Debbie Potts Coaching

Did you know menopause is just one moment in time?

Menopause is “officially” 12 months after not having your cycle … just that ONE day when it has been exactly ONE year we can say “I am in MENOPAUSE”!

Then the next day you are officially entering “POST MENOPAUSE”!  

Dr. Elizabeth Bright explains in her book and on her podcast videos (including our two part interview here) about the history of the term “MENOPAUSE”.  It is so fascinating to me.  Again, driven by big pharma to make more money- my end opinion.

Now I am I on a mission to beat the common side effects of going through the menopause transition- before and after that official day!

What are the common struggles the females experience as they start their second half of life?

  • Unexplained weight gain even with “eating healthy” and “exercising daily”
  • Hot flashes and sweating at night
  • Struggle sleeping
  • Feeling puffy and inflamed
  • Struggling to gain muscle even though lifting weights

I have been taking Dr. Stacy Sims “Menopause 2.0” program after ready both of her books ROAR and NEXT LEVEL.  I can’t wait for the new version of ROAR to come out this month.  Plus I have listened to other opinions of the menopause transition, opposite of Dr. Stacy Sims, with Dr. Anna Cabeca, Dr. Mindy Pelz and Cynthia Thurlow.  Dr. Stacy Sims focuses her research on the aging FEMALE ATHLETE, as compared to my other mentors who are working on the general population struggling with metabolic health issues.

My focus is to help educate the AGING FEMALE ATHLETE how to navigate through these years around middle age which is peri-menopause, menopause (one day of your life) and post-menopause.  We are high performing and high charging athletes who may be fit but fat or fit but unhealthy under the hood… and often living life as a race with signs and symptoms of CHRONIC STRESS.

So what does Dr. Stacy Sims teach us high performing endurance athletes how to adjust how we FUEL, TRAIN and PERFORM each day as we start our transition into our second half of our life? I know I want to live my best life in my second half of my life- as well as do everything I can do now to be in the best health (inside and out) when I am 80 plus years old (traveling around the world).

See my previous podcasts and blog posts on my tips how to TRAIN as an aging female athlete.  Now let’s focus on how to FUEL as an aging female athlete as per Dr. Stacy Sim’s research and experience.

REMEMBER… if you are doing the same thing (same program, same training schedule and same nutrition plan) over and over again without hitting your goals and desired results then you are probably feeling frustrated and confused. INSANITY right?

Are you struggling to get results even if doing all the “RIGHT” things you are reading about or listen to on social media?? 

Maybe you are not eating enough, working out in the “grey zone” or “black hole”, over training and under recovery issues plus fasting too much and not eating enough protein.

The struggle is REAL but you don’t have to just accept the changes!  Instead learn how to fuel and train to improve your metabolism.

We all hear about the mid-life common struggles…

  • Increase in fat weight gain
  • Decrease in lean body mass
  • Increase in total body weight
  • Decrease insulin sensitivity
  • Increase in blood glucose levels
  • Decrease in bone mineral density and bone mass
  • Increase in our baseline cortisol and our ability to respond to stress
  • Changes in our estrogen receptor sites
  • Decrease in our immune response
  • Increase in fatigue and reduced ability to recover from workouts
  • Decrease in quality of sleep
  • Decrease thyroid function  (LEA)

Why do we see, experience and feel these changes in our “transition years” as a female athlete?

Are you struggling to get results even though you are doing all the “right” things that used to work for you as…

  1. Our resistance training program isn’t give us the same results
  2. Our meal planning, macro ratio and eating window (fasting?) isn’t working to help change body composition
  3. Feeling flat, tight, puffy and inflamed even with your recovery protocol!

What are the solutions as per research and findings shared by Dr. Stacy Sims in her books, podcast interviews and blogs?

  1. Change your routine to HEAVY resistance training
  2. Time your nutrition – what you eat and when you eat with your training schedule (protein!)
  3. Manage your stress as we experience an elevation in our baseline cortisol (what about if you have already been “living life as a race” and addicted to busy-ness or “rushing-women’s syndrome”?)- CHRONIC STRESS -> sympathetic dominance
  4. Our changes in hormones may impact our stress – be sure to add in breathing techniques, active recovery days, sleep hygiene routine…
  5. Reduce inflammation with an anti-inflammatory diet

Here are some key features of an anti-inflammatory diet in functional medicine:

  1. Personalization: Functional medicine practitioners take into account a person’s unique health history, genetics, lifestyle, and sensitivities to tailor an anti-inflammatory diet plan that suits their individual needs.
  2. Elimination and Reintroduction: Some versions of the anti-inflammatory diet involve an elimination phase, during which potentially inflammatory foods are temporarily removed from the diet. This can help identify food sensitivities or triggers. These foods are then systematically reintroduced to assess their impact on inflammation.
  3. Emphasis on Whole Foods: Like other anti-inflammatory diets, the functional medicine approach emphasizes whole, nutrient-dense foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats. These foods provide essential nutrients that support the body’s natural anti-inflammatory processes.
  4. Focus on Gut Health: Functional medicine often places a strong emphasis on gut health, as the gut plays a crucial role in immune function and inflammation regulation. This might involve incorporating foods that support a healthy gut microbiome, such as fermented foods and prebiotic-rich foods.
  5. Balancing Macronutrients: The functional medicine approach may involve customizing macronutrient ratios (carbohydrates, fats, and proteins) based on an individual’s needs and metabolic profile.
  6. Targeted Supplementation: In some cases, functional medicine practitioners might recommend specific supplements or herbs that have been shown to have anti-inflammatory properties, based on an individual’s health goals and needs.
  7. Stress Management and Lifestyle Factors: Functional medicine considers lifestyle factors such as stress, sleep, and physical activity as important components of overall health. Managing stress and getting adequate sleep are seen as integral to reducing inflammation.
  8. Continuous Monitoring and Adjustments: The personalized nature of functional medicine means that the anti-inflammatory diet is not a one-size-fits-all approach. Practitioners work with patients over time to monitor progress, make adjustments, and refine the diet plan based on the individual’s response.

It’s important to note that while functional medicine offers a personalized and holistic approach to healthcare, it’s always recommended to work with a qualified and experienced functional medicine practitioner or registered dietitian if you’re considering making significant changes to your diet or health regimen.

Are you trying to exercise MORE and eat LESS to change your body composition?

Is it actually working for you or is being too strict on all fronts back firing for you as an active aging female athlete??

I know I was doing more fasted exercise, OMAD (one meal a day) too many days and strict intermittent fasting no matter my workout schedule (evening workout and early morning session) of 16/8 with some days of longer fasting on my “rest” day.


The information we hear out there in our health space is often based on metabolic diseased individuals, obese, Type II Diabetic and sedentary.  The guidelines we hear about for nutrition and fasting for our low carb community is NOT for the active athlete or aging female athlete.  We are different!

What we learn from Dr. Stacy Sims…

  • Low energy availability (LEA) is a real thing
  • Changing your body composition is not about calories in and calories out
  • Women need apx. 40-45 calories per kg of lean body mass per day (threshold but average is 35-40) to train and respond to the training load vs Men around 15 calories
  • Not eating enough nutrient dense calories results in reduced ability to ADAPT and change our body composition (lower fat mass and increase lean body mass)
  • Focus should be on choosing the right type of training and life stress plus eating enough nutrient dense calories to hit macro goals (protein!)
  • Avoid hormone dysfunction
  • Learn HOW to eat, WHEN and WHY with your coach to hit your muscle building protein goals, hormone building healthy fats and nutrient dense carbohydrates for high intensity workouts.


  • Reduce your training volume (yes -less is more for us aging endurance athletes)
  • Increase the intensity (with the decreased volume)
  • Increase your energy intake (what you eat) around your exercise (when to eat)
  • Avoid fasting and fasted exercise for the female athlete… instead of Intermittent Fasting, do Time Restricted Eating 12/12 by stopping eating 3 hours before bed
  • If you are training hard (changing how you TRAIN), but not changing how you FUEL (what, when and why) -> stressing the body by staying in the sympathetic drive post workouts (eating post workout will help decrease stress for exercise) -elevating cortisol (CHRONIC STRESS if you don’t turn “the faucet” on/off) signals the body not to adapt to the training stimulus
  • Fueling around exercise with some calories as in your black coffee before the early morning workout (Kion Whey Protein Powder or Paleo Valley Bone Broth Protein, plus Redmond’s Sea Salt plus grass fed butter is my trick for me)
  • Try eating something after breakfast (which is often a struggle for me as I am not hungry for a few hours) as eggs avocado toast (gluten free for me) or some people can tolerate (gut warning) chia seeds soaked in water with cream and local berries with a scoop of protein powder mixed in to hit 20-50g protein
  • Fueling post workout will teach your body that it can shift back to parasympathetic drive (rest, digest and recover)
  • Avoid over training, under recovery and under eating if you want to see body composition results!
  • Adapt to the training stimulus with the right fueling and recovery strategies

Do you have enough energy on board for the basic life activities and everything you are doing in a day?

Why do you have a decrease in your training response and adaptation from your training sessions?


    • A decrease in hormone- endocrine function
    • A decrease in our training response- adaptation
    • A decrease in endurance performance (longer sessions require more fuel)
    • A decrease in strength
    • A decrease in bone mineral density
    • A decrease in our IMMUNITY (more infections!)
    • An increase in gut dysfunction, leaky gut and nutrient absorption
    • A decrease in neuromuscular coordination

Should you do fasting as active aging female??

We have been told in the past few years how beneficial intermittent and extended fasting is beneficial for weight loss, cell autophagy, and telomere length for longevity purposes but for WHO?  Did they run these studies on fit and active athletes and fit active aging female athletes?

Dr. Stacy Sims points out that TIME RESTRICTIVE EATING is “normal” eating window of 12 hours and 12 hours of not eating… this is not the same concept of INTERMITTENT FASTING as the 16/8 we hear the most about.  If we are fasting as active fit athletes and female athletes, we may risk not getting enough calories in during our feeding window.  Why don’t we focus on stop eating before bed and eating when hungry -especially around our exercise session (especially when more carb depleting and stressing the muscle).

What is the MECHANISM OF ACTION for fasting??

Does EXERCISE provide the same benefits as intermittent fasting?

  • changes within the cell to improve our glucose signaling


  • cellular debris taken “trash” out – Cell Autophagy to save from oxidative stress
  • Decrease in metabolic stress when body learns to switch from ketones to glucose and back to ketones
  • stimulates cell signaling to improve glucose metabolism
  • less stress on the body for fueling


What is the role of the hormone kisspeptin?


It is named after the “kiss” behavior it elicits in animals due to its role in facilitating sexual maturation and reproductive processes.

The primary role of kisspeptin is to stimulate the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. GnRH, in turn, controls the release of two key gonadotropin hormones from the pituitary gland: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These gonadotropins are responsible for the regulation of sex hormone production in the gonads (testes in males and ovaries in females).

Specifically, kisspeptin acts as a crucial regulator of the hypothalamic-pituitary-gonadal (HPG) axis, which controls the reproductive hormone cascade. Here’s how the process generally works:

  1. Puberty Initiation: At the onset of puberty, the hypothalamus starts secreting kisspeptin in larger amounts. This increase in kisspeptin levels triggers the release of GnRH, which leads to the release of LH and FSH. These hormones then stimulate the gonads to produce sex hormones (testosterone in males and estrogen in females), resulting in the development of secondary sexual characteristics and the maturation of reproductive organs.
  2. Reproductive Cycle Regulation: Throughout the reproductive years, kisspeptin continues to play a role in the menstrual cycle in females and the reproductive cycle in males. It helps regulate the timing and release of LH and FSH, which are essential for ovulation in females and sperm production in males.
  3. Pregnancy and Fertility: Kisspeptin’s role in the HPG axis extends to fertility and pregnancy. Proper kisspeptin signaling is crucial for maintaining appropriate hormone levels, which are essential for conception, pregnancy maintenance, and fetal development.
  4. Role in Reproductive Disorders: Dysregulation of the kisspeptin pathway can lead to various reproductive disorders, such as delayed or absent puberty (hypogonadotropic hypogonadism) and certain forms of infertility.

Research into kisspeptin is ongoing, and scientists continue to investigate its role in various aspects of reproductive health and other physiological processes. Kisspeptin’s discovery has also raised interest in its potential therapeutic applications, including its use in managing reproductive disorders and exploring its role in other conditions influenced by hormonal imbalances.

How is kisspeptin involved in extended fasting and low energy availability for menopausal female athletes?


Kisspeptin’s role in extended fasting and low energy availability for menopausal female athletes is an area that requires further research, as the interaction between kisspeptin, energy availability, and hormonal changes during menopause is complex and not yet fully understood. However, I can provide some insights into how these factors might be interconnected.

  1. Energy Availability and Hormonal Regulation: Kisspeptin is known to play a role in the regulation of the hypothalamic-pituitary-gonadal (HPG) axis, which controls reproductive hormone release. Low energy availability, often seen in individuals undergoing extended fasting or intense training without adequate caloric intake, can disrupt the normal functioning of the HPG axis. In particular, low energy availability can lead to reduced secretion of gonadotropin-releasing hormone (GnRH), resulting in decreased release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This disruption can lead to menstrual irregularities, amenorrhea (absence of menstruation), and other hormonal imbalances.
  2. Menopause and Hormonal Changes: Menopause is characterized by the natural decline in reproductive hormones, including estrogen and progesterone, as ovarian function decreases. This hormonal transition can impact various physiological systems, including bone health, cardiovascular health, and metabolic function. Kisspeptin’s role in the regulation of GnRH release is likely influenced by the changes in hormonal milieu that occur during menopause.
  3. Interaction of Factors: In the context of menopausal female athletes, the interaction between low energy availability, kisspeptin, and hormonal changes is complex. Low energy availability can exacerbate the hormonal changes associated with menopause, potentially leading to greater disruptions in reproductive hormone release. This can further contribute to bone density loss and other health issues commonly seen in menopausal women.
  4. Research Gaps: While research has shown the relationship between energy availability and reproductive hormone disruptions in athletes, there is limited research specifically addressing menopausal female athletes. The role of kisspeptin in this context is not well-established. Future studies are needed to better understand how these factors interact and impact women undergoing menopause who are also engaged in athletic training.

Research is ongoing to understand the complex interactions between kisspeptin and various hormonal systems, including the thyroid and adrenal glands. While there is no definitive conclusion at the time of my last knowledge update in September 2021, I can provide some insights into the potential connections between kisspeptin dysregulation, hypothyroidism, and adrenal function based on existing knowledge.

  1. Hypothyroidism and Kisspeptin: Thyroid hormones play a significant role in regulating metabolism and overall hormonal balance in the body. Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, can lead to various metabolic and hormonal disruptions. Some studies suggest that thyroid hormones may influence the hypothalamic-pituitary-gonadal (HPG) axis, potentially impacting kisspeptin levels and its regulatory role. However, the exact mechanisms and relationships are not fully understood and require further investigation.
  2. Adrenal Function and Kisspeptin: The adrenal glands are responsible for producing various hormones, including cortisol and adrenaline, which play critical roles in stress response and overall hormonal balance. Chronic stress and dysregulation of adrenal function can impact the reproductive system, potentially affecting kisspeptin signaling and the HPG axis. Stress-induced changes in kisspeptin levels could contribute to reproductive irregularities.
  3. Hormonal Cross-Talk: Hormonal systems in the body are interconnected, and disruptions in one system can influence others. While the direct links between kisspeptin dysregulation, hypothyroidism, and adrenal function are not fully elucidated, it’s plausible that imbalances in one system could have downstream effects on others, contributing to broader disruptions in hormone regulation.
  4. Clinical Implications: Understanding the interactions between these hormonal systems could have clinical implications for conditions such as reproductive disorders, menstrual irregularities, and fertility issues. Additionally, addressing thyroid and adrenal imbalances in individuals with reproductive concerns may help optimize overall hormonal health.

It’s important to note that menopausal athletes, like all individuals, should prioritize their overall health and well-being. Adequate energy intake, proper nutrition, and a balanced training regimen are essential to support hormonal balance, bone health, and overall performance. If you’re a menopausal athlete or if you’re experiencing changes in your menstrual cycle, it’s advisable to consult with a healthcare professional who specializes in sports medicine or reproductive health to receive personalized guidance and recommendations.


Does exercise provide the same cell autophagy benefits as fasting?


Fasting and Autophagy:

  • During fasting, especially prolonged periods of fasting, the body’s energy reserves become depleted.
  • In response, cells switch to a state of autophagy as a means to break down and recycle cellular components for energy.
  • Fasting has been shown to enhance autophagy, particularly in organs like the liver and brain.

Exercise and Autophagy:

  • Exercise, particularly intense or prolonged aerobic exercise, can also stimulate autophagy.
  • The mechanical stress and energy demands placed on cells during exercise can trigger cellular responses that include increased autophagy.
  • Muscle cells, in particular, show increased autophagy as a response to exercise.
  • This process helps remove damaged proteins and organelles, contributing to muscle health and adaptation.


  • While both fasting and exercise can promote autophagy, the extent to which they do so can differ.
  • Prolonged fasting or intermittent fasting regimens tend to have a more significant impact on autophagy due to the extended periods of low nutrient availability.
  • Intense or prolonged exercise can also stimulate autophagy, especially in muscle cells, but the degree might not be as pronounced as during fasting.

Moreover, it’s worth noting that the benefits of fasting and exercise go beyond just autophagy.

  • Fasting can have various effects on metabolism, insulin sensitivity, and hormone regulation.
  • Exercise, on the other hand, promotes cardiovascular fitness, muscle strength, and overall metabolic health.
  • Incorporating both regular exercise and intermittent fasting into a healthy lifestyle can have synergistic effects on overall health, including cellular health through mechanisms like autophagy.
  • However, individual responses can vary, and it’s important to consult with a healthcare professional before making significant changes to your exercise or fasting routine, especially if you have underlying health conditions.

What is metabolic switching?

  1. Glycolytic State (Carbohydrate Metabolism): In this state, the body primarily relies on carbohydrates (glucose) as its main energy source. Carbohydrates are broken down into glucose, which is then used to produce ATP (adenosine triphosphate), the cell’s primary energy currency. This state is prevalent when you consume a carbohydrate-rich meal. The body uses glucose from the bloodstream or glycogen stored in the liver and muscles to fuel its energy needs.
  2. Ketogenic State (Fat Metabolism): In this state, the body shifts its energy source from carbohydrates to fats. When carbohydrate intake is limited, as in situations of fasting, low-carb diets, or intense exercise, the body starts breaking down fats into molecules called ketones through a process called ketogenesis. These ketones can then be used by various tissues, including the brain, as an alternative energy source to glucose. This metabolic state is known as ketosis.

The transition between these two metabolic states involves complex regulatory mechanisms that help the body adapt to changes in nutrient availability. For example, when carbohydrates are restricted (such as during fasting or a ketogenic diet), insulin levels drop, which allows for the breakdown of stored fats and the production of ketones. This metabolic switch can take several days to fully occur, as the body adjusts its cellular machinery to efficiently utilize ketones for energy.

Metabolic switching has gained significant attention due to its potential implications for health and disease. Ketogenic diets, which induce a metabolic shift towards fat metabolism, have been studied for their effects on weight loss, insulin sensitivity, epilepsy management, and other health conditions. However, it’s important to note that the effectiveness and safety of such dietary approaches can vary among individuals, and consultation with a healthcare professional is recommended before making significant changes to your diet or lifestyle.

What is the mechanism of action for fasting?

  1. Insulin and Glucose Regulation: When you fast, especially for an extended period, insulin levels decrease. Insulin is a hormone that helps regulate blood glucose levels by promoting the uptake of glucose into cells for energy or storage. With reduced insulin, the body shifts from using glucose as its primary energy source to using stored fats, leading to a decrease in blood glucose levels.
  2. Glycogen Depletion: The body stores glucose in the form of glycogen in the liver and muscles. During fasting, glycogen stores are gradually depleted, which can contribute to lowered blood glucose levels. As glycogen is broken down, glucose is released into the bloodstream to provide energy.
  3. Ketosis and Ketogenesis: As glycogen stores are used up, the body turns to fat metabolism for energy. Fatty acids are released from fat tissue and transported to the liver, where they are converted into molecules called ketones through a process called ketogenesis. Ketones can serve as an alternative energy source, especially for the brain and other tissues that can’t directly use fatty acids.
  4. Autophagy: Fasting promotes the activation of autophagy, a cellular recycling process that helps clear out damaged or dysfunctional cellular components. During fasting, the body starts breaking down unnecessary or damaged proteins, organelles, and cellular debris, which helps maintain cellular health and function.
  5. Hormonal Changes: Fasting triggers changes in various hormones, such as increased release of glucagon (which opposes the actions of insulin and encourages glucose release from stores) and growth hormone. These hormonal shifts play a role in facilitating the use of stored energy sources during fasting.
  6. Caloric Restriction and Energy Conservation: Fasting involves a period of reduced calorie intake or caloric restriction. In response, the body adapts by conserving energy and becoming more efficient in its energy utilization. This can lead to metabolic changes that support weight loss and improved insulin sensitivity.
  7. Cellular Signaling Pathways: Fasting activates various cellular signaling pathways, such as the AMP-activated protein kinase (AMPK) pathway and the sirtuin pathways. These pathways help regulate energy metabolism, cellular stress responses, and longevity.
  8. Inflammatory and Immune Responses: Some research suggests that fasting can have anti-inflammatory effects and influence the immune system. Fasting may modulate immune cell function and reduce inflammatory markers, which could have implications for immune-related disorders.

It’s important to note that the effects of fasting can vary based on factors such as the duration of fasting, individual metabolic responses, and underlying health conditions. While fasting can offer potential benefits, it’s recommended to approach fasting with caution and consult with a healthcare professional, especially if you have specific health concerns.


 exercise does the same thing. So let’s look at what the mechanism of action is of fasting. So the primary idea is we want to increase our metabolic switch, or our ability to switch between liver derived glucose and adipose cell derived ketones. The idea behind it is that during the fasted period, we are primarily using ketones as a fuel, similar to the ketogenic diet. And we are saving our

00:07:08    liver and our muscle glycogen for key functions of the body. So the idea behind intermittent fasting, or the research behind it is showing that intermittent fasting stimulates adaptive cellular responses. So what does that mean? It means that we have changes within the cell, and signaling to improve our glucose regulation. We see the body becomes more stress resilient, so it’s responses to cortisol and overt stress is reduced. We

00:07:38    see a suppression of inflammation, specifically systemic inflammation. And we also have an up regulation autophagy. So what autophagy is, is when we see cellular debris that is packaged up, and kind of let go from the cell for the immune cells to take it up, regenerate it, and see what kind of parts can be used for other cells in the body. And this is really to defend the cells

00:08:06    against oxidative and metabolic stress. So we have a high amount of oxidative stress when we are overly stressed to begin with, and we have a poor diet. And we also see a decrease in metabolic stress, because when the body is learning how to switch from glucose to ketones or fatty acids, there’s less stress on the body when it comes to fueling for the day. So this is the

00:08:32    outcomes when they’re looking at the research for the mechanism actions of fasting. So when we look at intermittent fasting, now remember this is not time restricted eating that goes with your circadian rhythm. This is according to the 12 on 12 off, 16, four, 20 hours of fasting, four hours eating, alternate day fasting, true intermittent fasting. We see the outcomes for men, and the population, again, remember is obese,

00:09:06    or sedentary, overweight non-active men. We see there’s an improvement in our insulin sensitivity. We see a decrease in the low density lipoprotein, or the, quote, bad cholesterol and triglycerides, or the free floating fatty acids. We have an improvement in autophagy, so the body is able to respond better to oxidative and metabolic stress. We have an overall reduction in oxidative stress. So that means there’s less damage to the

00:09:34    mitochondria. We see an enhanced verbal memory performance. So this means there’s an up regulation of parasympathetic drive, which again, we see an enhanced parasympathetic nervous system. Which means that men are able to get out of that tired but wired state, and be able to calm down and have more mindfulness responses. Now let’s have a look at what happens when we see the data for women. We see that

00:10:00    the data indicates no effect on insulin sensitivity. In fact, the women who were pre-diabetic, and started following various protocols of intermittent fasting actually tipped over into being diabetic. So it did not help with insulin sensitivity, and it had a very adverse response for pre-diabetics. We do see an increase in HDL, which is our good cholesterol, but there was no shift in our low density lipoproteins or triglycerides. So

00:10:28    overall, lipid profile does not improve. We see minimal to no effect on autophagy. We have an increase in oxidative stress. We have disrupted sleep, and disrupted sleep architecture. So there is less slow wave sleep, and less REM sleep. And we see an enhance in the sympathetic nervous system. So this increases women’s tired but wired, and inability to fall into a deep sleep, inability to reduce baseline cortisol, and

00:11:00    the inability to improve overall health outcomes, because their body is in a stressed state. So this brings me to exercise. We look at the data on exercise, specifically in peri-and postmenopausal women. And we’re looking at high intensity interval training, sprint interval training, endurance based stuff, and resistance training, or strength based. And this is in women who are trained in these situations of exercise. We see that it does

00:11:32    induce that metabolic switch. We see more uptake of free fatty acids, and better glucose homeostasis. It also stimulates adaptive cellular responses. Again, we see better glucose regulation, and this can come from a lot of the epigenetic changes I discussed in the training module. We see an increase in stress resilience, because we we have better ability to go from a high heart rate to a low heart rate, and

00:11:57    better ability to buffer cortisol and our responses to stressful situations. We have a suppression of inflammation. After each exercise about, we have an increase in our anti-inflammatory and antioxidative responses. So overall, it reduces systemic inflammation, and improves our body’s oxidative responses. We also see an up regulation of autophagy, which again, defends against oxidative and metabolic stress. Remember, exercise in itself is a fasted state. So all of these

00:12:33    adaptive cellular responses will occur with exercise. So for looking at women who are trying to lose weight, and often follow intermittent fasting because they’ve heard it’s a great way for losing weight. Yes, if you are not exercising, it can be a short term way of losing body fat. But for women who are exercising on purpose, it is not beneficial. It actually rebounds, and does the opposite of what

00:13:06    you want. So if you are exercising on purpose, and trying to lose weight, we want you to fuel for exercise. Remembering that women do not do well in a fasted state. It causes too much of a stress perturbation, and not enough signaling for adaptation. We follow time restricted eating. So we stop eating after dinner, and then eat breakfast. So we do have time overnight for the body to

00:13:32    get into that parasympathetic drive, to get into really good reparative sleep, which is where we have memory consolidation and physical reparation of our muscles, our tendons, our ligaments, our hearts, our cells, et cetera. If you are trying to lose weight, we don’t want to lose lean mass. So we have to aim for that higher protein intake, the upper end of a range. And then you want to look

00:13:57    at a very slight calorie restriction in the afternoon away from training. If you are training in the afternoon, then you take away a morning snack. But again, if we stop eating after dinner, and then eat breakfast, this calorie restriction most often comes from not grazing after dinner. Now, if we are looking for overall longevity and cellular adaptive responses, we fuel for exercise. Again, ’cause women do not do

00:14:28    well in a fasted state. And we follow time restricted eating, because exercise in itself, as well as fueling for the stress our body is under in the day, improves our body’s ability to be resilient to stress, and create cellular signals to improve longevity, telomere length, autophagy, glucose homeostasis, et cetera. So the outcomes for women who are exercising on purpose is not to follow intermittent fasting, or follow any

00:14:59    of the fasting modalities, because it is counterintuitive and counterproductive. We look at using time restricted eating, and fueling for when our body is under stress. Now, the other big hot diet trend is the ketogenic diet. And I have seen many late perimenopausal early postmenopausal women coming and saying, “My doctor told me I should be following the ketogenic diet “because of my body comp change.” Now, hold that thought.

00:15:30    Because when we look at the original population on which the ketogenic diet was designed, was for obese men who were primarily diabetic trying to lose weight for either insulin control or for surgery. The other aspect is looking at traumatic brain injury, and trying to recover from concussion, or other traumatic brain injuries such as stroke. And then we also have the really deep dive into epilepsy medicine that started

00:16:00    in the 1920s. Finding that when you’re using ketogenic diets, that you can control seizures, and sometimes eliminate them. But it is a very tightly controlled method, where hospitalization is required for the first three to five days to make sure the diet is actually adhered to. So the method and assertations for the ketogenic diet is trying to adhere to 30 to 50 grams of carbohydrate only per day, 75

00:16:30    percents from fat, 18% from protein. And the goal is to increase ketone bodies for fuel. So when we’re looking at this, this is primarily the reason why and the rationale why starting in hospital is necessary when we are looking from a clinical population, which is where this original research started. Because most individuals trying to follow this diet on their own fall short. But we still see this increased

00:16:58    amount of fat from diet, and all the ketogenic type products that are on the market. Are they appropriate for this diet? This is hit or miss, but let’s look at why people are looking to follow the ketogenic diet. Besides just body weight loss, we see an improvement on the use of fat for fuel, spares carbohydrate. We see an improvement in insulin sensitivity and glucose homeostasis. And of course,

00:17:26    it induces rapid weight loss. But again, it’s been done on men, except for two to three studies that were done on postmenopausal, sedentary, obese women. Most of the research that is done on postmenopausal women is because they have some kind of clinical issue, such as obesity, or cardiovascular risk factors, or metabolic issues. And this is why some women have been prescribed the ketogenic diet, because they need to

00:17:55    improve insulin sensitivity, and they need to induce rapid weight loss. But again, this does not hold true for women who exercise on purpose and need carbohydrate. So when we look at postmenopausal women who don’t exercise. So this falls in those studies that were done on the sedentary, obese, postmenopausal women. We did see a reduction in weight gain. It improves insulin sensitivity. It also reduced cravings and food, quote,

00:18:24    moods. So overall, yes, this looks good if you’re not exercising. But the flip side of it is there is an increase in cardiovascular risk factors. There’s a decrease in bone mineral density, and a significant reduction in the microbiome diversity. Now, if we think back to the module on the gut microbiome, we don’t want to reduce diversity. And part of the issue with bone density with the gut microbiome

00:18:51    dysbiosis to say, is it reduces the immune cells that are responsible for helping improve our bone turnover, and improve our bone mineral density when we start to lose that estrogen and progesterone. So when we start looking at women who are following the ketogenic diet, who are peri to post-menopausal, and they’re exercising on purpose. These are not randomized controlled trials. Those have not been done. These are small ins,

00:19:24    and there are many studies that are looking at peri-postmenopausal women who are relatively healthy. And they’re looking at the effect of the ketogenic diet on these women who exercise. Now, we see thyroid suppression. Not surprising, with low carbohydrate intake. And the satiation that comes with a high fat diet, inadequate calorie intake. So thyroid suppression within four to five days, similar to low energy availability. We have an increase

00:19:52    in cortisol, baseline cortisol. Primarily because the body is under stress. And unfortunately, there’s an increase in the visceral and total body fat. We also see, because of this decrease in our gut microbiome diversity, there’s an inhibition of the bifidobacteria growth, which we need for brain health immunity, and to help with preserving lean mass. And again, a reduction level of the immune cells, the Th17 cells, those immune cytokine

00:20:23    cells that are needed for bone density. So when we start looking at the outcomes for women who exercise following ketogenic diet. From the data, it appears to be more harmful than good. And from a performance factor, when we look at the ketogenic diet, we don’t need to teach our bodies to use ketones. We don’t need to teach our bodies to use more free fatty acids. Because women are

00:20:52    already at their maximum fatty acid oxidation capacity. Why, because we are born that way as XX, to have more protein within the mitochondria, to be able to use and capitalize on free fatty acid. We have the ability to have that metabolic switch by the nature of having gone through menstrual cycles, and having perturbations of estrogen progesterone that do change the body’s fueling across the month. And we know

00:21:23    that exercise is a stronger adaptive stress for insulin sensitivity, body composition change, and metabolic control. So when we’re looking across the board for women who exercise, again, the data does not support using the ketogenic diet. So the third one that’s often really popular now is plant-based. Now, there’s a little bit of history here around the plant-based diet. The original population was observational, so was not done in the

00:21:53    lab. And it was across the general population, so physical activity levels were not taken to account. The plant-based diet evolved from the ethical view of animal rights and extreme vegetarianism. So this is kind of a hold over of why we have vegan and we have plant based. So when we’re talking about veganism, this is the extreme vegetarianism culture, where there’s no animal products or byproducts use, and people

00:22:22    don’t use leather, they don’t eat honey. So this is the big cultural aspect of plant based. But when we look at the modern take out of the 1970s, and bring us up to 2022, the modern take of plant based is you’re eating mostly plants. So you have an eye to your plate being full of beautiful, fresh fruit, veg grains. And then some do have an accent of animal

00:22:48    products, of fish, beef, chicken, just lean small amounts. So they’re not totally vegan, but the idea is to be mainly plant based. When we look at the assertations from the data, being plant based increases weight loss, blood sugar control, cancer prevention, cardiovascular disease prevention, and improved recovery. This has to do with the amount of fruit and veg that is ingested having to do with more phytochemicals and better

00:23:21    fiber intake. We see an overall general physical and mental health improvement, primarily due to, again, the fruit and veg intake, and the phytochemicals that are involved. Not to mention the better signaling from the gut brain, due to better microbiome diversity because they’re being fed all that fiber. So we see that we have have weight loss, blood sugar control, cancer prevention, cardiovascular disease prevention, and overall better physical and

00:23:51    mental improvement, of course, but we also see there are some performance enhancements here. So if we’re looking at exercise. We see a decrease in oxidative stress. We have a decrease in inflammation, and of course, better gut health. Although we see these positive outcomes, there are still some concerns with plant-based diet, especially for women who are exercising. It can lead to low nutrient density, low energy intake, because of

00:24:22    the high fiber content and longer satiation. So women will eat a big amount of greens, but they’re not getting enough nutrition from that. They don’t have enough calories coming in, ’cause they end up being too full, and stay full for a long period of time. The other thing that a lot of people fall into is eating too clean. They’re very, very conscious of the food that they’re eating

00:24:43    and where it comes from. So they tend to eat in a narrow band, and can end up missing the mark on nutrient density by eating, quote, too clean. But we do see from randomized control trials of people who are following plant-based versus a normal American diet. You have improved blood lipid profile, you have better weight management, a lower cardiovascular disease risk factor. And then we also have the

00:25:10    conversation of environmental considerations, of being able to be sustainable. And this is a long cultural conversation that still needs to be had, that’s outside of the scope of this course. But again, being aware of people who are following plant based, it can be not necessarily for health outcomes, but also for environmental considerations. We do know from randomized controlled trials that this is the most efficacious type of diet

00:25:39    for women in peri-and postmenopausal timeframes. Because you have better insulin responses, you have less oxidative stress. And the thought is really because of the microbiome diversity. We see an increase in gut microbiome diversity, which is countering the natural response of a decrease around the menopausal transition. (cheerful instrumental music).


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