Fat Loss, Gut Health and Hormone Imbalance with Dr. Stacy Sims

Welcome to The Betty Rocker Show! You’ll recognize today’s popular guest if you’ve been following my show for any amount of time! Dr. Stacy Sims is a powerhouse in the health space who is on a mission to support and empower women with women-specific research and science.

If you are new to her work, Dr. Stacy Sims is a scientist, educator and leader in the field of women specific research in health, nutrition and exercise. She served as an exercise physiologist and nutrition scientist at Stanford University from 2007 through 2012.

Her first book Roar teaches women-specific training and nutrition tips across the lifespan, and her latest book Next Level is designed specifically for the peri and post menopausal female athlete.

In past episodes we’ve broken down the topics from her books, including eating and training strategies for women in their reproductive years, considerations for the pill, eating and training strategies for women in perimenopause and post menopause, and conversation about women-specific research.

Today we’re digging into…

  • How gut health impacts us from a hormone perspective over the course of our lives,
  • Considerations for those with PCOS,
  • Information about iron deficiency and how to navigate it,
  • How getting more residual movement in daily aids in fat loss,
  • The benefits of using a creatine monohydrate supplement for women,
  • Hot and cold training therapies for women,
  • Strategies for dealing with hot flashes, and
  • Discussing the way the media portrays information about women’s health and what they get wrong.

Get more from Dr. Stacy Sims:

Episode Transcript

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Betty Rocker (00:02):
Welcome to The Betty Rocker Show the place to be to nourish your mind, love your body, and rock your life.

Betty Rocker (00:14):
What’s up, rock stars Coach Betty Rocker here. Thanks so much for joining me today for what Promises to be a great conversation with my good friend, Dr. Stacy Sims, who I’m guessing you’ve heard about before or heard me talk to before, as this will be our fourth podcast episode together, if you are new to her work. Dr. Sims is a scientist, educator and leader in the field of women specific research and health, nutrition and exercise. She served as an exercise physiologist and nutrition scientist at Stanford University from 2007 through 2012. Her first book, ROAR teaches women specific training and nutrition tips across the lifespan. And her latest book Next Level is designed specifically for the peri- and post-menopausal female athlete.

In past episodes, we’ve broken down optimal training and nutrition strategies for women in all life stages. So have a listen to those conversations for more on these topics. Today we’re digging into how gut health impacts us from a hormone perspective over the course of our lives. Considerations for PCOS more about iron deficiency and how to navigate it, hot and cold training therapies for women, strategies for dealing with hot flashes and discussing the way the media portrays information about women’s health and what they get wrong. I think you’ll get a lot out of this conversation. So join me in welcoming Dr. Stacy Sims to the show. Welcome back, Dr. Stacy Sims, how wonderful to see you.

Dr. Stacy Sims (01:47):
Thanks for having me. I’m excited to chat with you again. It’s always fun, always good to share information.

Betty Rocker (01:54):
It’s so great to share and you’ve been putting out a great body of work since we last talked: logs, podcasts, articles, interviews, your new membership, which has live chat with you. And it’s just really an amazing amount of resources to help us navigate and make sense of all of the, I feel like conflicting information that’s out there for women.

Dr. Stacy Sims (02:21):
And I feel like it’s becoming more and more skewed as we start to see mass media jump onto some of the context or rather skew the context of some of the science.

Betty Rocker (02:32):
And just before we started recording, we were talking about two different articles that have come out in two big publications that I follow. One was in the Washington Post; one was in the New York Times. Let’s talk a little bit about those articles because they’re both covering topics that are about women’s health and they’re so interesting. The first one that you brought to my attention;the Washington Post article was about cycle training for women. And I didn’t read that one yet, but why don’t you tell us about what they were recommending and what did they get right and what did they get wrong?

Dr. Stacy Sims (03:09):
Well, now that there’s a big buzz about “cycle sync,” and when you’re looking at the actual physiology and science of the menstrual cycle and how your body is affected, you can see that there are different protein expressions for better muscle development in the low hormone phase. We see different immune responses to your body’s more resilient to stress. And the low hormone phase, you have better capacity for using carbohydrates. It’s better for intensity and recovery. But when you look at just blanket sport science research and some of the new meta-analyses that have come out, their methodology of just sport science isn’t robust enough to say that there are any differences between the [inaudible 00:03:52] phase. So then when that feeds forward into the media or it feeds forward into the medical world, they grab onto it and say, “Oh, there’s no effect to the menstrual cycle.”

But when you look at outside of it and you’re looking at the nuances of women and you’re saying, okay, well cycle syncing is really following your own menstrual cycle. Knowing that the undercurrent is, there are these differences between the phases where you can manipulate your training to be more advantageous for you in certain places, but really knowing your own cycle so that days that you’re really onto it and other days that you’re flat so you can periodize your training according to your cycle. But what the media missteps is that they don’t put that individualization, they’re like, “There’s no evidence, you know, stop saying this because there’s no evidence.” So then when you hear it from New York Times or Washington Post or some of these other people that are really trying to debunk it, to me, I feel like it disempowers women. ‘Cause the main thing about menstrual cycle tracking is it gives women more awareness of their own body and they can take a hold of their own physiology and really train for themselves.

But if they’re reading in these really wide read, respected publications that it’s bullshit, then it really puts women back. I feel like it pushes women back because every time an article like that comes out, I get pinged on Instagram or I get emails about, “What is this? How come is they’re saying this?” And so I have to go through the whole like, “oh, okay, well these are the things in physiology that we see, and you have to track your own cycle to understand it, and you can work with your own cycle,” but that’s the thing that gets missed out. And the medical people aren’t talking about the nuances of an individual woman. They’re looking at the whole bell curve. And we know every woman’s cycle is different.

Betty Rocker (05:49):
I really liked how you pointed out how you have to be looking at your own cycle and seeing what’s going on with your own cycle. Of course, I wear the Oura ring and they have come out, they’ve constantly trying to update and upgrade their app, and they came out with the new version of the ring this past year, which measures your basal body temperature. So it’s, mine is always so spot on when I’m tracking, I use it to track my cycle that way. And ever since I’ve been tuned into this method of thinking about my cycle and how it works, I have had the confidence to start training harder as soon as I get my period. I feel… it really is not, and I’m an individual. Some women may have a really heavy flow and they feel more tired the first couple of days of their period, and we’re all individuals, which is your point.

But the hormones change once we start to get our period, we’re in what you call the low hormone phase or the follicular phase, and that’s the time when we can push hard. I mean, I hit PRs today in my training and that felt awesome. Can you guess where I’m at in my cycle? I noted towards the end of my cycle in the luteal phase to up my creatine consumption because-

Dr. Stacy Sims (07:10):

Betty Rocker (07:10):
… of stuff that you’ve been talking about recently. And quick tangent, tell us why creatine is so important for women and why we should be using it as a supplement.

Dr. Stacy Sims (07:23):
Yeah. I think creatine still has the history of the bodybuilding set of men are using it in the gym to really load up and get good muscle performance and bulk out, but that’s not what it’s about. Everyone produces creatine. Our liver produces about one gram a day, and it’s really important for all what we call the fast energetics of the body. So things like maintaining our intestinal integrity so that we aren’t getting GI distress or IBS symptoms. It’s really good for brain health because our brain is always active and we need creatine for that. And we’re looking at heart health and of course muscle performance. So if we’re just using a really low dose of three grams at the most, five grams of creatine a day, it boosts our saturation levels. And women have around 70% of the stores of men, and we’re not actually producing as much as our body needs or our activity levels that we’re doing when we’re active.

So just by supplementing with the creatine monohydrate, preferably instantized, because then you don’t have side effects. You’re just boosting all of those, I guess, energy levels. And we’ve seen some randomized control trials where women who have really bad depressive episodes or anxious episodes, and they’re usually put on a serotonin reuptake inhibitor when they’re using creatine with a very, very low dose of SSRI, they get out of the symptomology a lot faster and stay out of it. So creatine is really important for neurotransmitter and brain health. And so when we’re starting to seeing more and more of this information getting out, especially even in pregnant women because they go through creatine really, really quickly. So boosting creatine levels is really important in pregnancy as well. And people are like, “Well, why can’t I just eat the meat products for it?” It’s like, “Well, you have to have a three six-ounce portions of steak in order to get the same level of creatine that you would get from a half a teaspoon of the creatine monohydrate supplement.” So yeah.

Betty Rocker (09:37):
Thanks for that tangent. And I had shared with you recently that I had experimented with creatine HCL because there’s a lot of experimental data about it, and the research is fairly new. And wouldn’t you know it? I got blood work back saying that I was severely dehydrated. My kidneys weren’t functioning very well, and I attributed it that was the only thing I had changed in that period, and I got back on the monohydrate and am very glad to have had your guidance because yeah-

Dr. Stacy Sims (10:08):

Betty Rocker (10:08):
It was like we all do. We all try things out, guys. I’m just the same as anybody looking around looking for the next best thing. And this was a great good experiment that fortunately didn’t have any real consequences except that I got dehydrated and bounced right back. But great-

Dr. Stacy Sims (10:28):

Betty Rocker (10:28):
… great tangent there. And then another really important element of our diet that our needs really go up for in the luteal phase is protein. And-

Dr. Stacy Sims (10:37):

Betty Rocker (10:37):
… our protein needs go up at different times of our lives due to how active we are, what our goals are. For instance, when we’re older and we want to maintain muscle mass, we need more protein at different times in our lives. And this New York Times article that I sent you today was about it. This article literally said, you’re probably getting enough protein. And then it went to those old RDA numbers. That’s the recommended dietary allowance for anybody who’s not sure what that RDA meant. Those old recommendations were 0.8 kilograms per pound of body weight, which is very low amount. And that’s really, I think that was a study done on sedentary men and that was what it was based on. And so sure, you can survive on that very low amount of protein, but is it optimal and it doesn’t really serve your needs as a woman in peri or post menopause, a active athletic woman who’s young and you’re cycling. I mean, you tell us. This article was crap.

Dr. Stacy Sims (11:48):
Yes, it was. And I just got this position stand that I’ve been working on for almost two years. It got published last week, end of last week. And I talk specifically about protein and protein needs. So when we’re looking at an article like that and they’re using the very old RDA, it’s like, wait, this is very old science. It’s based on male data and generalized to women because they say, “Oh, sedentary older men have around the same amount of muscle mass,” but they don’t look at the quality of the muscle mass and what women need. So we know that premenopausal women, they need around 12% more protein in the luteal phase. So this is above and beyond that one gram per kilogram of body weight that people are talking about. So we’re looking around that two grams per kilogram of body weight in the luteal phase or about one one-ish grams per pound.

And then in the follicular phase about 1.8 grams. So it’s just about that 1.9 grams per pound. So when you’re thinking about, okay, if someone’s 120 pounds, you’re looking between 120 and 130 grams of protein a day and evenly distributed. But when you get into perimenopause, and this is a really great study that came out last week, looking at muscle quality and protein and nitrogen turnover, not only do you have less of the muscle mass, the quality of the muscle is not as robust as when you’re premenopausal. So you’re looking at muscle contraction, how much [inaudible 00:13:33] it can store, how it functions.

But there’s also a negative nitrogen balance. So that means that the body is breaking down more protein and not recycling it and not building lean mass unless you’re doing some kind of intervention. We also know that as you get older, regardless of age, you become more anabolically resistant. So it’s really difficult to build lean mass. And we see that discernible point in women who are peri and post menopause. So the protein intake for women who are older is sitting around 2.2 to 2.4 grams regardless of where they are in their menstrual cycle, because perimenopause is all over the place and post menopause, you need to really hit that higher end of protein.

Betty Rocker (14:20):
And when you say 2.4 grams per kilogram, right?

Dr. Stacy Sims (14:23):

Betty Rocker (14:24):
And previously Stacy, because we know that we want more protein in the luteal phase than the follicular phase. And I think you said two grams per pound previously for and but I think you mentioned [inaudible 00:14:38]-

Dr. Stacy Sims (14:37):
Two grams per kilo. Two grams per kilo, which is about that one gram per pound.

Betty Rocker (14:43):
Right? Yes.

Dr. Stacy Sims (14:44):

Betty Rocker (14:44):
Just wanted to clarify because there’s a lot to compute. So basically-

Dr. Stacy Sims (14:47):
Going in there.

Betty Rocker (14:49):
If you stick to that one gram per pound of body weight ideal in the luteal phase, and you maybe are just a little bit, you can be get away with a little bit less than that in the follicular phase, but in both cases, it’s ideal to be getting that load, that number, up there. And this is not that…. And 0.8 grams per kilogram is part of why we all get confused because we sort of like, “Wait, what’s the calculation to get to pounds?” Because we’re, of course, in the pounds system.

Dr. Stacy Sims (15:18):
Yeah. Sorry, that’s my fault.

Betty Rocker (15:23):
So, it gets a little… No, no, no. It’s not anybody’s fault. It’s the stupid system that doesn’t have just one… Why can’t we just have one system that everybody gets to use?

Dr. Stacy Sims (15:31):
I know.

Betty Rocker (15:33):
It’s so dumb. But I just want to make sure.

Dr. Stacy Sims (15:34):
Yeah, being an expat. I really appreciate the metric system because it makes sense.

Betty Rocker (15:39):
It does.

Dr. Stacy Sims (15:39):
The imperial system in the States is like, oh gosh, it’s really hard to convert.

Betty Rocker (15:44):
It’s very hard to convert. I completely agree. It’s very challenging. But I just want women to understand what we’re talking about.

So, back to what you were saying about per and postmenopausal women, that 2.4 to 2.8, did you say?

Dr. Stacy Sims (15:59):
2.2 to 2.4. So, it’s about 1-

Betty Rocker (16:02):
Grams grams kilogram.

Dr. Stacy Sims (16:03):

Betty Rocker (16:04):
1.2 to 1.5?

Dr. Stacy Sims (16:07):
About, yeah, for pound.

Betty Rocker (16:09):
Grams per pound of body weight.

Dr. Stacy Sims (16:11):

Betty Rocker (16:11):
Yeah. And I like to help women think about this by seeing, look, try to get, especially for breakfast, like 30 to 40 grams of protein in your breakfast. Just if you’re having trouble with all the calculations and you’re not sure about your body weight and all this stuff, just start with that. And first start by seeing how much protein you’re eating now, and just see how you can just incrementally go a little bit higher than that. Because sometimes people get sticker shock and they’re like, “This sounds like so much protein.”

Dr. Stacy Sims (16:40):
I know.

Betty Rocker (16:42):
And that’s why those types of articles can be really damaging is because, like you said at the beginning of this, they undermine the work that’s been done. And I actually did an article about this on the blog, my blog, recently, where I went and looked up all the newer research that debunks that old nonsense. And there is plenty. And that’s why I’m like, these journalists are being irresponsible. They’re not actually looking for the newer data.

Dr. Stacy Sims (17:06):

Betty Rocker (17:06):
They’re just relying on old, regurgitated crap that has been just out there forever. I think it’s time to uplevel that conversation.

Dr. Stacy Sims (17:18):
I feel like I need to write a letter to the editor about that one just because it’s-

Betty Rocker (17:22):
I think you should.

Dr. Stacy Sims (17:23):
… so damning. Another way to really think about protein and intake is you want a fist-size portion of protein at every meal.

Betty Rocker (17:33):
That’s great.

Dr. Stacy Sims (17:33):
And so when people look at it’s like, “Oh, it’s two and a half eggs. It is a handful of nuts and seeds with oatmeal.” So you’re really looking at what is palm size or fist-size portion of protein. So, we say fist size is around 25 grams. So, for women who are looking for that 30 to 40, it’s like fist and a half. But it’s a little bit better to visualize when you’re going, “Oh, what’s my fist look like?”

Betty Rocker (18:02):
Yeah, that’s helpful. And remembering that different foods come with different nutrients.

Dr. Stacy Sims (18:07):

Betty Rocker (18:07):
It’s different if you’re talking about a palm size of a chicken breast versus a palm size of nuts and seeds, which also have a lot of fat as well as some protein. And when you’re thinking about your quality, high quality organic protein powders, if you’re going to use a protein powder. Remember a lot of protein powders are made by servings that are in the 20 to 25 gram range of protein. And remember that you can do a serving and a half or two servings of your protein powder, just double it up or one and a half times it to really get the amount that you need for yourself so you don’t have to feel like this is so hard to do.

But anyway, just wanted to debunk a couple of these recent articles in context of our conversation, because this stuff is just so… Like you said, it takes us backwards and it-

Dr. Stacy Sims (18:54):
It does.

Betty Rocker (18:56):
… and it undermines what women are learning about themselves. The cycle sync, I got to read that article in the Washington Post. It’s sounds like they were just saying, “That’s not a thing. Cycle syncing isn’t even a real thing. There isn’t data out there that says that there’s any differences in the phases of a woman cycle,” when any woman can tell you she feels differently around her period. A lot of women can tell when they ovulate.

Dr. Stacy Sims (19:19):

Betty Rocker (19:19):
It like, “[inaudible 00:19:21].”

Dr. Stacy Sims (19:20):
I know.

Betty Rocker (19:22):

Well, I guess in the context of the current political climate and what else is happening in the United States with how they’re taking away all kinds of rights for women-

Dr. Stacy Sims (19:30):
I know.

Betty Rocker (19:30):
… is it really, really surprising that they’re out there trying to say, “Oh, there’s no difference in the phases of your cycle.” What a bunch of crap.

Dr. Stacy Sims (19:37):
I know. I know, it’s very frustrating. And that one article is really frustrating because I talked to the journalist and I sent her a page worth of references to look into, and I can tell by the way the article was written, that she didn’t do it. So, yeah, it’s like you try to be responsible and help journalists and then they aren’t that proactive. There are definitely exception to the rule though, there are some really good ones.

Betty Rocker (20:05):
And the system is messed up, too, for people. Our healthcare system is messed up. Our news system is messed up. There’s a lot going on right now in our world, and that’s why conversations like this are so important to have and to listen to.

For those of you guys listening, thank you for listening because we think, I think Stacy would agree, we just want women to have access to high quality information, the newest research, Information that’s been specifically studied on women’s bodies.

And also one of the things I loved in Women are not Small Men was the activity where you… This was one of Stacy’s courses that you can go through. The activity where you had us read different articles, and then you had us think critically about the article from different viewpoints. And it was really interesting because we are so used to reading scientific… Well, not everybody’s used to reading scientific articles. But basically we think if we find it on Google, it must be true, or we find it in a scientific article, it must be true. Well, there’s a scientific article and I’m going to plug that in at the end of my blog, and that means that what I said is true or real.

But the learning to be discerning about the way that they designed the study, the way that… Who did they leave out of the study? Are the interpretations and conclusions that they’re making in the study really relevant to you? Did they study anyone like you? What did the researchers even think about when they were designing the study? And that was fascinating to do that, and it changed the way that I looked at the literature from then on.

Dr. Stacy Sims (21:39):
Oh, good.

Betty Rocker (21:39):
Very helpful.

Dr. Stacy Sims (21:41):
Good. I feel like every time I peer review an article, I am pulling some of the authors up for just reading the abstract and going with what the abstract says. I was like, “You need to dig deeper.” Because I’m like, “Wait, you’re a scientist who’s trying to get this paper published, and yet you’re not digging actually into the research to see what the results and everything say.” So, it’s becoming part of the fault of the system. So, I’m hoping that more and more reviewers are going to be robust about picking out things. Otherwise, who knows what’s going to end up as a scientific journal article. But, yes, I always tell people, read the methods, read the results, and look at that specifically before you go into the discussion and the abstract, because the researcher bias is often in the discussion and the abstract.

Betty Rocker (22:37):
It’s so interesting. Well, fortunately we have people like you to help translate a lot of this stuff for us.

Dr. Stacy Sims (22:42):
Yeah, thanks. Thanks.

Betty Rocker (22:43):
And one thing, we’ve been talking a lot in my community about gut health recently, and it’s such an important and interesting topic that’s so relative to our menstrual cycle, there’s changes that happen as we get into perimenopause, as we get into menopause. There’s an impact for those who are dealing with things like PCOS.

I’d love to talk a little bit about some ways that we should think about optimizing our gut health and why that’s so important.

Dr. Stacy Sims (23:14):
Yeah. First, I’ll give the geeky overview of what’s going on with the gut-

Betty Rocker (23:19):

Dr. Stacy Sims (23:19):
… especially when we’re talking about sex hormones. So, typically, someone thinks about our sex hormones is like, “Oh, okay, the ovaries release estrogen, and the corpus luteum releases progesterone, and they circulate and they do their thing,” which isn’t 100% true. What happens with these sex hormones is they go to the liver to be metabolized. And what I mean by that is they are bound up with sex hormone binding globulin. So if you get your blood test results, they always have sex hormone binding globulin with your sex hormones. Because they get bound to the sex hormone binding globulin and then get excreted into the gut by bile. So, you’re seeing that your sex hormones are actually bound up and then they get excreted into your intestines. And there, your little gut bugs unbind it and shoot it back out into circulations. So now, your sex hormones can actually do the thing.

So, when we’re looking at things like PCOS, endometriosis, perimenopause, post-menopause, we have significant differences in our gut microbiome because we’re having different levels of these sex hormones. And so the amount of certain bugs in our gut that’s responsible for maintaining more of a hormone balance and maintaining the circulation of our sex hormones is off. So if we’re looking at someone with PCOS and they have a higher androgenicity, so that means they have a higher level of active testosterone as well as inflammation because of some of the aspects of PCOS, we really want to disseminate down into the gut.

And so there’s new research coming out and looking at specific strains. And regardless of what those strains are, we know that if you’re eating a really good, high level of vegetables, fruit, nuts, seeds that have a high fiber content, it increases the amount of these bugs that are responsible for hormone balance and decreasing inflammation.

So when we see things like PCOS, so what’s a PCOS diet? And you’re looking at it from a high touch, it’s really lots of fibrous fruits and veg, not a lot of the quick hit processed foods and really good protein. Because if you’re doing the fibrous fruit and veg and good protein, it creates a diversity in the gut that really does help metabolize the hormones and really stabilize inflammation and reduce insulin resistance.

And when you can pull that forward into perimenopause, as well. Because with perimenopause, you start losing the ratio your body’s used to. So you’re having more estrogen dominance at some point. Maybe you have a burst of testosterone because you’ve had an ovulatory cycle. But because you’re not having a really good pulse of these hormones and your body’s going, “Hey, what’s going on?,” because it’s changing so much, there’s a significant reduction in the diversity of the gut, where we start to see more of an obesogenic type gut microbiome. So, it’s the kinds of bugs that promote obesity, visceral fat gain.

And we can counter this by increasing, again, our really good fibrous veggies, a little bit of fruit, and that protein hit. But you have to actually look at what else am I going to do to help with the diversity? And this is where that sprint interval training or true high intensity work comes into play. Because there’s a crosstalk between the exercise and the hormones that are responsible for fat development, especially the visceral fat, where that high intensity work tells the visceral fat to go away, and it also helps create an environment of heat and hypoxia that kind of kills off the obesogenic bugs, and encourages the growth of the bacteria that helps with lean mass and keeping body fat down. So, when we’re looking at, as we get older, we need the combination of good fiber foods and high intensity work in order to create this crosstalk between the bugs and body composition.

Betty Rocker (27:39):
Wow. I’ve never heard it put in those terms exactly before. That’s so cool, so specific. Yet another reason to really up your fiber intake. And this is something that a lot of people are missing because of convenience foods, because of time shortage, because of just not maybe realizing how essential that is.

And we talk a lot about gut motility as well and how important it is to be having regular bowel movements because we do need to offload some of those estrogenic compounds, right-

Dr. Stacy Sims (28:11):

Betty Rocker (28:11):
… through the bowels, basically.

Dr. Stacy Sims (28:16):

Betty Rocker (28:16):
So, that’s a super important, and without enough fiber in your diet, you won’t have those regular bowel movements, and that can also cause a higher estrogen burden in your system.

Dr. Stacy Sims (28:30):

Betty Rocker (28:31):
And we’re talking a little bit about fat loss here. One of the things we talk about, and we just talked about this in your last meeting, was about residual movement and how important that is for fat loss. I know we talk about strength training and how important that is. High intensity interval training is so important. And also, residual movement being sort of an overlooked aspect of fat loss. And this is why we talk about walking and getting out and walking after you ate a meal is one of the best times to walk because it helps stabilize your insulin level, it helps your gut motility function better. You want to add on to this? Because I’m all about this.

Dr. Stacy Sims (29:12):
Yeah, no, I see a lot of women are like, “Hey, I’m doing all these things and I’m still not losing body fat.” I’m like, “Well, are you doing the things and sitting the rest of the day?” Because if you are, we see research that shows that sitting the rest of the day, even with activities, is just the same as being sedentary. So that incidental movement and walking is so important for overall vascular health, for metabolic health, for getting body composition change that you want. Often, I’ll have women who are like, “I’m doing the things. I’m doing sprint interval training, I’m doing the heavy lifting, but it’s still not any body composition change.” So I’m like, “Okay, well at least twice a week try to hit 20,000 steps a day, just through incidental exercise.” And then they start becoming more and more aware of how much they’re sitting and their incidental exercise just increases. It’s not a training session, it’s not going out and saying, “I need to walk for an hour.” It’s making sure that you’re moving, you’re standing, you’re sitting, whatever you are at your workplace, all of the things. And then the body composition really does start to shift in their favor. So the incidental stuff is not just about the weight loss and the fat loss, but it’s all about the total body health that you’re talking about. So you’re looking at the vascular health, the insulin sensitivity, all of those things, super important. And yeah, I think there’s a whole body of research that’s looking at athletes who train hard and then sit the rest of the time, and their metabolic status and vascular status is no different than someone who doesn’t exercise.

Betty Rocker (30:50):
That seems insane to me. I mean, because at least they’re exercising, right? That’s good. Do something, all or something, right?

Dr. Stacy Sims (30:59):

Betty Rocker (30:59):
And if 20,000 steps sounds like a lot, I’ll tell you, I take the pressure. I always try to say, look at the average over the course of the week. If you’re worried about hitting protein goals, first start just by looking at over the course of the week, 70, 80% of the time, are you hitting your protein goals? With your step count, just like if you can walk for 10 to 15 minutes after breakfast, after dinner, try to move after lunch. I got a little stair stepper in my house for those days when I can’t leave the computer and I just… Or it’s too cold and I just need to… And get moving and household chores, cleaning my house.

These are all things that increase my step count. Going shopping, super-duper increases my step count. So there’s my days when I get 20,000 steps. Well, I went to the mall or the farmer’s market, or I went to an outdoor thing and I walked around and looked at stuff. And those are good for our mental health too, to get outside and go out and look. And I mean, window shopping, you don’t have to spend money on all the stuff. You can just look at stuff. It’s okay.

Dr. Stacy Sims (32:02):
Yeah, I know. It is great.

Betty Rocker (32:05):
It’s great. Yeah. And hiking and obviously, but that can also feel sort of seasonal. But this is why you see a lot of people, a lot of elderly people, you’ll see them in the mall before the malls even open, getting their steps, walking. It’s great. And I can tell you, my amazing aunt and uncle who are in their eighties, they’re out walking every day and they are so trim and healthy and-

Dr. Stacy Sims (32:28):

Betty Rocker (32:29):
… and I’m so proud of them.

Dr. Stacy Sims (32:31):
And movement facilitates more movement, right? So you’re seeing them walking and stuff and you’re like, “Well, that’s because they want to walk and keep walking.” And once you stop, it gets really hard to get it back. And the older you get, the worse it is.

Betty Rocker (32:45):
Yeah. It really, really does. So that’s a great overview of gut health and how it impacts us and why it’s so important to pay attention to our fiber intake. Another thing that has come up so much recently has been iron deficiency. I’ve got one woman in my group who is a vegan athlete, and she just was talking the other day about how she’s feeling lightheaded sometimes. And we obviously told her, go get some blood work done, but have you had your iron tested recently? And she was, “Oh, ding, ding, ding. That’s happened to me in the past. I haven’t thought about that in a long time.” And so she’s going to go get tested. I have another person in my group who recently was asking what foods are rich in iron? So we know iron is such an important thing for women. Want to talk… I know this is a topic that you’re interested in.

Dr. Stacy Sims (33:41):
Yeah. From a personal level too, because I fluctuate, I feel really good when my ferritin is up around 90 and recently I got tested, it’s down to 30, but because it’s at the very low end of normal, they’re like, “Yeah, you’re fine.” I was like, “No, I’m not fine.” And this is the problem where you go get a blood test, they’re like, “Oh, you’re in the normal range,” but you kind of want to know what’s normal for you. So we see shortness of breath, lightheadedness, and really dead end fatigue. And these are signs of not necessarily anemia, but low ferritin. And ferritin is a storage form of your iron. So your blood levels of iron might be fine, but your storage is really dropping because your body’s trying to keep your blood levels up. So that’s why you want to see both of them.

And we see this significant problem in vegans primarily because, not because they’re not eating foods that are rich in iron, but they tend to have too much fiber that they get too full before they can actually get the iron they need. And we also see it in a lot of vegan athletes because there’s a residual inflammatory response that happens after every exercise session. And when you have inflammation, you have a up rise in this hormone called hepcidin, and hepcidin inhibits your gut’s ability to absorb iron. It’s an iron regulatory hormone. So if you have someone who is vegan and they’re doing an exercise and then they’re eating or drinking their spirulina smoothie that’s really high in iron, cause spirulina is high in iron, they’re not going to absorb it. So it’s the timing of your food as well around your training. Then as we get older, we see that especially perimenopause and into post menopause athletes, that the hepcidin can stay elevated for up to 24 hours after a training session.

So if we’re looking at how are we going to get our iron in, we have to be very cognitive of where we’re putting our training in versus our food. And if you are on the low end and you can’t an infusion or anything from your physician, then you can buy over the counter, preferably carbonyl iron. It’s a very high bioavailable form and you want to take it every other day and not every day, but every other day. And a lot of people get up, they do training, they have coffee, and both of those things will inhibit iron absorption. So take it at night with your dinner. So you’re going to have an increase in the amount of iron that your body is absorbing because it’s also being absorbed through food and you want it every other day because if you have it every day, it’s too high of an iron load at once and your body won’t absorb it.

So we say every other day, preferably if you’re premenopausal and starting day one of your period all the way up to ovulation, because after ovulation you have a increase in the amount of circulating hepcidin. Not that you won’t absorb it, but it’s not that ideal. And then if you’re peri or postmenopausal, you want to time your training to be in the morning and your iron at night or your iron in the morning and your training in the afternoon so that you’re really leveraging that timeframe where you’re getting that hepcidin at its lowest point to be able to absorb that iron.

Betty Rocker (37:10):
Thanks for those tips. I look forward to passing them on to these women. And I think the caveat with any of these recommendations are get tested first, before you just go buy anything over the counter and start dosing yourself with it. I find it absolutely, it’s insane to me when people ask medical-based questions in a public forum that’s not run by doctors or their own doctor. And I get the desire to just have feedback from other people, but I also find it dangerous sometimes because I think people are, they don’t maybe have a doctor that they feel comfortable with, and so they’re looking for the anecdotal evidence from other people.

But without your own blood work, without testing and without someone who’s… Because there’s no fast fix for some of these things. Sometimes even your doctor needs to try some things out to see how your individual body responds. Even the best doctors don’t know the exact answer to your body every single time for everything. So I just feel like just be cautious with where you’re asking for information and what you’re taking action on without real data to back it up on you yourself.

Dr. Stacy Sims (38:21):
Exactly. Because the other thing about iron is if you just take it and you don’t have necessarily low iron and your body doesn’t need it, a lot of people will be like, “Oh, I’m going to take iron.” And they end up taking a high dose iron supplement every day. Then they get iron overload, which has the same signs and symptoms as anemia. So then they go to their physician and the physician’s like, “Oh, you’re in the high end of normal, it doesn’t matter.” So they won’t stop taking it, but then they still have the fatigue, the shortness of breath, the lightheadedness, and they’re like, “What’s going on?” So it’s really important that you know your own body through data like you just said. Yeah.

Betty Rocker (39:01):
Yeah. I would say that to be true about so many things. Now, I want to talk just for a minute about, I recently went through, I had COVID after Christmas, and then about three months later I started having hot flashes out of nowhere. And of course I got my blood tested, speaking of blood work.

Dr. Stacy Sims (39:19):
Sure, yeah.

Betty Rocker (39:19):
My testosterone was in the trash again, my estrogen levels had tanked. All of my sex hormones had crashed. And I had spent the last couple years really dialing everything in again and getting just in a really good place and really navigating perimenopause for me in the best possible way. And so I have this amazing doctor, and she was talking about the impacts of COVID and how that impacts women’s hormones. And we started doing some tests and I started getting my levels back up and I’m feeling awesome.

Dr. Stacy Sims (39:51):

Betty Rocker (39:51):
But the hot flash piece is one that many women struggle with, and not everyone is comfortable just using hormone replacement therapy. So there are other strategies that you’ve shared before about dealing with hot flashes, I find so fascinating. We talked, I remember you had talked about controlled heat exposure at one point as a training method. Tell us a little bit about what that means.

Dr. Stacy Sims (40:20):
Yeah, so when we’re looking at hot flashes, it’s a hypothalamus. So a hypothalamus is our central nervous system area of heat control, really our temperature control. And when we start seeing this misstep in estrogen, progesterone, it affects the hypothalamus. So what we want to do is we kind of want to overload the hypothalamus and get it to understand what heat is and what is not heat so that you don’t go into these automatic false senses of being too hot. So if we’re looking at controlled heat therapy like sauna exposure, and you are driving your core temperature up, then your hypothalamus is learning what it means to have a high core temperature not during exercise, because during exercise you have other mechanisms that help you offload. So if we’re looking at driving the core temperature up and you’re sitting in the sauna for 20 minutes and you start to get that big sweat on, then you’re getting these signal cell hypothalamus of what to do.

So we have more vasodilation, we have more sweating control, and then when you step out of the sauna, because it’s not exercise induced, but it’s a internal temperature sweat, you dry really quickly and you stop sweating rather quickly. So the hypothalamus is going, “Oh, okay, so now I know what cool feels like.” So if you’re doing this controlled heat therapy, preferably sort of passively dehydrated so that you’re really getting a message to the hypothalamus, “Hey, it’s not about blood flow, it’s about core temperature coming up.” Then it starts to attenuate your hot flashes. It starts to have better control over the signal of estrogen and progesterone being different and serotonin being different.

So we see that if you’re doing about nine days of sauna exposure, then you start to have less hot flashes at night or night sweats and less incidences a day. And then you get the other benefits of heat exposure like heat shock protein and telomere length and less inflammation and less joint pain and all these other things that come with the heat exposure. But specifically for hot flashes, it’s really kind of tricking the hypothalamus to get out of the hormonal control of temperature responses and more into what’s going on with our core temperature itself.

Betty Rocker (42:56):
Fascinating, fascinating stuff. And nobody’s talking about this, nobody. It’s so freaking cool. And we have some differences. We have traditional saunas, which just raised the ambient temperature in the room. We have infrared saunas, which raise our core temperature. I assume you’re talking about infrared saunas being probably superior for this methodology or could both be beneficial?

Dr. Stacy Sims (43:18):
Both. So if we look at a traditional sauna, it’s not about heating the skin as it is just giving you a whole… You’re wrapped in this hot environment. With the infrared sauna, it specifically heats skin into the core, so the environment doesn’t have to be as hot. So when people aren’t that comfortable in the heat, I’m like, “You can go infrared.” But for people who love that walking in and feeling that hot, hot, I’m one of those people. I want one of the true Finnish saunas to really get that heat response.

Betty Rocker (43:56):
And I’m the opposite. I like the cool. I have an infrared sauna actually for this-

Dr. Stacy Sims (44:01):

Betty Rocker (44:02):
… because I like that so much because I really enjoy less heat, but those same benefits and it’s very relaxing. And so both, so that’s great. Thank you for explaining that both can be beneficial. And so would you want to use it maybe like, could you use it every day? Most people are probably going to use a sauna at their gym, so maybe they’re going every other day or whatever it is. Is that enough to get the benefits?

Dr. Stacy Sims (44:29):
Yeah, it’s just heat exposure. So we get so comfortable in a certain temperature range. We have air conditioning, we have heat, and we aren’t really exposed to the extremes. But if you’re going to a sauna in your gym for 10 minutes, three times a week, that’s going to give you benefit. Ideally, we want to spend up to 30 minutes, nine days in a row, which is ideal, but that’s not practical. So for like, okay, I’m in the gym, I’ve done my workout and I have 10 minutes, I can hop in the sauna. Fantastic. Get in there. Don’t rehydrate as much. Slowly rehydrate over the course of a few hours afterwards, and you’re going to maintain some of those heat benefits. So yeah, three times a week, 10 minutes, go for it.

Betty Rocker (45:14):
Awesome. So I think the last thing I’ll just tie it off with is the opposite to heat, which is cold. You’ve been talking about some interesting upgrades to the science recently that shows that there are some variances between the way that men and women experience cold and maybe ways that women could utilize cold therapy that’s maybe a little more gentle than they’ve been told they have to do for benefits. Would you speak to that, please?

Dr. Stacy Sims (45:42):
Yeah, for sure. So we see the traditional cold water immersion. You have to be in four degrees Celsius, below zero, ice cubes, all that kind of stuff. Probably more from the Wim-Hof method that’s come out. But when we look at women, we don’t have to be in that kind of cold temperature. We look at the gradient and where women start to really feel the cold, and it sits around 14 to 16 degrees C. So that’s around that 45 to 50 degree Fahrenheit mark.

So it does not have to be ice bath, it just has to be cool to cold when you first feel it, and you don’t have to spend a long time in it. We’re saying a minute to two minutes max, and you’re going to get the same response as a man who sits in an ice bath for 30 seconds to five minutes.

Betty Rocker (46:40):
And I just want to say what a difference there is between 40 to 50 degree air to 40 to 50 degree water. So if you’re trying to compare, think, oh, 40 degrees is nothing. When you’re in water, immersed in water, that feels very cold. Yeah, just wanted to …

Dr. Stacy Sims (46:57):
Yeah. So if we look at a traditional swimming pool, like an indoor swimming pool, people will go do laps or whatever, they keep it around 80 degrees Fahrenheit. And you know when you jump in a pool of water, you’re like, woo, chilly. And then you start swimming, you feel great. So when you’re thinking about how cold that 45 to 50 degrees Fahrenheit, it’s cold. You feel it.

Betty Rocker (47:21):
It’s cold.

Dr. Stacy Sims (47:22):
Yeah, but it’s not ice.

Betty Rocker (47:25):
I know. And I think that that’s really helpful because there’s so much biohacking out there. There’s so much information from people who I think are wonderful scientists and wonderful researchers and have a lot of good to contribute to the world. But I don’t know that they’re always looking at the differences between men and women. And the science is a little bit towards men. So I just feel like there’s just still this massive gender bias and women are jumping on board with that, and they’ll fight with me about certain topics because they feel like someone has told them that they’re going to get this amazing health benefit from doing this thing.

And it’s like, well, does the literature support that for women in our age group or over time are you actually causing harm to yourself potentially by doing this very extreme thing that maybe you feel good right now, and that’s partly the high of feeling you’re part of what’s going on or what’s current or what’s cool because you’re resilient, you’re a woman, you’re freaking badass strong, and it’s going to take a while before you actually feel the impact of whatever it is, this thing that you’re doing. So I guess I just want to say it’s like let the buyer beware. Let women beware.

Dr. Stacy Sims (48:48):

Betty Rocker (48:49):
All this information out there, I think experimentation is great. I think we should all have the opportunity to try new things. They make us stronger, more resilient, but not everything out there is made to do exactly what it says it’s going to do for you. It may be very beneficial for another population, for instance, who it was specifically studied on. Maybe they just haven’t figured out what’s good for women yet. It’s just like until they do, just don’t blindly follow everything people say basically.

Dr. Stacy Sims (49:24):
Yes. Yes. Very true. And I find it’s interesting in the media for experts and stuff, it’s like if a male comes out and says something, they’re never necessarily questioned. They’re not asked for the specific studies to back up what you’re saying. But when you have a woman who says something and you say, “This is not good for women, or we want to look at this for women,” the automatic response is, “Where’s the science to back it up?”

And I find it very frustrating because if the male expert was asked for that, then it would be more transparent of what the study population is. And so in research articles as well you never see, you might say caffeine promotes cycle sprints or something like that, but it doesn’t say caffeine promotes cycle sprints in men, but it would say if it was in women. So the general person is like, “Ooh, let’s take caffeine because it’ll improve my sprinting capacity.” But it doesn’t say what the population is unless it’s specifically in women.

So there is that gender bias as well in the way that information is portrayed. And I find it very frustrating because if I see something in the media and it’s a male expert, then I want them to be like, “Hey, where’s the science to back up your statement?” Instead of the female expert being asked, “Where’s the science to back up your statement,” if it also has to pertain to women.

Betty Rocker (51:03):
Yeah, I am grateful to have these conversations with you because everybody who listens is impacted by these topics, and they will then think twice about the things that they’re reading, I hope.

Dr. Stacy Sims (51:16):
I hope so. Yeah.

Betty Rocker (51:21):
I think some of this is changing. I’m starting to see more studies focused on women, which is freaking cool and awesome.

Dr. Stacy Sims (51:27):
It’s awesome.

Betty Rocker (51:28):
You sent me some great stuff today. Just like we were saying before, listen to your body, treat your body as an individual body and don’t fall victim to all of the jargon out there that isn’t for you. And even stuff that is just generally for women might not be specifically for you, for your life stage or for your unique situation. You are unique, and this is again why I’m such a big proponent of testing blood work, getting tests regularly, not just like one time.

And there’s so many more great consumer labs out there now that you can get stuff tested more readily yourself. Yeah, anyway, just it’s great to talk about this with you and thank you so much for your time. I’m sure we’d all love to talk to you for three more hours, but if people want to talk to you for more hours, they can join your new amazing membership where-

Dr. Stacy Sims (52:31):
Well, thanks.

Betty Rocker (52:31):
Can you tell us a little bit about that?

Dr. Stacy Sims (52:34):
Yeah, so we have a new membership platform where we have a community and then so we have regular conversations. I go in there and I’m answering questions almost every day. And then we have about once a month or even more frequently than once a month of an ask me anything live session. So the goal of it is to have a resource where women can come and feel safe to ask questions that they wouldn’t ordinarily be able to and get the right information.

And I’m free to say, “Look, I don’t know. I’ll look that up for you so I can get the right information to you.” It’s a rarity. I’ll say that. But no, for the most part, it’s really trying to facilitate conversation and getting the right kind of information to women so they can understand their bodies and the environment that they’re in a lot better.

Betty Rocker (53:32):
It’s a great resource. You’ll see me in there some weeks as well, and there’s always a recording.

Dr. Stacy Sims (53:37):

Betty Rocker (53:39):
You can find that on DrStacySims.com on her website, as well as her recent blog articles full of information like this. She’ll update things when the literature gets updated. I’ve seen you update posts and reissue them because the science is always changing and we’re always finding new things out, and you’re really conscientious and dedicated to making sure that the latest information gets in front of the women who need to read it.

So utilize Stacy’s website as a resource and Roar, her amazing book about training with your cycle, it’s getting re-released this year, I believe.

Dr. Stacy Sims (54:16):

Betty Rocker (54:18):
That’s very exciting. We know that that’s coming. And her Menopause 2.0 course is currently enrolling, I believe, and just have to check her website to see what is going on in Stacy’s world and take advantage of all of the great content and books and programs that she has to offer so that you can continue to educate yourself because this stuff constantly changes. And if you’re one of my members, I would say it’s incredibly complimentary to the work we do in our programs and our workouts and the nutrition things that we do.

And it will just elevate the conversation for you in your own life and help you get even more out of it as you go through time. So definitely I couldn’t recommend it more, so thank you, Stacy.

Dr. Stacy Sims (55:02):
Oh, thank you.

Betty Rocker (55:03):
Thank you for everything. Thanks for your time. And if you’re not following her on Instagram or Facebook, please, you can find her all of the places and all of the things. And thanks again, guys, for joining us for this conversation. Stacy, is there anything that you want the last word on? Anything that you want to drop into the conversation?

Dr. Stacy Sims (55:23):
Oh, no, I think you covered it all. Thanks.

Betty Rocker (55:25):

Dr. Stacy Sims (55:26):

Betty Rocker (55:26):
It’s a pleasure. Thanks again.

Betty Rocker:

I just wanted to mention real quick that one of the most common mistakes I see women making when it comes to their health and fitness goals is putting too much emphasis on their workouts and not prioritizing nutrition or sleep or stress management.

Because one workout makes us feel good, a lot of us think more workouts will make us feel better and give us more results. So we get into this no days off mentality, sometimes going for two workouts a day, and endlessly pouring our valuable energy and time into exercise when that’s actually burning us out and breaking down muscle tissue as the body doesn’t have the building blocks in the form of nutrients or balanced hormones to support all that output.

It’s not really about how much you do, it’s about the way all these important elements, like sleep, nutrition, stress management, and exercise, come together that truly drives your results, supports your body long-term, and as a nice byproduct, produces the results you are looking for physically.

This holistic approach is a long-term sustainable approach that focuses on how you talk to yourself, how you nourish yourself, and how you care for yourself on every level.

And that’s exactly what we focus on in Rock Your Life, my online home workout studio and women’s fitness community. It’s a holistic approach to your health and fitness because you are a whole person.

And in Rock Your Life, you can enjoy the structure of a workout challenge program combined with a balanced guidance around eating healthy, getting good rest, and prioritizing your mental health. I’d love nothing more than to welcome you to our uplifting community.

And to make it easy for you, there’s even a 30-day trial for new members that you can take me up on. No obligation to stay. Just come enjoy the space and see how we can support you in nourishing your mind, loving your body, and rocking your life. Grab the trial at thebettyrocker.com/coaching.



This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Bree Argetsinger, Betty Rocker Inc and the producers disclaim responsibility for any possible adverse effects from the use of information contained here in. Opinions of guests are their own, and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guest qualifications or credibility. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to here in. Before starting a new exercise, fitness or health protocol, or if you think you have a medical problem, always consult a licensed physician.

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Rock Your Life is my online workout studio that you can attend from anywhere you are, and access workout challenge programs, healthy recipes, and get coaching and support in our private women’s fitness community for all 4 Pillars of Health. We provide support and strategies for women in training with their cycle, training in perimenopause and training in menopause.

All of our workouts and training programs include a strong focus on form and alignment to keep you healthy and balanced. You’ll find workout classes to take a la carte of all types, including strength training, HIIT, kickboxing, yoga, barre, mobility and more!

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