Most Replayed Moment: This Is The Best Exercise Protocol For Women!
In this two-part roundtable, Dr. Stacy Sims, Dr. Vonda Wright, Dr. Mary Claire Haver, and Dr. Natalie Crawford discuss exercise advice women are rarely given. They cover why more running isn't always better, how hormones and stress impact training, and the crucial role of intensity for strength, body composition, and brain health, especially during menopause.
Deep Dive Analysis
15 Topic Outline
VO2 Max Training and Intensity
Running Trends and Hormonal Health
Marathon Running Physique and Visceral Fat
Evolutionary Biology of Calorie Deficit and Stress
Overtraining vs. Under-recovering in Women
Exercise Rules for Perimenopause
Adaptive Stress and Polarized Training Explained
Weekly Exercise Structure for Women
Pillars of Health: Sleep, Nutrition, Activity, Community
Exercise Recommendations Post-Menopause
Understanding 'Heavy Lifting' for Women
Future Self and Long-Term Health Planning
Brain Health and Lactate Production
Sex Differences in Brain Metabolism and Dementia Risk
Sociocultural Factors and Neuroplasticity
7 Key Concepts
Relative Energy Deficiency
This occurs when the body doesn't receive enough energy to support the demands of exercise and daily functions, often leading to hormonal imbalances like luteal phase defects in runners.
Visceral Fat
Fat stored around internal organs, which can be high even in outwardly lean individuals (skinny fat) due to inflammation, low energy intake, and estradiol suppression, often seen in long-distance runners.
Hypothalamic Amenorrhea
A condition where the hypothalamus in the brain shuts off reproductive signals (FSH and LH), leading to a cessation of ovulation and estrogen production, acting as a survival mechanism during periods of extreme stress or underfueling.
Adaptive Stress
A type of training stress, like heavy resistance training, that causes a signaling cascade in the body to repair and strengthen muscles, leading to improved health and function.
Polarized Training
An exercise strategy that involves very high-intensity work (Zone 5/6) and very low-intensity work (Zone 1/2), while largely avoiding the moderate intensity (Zone 3/4) zone, to maximize adaptive responses and minimize chronic stress.
Lactate Production
The generation of lactate during high-intensity exercise, which is crucial for women's brain health, as it can be used as a preferential fuel by the heart and brain, potentially reducing the risk of dementia and Alzheimer's by addressing missteps in brain metabolism.
Neuroplasticity
The brain's ability to form new neural connections and pathways, which can be stimulated through activities like reading and complex tasks, contributing to a stronger, more resilient brain and potentially reducing the risk of cognitive decline.
8 Questions Answered
No, it doesn't take much to build VO2 max; it requires high-intensity efforts that are uncomfortable, typically pushing at maximum heart rate for about four minutes, or shorter sprint intervals.
While running can be part of a healthy lifestyle, if it's the only form of exercise, it's not optimal for whole-body health and can lead to issues like luteal phase defects due to relative energy deficiency.
Despite appearing super lean externally, some long-distance runners can have a high percentage of visceral fat due to inflammation, low energy intake, and likely estradiol suppression caused by the chronic stress of their training.
Modern chronic stress causes continuous hormone shifts, like elevated cortisol, preparing the body for a 'lion' that never comes, leading to unused glucose and perpetuated body fat, unlike episodic stress which would resolve after the threat.
While some women are overexercising, especially in fitness-focused areas, it's more accurate to frame it as under-recovering, meaning they are not adequately fueling or allowing their bodies to repair, leading to negative hormonal impacts.
In perimenopause and post-menopause, the focus should shift to quality over volume, emphasizing high-intensity interval training and heavy resistance training to create adaptive stress, improve body composition, and support hormonal balance, as estrogen's protective effects diminish.
Heavy lifting is relative, but a good guideline is lifting 70-80% of your one-rep max (the heaviest weight you can safely lift once with good form), which typically allows for about five repetitions before reaching failure.
High-intensity exercise, particularly for women, is crucial for producing lactate, which the brain can use as a preferential fuel. This process helps reduce missteps in brain metabolism, potentially lowering the risk of dementia and Alzheimer's, especially given women's biological predispositions.
9 Actionable Insights
1. Prioritize Sleep for Performance
Make sleep your biggest positive investment in performance and recovery, as it’s non-negotiable for metabolic and body composition changes and improves stress resilience.
2. Balance Running with Strength Training
Combine strength training three times a week with running on other days to optimize your body and hormonal health, improving running economy and preventing injuries.
3. Polarize Your Exercise Intensity
Focus on very high-intensity training (Zone 5/6) for short bursts and low-intensity work (Zone 1/2) for recovery, avoiding the moderate intensity (Zone 3/4) zone which can exacerbate inflammation and cortisol.
4. Lift Heavier Weights for Muscle Growth
Challenge yourself with heavier weights (70-80% of your one-rep max for 5 reps) rather than high repetitions with light weights, as this builds strength and muscle, especially for women who often underestimate their capacity.
5. Engage in High-Intensity Sprint Intervals
Perform short, high-intensity sprint intervals (e.g., 30 seconds on, 2-3 minutes full recovery, repeated 4 times) a couple of days a week to build VO2 max, improve insulin sensitivity, reduce visceral fat, and produce lactate beneficial for brain health.
6. Combat Chronic Stress with Active Planning
Acknowledge that modern society creates chronic stress and proactively implement strategies like high-intensity exercise to produce lactate, which helps combat the pro-inflammatory state and supports brain health.
7. Focus on Recovery, Not Just Training
Reframe ‘overtraining’ as ‘under-recovering’ to emphasize the importance of adequate fueling and recovery days, ensuring your body can adapt and repair effectively from exercise.
8. Build Brain Pathways Younger
Engage in activities that stimulate neuroplasticity, such as reading and social interaction, to build a stronger, more resilient brain earlier in life, which can help combat cognitive decline later.
9. Prioritize Community and Mindfulness
Include mindfulness and community activities like spending time in nature, connecting with friends, or group exercise, as these are crucial for parasympathetic balance and overall well-being, impacting longevity.
8 Key Quotes
If all you do is running, then that is definitely not the best way to be. It's not the healthiest for your whole body.
Dr. Natalie Crawford
Most of the time we see a higher visceral fat in and around the organs... Even though on the outside, they're like super lean.
Dr. Natalie Crawford
I like to frame it where women are under-recovering, not over-training.
Dr. Stacy Sims
If we stay in that moderate intensity zone, we aren't creating a strong enough stress to create that signaling. What are we doing? We are exacerbating inflammation or exacerbating cortisol.
Dr. Stacy Sims
You cannot invoke any kind of metabolic or body composition change without adequate sleep. Also improves stress resilience.
Dr. Mary Claire Haver
In our brain, we almost see our future selves as a bit of a stranger.
Host
If you choose to become a caretaker of a parent with dementia, you have a 60% increased risk.
Dr. Natalie Crawford
The brain is that too. We need to think about active ways we're going to combat what is happening in today's world naturally.
Dr. Natalie Crawford
4 Protocols
Norwegian 4x4 VO2 Max Protocol
Dr. Vonda Wright- Warm up thoroughly.
- Perform four minutes of high-intensity exercise at maximum effort (pushing heart rate as high as possible).
- Recover completely for four minutes.
- Repeat the high-intensity and recovery cycle four times total.
- Perform this protocol once a week at most.
Sprint Interval Training (SIT)
Dr. Vonda Wright- Warm up thoroughly.
- Perform 30 seconds of all-out effort (heart rate as high as possible, e.g., on a treadmill at speed 11).
- Recover completely for 2-3 minutes.
- Repeat the 30-second sprint and recovery cycle four times.
Weekly Exercise Structure for Women
Dr. Vonda Wright- Lift heavy (progressively, heavier weights, fewer reps, one compound lift plus augmentative lifts) 2-4 days a week.
- Perform low-intensity continuous motion (e.g., brisk walking) on other days for recovery and blood flow.
- Add sprint intervals (high Zone 5/6 intensity) a couple of days a week.
- Optionally, add the 4x4 VO2 max protocol on one of the other days.
Four Pillars of Health
Dr. Mary Claire Haver- Nail sleep: Ensure adequate, non-negotiable sleep for metabolic and body composition changes, and stress resilience.
- Optimize nutrition: Focus on fueling habits.
- Engage in physical activity: Implement a balanced exercise routine.
- Prioritize mindfulness and community: Connect with friends, engage in group activities, spend time in nature for parasympathetic balance and overall well-being.