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The fitness industry prescribes energy deficits without the framework to know when a deficit becomes harmful. This episode translates the RED-S research into practical application for coaches and individuals working on body composition.

In this episode we breakdown the key concepts from recent conversation with Professor Louise Burke.

You'll learn:

• Low energy availability (the exposure) vs RED-S (the syndrome) - why the distinction matters for application

• Why fat-free mass, not total body mass, is the correct denominator for energy availability

• The threshold numbers: ~20 cal/kg FFM for fat loss; below 15 cal/kg FFM where adverse consequences are well-documented

• Which systems are affected first - reproductive hormones and bone turnover - and how quickly (research shows within five days at 10 cal/kg FFM, which the transcript notes is not uncommon in physique sport)

• Why metabolic adaptation is a consequence of RED-S, not a separate phenomenon

• What the evidence does and doesn't support on sex differences in fasted exercise, including the kisspeptin hypothesis

• Why fasted training and low energy availability are not the same thing

• The 2023 RED-S questionnaire toolkit

• Prevention: returning to energy balance (30–40 cal/kg FFM) one to two days per week

• Recovery: stepwise calorie increase and gastrointestinal adaptation

Key insight: Low energy availability is the exposure; RED-S is the syndrome.

Fasted training is not the same as low energy availability.

These distinctions are foundational to applying this research correctly.

Topics: RED-S, low energy availability, fat-free mass, metabolic adaptation, fasted training, kisspeptin, body composition, physique sport, Louise Burke, Stronger With Time

RESOURCES & LINKS

• Dr Tony Boutagy → tonyboutagy.com

• Professor Louise Burke - Australian Catholic University → https://www.acu.edu.au/research-and-enterprise/our-research-institutes/mary-mackillop-institute-for-health-research/our-people/louise-burke

• IOC RED-S CAT 2 Tool (PDF) → https://stillmed.olympics.com/media/Documents/Beyond-the-Games/Health-and-Wellbeing/2023-IOC-REDS-CAT2.pdf

• IOC 2023 Consensus Statement on RED-S → https://pubmed.ncbi.nlm.nih.gov/37752005

• Sports Dietitians Australia → https://www.sportsdietitians.com.au

• Polar H10 heart rate monitor → https://www.polar.com/en/sensors/h10-heart-rate-sensor

🌐 Visit → https://tonyboutagy.com/

📲 Follow us on Instagram → @tonyboutagy

If you've experienced unexplained fatigue, lost your period, or can't build muscle despite training hard - this episode will help you understand why.

Professor Louise Burke - IOC expert panel member on RED-S - explains the complexity behind low energy availability, why it's being oversimplified on social media, and why context matters more than rigid rules.

You'll learn when energy deficit becomes problematic, which body systems are affected first (and why), why stress makes everything worse, and whether the fasted training fears are actually supported by evidence.

We also discuss Professor Burke's groundbreaking Melbourne study using the only metabolic chamber in the Southern Hemisphere to compare diet-induced versus exercise-induced energy deficits.

In this Episode:

• The difference between low energy availability (exposure) and RED-S (syndrome)

• Why energy deficits aren't always intentional (training volume, time constraints, budget)

• Which body systems are affected: reproductive, bone, GI, metabolism, performance

• Why some systems shut down before others (evolutionary perspective)

• Stress as a major amplifier of symptoms

• RED-S CAT 2 clinical diagnosis tool (requires medical expertise, not self-diagnosis)

• Evolution from Female Athlete Triad to RED-S (males affected, multiple systems involved)

• Cultural issues in endurance sports (Tour cyclists surviving on coffee for 7-hour rides)

• Does the method of creating deficit matter? Diet vs exercise-induced

• Melbourne metabolic chamber study: comparing both methods (results expected 2027)

• Fasted training controversy: insufficient evidence for rigid rules

• Sex differences in sensitivity to energy rhythm (confounded by stress factors)

• Louise's perspective: better to exercise fasted than not exercise at all

Key insight:

RED-S is far more complex than simple numerical thresholds. Context, individual variation, stress, and the method of creating deficit all matter. Oversimplified social media advice may cause more harm than good.

Melbourne Study:

Professor Burke is recruiting runners, triathletes, race walkers (50k+/week) for a study comparing exercise-induced vs diet-induced energy deficit using the only metabolic chamber in the Southern Hemisphere. Results expected 2027.

Contact  ⁠[email protected] for recruitment information.

Go straight to the redcaps screening tool   https://redcap.link/acu-agility

Topics: energy deficit, undereating, overtraining, hormones, bone health, metabolic adaptation, female athlete triad, amenorrhea, stress fractures, fasted training, sports nutrition

What started as 6 planned episodes became 31 conversations throughout 2025. This is my year-end reflection on the final five conversations - and the one consistent message that emerged from every expert.

The core message:

Individual variation matters more than sex-specific protocols. Training principles apply to human physiology, not gender categories. What you do consistently shapes who you become.

Key insights from 2025:

💡 You are what you do repeatedly" - Professor Sophia Nimphius. Your training history shapes your physiology more than your sex does.

💡 Research + coaching perspectives both matter. Research shows what works on average. Coaching finds what works for you.

💡 The public message has become too complex. 80% of women aren't lifting weights, yet the advice has become increasingly segmented and contradictory.

💡 Training frequency: The pre-steroid era (1800s-1950s) used 2-3x per week full body training. Modern muscle physiology supports this approach for natural lifters.

💡 Menopause care is patient-centered. History, symptoms, and goals drive treatment decisions - not blanket "every woman should" recommendations.

💡 Low energy availability is the hidden epidemic in midlife women. Even 35-year-olds are showing perimenopausal symptoms from chronic under-fueling.

Brief highlights from 5 conversations:

🎙️ Round Table (Paul Laursen, Jake Doleschal, Dana Lis): How strength, endurance, and nutrition interact in real life. Why zones are coaching prescription tools, not gender-specific protocols.

🎙️ Jake Doleschal: Training frequency and the muscle fiber-specific nature of hypertrophy. Why first sets give you 50% of stimulus with diminishing returns after.

🎙️ Dr. Nadya Chami: What happens in a menopause consultation. Individualized hormone therapy decisions based on patient needs and contraindications.

🎙️ Professor Abbie Smith-Ryan: Context matters for fasted training. Fueling around training sessions for better body composition. Why short-term studies miss real-world complexity.

🎙️ Professor Sophia Nimphius: Research quality issues (85% of top meta-analyses contain errors). The circle of resistance training life. Why more overlap exists than difference between male and female training responses.

📅 2026 plans: Body composition focus, continued women's health and performance, and the experts doing the actual research.

If you found this valuable, follow for more evidence-based insights in 2026.

📲 Instagram → https://www.instagram.com/tonyboutagy/🎧 Watch on YouTube → https://www.youtube.com/@tonyboutagy-PhD/

Professor Sophia Nimphius's research on training adaptation reveals that your training history shapes your physiology more than demographic categories. Her work bridges exercise science research with practical coaching application.

In this episode, you'll discover:

• Research quality in exercise science: why 85% of influential meta-analyses contain calculation errors

• Within-group variation versus between-group differences in male and female training responses

• "You are what you do repeatedly" - how consistent training patterns shape physiology

• The circle of resistance training life: cycling through muscle mass, strength, and work capacity phases

• Why it takes 3-4 years of consistent training to understand your true capabilities

• Programming for muscle mass: higher reps, total work, and learning what "heavy" means

• Cluster sets and rest redistribution as alternatives to traditional set structures

• Power decline with age: maintaining fast movements across the lifespan

• Bone health: both impact and tension stimulate adaptation (with satiation effects)

• Multimodal and multi-directional movement for comprehensive development

• Muscle imbalances: practical screening and monitoring changes over time

Key insights:

Training principles apply to human physiology rather than gender categories. Within-group variation (differences between individuals of the same sex) exceeds between-group differences (average differences between sexes). Your training history - what you do consistently over years - determines your physiological adaptations.

The "circle of resistance training life" applies universally: build muscle mass, maximize strength and efficiency, develop work capacity, repeat. Cycle through 3-8 week blocks of each phase across your entire training lifespan.

Guest:

Professor Sophia Nimphius is Pro Vice-Chancellor of Sport at Edith Cowan University, with over 20 years of experience bridging research and elite sports coaching in surfing, softball, and strength sports.

Resources:

Professor Sophia Nimphius → https://www.docsoph.com/Instagram → @docsoph

If you found this valuable, follow for more evidence-based insights.

📲 Instagram → https://www.instagram.com/tonyboutagy/🎧 Watch on YouTube → https://www.youtube.com/@tonyboutagy-PhD/

Professor Abbie Smith-Ryan's research reveals why individual variation in women's training and nutrition response matters more than group averages - and why rigid protocols often miss the mark.

In this episode, you'll discover:

• Why menstrual cycle training needs vary dramatically between women (and how to track your own patterns)

• When body composition measurements provide useful feedback versus create psychological problems

• Creatine for women: dosing, timing, and benefits for muscle, cognition, and bone health

• Strategic fueling around training sessions while maintaining fat loss goals

• Low energy availability in midlife: why some women eating 1,400 calories still aren't fueling adequately around training

• How chronic energy deficit suppresses metabolic rate by 300-400 calories

• Case studies: world champions who fuel strategically versus chronic under-fuelers with suppressed metabolism

Key insights:

Individual response to menstrual cycle changes varies significantly - some women need training modifications, others don't notice differences. Track your own patterns rather than following rigid protocols.

You can maintain calorie restriction for fat loss while still fueling strategically around training sessions. The timing matters for body composition and metabolic health.

Guest:

Professor Abbie Smith-Ryan is co-director of the Applied Physiology Laboratory at UNC Chapel Hill, with 230+ peer-reviewed publications on women's health, performance nutrition, and body composition.

Resources:

Professor Abbie Smith-Ryan → @asmithryan (Instagram)Professor Abbie Smith-Ryan - Website → https://asmithryan.com/Applied Physiology Laboratory → https://exss.unc.edu/

If you found this valuable, follow for more evidence-based insights.

📲 Instagram → https://www.instagram.com/tonyboutagy/🎧 Watch on YouTube → https://www.youtube.com/@tonyboutagy-PhD/

Most menopause advice on social media comes from doctors who don't see patients. Dr. Nadya Chami actually works with menopausal women every single day.

In this conversation, she explains what really happens in a menopause consultation, how specialists make treatment decisions, and why individualised care matters more than blanket protocols from social media.

What you'll learn:

• What actually happens during a menopause consultation and how treatment decisions are made

• The 2002 study that scared a generation off hormone replacement therapy (HRT) - and what's changed since

• Body-identical hormones vs. synthetic: why type and delivery method matter

• Testosterone therapy for women: research on libido, muscle, bone, and cognition

• Why sex hormone binding globulin (SHBG) can block testosterone effectiveness

• Non-hormonal options when menopausal hormone therapy isn't suitable

• Sleep solutions: night sweats vs. anxiety vs. bladder issues

• Why body composition changes are the hardest menopause problem to solve

• Whether you can stay on hormone therapy indefinitely or should wean off at 60

Key insight: Menopause care requires working with a specialist who considers your complete medical history and individual circumstances - not following rigid social media protocols.

Guest: Dr. Nadya Chami is a specialist obstetrician and gynecologist working exclusively in menopause gynecology at Prince of Wales Private Hospital and the Menopause Hub (Royal Hospital for Women).

Resources:

• Dr. Nadya Chami → drnadyachami.com.au

• The Menopause Hub → Royal Hospital for Women, Sydney

If you found this valuable, follow for more evidence-based insights.

How often should you train each muscle group for optimal growth?

Strength coach Jake Doleschal breaks down why training muscles 2-3x per week with moderate volume beats once-weekly high-volume approaches - and how it aligns with modern science.

You'll learn:

• Why twice weekly training outperforms once weekly with high volume

• How muscle growth peaks in 48 hours but atrophy starts by day 5

• Why 3-4 sets per week maintains muscle but doesn't build it

• How to structure AAA vs. ABA workout splits

• The enhanced lifter problem: copying 40-set workouts leads to overtraining

• CNS fatigue and practical recovery strategies

• Exercise selection: start with muscle regions, not set counts

• Practical guidelines: 8-16 exercises per session

• Why rep ranges (5-15) don't significantly impact hypertrophy

• What pre-steroid era bodybuilders got right about sustainable training

  
  

If you found this valuable, subscribe for more evidence-based training insights and share this episode with someone who's spinning their wheels in the gym. 

📲 Follow us on Instagram → @tonyboutagy

This is a special round table episode where three experts come together to discuss what most podcasts keep siloed: how to integrate strength training, endurance work, and nutrition into one cohesive program.

You'll learn:

• Why training frequency (2-3x/week) matters more than total volume for most people

• The non-linear dose response: first sets give the most stimulus

• How to balance high and low intensity without constant fatigue

• Why males and females respond similarly to the same training programs

• When to train fasted vs fed (and why gut health matters)

• Protein targets: 1.7-2.5g/kg body weight for muscle gain or fat loss

• Zone two vs HIIT: when to use each and how to balance them

• 30/30 intervals: why short work/rest periods optimize adaptations

• The parallels between interval training and cluster sets in the gym

• How to structure your week for strength + endurance without interference

• What changes for athletes over 55-60 years old

  
  

Key insight: Context always matters more than rigid rules. Training adaptation equals molecular signaling plus autonomic balance.

 📲 Follow me on Instagram → @tonyboutagy

📲 Follow me on Instagram → @tonyboutagy

This is a summary episode of Stronger With Time, where I look back at eight powerful conversations and share the key insights I took away as both a coach and lifelong student of exercise science.

You'll learn:

• Why vitamin D testing matters and how to use sensible sun exposure (Prof. Michael Holick)

• How to gradually increase fiber intake without digestive distress (Dr. Joanna McMillan)

• Why resistance training programs don't need to be different for men and women (Prof. William Kraemer)

• Where to find reliable menopause information beyond social media (Dr. Jen Gunter)

• When to get a DEXA scan and how resistance training builds bone site-specifically (Dr. Jared Merkin)

• Which wearables actually track sleep well and why recovery strategies matter (Prof. Shona Halson)

• How short interval training compares to steady-state for glucose control (Prof. Jonathan Little)

• Why most cardio and strength advice for women is missing critical nuance (Dr. Alyssa Olenick)

  
  

Whether you're coaching women, training through menopause, or simply want clarity in a noisy fitness landscape - this episode gives you the science-backed highlights from eight world-class experts.

What if most of the "female-specific" training advice you're hearing is missing the bigger picture?

Dr. Alyssa Olenick breaks down the science of what actually works for women - from cardio programming to strength training protocols - and why the fear-based messaging around hormones, cortisol, and zone training is doing more harm than good.

You'll learn:

• How to spot BS fitness advice (hint: absolutes and fear-mongering are red flags)

• Why cardio isn't "destroying your hormones" - and what poor programming actually looks like

• The truth about zone training: when it matters and when you can ignore it

• How to balance HIIT, steady-state, and recovery across your week

• Why the "cortisol from cardio" fear is overblown (and what actually raises cortisol)

• What makes a good resistance training program (spoiler: it's not just 5x5 heavy lifting)

• The menopause training narrative: why 8-12 reps still work

• How to train with intention instead of just "going hard" every session

• Why fitness status matters more than sex differences in training response