BETTER! with Dr. Stephanie Estima | Strength, Body Composition & Perimenopause

00:54 – Dr. Stephanie introduces today’s guest, Gabrielle Lyon 

06:19 – Dr. Gabrielle opens up about being a new mother 

12:41 – Dr. Gabrielle’s training and nutrition 

17:14 – Why Dr. Gabrielle believes that muscles are the organ of longevity 

22:40 – Obesogenic Sarcopenia 

26:30 – The PROT-AGE Study 

34:48 – Myths about muscle-protein synthesis in men and women 

37:45 – How aging impacts muscle-protein synthesis 

45:43 – Dr. Stephanie asks about amplifying muscle-protein synthesis through her personal diet and training regiment 

52:10 – Animal and plant proteins 

1:00:44 – Growth pathways 

1:08:26 – Dr. Stephanie and Dr. Gabrielle share their thoughts on the documentary, The Game Changers 

1:14:24 – The vegetarian and vegan diet 

1:19:13 – Dr. Gabrielle speaks to observations she’s seen from the mindset of the Navy SEALs and how we can apply their resilient, forward-thinking mindset 

1:27:55 – Dr. Gabrielle breaks down the different types of stress 

1:32:37 – Where listeners can follow and connect with Dr. Gabrielle 

1:34:28 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter 

TWEETABLE QUOTES

“It’s incredible. Ya know, I’ve been thinking a lot about what significant life events change one completely. There’s the before and the after. I would say there’s probably two, and that’s death, you’re no longer the same person, and birth. It is an instantaneous right of passage.” (06:39)  

“The moment we become comfortable is the moment that our progress stops.” (16:42)  

“There’s a lot of myth out there that individuals believe that the protein requirements are different for men versus women. And that’s actually not true. Protein requirements are based on blood volume and lean muscle mass.” (35:10)  

“It is probably the single worst piece of advice that anyone could be given is to, in mid-life, go vegan or vegetarian.” (37:45)  

“Really you should keep your protein consistent. So, whether it’s the first meal of the day, your first meal of the day, the first thing you’re eating doesn’t have to be breakfast, but it needs to be high-protein.” (48:23)  

“I think it [The Game Changers] does a good job to show diversity. But, the truth is it’s a fear-mongering, propaganda film that is dangerous for the public and dangerous for our aging population. There’s little to no science in that film.” (1:11:22)  

“That actually is one of their [Navy SEALs] superpowers is humor. It could literally be the worst situation ever and they’re making jokes about it. It is uncanny their capacity for optimism.” (1:19:57)  

“So, we all think practice makes perfect. But really, practice – and I’m talking about the mental practice – makes permanent.” (1:24:05)  

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Dr. Gabrielle’s Website

Dr. Gabrielle’s Instagram – @drgabriellelyon 

Dr. Gabrielle’s Twitter – @drgabriellelyon

Dr. Gabrielle’s Facebook 

Link to PROT-AGE Study  

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

01:31 – Dr. Stephanie introduces the topics she and Dr. Jolene Brighten discuss in Part Two of her interview

06:00 – A 2016 study out of Denmark of the association of hormonal contraception with depression

11:57 – Mood disorders and the tryptophan pathway

15:52 – The incidence rate of depression and Alzheimer’s in women

17:40 – Elevated cortisol levels

20:04 – Progesterone and head injuries

21:55 – How hormonal birth control affects sexual health and libido

26:37 – How testosterone affects inflammation

27:13 – Yeast infections and vaginal wall atrophy

30:18 – Orgasms

33:31 – The importance of communication during sex

34:42 – Dr. Jolene’s Top 10-12 Things to Know about Orgasms

42:37 – Hormonal birth control’s impact on gut and gastrointestinal health

46:54 – A recent Harvard study on birth control and Crohn’s Disease

50:16 – The value of supplementation while on the pill

59:31 – Seed cycling

1:04:35 – Evidence-based medicine

1:06:55 – Defining Post-Birth Control Syndrome

1:08:48 – Fertility Awareness Method (FAM), defined

1:16:56 – Where listeners can follow Dr. Jolene

1:18:08 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“We have to have these inconvenient conversations so that we can keep our daughters, our sisters, our future mothers safe.” (11:28)

“We can do better when we know. But when we don’t know, then we’re flying blind.” (21:47)

“If you’re a woman having sex with a male, that sexual intercourse is inviting someone else’s body into your body.” (32:18)

“Now, the other great thing about orgasms, they can give you easier periods, more regular cycles, and relief from menstrual cramps.” (40:44)

“We’ve now come to understand that what grows in your mouth can impact your fertility and also impact pregnancy outcomes.” (46:38)

“Anybody who lives with women or is a woman knows, women will power through just about anything until they can’t and then they’ll go to the doctor.” (1:08:29)

“It’s really important, I think, for all women to understand that if you’re not in a monogamous relationship, the pill, IUDs, patch, they’re not going to protect you against sexually transmitted infections. And that’s something that often gets glazed over.” (1:14:34)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Dr. Jolene’s Website

Dr. Jolene’s LinkedIn

Dr. Jolene’s Instagram – @drjolenebrighten

Dr. Jolene’s Twitter – @drbrighten

Dr. Jolene’s Facebook

Dr. Jolene’s YouTube Channel

Depression, Anxiety, Stress Scales (DASS)

DASS Questionnaire

Link to Seed Cycling Article

Dr. Jolene’s Books:

Beyond the Pill: A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

01:02 – Introducing today’s guest, Dr. Jolene Brighten

06:57 – Dr. Jolene talks about the history of hormonal birth control

10:38 – Worldwide use of hormonal birth control

13:06 – Birth control and infertility issues

14:41 – The purpose of your menstrual cycle

17:57 – Symptom management

18:49 – The buffet approach to birth control

20:05 – Understanding that belief has no place in medicine or science

25:11 – The inherent medical bias against women

28:41 – How hormonal contraception affects mate selection

34:53 – Hormonal contraception’s influence on women’s behavior

37:40 – How to stay safe on birth control in the wake of dangerous side effects

41:00 – Reversing Metabolic Mayhem

44:01 – Physiological side effects of hormonal birth control

47:51 – Inflammation

49:47 – The complex nature of hormones

52:06 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“Your doctor doesn’t need to have a research study to believe your story.” (07:55)

“What often happens is that you are put on birth control for symptom management and, as it turns out, those symptoms are really rooted in conditions that are associated with infertility.” (13:06)

“Hormonal birth control can rob us of what I call our superpowers. Throughout the menstrual cycle we have this ebb and flow of hormones that really gives us superpowers.” (16:42)

“For me, and really I think for many women, we don’t need other people’s beliefs when we’re trying to make an informed decision. We need the facts and we need the information, and we can frame those within our belief system.” (23:12)

“While hormonal birth control can rob you of your libido, when you come off of it, if you’ve selected your mate while you were on it and you come off of it, you may report more sexual dissatisfaction.” (32:47)

“If women have ever used hormonal birth control for six months or more in their lifetime, they have over thirty percent risk of developing diabetes post-menopausal.” (44:04)

“Women are dismissed and die at higher rates of heart attacks than men because we’re often told, ‘Oh you’re just stressed. You’re just anxious. It’s just in your head.’” (46:49)

“Women are tricky. But ya know what isn’t tricky about women? How well they know their body. So, what we have to do as doctors is listen to them because women are really smart and really in-tune with their body.” (47:40)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Dr. Jolene’s Website

Dr. Jolene’s LinkedIn

Dr. Jolene’s Instagram – @drjolenebrighten

Dr. Jolene’s Twitter – @drbrighten

Dr. Jolene’s Facebook

Depression, Anxiety, Stress Scales (DASS)

DASS Questionnaire

Dr. Jolene’s Books:

Beyond the Pill: A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

00:57 – Introducing today’s guest, Shawn Wells

05:53 – Shawn breaks down the role of mitochondria its impact on energy

07:14 – Insufficient Cellular Energy (ICE) states

09:38 – Glycation, explained

12:17 – Signs of accelerated glycation

14:10 – The benefits of the supplement, Berberine

16:22 – The value of context

17:53 – The importance of checking and modulating your blood sugar

20:23 – How Barberry works

22:09 – How chronic low-grade inflammation can affect our mitochondria

25:06 – Dr. Stephanie and Shawn discuss why it’s not ideal to rely on caffeine and other energy boosters that have negative side effects

28:39 – Dr. Stephanie explains oxidative phosphorylation

29:25 – How keto works

30:49 – Key differences between ketogenic diets and Standard American Diet

39:41 – Digestive resistant starches

45:39 – Benefits of being metabolically flexible

51:22 – Shawn’s favorite foundational supplements

55:11 – Dr. Stephanie and Shawn talk about the supplement NAD

59:02 – The power of mitochondrial pathways

1:02:21 – The value of recovery

1:03:44 – Happiness

1:06:50 – Sleep deprivation and social jetlag

1:09:19 – Community and sex

1:11:47 – Shawn answers a series of rapid-fire questions

1:18:21 – Where listeners can follow Shawn

1:18:59 – Dr. Stephanie thanks Shawn for joining the show

1:19:23 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“What happens though, that’s so important that we’re finding out, why I say, ‘mito is the new keto,’ is that we are often in insufficient cellular energy states, which is an acronym called ICE. And, there’s something else that’s in neurological diseases, it’s a very similar idea called brain energy gap.” (07:14)

“It’s [Berberine] been shown in studies to be as effective, if not more effective, than Metformin, which is known as an incredible glucose disposal agent.” (14:47)

“One of the ways that keto works is that you’re not creating as much oxidation and you are using an alternate fuel source – ketones – and you are insulin-resistant, and you are in this insufficient cellular energy state, and you don’t have enough glucose readily available for substrate. That’s why keto is a miracle.” (29:34)

“It’s a beautiful thing in terms of evolution that we could be by the ocean, we could be in the trees, we could be in a barren winter wasteland, we could be in whatever climate all over the world and find a food source. That’s incredible.” (46:53)

“When we’re in an optimized state, when our mitochondria are functioning optimally, we’re not only anti-aging, anti-disease, pro-energy, but we’re able to deal with stress better.” (1:01:08)

“I think happiness is a choice. Every day you can choose whether you’re happy or not, whether you’re positive or not.” (1:04:24)

“I have amazing people like you [Dr. Stephanie] in my life because of the energy I’m putting out is coming back to me. And, it’s so important that yes you’ve been burned, yes you’ve been hurt, but don’t let that change what’s going out because that’s what’s going to come back.” (1:12:44)

“Whatever you’re thinking right now is your weakness is actually probably your superpower. You’re hiding it away and it’s the thing you’re so blessed for that makes you unique. And, once you let it out, you’ll become so powerful.” (1:15:28)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Shawn’s Website

Shawn’s Instagram – @zonehalo

Shawn’s LinkedIn

Shawn’s Twitter – @ZoneHalo

Shawn’s Facebook

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

00:50 – Introducing today’s inaugural AMA episode

01:03 – Dr. Stephanie introduces her co-host for today’s episode, Stephanie Major

06:19 – Differentiating between time restrictive eating and fasting

12:16 – Benefits of fasting

13:28 – Timing your post-workout meal

16:23 – Breaking down PCOS, polycystic ovarian syndrome

18:39 – The important role that hormones play

20:03 – Fasting with PCOS

21:49 – Why Dr. Stephanie never does an extended fast in the week leading up to her period

26:20 – The incredible differences in a woman’s biology

28:16 – Dr. Stephanie speaks to some recent studies on rodent fasting

32:27 – HPA Access Dysfunction

35:32 – How fasting can affect thyroid issues, including Hashimoto’s Disease

40:47 – Fasting and hair loss

41:54 – The three stages of hair growth

43:29 – Supplements to combat hair loss during fasting

44:34 – Best practices for preparing for an extended fast

49:10 – Signs and signals that indicate you should end an extended fast

52:05 – Breaking a fast

54:30 – Dr. Stephanie discusses fasting while travelling

57:44 – When Dr. Stephanie does longer fasts

58:41 – How to explain fasting to your children

1:04:19 – Who should not be fasting

1:05:37 – Dr. Stephanie announces another upcoming AMA episode

1:07:01 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“When you allow for the stomach to fully empty, you will have a better quality sleep.” (09:42)

“When she does eat her next meal, it should have protein in it, and a minimum of twenty grams. So, a minimum of twenty grams of good, quality protein to be able to drive that muscle protein synthesis from her diet.” (16:07)

“Around Day 21 is when we start to see progesterone rising. Progesterone is a potent stimulator of your appetite. It slows down your bowels. And it can also affect your mood and it drives cravings.” (23:05)

“When you are obese, male or female, the data is clear in terms of fasting and the benefits that it’s going to impart to you. So, if you are overweight, if you have excess adiposity fasting is probably the most powerful weight-loss tool on the planet.” (31:28)

“That’s why I always say females are the original biohackers. We will do anything to feel better.” (35:24)

“When you start fasting, it is a temporary change you may notice like clumps of hair falling out, but it tends to return somewhere between three to six months. You’ll notice that that falling out stops.” (41:40)

“When you’re thinking about what breaks a fast, you have to be thinking about what your goal is surrounding the fast.” (52:32)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Dr. Stephanie’s Twelve Step Guide to Fasting

RELEVANT STUDIES, COMMENTARY, AND RANDOM BITS FROM MY PREP NOTES

Time Restrictive Eating (TRE) vs. FASTING

TRE - is restricting the hours in which you consume calories. This is where 
I start most people off if they have never heard of the concept of fasting, or they are intimidated by it.

So very basic would be a TRE of 12 hours – 12 hours of fasting, 12 hours of eating starting at 7am - 7pm.

I would quickly move this to a tighter eating window of 8-9 hours as the baseline for how you eat all the time. If one were so inclined, and if you’re listening to this podcast, I would also add in the caveat of making your last meal 3 hours before your bedtime. This allows the stomach to fully empty, and for our central and peripheral clock to sync up.

SCN is your central clock. It detects light coming in from the back of the retina and is the sleep-wake cycle master regulator.

However, we have other clocks in our bodies: the liver, pancreas, and kidneys, for example. The liver in particular senses intake of food.

If you have a late meal, there is a sort of homeostatic dissonance where the brain is saying ‘less light, time for bed,’ but the liver is saying, ‘but we just got a huge bolus of energy!’ This will affect sleeping quality and quantity. It is hard to sleep well on a full stomach.

If you listen to Sachin Panda, he will say anything with a caloric value will start the clock. So, in the strictest sense, the 5 calorie pre workout drink would start the clock. As far as I am aware, Mg does not have a caloric value, and neither does L-theanine.

FASTING is for 24 hours or more and there’s a myriad of ways to do it: Water only, NC LF, or CR.

Benefits are similar and, like anything, has a bell shaped curve:

• drops in insulin
• activation of sirtuins
• Autophagy - cellular cleaning up of debris
• BDNF
• improve lipid profiles ( HDL: LDL ratio, TG levels)
• allow for rest and repair of gut
• FFA & ketone production / alternative substrate
• mental clarity and focus
• amps up GH
• changes in gene expression upping longevity / FOXO
• cardioprotective benefits
• Powerful weight loss tool

On Refeeding Within 15-30 Minutes Of Exercise:

There has been considerable work undertaken to determine the optimal timing of nutritional intake in order to maximize post-exercise MPS and ensuing adaptations to training (Cribb & Hayes, 2006; Hoffman et al. 2009). In general, it is largely irrelevant whether the feed is given pre-, during or post-exercise. This is because the delaying of the muscle-full response appears to last at least 24 hours (Burd et al. 2011) after a single bout of exercise, which may help explain adaptations likehypertrophy/remodelling of muscle over time, which is independent of proximity-dependent feeding patterns.

Types of Exercise:

Endurance-type exercise such as running or cycling is associated with increased synthesis of mixed muscle proteins. However, these acute responses are not associated with significant changes in muscle mass (i.e. hypertrophy observed with resistance exercise).

The same individuals performed a 10-week resistance (weight-lifting) programm in one leg and a 10-week endurance (cycling) programm in the other. After training, post-exercise myofibrillar not mitochondrial protein synthesis increased with resistance exercise (Wilkinson et al. 2008). Conversely, after training mitochondrial protein synthesis increased only in the endurance-trained leg, whereas myofibrillar did not. These data seem to suggest a ‘matching’ between MPS responses and phenotypic changes, i.e. muscle hypertrophy in resistance training versus mitochondrial biogenesis in endurance training.

I have a general disdain for traditional cardio machines and feel like I am on a hamster wheel. I have retrofitted my outdoor bike with a TacX and use an app called ZWIFT so I can have some sort of indoor cardio in the winter months. I love to climb hills, have a psychological and physical resistance to sprints. I have to pump myself up mentally and physically when I know I’m sprinting, but generally I hate them. If I were to guess, I have way more type 2a mm fibres than 2b, because I despise sprints. It feels like I peter out and need a much longer recovery. This may be due to my years as a step instructor and being an endurance runner.

Best practices:

• Vary workload and intensity
• Aim for at least 20g of good quality protein per meal(this can change as we age, necessitating the need for more protein to continue to stim MPS)

A few more studies should one want to read up further:

No effect on protein supplement timing:

https://www.ncbi.nlm.nih.gov/pubmed/19478342/

24h window for refeed:

https://www.ncbi.nlm.nih.gov/pubmed/21289204/

20g for MPS:

https://www.ncbi.nlm.nih.gov/pubmed/19056590/

PCOS & Fasting:

• Insulin levels elevated:
• inverse relationship to SHBG (high insulin, low SHBG, more free T)
• direct relationship with LH (high insulin, higher LH, lower relative surge before ov)

Insulin is a nutrient sensor. You eat carbohydrates or proteins, and insulin goes up. This signals to the body that there is sufficient food to drive growth. (There are other nutrient sensors involved - mTOR and sirtuins, but let’s stick right now to insulin and its role in PCOS)

High insulin levels drives growth. For women of reproductive age, the ovaries are the queen of cells. They have 100-600K mitochondria in them, and are the most rapidly growing cells in the body.

The other issue excess insulin has on a reproductive female is is drives up LH. LH levels should only surge right before ovulation, to help the mature follicle release the viable egg. If LH levels are higher throughout your cycle, the egg cannot be released. I always liken LH to that uncle that comes over for dinner, slaps you on the back so hard to make you spit out your food. That is basically what LH is doing to your follicle.

Insulin has an inverse relationship the shbg. Shbg will, like its name suggests, bind sex hormones, like testosterone. Sex steroids and thyroxine are shbg regulators, but so is insulin. More insulin, less shbg, meaning more testosterone is free and able to exhibit its masculinizing effects.

So when we are fasting, we are not stimulating insulin to rise, and therefore will see a lowering of LH throughout the cycle, and an increase in shbg, which will lower free T.

With PCOS patients, fasting is a powerful tool to help regulate this hormonal derangement. At the very least, depending on the severity of symptoms and the patient’s goals, a TRE of 8 hours. I would also be strongly inclined to throw in several OMADS, and potentially a monthly or quarterly long fast in there as well if there was excess adiposity.

I would also be looking at other lifestyle changes, like weight lifting with a focus to increasing lean mm to assist in further insulin regulation and glucose disposal.

On Females & Fasting:

Fasting for women is different for men and women. We do see some gender specific differences. For obesity, whether male or female, the benefits are largely ubiquitous. It is when you get closer to normal BMIs that the data begins to differ. Some rodent studies have demonstrated deleterious effects on females and either alternate day fasting or prolonged CR.

Males

• improved insulin sensitivity
• waking and sleep patterns were uninterrupted,
• they were more fertile (gonadal transcription factors),
• Improved lipid profile

Female rats ‘masculinize’ - meaning their ovaries shrunk,

With 20 CR:

• irregular cycling patterns

With 40% CR:

• they ceased ovulation and menstruating altogether
• became hyper alert,
• learning and memory went up,
• sleep patterns were disrupted,
• heightened stress response,
• Upregulated BDNF
• Increased adrenal size

In human females

• ADF showed poor glucose tolerance and no change in insulin sensitivity in non-obese women
• did not see this negative effect with men, and only the men showed improvement in TG levels

So what do we as women do?

So if you are overweight, fasting is going to be a good option for you to reduce adiposity, and to help regulate metabolic hormones. Most of the studies I have looked at that detail fasting interventions report positive outcomes in cardio metabolic parameters.

It is when we trench into waters of hormonal issues, and also fasting with women who are not obese, where things can get murky. Even women with the same condition are going to be different. You are not the same hormonal each day of your cycle. We are just extra like that.

Must consider:

HPA Axis Dysfunction

• chronic low grade stress (physical, chemical, emotional)
• pro -inflammatory - pro cytokines
• long term fasting is a stress, and may contribute to the allostatic load
• short term fasting like TRE is appropriate
• most women have some sort of HPA derangement until proven otherwise
• pregnant, delivered a child, sleepless nights associated with kids, and then if you work...good luck

PCOS

• in this condition, our bodies behave more male
• fasting, especially longer term fasting on a monthly or quarterly basis is great
• allows for the drop in insulin, and can lend to better T regulation

For women like myself who are not obese, do not have hormonal issues, what do we do?

The truth is the jury is completely out, and we do not have enough literature to really tell us either way. I think there are measurements you can watch: ketone levels, glucose levels, and subjective observations that can help you monitor your fast. But, I would definitely seek counsel in a trusted primary care physician so you can be monitored while doing it.

I personally TRE everyday - it is around 4-5 hour eating window when I eat. While I love eating, I find it incredibly distracting and annoying to getting into my work, so I will have a large meal around 11am, and then a snack with the kids when they get home. Usually no dinner.

For women of reproductive age, there is no wrong time to fast, but there are decidedly easier and more difficult times

Again, talking in depth about gaming your menstrual cycle for metabolic and body comp gains soon, but the first week of your period - when P and E are low is much easier than the week leading up to the bleed.

Reproductive Function in Response To Fasting

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0002398

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004146

Alternate Day Fasting in Humans

https://www.ncbi.nlm.nih.gov/pubmed/15833943?dopt=Abstract

https://academic.oup.com/ajcn/article/81/1/69/4607679

Sex Differences

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200169/?tool=pubmed

https://academic.oup.com/ajcn/article/85/4/981/4648934

Obese Females & Fasting

https://www.ncbi.nlm.nih.gov/pubmed/23171320

https://www.ncbi.nlm.nih.gov/pubmed/29534545

On Autoimmunity & Fasting

https://www.ncbi.nlm.nih.gov/pubmed/27239035

On Fasting & Hair Loss

3 Distinct Phases of Hair Growth

Anagen Phase is the active growth phase. It lasts anywhere from 2-6 years and is largely genetic in terms what your window is. It could be up to 1 cm every 28 days.

Catagen Phase - follows the anagen growth phase

• transitional stage where growth stops, somewhere around 2-3 weeks
• follicle stops producing fiber

Telogen Phase

• resting phase
• When the body is subjected to extreme stress, as much as 70 percent of hair can prematurely enter the telogen phase and begin to fall, causing a noticeable loss of hair
• 3 months in length

Reasons for Hair Loss

It’s not the fasting per se, but the large, sudden change in calories. The body repurposes energy for vital function (brain > hair). It can also be caused by vitamin & mineral deficiency. Zinc has been shown to be a cause of hair thinning. As you use up glycogen stores, your kidneys excrete excess water, Na, zinc, Mg, K.

Hair loss can also be affected by the supplement or foods once you resume eating (ex. beef, lamb, chicken, mushrooms). It can be caused by not getting enough protein in your diet (aim for 20-30g good quality protein per meal). When you do start eating again, making sure you are getting adequate biotin, which is known to increase hair thickness.

Foods with biotin

• eggs w yolk
• avocadoes
• salmon
• spinach

MSM - methylsufonylmethane - forms the structural links in things like skin, hair, and nails and strengthens cartilage and tissue

• found in animals & animal proteins

Collagen - (from bone broth or supplementation)

Lack of collagen has been linked to early hair loss, hair thinning, hair graying, and spine degeneration.

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00:47 – Introducing today’s guest, Dr. Anthony Youn

06:13 – Dr. Anthony explains the important distinction of being a board-certified plastic surgeon

08:43 – The decision to become a plastic surgeon

11:03 – Dr. Stephanie brings up a specific story from Dr. Anthony’s most recent book

15:52 – The role of morality and faith in medicine

20:47 – An advocate first

23:56 – Guidelines for choosing a plastic surgeon provider

20:00 – Non-invasive alternatives to surgery

27:39 – Dr. Anthony and Dr. Stephanie touch on skin care

31:33 – Best practices for healthy skin care routines

36:55 – How to avoid that unnatural look that can be associated with plastic surgery

40:34 – Best practices when having botox

41:41 – The three most common areas that are injected with botox

46:00 – The dangers of filler

46:55 – Dr. Anthony and Dr. Stephanie discuss breast augmentation

52:26 – Dr. Stephanie thanks Dr. Anthony for joining the show

53:00 – Where listeners can follow Dr. Anthony

53:40 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“There’s a handful of patients throughout any doctor’s career that you remember. Sometimes, these are patients that they’re such great successes that you take a lot of pride in…but even more important are those patients that you failed.” (14:42)

“That’s why the title of the book is Playing God, because so many doctors think they’re playing God. And, in the end, what I’ve come to realize is that it’s not that as a doctor you’re playing God, it’s that you need God to help you to help your patients.” (20:03)

“One thing I think that I have learned over the last many years, as I’ve gotten to know doctors like yourself and a lot of our holistic health colleagues, I’ve learned how much I don’t know. And that’s a lot.” (22:10)

“There are actually studies that show that if you combine Vitamin C and Vitamin E, their antioxidant power, basically, is synergistically increased. For some reason, you put them separately, they do what they do separately. You put them together, and it’s much better than them separate.” (33:00)

“If you don’t care that you’re having a medical procedure done that’s unnecessary, well think about that maybe you may be screwing yourself in the future because if you do it too much when you’re young, it might not work when you’re older.” (41:26)

“The important thing to take away from this is that there are no smooth surface implants that we know of that have been related to this ALCL on their own.” (49:07)

“Literally five years ago if you were to ask the majority of plastic surgeons if breast implant illness is real or is it a psychiatric condition, probably ninety-eight percent of them or more would say it’s a psychiatric condition, it’s the women thinking this and they’re wrong.” (50:38)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Anthony’s Website

Anthony’s Instagram – @tonyyounmd

Anthony’s Twitter – @TonyYounMD

Anthony’s Facebook

FDA's new warnings around breast implants

ANTHONY'S BOOKS

Playing God: The Evolution of a Modern Surgeon

In Stitches

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Podcast production and marketing provided by FullCast

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P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

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Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

00:52 – Introducing today’s guest, David Sinclair

06:28 – David’s origin story

08:38 – Why we age

11:17 – The genome and epigenome

13:00 – The piano metaphor

15:51 – Sirtuins explained

21:59 – Other environmental stressors that sirtuins detect

25:11 – Hormesis defined

28:13 – How NAD+ and its precursors combat aging

35:11 – Dr. Stephanie brings up a specific story from Dr. David’s book

38:40 – Friedreich's Ataxia

39:27 – Benefits of resveratrol

45:11 – Horvath's Clock and measuring age accurately

47:58 – The backup copy of the epigenome

53:44 – Anti-aging technologies on the horizon

55:07 – Other anti-aging best practices

56:47 – Dr. Stephanie suggests a new sequel to the Avengers franchise

57:48 – Dr. Stephanie thanks Dr. David for joining the show

58:21 – Dr. David shares with the audience where they can find the cheat sheet in his book

58:48 – Where listeners can follow Dr. David

1:00:00 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“I wrote the book because there’s a lot of really interesting technology and things people can do in their daily lives, I believe, to live significantly longer and healthier. But, I also wanted to start the conversation because I felt no one was really saying the kinds of things that I was saying.” (08:15)

“I think that the major driver of aging, put simply, is a loss of information.” (10:19)

“I think it’s worth clarifying that the sirtuins are protectors of our bodies, but they can also cause aging by being distracted too much.” (25:11)

“It’s all about being uncomfortable. Our bodies would much rather sit in a chair and eat popcorn. There’s a whole industry based on that.” (26:19)

“I like to joke that scientists like to fight because the stakes are so low.” (42:41)

“We can predict, very accurately, how old someone is biologically. And that’s not so much related to birthday candles. It’s more about how you’ve lived your life. Twenty percent of your age will be genetic and eighty percent will be how you’ve lived.” (46:59)

“What I don’t know is how to bring people back from the dead, but I think we’re getting close to being able to keep people alive in a healthy way for much longer.” (57:31)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Dr. David’s Book - Lifespan: Why We Age―and Why We Don't Have To

Dr. David’s Website

Dr. David’s Instagram – @davidsinclairphd

Dr. David’s Twitter – @davidasinclair

Dr. David’s Facebook

ADDITIONAL RESOURCES FOR THIS PODCAST

In animal models, more NAD is better

At least when it is paired with exercise

The Mathematical Theory Of Aging

The Horvath Clock

Reversal Of Aging & Cellular Reprogramming

Resveratrol effects 1 

Resveratrol effects 2

NMN & lifespan in mice

David’s Newsletter

David’s book

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🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

01:05 – Introducing today’s guest, Connor Carrick 

04:11 – Connor’s NHL origin story 

08:56 – Connor recaps his time with the Washington Capitals 

10:04 – What it was like to be traded to Toronto 

13:26 – The mental toll of being traded multiple times 

18:11 – Joining the New Jersey Devils 

20:10 – Connor touches on his struggles with mental health 

26:21 – Short-term vs. long-term mindsets 

32:45 – Techniques and strategies Connor implements for longevity in the NHL 

34:36 – The importance of diet and nutrition 

39:12 – Connor’s performance and training regiment 

43:28 – The specific skills necessary to be a professional hockey player 

45:36 – Connor speaks to the sacrifices he, his wife Lexi, and their family have made for his career 

50:33 – Making effort cool again 

53:24 – Life post-NHL

56:46 – Connor answers some rapid-fire questions about one of his passions: coffee 

59:57 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“There’s something to be said about being a Toronto Maple Leaf. It means something in Toronto. It means something to people. It’s an Original Six franchise. There’s so much history and expectation there.” (11:31) 

“The NHL game, every ten games let’s say, is played at a different pace. So, every team at ten games is a different team at twenty. Every team at twenty is a way better team at forty.” (19:06) 

“I play a sport that, if you ask any GM, any coach, any player for that matter, what percentage of the game is mental, you’re not gonna get a percentage lower than eighty.” (23:57) 

“I think athletics puts you uniquely in touch with that because you know you can go sprint and run as fast as you can or jump as high as you want. You can’t just go faster because you want to. It’s hard. It takes a lot of work.” (30:24) 

“If you don’t have a skill and you can’t skate, this game is not going to be friendly to you.” (33:49) 

“The concept of making effort cool again, I relate to that greatly.” (51:40) 

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Connor’s Instagram – @connorcarrick

Connor’s Twitter – @connorcarrick

Connor’s Facebook

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

00:59 – Introducing today’s guest, Emily Fletcher 

05:45 – Meditation and sex 

09:42 – Mirror Neurons 

14:31 – Other reasons to practice meditation 

16:39 – Mindfulness defined 

20:41 – Identifying and dealing with stress from the past as well as the present 

23:20 – Manifesting 

26:05 – Adaptation energy 

30:54 – The physiological effects of stress 

34:09 – Cortisol 

36:30 – How stress affects your competitive edge 

40:58 – Why people don’t meditate as much as they should 

44:18 – Far-side simplicity 

46:46 – Emotional detoxification 

50:45 – Reasons to get a meditation teacher 

53:15 – The computer analogy 

54:30 – Purging physical and mental trauma 

56:41 – Emily shares how meditation has improved her own life 

1:00:19 – How meditation has impacted Emily as a mother 

1:02:54 – Dr. Stephanie speaks to how meditation has helped her as a mother 

1:04:31 – Emily provides additional parenting tips 

1:06:07 – Best practices for an ideal meditation routine 

1:08:47 – Caution with caffeine 

1:12:04 – Where listeners can find and follow Emily 

1:13:26 – Where listeners can follow Dr. Stephanie and subscribe to her newsletter

TWEETABLE QUOTES

“Forty percent of American cohabitating couples say that the number one reason that they’re not having as much sex as they would like is that they’re tired.” (08:15)  

“There is some science coming out of Tufts and Wake Forest University suggesting that meditation can reverse your body age from anywhere from eight to fifteen years.” (15:15)  

“Mindfulness I would define as the art of bringing your awareness into the present moment.” (17:31)  

“To me, manifesting simply means consciously creating a life you love. It’s you getting intentional about what you want your life to look like.” (23:52)  

“Stress is not what’s happening to you. Stress is your reaction to what’s happening to you.” (26:56)  

“While it is possible to change your state of consciousness, it is not possible to give your mind a command to shut up.” (43:01)  

“It’s better to cry this stuff out into your tissues than it is to have the stress stored in your tissues.” (55:17)  

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Emily’s Instagram – @emilystellafletcher

Emily’s Twitter – @ZivaMeditation

Emily’s Facebook

Emily’s LinkedIn

Emily’s Website

Emily’s YouTube Channel

BOOKS MENTIONED

Stress Less, Accomplish More: Meditation for Extraordinary Performance

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This episode has Chapter Marks embedded for apps that support them (Apple Podcasts, OverCast, Pocket Casts, etc.)

TWEETABLE QUOTES

“Mindset is really about attitude. It’s about philosophy.” (11:44)

“People who really pursue the process [of success], they are undefeatable.” (31:41)

“The great thing about rage and anger is they are phenomenal focusers of energy.” (33:49)

“What matters to me is movement. Movement matters because movement creates momentum. Momentum creates confidence. And confidence creates certainty.” (36:08)

“The alter ego is simply a mental tool that we’ve got that allows us to disassociate ourselves from our own story and start to play through the idea of someone and something else that we admire.” (41:44)

“What makes us unique – human beings – is our creative imagination, our ability to create new stories about what we’re capable of. We can shift and we can change in an instant.” (52:23)

“I’ve had people who have picked an alter ego because it sounded like a nice idea, but they didn’t actually connect with that person. There wasn’t like an emotional tug and I need that emotional tug when I’m working with someone.” (1:02:21)

LINKS MENTIONED

Better! Website

Dr. Stephanie’s Website

Dr. Stephanie’s Twitter – @dr_stephanie

Dr. Stephanie’s Instagram – @dr.stephanie.estima

Dr. Stephanie on LinkedIn

Link to Dr. Steph’s Article

Todd’s Instagram – @todd_herman

Todd’s Twitter – @todd_herman

Todd’s Facebook

Todd’s LinkedIn

Todd’s Website

Todd’s YouTube Channel

BOOKS MENTIONED

The Alter Ego Effect: The Power of Secret Identities to Transform Your Life

The Hero with a Thousand Faces

ENJOYING THE SHOW, READY FOR MORE?

Please Subscribe to Better! With Dr. Stephanie

Join our Private Facebook Community for Better!

Rate and Review: Show your support and help spread the word by writing a review, along with a 5-star rating on Apple Podcasts: https://bettershow.co/apple

🎙️🎙️🎙️

Podcast production and marketing provided by FullCast

****************************
P.S. When you're ready, here are two ways Dr. Stephanie can help you:

Subscribe: The Mini Pause — My weekly newsletter packed with the most actionable, evidence-based tools for women 40+ to thrive in midlife.

Build Muscle: LIFT — My progressive strength training program designed for women in midlife. Form-focused, joint-friendly, and built for real results.

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.