Episode #365: Cycle Syncing, Fasted Cardio, The Pink Tax and More ft. Dr. Lauren Colenso-Semple

0:08 [SPEAKER_00]: Welcome back to the Barbell Medicine podcast where we bring modern medicine to strength conditioning and strength conditioning to modern medicine. [SPEAKER_00]: I'm your host, Dr. Jordan Feigenbaum. [SPEAKER_00]: On today's episode, we have a very special guest, Dr. Lauren Cullenzo Simple.

0:21 [SPEAKER_00]: So after receiving a master's and exercise in a PhD in muscle physiology and endocrinology, Dr. Cullenzo Simple has become an absolute force in the health and wellness space, especially when it comes to women specific topics. [SPEAKER_00]: Whether it's training considerations around in the menstrual cycle, [SPEAKER_00]: evidence-based takes on fitness.

0:39 [SPEAKER_00]: It's an honor to welcome Dr. Cleans of Simple to the Barbell Medicine podcast. [SPEAKER_00]: Thank you for joining me. [SPEAKER_00]: How's it going? [SPEAKER_03]: It's going great. [SPEAKER_03]: Thanks for having me. [SPEAKER_00]: Did I miss anything in your CV? [SPEAKER_00]: I don't want to like, you know, miss any of the top things you've done over the past.

0:53 [SPEAKER_00]: I don't know. [SPEAKER_00]: Probably been in this what like 15 years, 10 years, something like that. [SPEAKER_03]: I'm a co-owner of the mass research review. [SPEAKER_00]: That's right. [SPEAKER_00]: Yeah. [SPEAKER_00]: I knew you wrote for a mass. [SPEAKER_00]: Okay. [SPEAKER_00]: Cool.

1:02 [SPEAKER_00]: So how did you get into this space? [SPEAKER_00]: Was it like, okay, I'm in a fitness? [SPEAKER_00]: I'm in a science and then just bring them together or like, what was, how did you get here? [SPEAKER_03]: I actually have an undergraduate degree in psychology and you can't really do much with that except get another degree or get an unrelated job.

1:19 [SPEAKER_03]: So I got an unrelated job and I was always really into fitness. [SPEAKER_03]: I was actually a runner in my late teens early 20s and getting a stress fracture and more of the boot the rehab was terrible and I really put me off running and that's when I got into lifting. [SPEAKER_03]: So while I was working my corporate job, I started teaching group fitness and just training a few clients on the side just for fun just because I loved fitness and I ultimately ended up leaving my real job developing my own kind of training business in New York City at the time.

1:57 [SPEAKER_03]: And I was interested in the science and kind of muscle physiology more specifically because I was trying to get the best results for myself and for my clients at the time and I [SPEAKER_03]: work in the lab in that kind of applied setting and I decided ultimately that I wanted to go back to school and move to Florida, got the masters, and then moved to Canada, got the PhD.

2:33 [SPEAKER_00]: Oh yeah, okay, so you've been based really all over North America just with your education. [SPEAKER_03]: Yeah, and I think it's valuable that I have the background as a coach because even now having spent time in labs that are much more, well, both kind of applied and translational and then much more molecular, I can try to bridge that gap and we can have a conversation about what's scientifically interesting and then how should we actually communicate the important stuff to the general public?

3:05 [SPEAKER_00]: Yeah, yeah, I get a similar, yeah, I'm sure you get this feedback. [SPEAKER_00]: I'd be curious when your take is like, you know, people say, you went to medical school just to be a coach. [SPEAKER_00]: I'm like, well, no, that's a separate skill set. [SPEAKER_00]: The medical training is useful for like interpreting public health research.

3:18 [SPEAKER_00]: Obviously applying that and then my own specialty in such, uh, and I was a coach before. [SPEAKER_00]: But yeah, all of science communication is heavily, you know, pushed in in medical training and so people probably ask you like, look, you have all these degrees, would it just so you can so you can coach people and like I do more than that I assume.

3:36 [SPEAKER_03]: Yeah, I mean, I don't really do any one-on-one coaching anymore. [SPEAKER_03]: Now my goal is more to communicate to those who coach others or to those who work with others in clinical setting. [SPEAKER_03]: And so I think it's really important though because there are so many mixed messages nowadays.

3:58 [SPEAKER_03]: And I mean, that's really what encouraged me to even start being more active on social media is because I realized [SPEAKER_03]: You know, for so long, a lot of the science that we're doing stays in our own scientific bubble and so it's a handful of people reading each other's research and why are we doing human subject research about exercise when it's not getting pushed out to the people who can actually use it or.

4:24 [SPEAKER_03]: Conversely, if people are saying things that aren't supported by the science, then we do need to bridge that gap and make sure that there isn't just this huge divide such that you can kind of communicate whatever you want to the public or to your potential customers, and then the scientists are kind of sitting behind the scenes not chiming in.

4:46 [SPEAKER_00]: Yeah, yeah, there's an interesting thing with like if it's misinformation or if it's intentional like disinformation not only the definitions they're of but like what to do about it is it do we actively push back is that the You need to happen is do we start earlier better education for the public so there's something more scientifically literate is the it's tricky but I side with you that I do think this stuff needs to be called out on some level ideally to maybe have some sort of counter anchor.

5:13 [SPEAKER_00]: you know, out there where it's like, look, so and so is saying this, it appears to be credible. [SPEAKER_00]: I don't know what to make of it. [SPEAKER_00]: Is anybody saying anything to the contrary? [SPEAKER_00]: And I do think that needs to be there. [SPEAKER_03]: Yeah, because I think, unfortunately, especially social media is very, it really pushes controversial takes.

5:35 [SPEAKER_03]: And so if you frame something as five things you're doing wrong or five things your doctor won't tell you or, you know, they love that kind of content. [SPEAKER_03]: And so if your goal [SPEAKER_03]: Fairly simplified. [SPEAKER_03]: You know what? [SPEAKER_03]: Do what you prefer. [SPEAKER_03]: That's not going viral on Instagram.

5:58 [SPEAKER_00]: The algorithm does not reward either nuance or like very, you know, public facing takes that aren't controversial. [SPEAKER_00]: Yeah, you need to need to make somebody mad in order to get pushed by the algorithm, I think. [SPEAKER_03]: which is really unfortunate, but I think that what I mean people will say, you know, I'm the myth buster or I'm debunking this or that, and I never really intended to get into the myth busting space, but it was more of a sense that I realize that a lot of this information really does affect [SPEAKER_03]: people's lives, the way that they are trying to incorporate health-promoting behaviors.

6:41 [SPEAKER_03]: And so if we are with those out there are making it so complicated or so unattainable that they end up just throwing their hands up and saying, you know, fitness isn't for me, then that's the worst possible outcome. [SPEAKER_03]: So it's worth pushing back to kind of reach those people and say, Hey, hey, [SPEAKER_03]: Yeah, yeah, yeah, or at least at least have a raise their skepticism just a little bit like maybe I'll take this a piece of value Yeah, I think so much of the information that's out there is that very binary like you should never do this or you have to do that or Instead of saying actually, you know, there's many ways to be healthy.

7:27 [SPEAKER_03]: There's many ways to be fit [SPEAKER_00]: Totally. [SPEAKER_00]: Yeah, people like, what do you recommend for exercise? [SPEAKER_00]: I'm like, well, how much time do you have? [SPEAKER_00]: Because if it's 60 seconds, it's going to be fairly generalized and there's a bunch of ways to, you know, that lead, pass the lead to Rome, but then I would want to know more about the individual to like tailor that, but sure, yeah, public facing stuff is going to be, you know, broad by definition, and people prefer more concrete, more binary stuff, just generally speaking, which you're well aware of from the [SPEAKER_00]: Direct into, I'm sure.

7:57 [SPEAKER_00]: Well, let's get into the first of today's topics. [SPEAKER_00]: You're recent debate on the docks who live podcasts with an adult ski brothers against Dr. Stacey Sims. [SPEAKER_00]: I apologize in advance. [SPEAKER_00]: I know that you've probably been getting a lot of info. [SPEAKER_00]: people reaching out about this.

8:13 [SPEAKER_00]: I assume mostly positive will get into that. [SPEAKER_00]: So she has almost a million followers, her books roar in next level of sold ton of copy. [SPEAKER_00]: She's been platformed on popular podcasts such as Mel Robbins, Hooverman Lab, but despite her popularity and academic pedigree, some in the space.

8:29 [SPEAKER_00]: like you and I have serious issues with the accuracy of many of her claims regarding exercise of women and also just training at large. [SPEAKER_00]: So just general question, this podcast was recently released. [SPEAKER_00]: How do that go? [SPEAKER_03]: Well, I was happy that she was willing to do it.

8:47 [SPEAKER_03]: I think, unfortunately, we weren't really able to accomplish what I would have hoped, given that we only had an hour. [SPEAKER_03]: And the real shortfall was that she kept kind of promising that there were papers that I and the docks were unaware of, right? [SPEAKER_03]: And as a scientist who's not a complete narcissist, [SPEAKER_03]: I know the literature front to back and there couldn't possibly be a paper that I haven't heard of.

9:20 [SPEAKER_03]: So I was trying to be measured and say, you know, I'm pretty skeptical that that's out there, but I look forward to reading it when you send it over. [SPEAKER_00]: Yeah, yeah, that's that's got to be interesting because if somebody's saying look what I'm saying is evidence based me like look as a scientist and a science communicator Show me the data and if so I'm willing to change my mind 100%.

9:44 [SPEAKER_00]: being involved in the space and being aware of papers that come out on a regular basis in your area of interest and expertise, it'd be unlikely that you would be unaware of an entire like cadre of papers suggesting the diametric opposite of what you believe right now. [SPEAKER_00]: It'd be hard to rationalize those two things.

10:05 [SPEAKER_03]: That's right. [SPEAKER_03]: And I'm also really familiar with the claims that she makes. [SPEAKER_03]: And I've done the deep dive on my own time to say, but, I mean, prior to that debate, certainly, to say, hey, am I missing something here? [SPEAKER_03]: Because she's so confidently says this stuff on these huge platforms.

10:26 [SPEAKER_03]: And so I have spent the time really looking for some concrete data that would support the claims. [SPEAKER_03]: And I have not found it. [SPEAKER_03]: I've found Rodent data. [SPEAKER_03]: I've found kind of potential mechanisms that you can squish together to then maybe come up with that as a hypothesis.

10:45 [SPEAKER_03]: But she did send over her reference list after. [SPEAKER_03]: And for people listening, if you go to the episode, my references and hers are both linked in the show notes of that podcast. [SPEAKER_03]: surprise by some new paper that I wasn't aware. [SPEAKER_00]: Yeah, you're like, oh my gosh, this thing just came out in 2025.

11:09 [SPEAKER_00]: Oh my, my whole thoughts on Cycle Sinking have changed now. [SPEAKER_00]: All right. [SPEAKER_00]: Well, let's start there because one of the specific topics discussed was Cycle Sinking. [SPEAKER_00]: So adapting trading and nutrition approaches based on the different phases of a women's menstrual cycle.

11:23 [SPEAKER_00]: Dr. Sims is of the opinion that this would offer numerous benefits to presumably hell, trading outcomes at here and so on. [SPEAKER_00]: what in your opinion does the science actually say here about doing that, meaning that people would have specific types of training during the luteal phase, specific types of training during the follicular phase and maybe some nutrition stuff in there.

11:45 [SPEAKER_03]: This is one of the greatest examples of inappropriate extrapolation from rodent data. [SPEAKER_03]: So when we look at rodents with their ovaries removed, meaning you've completely shut down the hormone production, there appears to be something going on with muscle, meaning they are losing their ability to maintain muscle, and then you can kind of reverse this loss [SPEAKER_03]: So, very interesting model, but what does this mean for humans?

12:18 [SPEAKER_03]: First, the overreacting model is not even like menopause, because menopause transition is the gradual shift, whereas this is a radical surgery where you are just immediately shutting down hormones. [SPEAKER_03]: And it's certainly dissimilar to the short-term fluctuations that we would see throughout a menstrual cycle.

12:38 [SPEAKER_03]: So, when we, we can hypothesize, hey, is there something about a stradial that's anabolic? [SPEAKER_03]: And that's what people have hypothesized. [SPEAKER_03]: And then when you actually measure it in humans, in the menstrual cycle context, we see very similar proteins, synthetic and breakdown responses during the peak stradial or late follicular compared to that peak progesterone or mid-lutile.

13:07 [SPEAKER_03]: And then when we look at the menopause transition, estrogen-based therapies do not seem to affect muscle loss or muscle maintenance. [SPEAKER_03]: So we see this reasonable hypothesis generated from a rodent model that just doesn't really pan out in humans. [SPEAKER_03]: And that happens all the time.

13:24 [SPEAKER_00]: Yeah, though. [SPEAKER_00]: That's I really want to drive that point home to our listeners is that most the road in our animal models and or Petri dish models rather mechanisms their hypothesis generating studies. [SPEAKER_00]: And so then you need to go test those in humans and there are many Kate instances and not only medicine but also health fitness et cetera.

13:43 [SPEAKER_00]: where we don't have human data. [SPEAKER_00]: And at that point, it's basically a hedge. [SPEAKER_00]: It's a guess. [SPEAKER_00]: But when people, when scientists and researchers kind of make recommendations based on an absence of data, they tend to caveat that heavily. [SPEAKER_00]: They're like, look, this is a consensus statement.

13:57 [SPEAKER_00]: We don't really have good evidence in humans. [SPEAKER_00]: More research is necessary, right? [SPEAKER_00]: That thing that ends at every paper. [SPEAKER_00]: But when there's direct evidence in humans looking at the specific question, [SPEAKER_00]: that flips or it rebutts, the mechanistic hypothesis that someone's come up with, you either need to reject the hypothesis or modify it in some fashion.

14:18 [SPEAKER_00]: It seems like she's not really doing that for unknown reasons. [SPEAKER_00]: I don't know. [SPEAKER_03]: Yeah, it's strange because she said, oh, I've changed my mind on this a little bit, but then she went into how, you know, so many women aren't even ovulating and how all of the the kiss peptin neurons are going to affect your training outcomes and then we need to adjust recovery and nutrition.

14:48 [SPEAKER_03]: And so I think you haven't publicly changed your stance on it at all and it's one of those examples. [SPEAKER_03]: I mean, I think the crux of the issue is if you're going to brand women or not small men, then anything you say that contradicts that mantra starts to take away from that brand.

15:13 [SPEAKER_00]: Yep. [SPEAKER_00]: Yeah. [SPEAKER_00]: That's interesting. [SPEAKER_00]: It is just a, you know, the most charitable take here, at least in my estimation, you can, I want you to weigh on on this, is that if the body of research in humans, in women with different training protocols based on their, their menstrual cycle has not to date hand out.

15:31 [SPEAKER_00]: meaning that if you do it this way, this we think it was cycle sinking has not produced better hypertrophy outcomes, better strength outcomes, better body composition, trajectory, better health, you know, proxies and so on and so forth. [SPEAKER_00]: Then the most charitable takers like, well, they just didn't do it right.

15:47 [SPEAKER_00]: They didn't do the specific protocol that I would advise during the, you know, follicular phase and the luteal phase. [SPEAKER_00]: They did, they did something different. [SPEAKER_00]: but it wasn't what I would recommend. [SPEAKER_00]: That's like the only way that you could kind of keep that mantra going without kind of walking it back.

16:02 [SPEAKER_00]: At least that's how I'm giving her a charitable out here. [SPEAKER_03]: That's hard given this specific example because earlier data, they didn't actually make many papers. [SPEAKER_03]: They didn't track hormones. [SPEAKER_03]: They didn't track ovulation. [SPEAKER_03]: They just assumed, yeah, everyone has a 28 day cycle and everyone ovulates on day 14.

16:22 [SPEAKER_03]: So we have equal length phases, right? [SPEAKER_03]: And then at the end of the paper, they would conclude that these findings are due to high esterial or low esterial height, but you didn't even measure it. [SPEAKER_03]: And so that drove me absolutely nuts. [SPEAKER_03]: So the work that I have done, I meticulously tracked cycles for months, and then, [SPEAKER_03]: measured all the hormones and did a within subject design.

16:49 [SPEAKER_03]: So you can tightly control everything and other papers have come out that have employed the same far better methodologies. [SPEAKER_03]: And so I don't think you can discount the more recent clearly higher quality data. [SPEAKER_03]: I think the only thing you can say is menstrual symptoms are experienced differently by different women at different times, and you should feel free to adjust your training as needed, the same way that you would have an auto-regulatory component of a training program for a whole host of other reasons.

17:29 [SPEAKER_00]: Yeah, yeah, we we talk about this at our seminar quite a bit when it turn our special populations lecture, which interestingly is basically kind of removing that that label from folks or like look people that women are special population when it comes to training. [SPEAKER_00]: not not so much outside of a very special subset of conditions where there are some additional considerations maybe perhaps around pregnancy for example or older individuals is like well the real consideration here is that most older individuals are underloaded and under trained that's the real big problem here and not that like your special organism we have to do all these special training things but rather it's the same consideration for any individual that your

18:12 [SPEAKER_00]: As real, that's valid, and let's have a component of your program that makes it dynamically adjustable to what you need on a given training day or series of training days. [SPEAKER_00]: Same thing, nutritionally, it's based on the individual, not necessarily like what you happen to have a high estrogen level, right now, is a dial level or a high, a progesterone level.

18:30 [SPEAKER_00]: That's probably not the key to unlocking somebody's fitness, fitness annotations. [SPEAKER_03]: especially because nobody even knows what are you doing measuring your hormones every single day of course not um so you're making assumptions that you have this hormone profile on a given number of days that you may or may not have.

18:52 [SPEAKER_03]: which really doesn't make a lot of sense. [SPEAKER_03]: And I think the most detrimental version of this messaging is to say this week, you should plan on feeling terrible and performing poorly. [SPEAKER_03]: Because as soon as I've told you that as my athlete, of course you're going to feel worse in performance.

19:11 [SPEAKER_00]: Yeah, a little no sebo never heard anyone. [SPEAKER_00]: Oh wait, oh wait. [SPEAKER_00]: Yeah, so I think would it be fair to say that based on your interpretation of the current evidence and your current, you know, sort of thinking about this that based on a woman's menstrual cycle, there are no unique considerations to training or nutrition outside of the individual's experience.

19:34 [SPEAKER_03]: Absolutely. [SPEAKER_00]: I like that. [SPEAKER_00]: All right, cool. [SPEAKER_00]: One for one so far. [SPEAKER_00]: I like that. [SPEAKER_00]: I like I like when my bias is confirmed. [SPEAKER_00]: No. [SPEAKER_00]: Oh. [SPEAKER_03]: I think this should be good news. [SPEAKER_03]: And so it's very strange that some people are so upset when I speak about it.

19:49 [SPEAKER_03]: Because like anything that makes it simpler should be better because I don't have more options. [SPEAKER_00]: way more options. [SPEAKER_00]: Yeah, it doesn't have to be so specific. [SPEAKER_00]: So, so complicated. [SPEAKER_00]: It's like, nope, you can kind of do whatever you want to be honest.

20:03 [SPEAKER_00]: Yeah. [SPEAKER_00]: Next, there was a pretty interesting discussion about fasted cardio. [SPEAKER_00]: Dr. Sim suggesting there's a real risk for women to perform their conditioning and or other workouts without eating before. [SPEAKER_00]: What's your what's your take on this? [SPEAKER_00]: Is this a perilous for women?

20:21 [SPEAKER_03]: This is a strange one and again, I went through all of her references and there's not a single example of people actually performing fasted training on a regular basis and then them gaining more body fat or losing muscle. [SPEAKER_03]: or having some sort of endocrine dysfunction at the end of that training period.

20:42 [SPEAKER_03]: Meanwhile, we have four studies that I can think of just off the top of my head that have done that and have measured changes in body composition after [SPEAKER_03]: six weeks, eight weeks, 12 weeks of regular, fasted training, and there are no differences in changes in fat mass, changes in lean mass, changes in muscle thickness, even changes in strength performance, which may surprise some people, but really it comes down to overall calories and protein.

21:13 [SPEAKER_03]: And when we wake up in the morning and we go to the gym fasted, it's not like we are running on empty. [SPEAKER_03]: We still have stored glycogen from yesterday when we had dinner. [SPEAKER_03]: And so I think this this whole... [SPEAKER_03]: message is kind of pushing a narrative that you have no nutrient availability whatsoever, and so you're going to the gym and you're going to immediately lose muscle, and your court is always going through the roof, and therefore there will be hormonal disruption and potential fat gain.

21:52 [SPEAKER_03]: Those are all of the things that I heard her say in that conversation. [SPEAKER_03]: and we don't have evidence to support any of that and we do have evidence to suggest the contrary that it really isn't that important. [SPEAKER_00]: Yeah, having similarly done a deep dive on like, okay, fasted training is this terrible, not just in women, but in just people, humans, in general.

22:18 [SPEAKER_00]: And really what you see is that when someone's not used to it, they normally would train fed and then you put them in an experimental model where all of a sudden, out of nowhere, they're training fasted. [SPEAKER_00]: There may be a performance decline in the short term, right? [SPEAKER_00]: But if you stretch that out over eight weeks, [SPEAKER_00]: the actual fitness adaptations are very, very similar such that you couldn't really distinguish between the two groups.

22:40 [SPEAKER_00]: If you wanted to like hedge your bets for short-term performance, you probably would want to be fed or maybe have an intro workout snack or something that's reasonable for like performance in that workout. [SPEAKER_00]: But long-term, as long as the workout is a [SPEAKER_00]: Uh, yeah, they're probably going to get similar results.

22:59 [SPEAKER_00]: So when people freak out about, hey, I got to switch my work out to first thing in the morning, what should I do to counter this? [SPEAKER_00]: I'm like, it's probably doesn't matter as long as at the end of the day and really at the end of a longer period of time, your total energy balance is roughly the same, protein intake has been generally the same.

23:15 [SPEAKER_00]: Is that fair to say? [SPEAKER_00]: You feel like you agree with most of that? [SPEAKER_03]: I do. [SPEAKER_03]: Yeah. [SPEAKER_03]: This was all a debate about performance, then I would push back very, very little because I think it's probably likely that most people would perform better, especially if you're doing very high intensity work or long endurance exercise.

23:37 [SPEAKER_03]: But I think when we look at just the average gym gore, it's far less important because we're just trying to get them to go to the gym and do it consistently. [SPEAKER_03]: And so if you're saying, oh, you know, if you're going to the gym at 5 a.m., you need to figure out a way to have a meal beforehand.

23:55 [SPEAKER_03]: Then you're putting up a major unnecessary barrier. [SPEAKER_00]: Yeah, that works. [SPEAKER_00]: It's down here. [SPEAKER_03]: Right. [SPEAKER_03]: So it's not like I'm a proponent of fasted training per se, but I think we should stop the fear mongering about it because you should be allowed to do what you prefer.

24:20 [SPEAKER_03]: Maybe experiment with both depending on your schedule, how you train, and when you train typically, and then we can just move on. [SPEAKER_03]: And there's nothing to suggest it's different for women than it is for men. [SPEAKER_00]: Yeah, to me, there's like three separate claims in here.

24:36 [SPEAKER_00]: One is that fasted trading in general lowers the short term performance. [SPEAKER_00]: And I'm like, okay, probably true, more true, when it's in the short term setting, a person's not used to it, right? [SPEAKER_00]: They haven't like adapted or figured that out. [SPEAKER_00]: Um, the second claim is that if you do perform your training fasted, something bad is going to happen.

24:55 [SPEAKER_00]: You're gonna somehow gain fat and not must like whatever, right, or not gain strength. [SPEAKER_00]: That you're gonna have a maladaptive response to exercise. [SPEAKER_00]: And I'm like, so there's no evidence showing that at all in humans. [SPEAKER_00]: So you kind of, that's the second claim.

25:08 [SPEAKER_00]: And the third claim is that, oh, and by the way, it's much worse for women. [SPEAKER_00]: And it's like, okay, well, interesting hypothesis. [SPEAKER_00]: where's the evidence? [SPEAKER_00]: And then you look at the evidence in humans and you're like, so that doesn't appear to be true. [SPEAKER_00]: And so then yeah, it just comes back to say why are you saying this?

25:28 [SPEAKER_00]: You know, if you guys are watching this on YouTube, that was a shoulder shrug emoji. [SPEAKER_00]: That's what just happened. [SPEAKER_03]: Yeah, I wish I knew because I truly don't understand it. [SPEAKER_03]: And I think maybe there is some kind of mixed in [SPEAKER_03]: thought about relative energy deficiency and that if you are training fasted, then you're going to immediately put yourself in a state of low energy availability, but that's not true.

25:58 [SPEAKER_03]: I mean, low energy availability is chronic, under-fueling. [SPEAKER_03]: over exercising relative to your body composition, and so it's a very different conversation, and so that's why when I hear this pushback of, well, it's only for athletes or it's only for elite performance, but you're going on the Mel Robbins podcast and saying, women should never train faster.

26:30 [SPEAKER_00]: Never. [SPEAKER_03]: That's a lay audience of just women trying to be healthy. [SPEAKER_00]: Yeah. [SPEAKER_00]: Yeah. [SPEAKER_00]: I mean, if you wanted to again make a very charitable version of the claim, it's like, look, you have a highly active population, elite level athletes, you know, dozens of hours a week of training.

26:48 [SPEAKER_00]: And so if they don't eat before or work out effectively, they're limited on time availability to eat, which is could then cause like a low energy availability status. [SPEAKER_00]: But again, you would expect that to play out in the research and further that it would apply to a wide swath of the population, if you're just saying these things generally, which doesn't seem to be the case.

27:11 [SPEAKER_00]: Low energy, low energy availability, reds, all that sort of stuff, these are real issues. [SPEAKER_00]: But to my knowledge, it is not based on the time availability to eat, where people are just, I run it out of time, I can't eat because I'm exercising so much. [SPEAKER_03]: And if you're going to talk about a concern for very elite athletes or extremely lean individuals, clarify.

27:38 [SPEAKER_03]: That's like saying, you know, this advice is for pro bodybuilders, but all men should. [SPEAKER_03]: Yeah, exactly. [SPEAKER_00]: Wait, what? [SPEAKER_00]: Yeah, I mean, that kind of brings me to the final thought here with the respect to Dr. Simms and more over to people like Andrew Huberman, Rhonda Patrick, et cetera.

27:59 [SPEAKER_00]: There's just a lot of this, what I like to call generous, extrapolation of mechanistic studies, despite either no human evidence to support the specific claim or intervention or evidence to the contrary. [SPEAKER_00]: It's curious though. [SPEAKER_00]: Why does this happen? [SPEAKER_00]: Why do you think this is so common?

28:17 [SPEAKER_00]: Is it our short attention spans and incentivizing clickbait content over nuanced science communication? [SPEAKER_00]: Or do you think I don't want to put you on a hot seat? [SPEAKER_00]: But you think this is like some sort of nefarious intent here. [SPEAKER_03]: Is the question why are they doing it or why are they okay?

28:35 [SPEAKER_03]: Well, I think when you say something, no one else is saying it people take it as you have some secret and so the [SPEAKER_03]: People aren't saying it because they don't know what you know. [SPEAKER_03]: And that's very powerful and that gets a lot of attention. [SPEAKER_03]: And when you start talking about mechanisms that sound very complex and frankly, no one really knows what you're talking about, then you sound very intelligent.

29:07 [SPEAKER_03]: It's a good narrative. [SPEAKER_03]: and people will just take your word for it because you aren't explaining things in a way that people can connect with. [SPEAKER_03]: And that piece of it really bothers me because as somebody who can sit here with you and talk mechanisms and make things sound really complicated, I'm not doing that on a podcast.

29:31 [SPEAKER_03]: Like, why would I do that? [SPEAKER_03]: Because ultimately we want people to understand [SPEAKER_03]: And if you're just saying a whole bunch of what sounds like nonsense and then, and therefore, here's this thing you should do, then all people here is, here's the thing I should do. [SPEAKER_00]: Yeah, here's a solution to the problem you don't have, but you don't know that, because I'm deceiving you on some level.

29:58 [SPEAKER_00]: And yeah, thanks because it's got a boat payment coming up, so you to, I don't know that any of these people have boats, but that's just what I assume's happening. [SPEAKER_00]: Yeah, no, well, well said, and if you guys haven't checked out this particular podcast, it'll link that into the show notes below.

30:13 [SPEAKER_00]: It's pretty pretty well done, although, again, I wish you guys had more time. [SPEAKER_00]: And I also wish that there was really set up more like a official debate, where I was like, do you can see this point, you know, before moving on? [SPEAKER_00]: And because I think holding somebody's feet to the fire would be [SPEAKER_00]: just to me, and my nerdy, you know, since sensibilities, I would have preferred that, but hard to put it on.

30:33 [SPEAKER_03]: I agree. [SPEAKER_03]: And I mean, if it were up to me, then there are many other ways that I think we could have done it. [SPEAKER_03]: But I just was, I was going to take the opportunity to do it in any capacity. [SPEAKER_00]: Yeah, shout out to her agreed to it at least because that that was surprising to me.

30:50 [SPEAKER_00]: I'm like, oh, oh, this is not going to go. [SPEAKER_00]: Well, this is not going to go well for you, at least at least a people with scientific training because you just instantly recognize you're like, you're talking about rat data. [SPEAKER_00]: This person's talking about human data.

31:03 [SPEAKER_00]: So levels of evidence hierarchy of evidence. [SPEAKER_00]: This is a it's not really close. [SPEAKER_00]: So. [SPEAKER_00]: What do we do? [SPEAKER_03]: And I don't know if you, if you caught that at one point, she said she doesn't like meta-analyses because... Yes. [SPEAKER_00]: Yeah. [SPEAKER_00]: I was like, wait, what?

31:20 [SPEAKER_03]: I've literally never heard any scientist or physician or like, who, who, why? [SPEAKER_00]: Yeah, what do you like them? [SPEAKER_00]: I think it's fair to say something like, look, if you combine a bunch of data together, depending on the quality of said data, you can have concerns about how that is sort of, you know.

31:39 [SPEAKER_00]: The outcome there, what's being concluded from that, also if it's garbage in, garbage out short, that's a reasonable concern, also combining a bunch of data tends to prefer the null, just generally speaking, but it's not a bug, it's more of a feature because only if the effect or the outcome was very, very strong, would it turn up when you combine many, many studies together?

32:00 [SPEAKER_00]: Again, assuming that the inclusion criteria and the analysis is done correctly, but [SPEAKER_00]: Yeah, saying that you don't like meta-analysis to use a term of the youth is crazy. [SPEAKER_00]: I don't understand. [SPEAKER_03]: Yeah, no, I mean, I think you bring up a good point and it's true that in the exercise science field, there are some people who will do a meta-analysis when it's way too soon to do a meta-analysis.

32:25 [SPEAKER_03]: We got seven papers, everyone calm down. [SPEAKER_03]: We don't need to be doing a meta-analysis. [SPEAKER_00]: Yeah, yeah, that's what that's what I said. [SPEAKER_00]: So another thing I wanted to talk about is what I somewhat jokingly, but sometimes in a sad way, refer to as the paint tax for women in the fitness industry, many things are marketed directly to women, such as specific types of exercise like Pilates, walking with weighted vest, testing of various hormone levels and specific like creatine supplements.

32:52 [SPEAKER_00]: You got to take this pink gummy, whatever. [SPEAKER_00]: Let's talk about a few of these things. [SPEAKER_00]: I wanted to start with a topic. [SPEAKER_00]: I recently published a podcast on walking with the weighted vest. [SPEAKER_00]: What's your take on this? [SPEAKER_00]: Because on TikTok, it's all over the place.

33:05 [SPEAKER_00]: Oh, you can get more out of your walking. [SPEAKER_00]: It's basically like resistance training. [SPEAKER_00]: It's good for bone mineral density muscle, et cetera. [SPEAKER_00]: What's your what's your take on walking with the weighted vest? [SPEAKER_03]: I think anything that gets you physically active is good.

33:19 [SPEAKER_00]: But when the podcast, that's it. [SPEAKER_03]: Um, but I've spoken out about way to invest a lot because the people who are promoting them are using science, quote unquote, that doesn't actually support the message they claim it shows. [SPEAKER_03]: And so it was goes back to what we were talking about with with the fastest training or the cycle thinking, you know, if we're going to say, [SPEAKER_03]: going for 30 minute walks with a weighted vest increases bone mineral density or increases muscle mass or promotes fat loss.

33:54 [SPEAKER_03]: We actually need to see that happen over time and the only paper I'm aware of that we have. [SPEAKER_03]: It's remotely similar to that, meaning one group walked on a treadmill with a vest and the other group did not. [SPEAKER_03]: It was exactly the same. [SPEAKER_03]: There were no differences in adaptations between groups.

34:11 [SPEAKER_03]: And so the studies that people are using instead, are studies where a group was wearing a weighted vest, but doing squats and lunges and jumping exercises, compared to a group of people who were doing nothing. [SPEAKER_03]: And what that tells us is that exercise is better than no exercise.

34:30 [SPEAKER_00]: Yeah, I mean, there's also studies, and I'm sure you've seen these where people are wearing weighted vests for eight hours, 10 hours that they're supposed to wear them all day, just to see, like, oh, what would happen? [SPEAKER_00]: Is this a viable way to get people to either lose weight or better maintain weight or have more bone mental density, more muscle mass, whatever, and then relatively long-term data on this that shows, again, no significant difference.

34:51 [SPEAKER_00]: And that's statistically significant, different, which is much smaller, generally speaking, then [SPEAKER_00]: I'm open to the idea that weighted vests might be a way to level up a person's work out, you know, or at least improve their fitness adaptations. [SPEAKER_00]: I just want to see data to support that.

35:07 [SPEAKER_00]: But to my mind, and you can comment on this, the biggest issue with the weighted vests, as far as it like supercharging, somebody's results from a given amount of exercise. [SPEAKER_00]: Let's just say both groups are going to exercise, but one person's with the weighted vests, one person's not, and we're talking about conditioning in this particular case.

35:25 [SPEAKER_00]: The issue really is that if the weighted vest is heavy enough, most people are going to move more slowly and do it for a shorter duration. [SPEAKER_00]: So at the end of the day, if we're just talking about like energy utilization, it tends to be not that much different for a pretty significant weight.

35:41 [SPEAKER_00]: And then even if they did the same amount. [SPEAKER_00]: Again, you're looking at outcomes and you're like, I, is this not different? [SPEAKER_00]: No, well, instead of rejecting that the way to invest is some unique way to increase the adaptation from your workout and you should revise your hypothesis and say, maybe it's not heavy enough, maybe it's something else is going on, at least that's my understanding right now.

36:02 [SPEAKER_03]: Well, I think it can be viable for squats, lunges. [SPEAKER_03]: Maybe if you have grip issues and you know, you don't, you want to work out at home. [SPEAKER_03]: You don't have dumbbells. [SPEAKER_03]: Maybe that there's a use case there, sure. [SPEAKER_03]: But often what I hear people say is, well, it's getting my heart rate up.

36:21 [SPEAKER_03]: Or okay, well, why do you want to get your heart rate up? [SPEAKER_03]: Why are we tracking heart rate? [SPEAKER_03]: What's your goal? [SPEAKER_03]: That what for which heart rate tracking is meaningful because a lot of people are just tracking these things to track them and when let's say you're training for a marathon then sure [SPEAKER_03]: I understand we want to train in these different heart rate zones and hopefully that will be the optimal method for improving your law endurance running performance.

36:47 [SPEAKER_03]: You know, we're going to do a lot of those zone two and then we're going to throw in some sprint intervals and maybe we shouldn't track your heart rate for that. [SPEAKER_03]: But to just say, like, my heart rate is higher with the vest than it is without it, but a vest? [SPEAKER_03]: Well, you could also walk up a hill.

37:06 [SPEAKER_03]: You could also walk faster. [SPEAKER_00]: Sure. [SPEAKER_00]: You could also use cocaine. [SPEAKER_00]: You could also be here. [SPEAKER_00]: You could also have some sort of arrhythmia. [SPEAKER_00]: Like, there's a lot of ways to get your heart rate up. [SPEAKER_00]: In the way it's not that's not it's not like a carte blanche good It matters why your heart rate is elevated and then what's the purpose as you as you mentioned that's you know Yeah, your heart rate higher but like is it because you're requiring your muscles to produce more force and if that's the case like does it actually signal the adaptations that you want [SPEAKER_00]: Yeah, I do think you're right though with the use case for weighted vests for like resistance training applications at home, for example, if they don't have, you know, you could use a weighted backpack for that, but yeah, when I see people strap, I see people at the on the treadmill at the gym with the backpack on and they're like, and I'm like, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey

37:53 [SPEAKER_00]: Yeah, you're expanding more energy a little bit compared to if you're walking at the same pace for the same duration, whatever without the backpack on, but I don't know that that is net good, meaning that, oh, you're going to lose more weight. [SPEAKER_00]: Or you're going to gain more muscle mass or preserve more muscle something like that.

38:10 [SPEAKER_00]: To date, the studies don't seem to show that anyway. [SPEAKER_03]: they don't and I think it's also important and this is often really misunderstood is that if you just start exercising and then you're saying, well, I'm burning more calories and maybe you're tracking them on your wearable.

38:27 [SPEAKER_03]: First, wearables are horrible. [SPEAKER_03]: for tracking that. [SPEAKER_03]: So I would suggest nobody use that data for anything ever. [SPEAKER_03]: But even if we do sort of map out the expected weight loss over time from the expected energy expenditure with all of this exercise, we see if you aren't really monitoring your nutrition.

38:51 [SPEAKER_03]: A lot of people will [SPEAKER_03]: We're, if yes, you're exercising more, but perhaps you are moving less the rest of the day and there's some sort of shift there where you end up losing about 20 to 50% of what you would have anticipated if you really modeled it all out and so that's why I think so often when people just rely on exercise for weight loss.

39:17 [SPEAKER_03]: It ends up being pretty disappointing, and so for to throw in this example of weight advice and burning more calories, think now we're missing the mark here. [SPEAKER_03]: We shouldn't be doing it for that reason. [SPEAKER_00]: Yeah, are you familiar with the Gravitostat model of energy?

39:33 [SPEAKER_00]: Yeah, so this research group out of Sweden for the listeners who didn't listen to the way to invest podcasts that we did, they implanted the small weights in rodent abdoments. [SPEAKER_00]: And what they found was with this implanted weight. [SPEAKER_00]: the rodents actually lost an equivalent amount of body mass in response to that thinking like oh, maybe the bones are sensing this added load and it's like, ah, let's lose some additional weight so that we can maintain homeostasis.

40:02 [SPEAKER_00]: Hasn't played out in humans, but that's kind of what what prompted the idea. [SPEAKER_00]: Hey, what's it? [SPEAKER_00]: What would happen if we had humans where we'd invest all day? [SPEAKER_00]: with that do the same thing that turns out even if you wear a weighted vest for like 10 hours a day that that unfortunately is not going to be the solution to the obesity epidemic as it were.

40:19 [SPEAKER_03]: And it's another example of, you know, we study rodents because there's simpler systems are very easy to tightly control. [SPEAKER_03]: But ultimately, they have different metabolism. [SPEAKER_03]: They have different reproductive systems. [SPEAKER_03]: And what often what we see in this simple model doesn't play [SPEAKER_00]: Nope, nope, that never happens, never happens.

40:43 [SPEAKER_00]: Yeah, yeah, it's a big surprise for people again because do you own research, whatever you see this thing? [SPEAKER_00]: Oh, it's in rats, so that probably transfers over to humans, most of the time it doesn't, unfortunately. [SPEAKER_03]: And we've seen it, time and time again, with fasting, with artificial sweeteners, and we've seen it, and yet people, but butt, and going back to a lot of the kind of popular, [SPEAKER_03]: credentialed influencers or science communicators, they rarely say I've changed my opinion on this and I was really heavily relying on this road and data and now that we have a couple years of human data, I realized that I maybe shouldn't have been making recommendations and all of my books and podcasts for you guys to fast for three days.

41:32 [SPEAKER_00]: You know, yeah. [SPEAKER_00]: Well, you know what, it'd be funny. [SPEAKER_00]: Interestingly, if someone did that, right, they'd be like, and I wrote a new book about it. [SPEAKER_00]: There you go. [SPEAKER_00]: There's yours. [SPEAKER_00]: There's your. [SPEAKER_00]: There's the incentive to do so.

41:43 [SPEAKER_00]: Yeah, yeah, it's unfortunate. [SPEAKER_00]: The next thing I wanted to talk about was creatine. [SPEAKER_00]: I've seen obviously on your social media, you've been posting about that, especially because it's become topical with respect to cognitive function and quote brain health and such.

41:56 [SPEAKER_00]: So should women be taking creatine? [SPEAKER_00]: And if so, do they need a specific type of creatine? [SPEAKER_03]: No, and this is an excellent example of pink tax because the Creation that is now marketed to women is pink, and it makes all sorts of crazy claims like it's going to build muscle, build your glutes specifically, um, eliminate cellulite, um, restore energy, [SPEAKER_03]: I mean, it's so, so sad.

42:27 [SPEAKER_03]: And it's also twice the price, sometimes three times the price, then if you just get the tried and true creatine monohydrate from wherever, which we know works, and everything that's more expensive is in better. [SPEAKER_03]: It just isn't. [SPEAKER_00]: it's just more expensive. [SPEAKER_00]: Yep.

42:46 [SPEAKER_03]: Yeah. [SPEAKER_03]: And so it's, I mean, it's cool, I guess, that people are paying attention to creating, but creating has been around forever. [SPEAKER_03]: Creating is not new. [SPEAKER_03]: And so the way that it's being kind of repackaged and marketed specifically to women is part of this [SPEAKER_03]: push to especially perimenopausal women that is extremely supplement focused and hormone focused and really neglects to mention the really important basics like lifting weights, like regular physical activity, like a nutritious diet and so then you get people really really focused on these [SPEAKER_00]: Yeah, yeah.

43:37 [SPEAKER_00]: I mean, you can. [SPEAKER_00]: It's just probably not got to do anything. [SPEAKER_00]: You know, like, yeah. [SPEAKER_03]: And even if you are exercising, what it will do is minimal. [SPEAKER_03]: You probably won't even notice that you're taking it. [SPEAKER_00]: So it's so weird. [SPEAKER_00]: I feel like sometimes I'm like the killer of joy.

43:51 [SPEAKER_00]: You know, if you were like, I'm, I'm going to take create a team. [SPEAKER_00]: And I'm like, [SPEAKER_00]: Great. [SPEAKER_00]: Probably had a modest effect, but generally safe, here's the dosine, go forth in prosper. [SPEAKER_00]: You know, and they're like, what do you mean modest improvements?

44:02 [SPEAKER_00]: I'm like, well, it's not going to change your life. [SPEAKER_00]: You know, like, a little bit of strength, a little bit of maybe extra hypertrophy at the end of a long training term, some other benefits, but they're like, what about like brain health? [SPEAKER_00]: It's going to it's good for my brain, right?

44:15 [SPEAKER_00]: I've been reading all about this that, you know, can improve cognitive performance after sleep deprivation [SPEAKER_00]: Well, maybe, but the outcomes that have been measured, you know, and the changes in from placebo compared to the intervention arm are not like earth shattering, you know, but people see that these reports, the studies that look published in these journals that are to their mind, highly reputable and such, and they're like, I got to take this for brain health.

44:45 [SPEAKER_00]: I'm like, I don't know the creatine's a new tropic is, you know, it's so far. [SPEAKER_03]: Yeah, and I think we need to acknowledge the populations in which this has been studied are at some sort of deficit and so we're talking about Alzheimer's patients or as you said 24 hour 48 hours sleep deprivation or clinical depression in combination with an SSRI.

45:09 [SPEAKER_03]: And so this isn't like healthy people getting some brain boosts the way that it's like, oh, yeah, you know, I'm going to grab my cup of coffee and then I'm going to feel more awake. [SPEAKER_03]: It's not it's not that and importantly, these studies that are that are using really high doses, people need to be aware that a lot of people experience GI issues when they start taking 10 20 grams of creatine per day.

45:33 [SPEAKER_03]: So I don't think we were there yet to be recommending it to the masses. [SPEAKER_00]: This is kind of an aside, but like invariably, and I'm sure if you've ever done a, uh, some sort of talk on creatine, do publicly facing your like, because one of the most studied supplements that we have, if not the most studied supplement, which that happens to be true, but there are still gaps in our knowledge there, like for example, if you wanted to feel confident in, well, how many people are responders to creatine with respect to like musculoskeletal outcomes or in this case cognitive outcomes.

46:03 [SPEAKER_00]: you don't really have great data on like who's a non-responder, who's a responder or whatever, and like how are we ascertaining that there's some evidence. [SPEAKER_00]: There's not zero evidence, but it's not like as much evidence as we have on strength performance, for example. [SPEAKER_00]: And so if you really wanted to feel confident, I'm going to give a thousand people creatine and a third are going to be responders and a third are going to be pseudo-responders and a third are going to be non-responders.

46:24 [SPEAKER_00]: It's like [SPEAKER_00]: That's based off of trial. [SPEAKER_00]: I'm seven people. [SPEAKER_00]: So we should temper that. [SPEAKER_00]: Again, doesn't mean you can't take it, but like there are some gaps in our in our knowledge base here. [SPEAKER_03]: Yeah, I mean, what hasn't been done and done well is to say, okay, coming in at baseline, what are your actual creatine stores, either in muscle or brain, and then once we start supplementing, and that is saturated, you know, your proverbial cup is full, then what did it take to get you from baseline to there, and what are the performance effects if any?

47:00 [SPEAKER_00]: Yeah, we see the same thing in vitamin D research. [SPEAKER_00]: It's like, okay, we need to measure the vitamin D levels prior to intervention. [SPEAKER_00]: Then we need to apply the invention like a supplement, for example. [SPEAKER_00]: And then re-measure vitamin D levels to show, okay, it did improve that.

47:15 [SPEAKER_00]: And oh, by the way, that's correlated with these specific improvements in outcomes. [SPEAKER_00]: And when that's been done, it's like a vitamin D, actually doesn't really change the course here so much. [SPEAKER_00]: And people want to hear that they're like, so you're saying not to take vitamin D. My doctor told me to take it or this public health agency told me to take it.

47:33 [SPEAKER_00]: I'm like, I'm not saying don't take it. [SPEAKER_00]: It's dangerous, whatever. [SPEAKER_00]: I just am not confident. [SPEAKER_00]: It's doing anything based on available evidence. [SPEAKER_00]: And I suspect that these individuals recommending it if they were aware of the evidence, they'd probably can see that they're like, this is mostly a hedge because we see abnormal value, we want to treat the value, but we don't really know if it works.

47:51 [SPEAKER_00]: That'd be the honest take, I think. [SPEAKER_03]: And I think depending on what we're talking about, sometimes it really only matters that we achieve the outcome that's intended, right? [SPEAKER_03]: So you think about menopause hormone therapy, you're not actually treating to a hormone level, you're treating to alleviate those symptoms.

48:11 [SPEAKER_03]: So that's an example of, well, it's not actually important those before an after a number is necessarily what we're really focusing on is that outcome. [SPEAKER_03]: And I think given the safety and price of creatine, I would probably say, well, if you want to, and kind of, sure. [SPEAKER_00]: Go off, you can do it, yeah, yeah.

48:36 [SPEAKER_03]: But I think it also comes back to your kind of personal feelings on supplements in general and are you somebody who is just going to take it because why not? [SPEAKER_03]: Or do you actually want to make sure that you're taking it for a reason? [SPEAKER_03]: And I think in this whole discussion about supplements we often forget.

48:55 [SPEAKER_03]: the word supplement that we're, like, why are we taking that? [SPEAKER_03]: It's not that everything is going to make you better. [SPEAKER_03]: It's maybe, oh, you are lacking something and then we're kind of bringing that up, uh, and I think that gets lost because people are just obsessed with wanting to, to take supplements.

49:15 [SPEAKER_00]: Totally. [SPEAKER_00]: Yeah. [SPEAKER_00]: Yeah. [SPEAKER_00]: Huge industry as it turns out. [SPEAKER_00]: The next exercise trend on trend again as the youth would say is Pilates. [SPEAKER_00]: And again, I did a podcast on this as well. [SPEAKER_00]: And I saw the Yets of content on this too.

49:30 [SPEAKER_00]: So this isn't the the shit on Pilates section, but like the shoe fits. [SPEAKER_00]: Where are it? [SPEAKER_00]: Our Pilates really sufficient for resistance training in women. [SPEAKER_03]: I think it's not just Pilates, it's a whole host of exercise programs that have been marketed to women for a very long time.

49:50 [SPEAKER_03]: So it's the bar classes, it's the spin classes holding the dumbbells where you're supposedly that intermittently doing some upper body work. [SPEAKER_03]: Pilates in yoga, and I think just the theme is women have been marketed ineffective exercise programs for as long as I can remember.

50:13 [SPEAKER_03]: It's just the flavor of that changes every few years. [SPEAKER_03]: Pilates is fine, again, off is a glad to be as good if you love it, do it, but what people misunderstand is if you actually want to build muscle and then we need adequate resistance and adequate force production. [SPEAKER_03]: such that we are able to contract and stimulate muscle growth over time.

50:43 [SPEAKER_03]: And when we are in this sort of unstable position that inevitably compromises the force we are able to produce against a given load. [SPEAKER_03]: So even if you're doing something like a reformer Pilates and you have a weight attached to your ankle or a weight attached to your wrist, you're in that unstable position.

51:06 [SPEAKER_03]: unstable surface training, like standing on a busu or doing a chest press on a stability ball isn't as effective as the traditional resistance training. [SPEAKER_03]: And it's also much more difficult to progress over time because even something like a reformer isn't going to have the resistance options and often these exercises aren't set up in a way where progressive overload is really the way the method, part of the method.

51:36 [SPEAKER_00]: Yeah, I think also people can flate if something is hard, it has to, it's going to be useful, like proportional to the difficulty, right? [SPEAKER_00]: The harder it is, the better it is for me. [SPEAKER_00]: There's maybe some kernel of truth to that, like you do have to work adequately hard during exercise to get the most out of your training, but just because something is called harder doesn't make it better.

51:55 [SPEAKER_00]: We don't need more difficulty, we just need more better, as far as it being appropriately programmed to the individual. [SPEAKER_03]: Yeah, I think a great example of that is if I were to hold a one pound dumbbell and bring my arm out to the side and just hold my arm up straight out like this in a sort of lateral raised position, my shoulder is going to start to burn.

52:19 [SPEAKER_03]: But am I building muscle mass and my shoulder by just holding it here? [SPEAKER_03]: Not effectively. [SPEAKER_00]: No. [SPEAKER_00]: Yeah, maybe strength endurance, you know, in that particular position being specific, but it's like, that's what you want. [SPEAKER_00]: Like, I can imagine if there's a sport where that's involved, if you're a strong man competitor, you know, maybe doing that, you know, for the iron cross or whatever the event is, it might be specific to your sport.

52:40 [SPEAKER_00]: But like, it's hard. [SPEAKER_00]: It just doesn't mean that it's actually useful for what you're wanted to get out of exercise. [SPEAKER_03]: And I think that goes back to what we were discussing before with the vests. [SPEAKER_03]: It's, what is the goal here? [SPEAKER_03]: What are we measuring?

52:52 [SPEAKER_03]: And what are we programming? [SPEAKER_03]: What are we implementing? [SPEAKER_03]: And the problem is that the way a lot of these classes and methods are marketed, it's, oh, you're going to get ripped abs in 12 weeks. [SPEAKER_03]: Or you're going to have these long lean lines. [SPEAKER_03]: You're going to look like a ballerina.

53:10 [SPEAKER_03]: It's all these promises about dramatic changes in body composition. [SPEAKER_03]: and you aren't getting those with a group fitness class or just not, and so it's really that's the mismatch between what people are expecting to get out of it and then what they're actually getting out of it when there is a more effective option out there.

53:30 [SPEAKER_00]: Yeah, no hatecams against Pilates, like again, as you mentioned, any exercises is good. [SPEAKER_00]: 10 out of 10 would recommend, but I would also recommend that to be like an adjunctive sort of exercise modality to traditional resistance training and obviously some conditioning as well.

53:46 [SPEAKER_00]: Do it all. [SPEAKER_00]: But yeah, probably not going to get there with just Pilates. [SPEAKER_00]: Okay, so this is maybe the one, I don't know what the, the women's fitness market is, but I'm sure it's in the billions of dollars, why do you think that women are such common targets or like even unfortunately victims of all of this messaging and direct marketing like as a woman you need to do this or this is geared directly towards you.

54:10 [SPEAKER_00]: Why does that happen? [SPEAKER_03]: I think women are constantly, I think people, but women are looking for that next thing. [SPEAKER_03]: And so what I see just sort of anecdotally is that while men will be happy kind of going to the gym and doing the same thing for an extended period of time, women will be looking for that next program or that next class or that next piece of equipment or and so we're switching things up.

54:39 [SPEAKER_03]: to our detriment, because if you actually want the results, if you actually want to accomplish the goal, you just stick to something for long enough to actually experience those adaptations. [SPEAKER_03]: And I think, [SPEAKER_03]: Midlife women are a very easy target because you're getting people who are experiencing changes in their body composition, are experiencing perhaps menopause-related symptoms, and sleeplessness, and they're confused, and they're desperate, and they want to prioritize their health and fitness, and they have some income to spend, and so then you create this perfect storm of grief.

55:20 [SPEAKER_00]: Yeah. [SPEAKER_00]: No, that's well said. [SPEAKER_00]: I am in agreement, especially because, you know, when you look at the fitness landscape at large, predominantly men, there's a lot of, quote, subject matter experts, even if they're not real experts, that are male and are talking predominantly to male-centric audiences.

55:40 [SPEAKER_00]: You know, it's think about the competitive power-lifter, competitive body [SPEAKER_00]: mostly dudes right and that market is saturated with other dudes trying to try to say hey look do this method do this thing. [SPEAKER_00]: Women are in my estimation a more like vulnerable or ripe like market because there's not as many subject matter experts particularly legitimate experts generally underserved with respect to the actual research and women you know there's less [SPEAKER_00]: And so, yeah, between that and then, like, experiencing these actual changes that happen in their life.

56:18 [SPEAKER_00]: Yeah, you're right, it's a perfect storm. [SPEAKER_00]: And so, they're like, more apt to accept the stuff that's being marketed to them directly, even if it's not not great. [SPEAKER_03]: I think the other issue is that so many women grew up within this sort of era of prioritizing thinness.

56:37 [SPEAKER_03]: And so it's very, very difficult to sit down with someone and say, you know what, let's just maintain your weight and really focus on crushing it in the gym and building some muscle. [SPEAKER_03]: And then we'll worry about fat loss in six months. [SPEAKER_00]: Yeah. [SPEAKER_03]: That's our choice.

56:54 [SPEAKER_00]: Try to tell them that. [SPEAKER_00]: I was going to say I was like, [SPEAKER_03]: But what it means is that people say I want to prioritize my bone health and my muscle health and my longevity But they're really saying I want to lose 20 pounds and these are divergent goals and so it's very very tough Because you end up kind of spinning your wheels.

57:15 [SPEAKER_03]: You say you want this, but you're not actually doing everything you can in order to [SPEAKER_03]: Optimize your progress towards those goals because you keep coming back to the number on the scale. [SPEAKER_00]: Yeah, yeah, social pressures, the current cultural climate, also just stuff.

57:34 [SPEAKER_00]: I mean, obviously this changes over time, but yeah, it is a tough road to navigate, especially for someone who's not already a fitness expert. [SPEAKER_00]: How do you discern fiction from fact? [SPEAKER_00]: How do you, you know, make sure that you're doing it getting the most out of your efforts?

57:51 [SPEAKER_00]: It can be challenging, especially again, like I said, if you're not already well versed in this sort of stuff. [SPEAKER_03]: And there are so many conflicting views. [SPEAKER_03]: If I were to say, OK, how should I work out as a woman? [SPEAKER_03]: I will get 25 different recommendations whereas in the bodybuilder, power, lifter, or even just kind of general physique-focused male space, feel like you're going to have these arguments about a tenth of a gram of protein.

58:21 [SPEAKER_00]: At the front, at the margin, on the margins, rather than like everyone's in agreement like okay, you should lift relatively heavy weights, use compound exercises, predominantly some isolation stuff, get kind of close to failure on a number of these efforts, try to progressively load that over time as your fitness improves, you know, also it's a stuff like that, you know, the dietary patterns outside of like very fringe carnivore.

58:43 [SPEAKER_00]: you know, type, type, fruititarian. [SPEAKER_00]: It's very similar, right? [SPEAKER_00]: People, yeah, as you mentioned, argue on the margins, when it comes to women, that's not the case. [SPEAKER_03]: It's like, it's like, oh, you want a power lift, stop squat, benching, and deadlift.

58:57 [SPEAKER_00]: Yeah, yeah, yeah, yeah, you need specific, it's, it's wild. [SPEAKER_00]: So, but actually, it's a perfect segue to like maybe the most important question I'm going to ask you. [SPEAKER_00]: What women specific considerations for exercise and nutrition are actually legit if any? [SPEAKER_03]: controversial opinion.

59:17 [SPEAKER_03]: There aren't any. [SPEAKER_03]: We need to be and understand that when I got into this space, I wanted to know these sex differences. [SPEAKER_03]: But I'm a woman. [SPEAKER_03]: I would be doing the things if they were out there. [SPEAKER_03]: And I would be telling all the other women to do that too.

59:36 [SPEAKER_03]: So it's not that I'm being [SPEAKER_03]: in the mid 2000s. [SPEAKER_03]: There is a really big gap with a lot of this stuff when it comes to male and female focus data, but we have come quite a long way since then, and we now have examples of a lot of studies that were originally conducted in men and have now been conducted in women.

1:00:03 [SPEAKER_03]: And when we think about some of these questions about muscle growth or [SPEAKER_03]: programming variables like rep ranges or questions like changing your body composition and fat loss. [SPEAKER_03]: These outcomes that people really care about. [SPEAKER_03]: What we see is when these studies are replicated, there aren't differences.

1:00:21 [SPEAKER_03]: What works for men works for women. [SPEAKER_03]: Now, what works for you as an individual might be different than works for another individual. [SPEAKER_03]: But [SPEAKER_03]: that is not based on your biological sex. [SPEAKER_03]: It's based on a whole host of other factors, some of which we might not be able to identify.

1:00:43 [SPEAKER_03]: I think there are plenty from a scientific perspective about, note. [SPEAKER_03]: inter-individual differences that we don't fully understand, but from a practical perspective, it really needs to come down to you. [SPEAKER_03]: What are your goals? [SPEAKER_03]: What is your background?

1:00:59 [SPEAKER_03]: What is your training history? [SPEAKER_03]: What are your health and injury considerations? [SPEAKER_03]: What are your preferences? [SPEAKER_03]: What equipment do you have access to? [SPEAKER_03]: And then we kind of go down the line and [SPEAKER_03]: nowhere on that sort of initial questionnaire, what I say, and should we give you the program for men or the program for women?

1:01:18 [SPEAKER_00]: Yeah, the inter-individual differences, just as an umbrella term for all the things that make a person a unique biological organism, so not only their genetics and their anatomy and anthropometry, but also their psychology and social environment and [SPEAKER_00]: far greater than any sex specific differences age specific differences ethnicity specific differences and to my mind those latter three age ethnicity and sex don't really play a factor in how I would program for somebody unless it otherwise influenced those individual factors like you mentioned current fitness levels, goals, access preferences so on and so forth and so [SPEAKER_00]: I'm like, this is kind of as a red flag.

1:02:09 [SPEAKER_00]: Like if this is really geared to like capture people to get of underserved population more active, I don't know that you need to phrase it in this way, but I'm less of a red flag, maybe more of a pink flag there. [SPEAKER_00]: But if it's like, you gotta do this specific stuff because you are XX, and I'm like, not to say that that's the only way to be a woman, but in any case, that's a, [SPEAKER_00]: another podcast we can talk about it just to me that's a red flag i'm like that tells me you don't really understand this sort of stuff and there's some sort of grift uh that that's going on and that's uh it doesn't sit well with me.

1:02:44 [SPEAKER_03]: It also really ignores a key point, which is when you start exercising, we experience adaptations based on the way that we're exercising. [SPEAKER_03]: So if you look at things like fiber types or molecular signatures or fuel utilization, those are going to adapt depending on how you are training.

1:03:04 [SPEAKER_03]: And so when I hear people say, well, [SPEAKER_03]: No, there are differences in fiber type composition and therefore you should be doing more of this type of training or more of that type of training that makes no sense to me because we are going to adapt accordingly depending on the training we do therefore the training we do should be specific to the goal.

1:03:25 [SPEAKER_00]: Yeah. [SPEAKER_00]: Yep. [SPEAKER_00]: How you exercise will determine the nature of the adaptations that you get and then how much you exercise help influence the magnitude thereof. [SPEAKER_00]: So, yep, the program has to be appropriate, but probably unrelated to you being a woman or a man older, younger or a particular ethnicity.

1:03:42 [SPEAKER_00]: I think it's well said. [SPEAKER_00]: All right, a little lightning round question, a series of questions, thing one, I like to ask people that are guests on the podcast, what is their particular fitness modality of choice? [SPEAKER_00]: How would your, what's your exercise routine look like these days?

1:03:59 [SPEAKER_03]: I'm currently doing a split upper body pull upper body push lower body kind of a broke and just doing bros stuff. [SPEAKER_03]: I am doing bros stuff. [SPEAKER_03]: I like it because I prefer shorter sessions. [SPEAKER_03]: I like to go more frequently but for a shorter period of time. [SPEAKER_03]: And I do a mix of free weights and machines.

1:04:22 [SPEAKER_03]: I'm a fan of machines. [SPEAKER_00]: So women's specific program I've ever heard when I was getting just kidding. [SPEAKER_03]: I only go on the pink machine. [SPEAKER_00]: That's right. [SPEAKER_00]: Yeah. [SPEAKER_00]: There you go. [SPEAKER_00]: And then I like to ask our guests also for either what they're currently reading or a book recommendation if you have one.

1:04:38 [SPEAKER_00]: Anything come top of mind. [SPEAKER_03]: Ooh, I'm currently reading so many papers that I haven't read a book in a very long time. [SPEAKER_00]: That's fair. [SPEAKER_03]: I'm embarrassed. [SPEAKER_00]: I will, I will interject and make a recommendation. [SPEAKER_00]: Then in place, Herman Ponser's new book, Adaptability is very, very good.

1:04:59 [SPEAKER_00]: Unless you just want to read all the papers that Dr. Lauren Clens of Simple linked in her debate with Stacey Sims and you can read those, because those are listed in that podcast, Show Notes. [SPEAKER_00]: Either way. [SPEAKER_00]: Interestingly, that's right, and then last question here is if you get to put a message out to the barbell medicine listenership, who may be unfamiliar with you, or your ethos, or whatever, what's one thing that you'd like to communicate to everyone listening to this episode?

1:05:31 [SPEAKER_03]: If somebody tells you there's only one way to accomplish your health and fitness goals, they don't understand exercise induced adaptations and they don't understand people. [SPEAKER_00]: I like that. [SPEAKER_00]: Man, we got so many sound lights here. [SPEAKER_00]: This is great. [SPEAKER_00]: The algorithms are going to love this.

1:05:49 [SPEAKER_00]: Last but not least, where can people find you? [SPEAKER_00]: I'm going to link all of this in the show notes, but this is the time where you're at on social media platforms and otherwise. [SPEAKER_03]: I'm active on Instagram, Dr. Lauren C.S. [SPEAKER_03]: One, I am the co-owner along with Eric Chexler, Eric Homes, and Mike Zordos of the Mass Research Reviews.

1:06:07 [SPEAKER_03]: So if you're interested in long form breakdowns of the latest fitness-related research, the kind of bridges the gap to from research to practice, then you can check that out at Mass Research Review. [SPEAKER_03]: And I also have a podcast with my friend Eric Czechsler. [SPEAKER_03]: It's called Front Page Fitness and it's very light.

1:06:27 [SPEAKER_03]: We look at the latest sort of absurd headlines related to health and fitness. [SPEAKER_03]: And we laugh about it and we give you a little bit of information along the way. [SPEAKER_00]: I love that. [SPEAKER_00]: All of those things are going to be linked in the show notes below. [SPEAKER_00]: Thank you guys for tuning in.

1:06:41 [SPEAKER_00]: Special shout out to Dr. Lauren Collins of Simple for Join us on the Barbell Medicine podcast. [SPEAKER_00]: But for you guys going anywhere, please leave us a five-star rating and review. [SPEAKER_00]: It really helps drive traffic to our podcast so we can keep bringing you all the latest nuance and health.

1:06:52 [SPEAKER_00]: In fitness, from everyone here at Barbell Medicine, I'm Dr. Jordan Bygambam. [SPEAKER_00]: We'll catch you next week and every week right here on the Barbell Medicine podcast. [SPEAKER_01]: Thank you very much.