Aria or irregular cycles when you used to be regular. It could be none of those things. So it could be lack of motivation. It could be stalled progress in the gym. So it's really, really difficult because there is no one specific, there's not even actually an official definition. The only definition of overtraining or non-functional overreaching is did it actually deposit of adaptation? Well, there's a bunch of reasons why you might not get a positive adaptation. They're not necessarily overtraining or overreaching. So those are difficult. If you want to look at actually like biological metrics of it or biomarkers, you can pull blood markers off of it. We have a whole set of things that we look at to try to figure that out. And we actually try to differentiate between what's called low energy availability. Like this is simply a calorie issue. So in your blood, we can differentiate between is this calorie driven or is this actually physiological overload driven? Sometimes none of that's true and it's actually hydration issue. So like we try to differentiate that in blood to figure that stuff out. We can see this some of the stuff in various stages of sleep. There's actually a very specific sleep pattern that'll happen and that you won't be able to find in your wearables that we can see these things starting to peak there. So if you have a wearable, you could look at like really classic stuff like heart rate variability. More traditionally, to be honest with you, if you start to see rises in resting heart rate, long periods of time, independent of changes in physical activity and stuff like that, those are kind of hallmarks. The problem with all that though is they're post indicators. The problem's already been there. Like you've already happened. What we've been working on for a long time is actually trying to diagnose that prior to it happening. So there's actually a paper published, Friends of Mine in Stockholm. They had a really interesting thing where they actually took a bunch of muscle biopsies from folks, intentionally overtrained them and they looked at mitochondria markers and they were able to develop an algorithm that actually predicted neutral negative or positive mitochondrial adaptations ahead of time. But that required a muscle biopsy. And so we're trying to develop a synologue of that in blood, which we can do. We haven't finished it yet. So those are like the best ways if you're like pretty advanced and looking at it. But for the average person, it's hard because it's a symptomology. So you really have to have an exercise physiologist that can look at your training program or exercise scientists and go, great. You also then have to have your dietitian. You also have to have your mental health. You have to have your sleep because it could be none of those things of overtraining. It could be something in one of those buckets. Last way to think about it is all of that aside, what we're balancing here is the training versus the recovery. And so a lot of the times when we see these problems, we look at the training program, we look at the nutrition, we're like, this is not excessive training. You're feeling symptoms of overreaching, but this is not a training load issue. There could be some non-specific stressor in your physiology that's taking that total stress bucket to a level where it's overflowing quickly. Some people would call this like you have really bad recovery capacity. So this is not an overreaching issue. This is, if we don't need to train your training, you're not training too hard, you're simply under recovering. And this could be effort. You're not actually doing anything to recover. This could be sleep issues. This could be micronutrient deficiencies. This could be pathogens. This could be bacterial overcomes. This could be gut microbiome related. There's lots of non-specific stressors that put fatigue in the system that then make the little bit of training you're doing, or a lot of training you're doing, out kick your recovery capacity. And so that then either manifests itself in those symptoms or stalled progress. But really it wasn't a training issue. It was an under recovery. So I only got pretty technical there, but it's a really challenging one. Yeah, I can imagine it, because I think a lot about how that overtraining can show up as underfueling. And so I always say very, very humbly. I'm known for intermittent fasting, and I have been trying to apologize for a lot of what I stated when I didn't know better six, eight years ago. But I think for a lot of individuals, it's for a lot of women, it's chronically underfueling themselves. And how that shows up as not having enough energy to get through a workout, not having enough energy to show up. I want to be mindful of time, but I want to at least touch on this nutritional piece, whether it's relative energy deficiency, or people that are over fasting. I think this can be hugely problematic, that they're just underfueling their body chronically and habitually, that is exacerbating a lot of the frustrating symptoms they're experiencing at the stage of life. Yeah, underfueling is just the clients that we see. We tend to don't see a lot of people at their very, very start of their health journey. So we don't deal with morbid ability, or morbid, or morbid, well, that was awful. Morbidly obese, things like that. People are a little bit closer on that. So for us personally, for the women we have coach and do coach, we deal with low energy availability way more than we deal with gloric excess. Other folks in different areas and spheres this like maybe have the exact opposite problem. So I want to be clear about that because I don't want the person who needs to lose 90 pounds being like, oh, I need to eat more. Like probably not. Like probably not. But for our folks, this is there. And that's probably, well, that is exactly why we spent so much time building out that blood marker that differentiates low energy availability from endocrine, from other forms of functionality. So it is a challenge for sure. You will see this manifest itself in all kinds of areas, underperformance, peaking, plateauing in your training, sleep, mood, cognitive function. So when we tackle these problems, the first step actually on this entire journey is stupid, but hydration. If you're like, I think I'm under fuel, I'm over trained or whatever, like drink water for a couple of days, and you'll be stunned how many people are like, oh, I feel way better. Damn, like I had no idea. We actually had this really complex problem. I'm laughing because like the guy thought he had this super complex problem. I think I have these micronutrients, insufficiency somewhere, whatever we look, we're like, yeah, you're just dehydrated. And he was like, I just spent a lot of money. I'm like, yeah, you just spent a lot of money to drink some water. Hydration is more than water, but you get the point. And he's like, no, I was just so convinced he had some like mysterious path that didn't just gut. I'm like, well, hydration affects you acutely, which is to say you can get under hydrated or dehydrated really fast. And you'll know. So step one here that is free. Try to hydrate. Now that's not going to fix everyone's problem. Some small percentage, but some of you will go, oh, actually feel way better. We're done here. This was not a low energy availability. This is not under overfueling thing. This was actually there. So you can all try that. That is totally free. You can all do that. Now if that didn't work, now we're going to go to a second step analysis and say, okay, are we seeing this from a sleep perspective? And then what's happening? Are we waking up in the middle of the night? Great. When are we eating? How are we timing our fuel? So if we are in chronic caloric restriction and we deal with a lot of weight class based athletes, so we have professional UFC fighters, power lifters, Olympic wrestlers, all these people have to make weight. And by people, I'm getting in this context, I'm specifically referring to our female athletes. So we're not only dealing with low energy availability because they have to make weight on a scale on a certain day. This is not a static. This is like your contract, your shot at an Olympic gold medal is to hit this number on this day. We have to be there. So we can look at this and go, okay, we're starting to see problems. Can we mess with timing? In other words, can we fuel more around our training so that we can still continue to get training stimuli adaptation recovery and we can take our calories out during our other phases. We very, very, very, very rarely use fasting in the morning. I'm not fully against that. Again, we run a study in my lab. It's fine in a caloric surplus. We've had some women in our program that we leave on it because they've used it, experimented, they like it, okay, fine. But most of our females athletes are not, have done better when we give them fuel in the morning. If we want to pull calories in the evening, we can do that. It's a little bit easier unless it's impacting sleep negatively. But we can work kind of around that. So we are generally, if we need to be in a caloric deficit, we try to make sure that those calories are packed around our highest physical and cognitive demand. So if you're not a big exercise person, not an athlete, you're like, oh, it doesn't matter here. We would put this around, when's that stressful meeting? When's the interaction? When's that difficult thing? Because that's still calories. That's still energy. And we want to pack those around that so you feel good, feel recovered, and come back from that in there. So if you don't do that, then we have this whole, you mentioned reds briefly, but this whole cascade becomes really problematic. So all that to say, if you're needing to be or are using caloric deficit for long periods of time, consider changing and tweaking when you're fueling. Number two would be consider some sort of, and we don't like this term, but diet break, we use strategically increased caloric intake for typically several weeks, not a day. This is not cheat day. Like we don't do cheat days. It's just, you're human. Do whatever you want. Like not cheating on anything. But we might increase calories for a certain amount of weeks. You'll be stunned. People usually don't gain weight. Like they stay generally there. There's this is Herman Ponser, I had actually did a show, I had him on my podcast last year. He's got an adaptive thermogenesis model, which is to say, basically, you increase caloric intake, your body will increase caloric expenditure. There's a limit here, of course, right? And then the opposite happens at the bottom. So one of the things we see happen is people are convinced they have a slow metabolism. There's no such thing as those. That doesn't really exist physiologically. There's certainly people who gain weight easier and have a hard time losing weight. Fine. But if you're constantly pressing the pedal on metabolic stress internally a lot, there's a lot of survival mechanisms that are going to push back. So you have to be, it's not starvation mode, but if that helps people hear what's going on a little bit better, that's fine. So you want to be really, really careful about underfueling for long periods of time. And so we might ratchet that caloric load up 10% for four weeks. Something like that. Give your, it's not a three or four days, right? It has to be a situation where you have a physiological ability to adapt, where you can alter some of these long term processes that make your life a little bit easier. So we'll push things like that. So start with hydration, start with secondary be timing, third step that would be maybe consider a four to six week period where you're intentionally increasing calories. And if you want to get that from fat or carbs, I don't really care. There's different things there. Past that, then we start, need to start thinking about is there a hidden stress for going on? Is there some other thing happening in your system that is burning fuel that we don't, in a way that we don't want it to be burning? And then there's like series of steps. But we take people on these journeys to like figure out how we get you there. But hopefully those are three or four or five things that people can start with at home. This has been an incredible conversation. Thank you so much for your time today. Please let listeners know how to connect with you outside of the podcast and learn more about your work. Yeah, sure. Instagram and Twitter are the easiest places. They're pretty much exclusively science communication for me. So not a lot of personal stuff up there, but that's easiest place. Our sleep company absolute rest. We have a performance blood work company, Vitality, which you can see. And then actually, I don't know when this is going to come out. But on real life, Monday, we're launching a brand new program called Optima Muscle. So this allows us to take a rapid MRI and we can scan and give you a report back of 140 muscles on your body for muscle size, for fat infiltration, for muscle quality. And so you have a 3D interactive model, a digital twin, where we can know exactly what your right deltoid looks like relative to your left deltoid. And how does that compare? And that's all sex and age specific. So you can start to see and we're using this in programs with coaches because they're like trying to get their client to work on their glutes or whatever. And now you can physically show them not just how much muscle they have, but exactly how big their left glute is relative to the right glute. Or their vastus lateralis, next to their VM or whatever muscle you want. So it's individual muscle that is there. So super excited to launch that. That is, I think that's Optima Muscle.com or yeah, Optima Muscle, I think, or just Google me. It'll come up. Awesome. Thank you again for your time. Thank you for being here. If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.