Women Over 40: The Strength Training Plan for Muscle, Brain Health & Longevity | The Proof of Practice

0:00Today, we are going to be discussing the hot topic of exercise. All right, so I get to kick this one off and exercise, one of my favorite topics, passion for me and food to my soul. I think I am amongst other individuals, but there's a bit of controversy and overwhelm sometimes when it comes to exercise. A couple of key things I hope we can address today. I have women should lift heavy weights, talking a little bit about what that means and even

0:32does it really have to be heavy? Where do we start? And all just something that we have chatted about, thanks to my big bro who got me doing RDLs when I was eight, but just really thinking about what environmental things and even technology that we can use to leverage our exercise. So maybe, Amber, I'll start with you. If you want to give us some insight on how you use your technology, you have shown you use several elements of technology, how that helps you get started.

1:05Oh, gosh, that's a big question. I don't actually know if the technology helps get started. It definitely provides more anxiety and more questions. I have the Whoop, the Ultra Human. I've tried the Aura and the Garmin. The things that I find fascinating are how HRV changes throughout the month and resting heart rate changes throughout the month. The things I never pay attention to, and you were saying this about your husband yesterday too, is when my Garmin says rest day, normally I'm like, a few Garmin, I need to go for a

1:39run. And so even though I wear all of them, it's more about the curiosity on what data they're tracking. The thing that I do love is the community that comes with some of these, because I find that it's not so much, the personal data is interesting for me to see what the trends are with what my cycle is, and then what I'm doing in fitness and exercise. But the thing that motivates me is the community that comes with them. So things like the leaderboard in Whoop or the forum to talk to other people and to get

2:12tips. And that's more the data that I pull from the wearables that helps educate some of it. That's great. Yeah, I always hate when it tells me I need a rest day, because we don't need that.

2:24You don't need a rest day or you don't need them telling you? Exactly. Every day I feel pretty crappy. You just do it anyway. I'm using machine-splained instead of mansplained. Well, let's talk about that. So as a scientist, we add these wearables because they help with feasibility, but I'm not really sure what they tell us. And I know, Stacey, you've had some insight and used them when working with some of the athletes. Any insight on some of these wearables and what they're telling us? Well, I always question the algorithms, because the algorithms aren't designed for women's

2:54physiology. Even though they say they are? Right. Because like the heart rate variability for a woman, when you're seeing it decrease because progesterone has been expressed and it changes your nervous system, people automatically in the algorithm, whoever written the algorithm, it's like, oh, you're not recovered. But in actuality, you might be because they're not comparing no progesterone phase to a progesterone phase. So when you start looking at the algorithms and understanding that the actual algorithms

3:27are not really based on female data, what is it really telling you? Well, so let me ask you this too. We talked a little bit about hormones last time. What if I have a wearable and then I start taking hormones? I mean, what do I do with that data? Then you have to track over time because you don't know how those hormones are going to affect your autonomic nervous system, which is what HRV is based on, right? And the algorithms are tracking that and blood flow. So all of a sudden you're taking a higher estradiol or you put on a patch or something like that, or your oral contraceptive pill has a different formulation of estrogen.

3:59It's going to affect your vasodilation and your blood flow capacities. So that's going to come out in as a different reading in your wearables. So if we're looking at it as tracking over time and you can mark where you are changing your intake of things or travel, like whenever I'm trans-meridian traveling across hemispheres, WHOOP is always like, oh, you had a really good sleep last night because it's taking two nights of sleep. And when you take those two nights of sleep, it really adds up to one.

4:30And so it puts me in the green. And I was like, I am 19 hour time difference and I'm supposedly in the green. Like that doesn't work. So there's so many different schematics within those algorithms that don't work. And I think people get so bought into, oh my gosh, it says red, I can't train today. And when I'm working with athletes, I don't have them wear wearables leading up to major competitions or the end of a major training block, because I don't want that outcome to be influenced by what they're reading from a digital wearable.

5:04Can I ask you guys this though? Cause it tripped me up. My HRV a couple of weeks ago was 170 and I thought that I could rule the world. I thought that I could, well, I will never be the next Gabby Reese because I don't know how to play volleyball or any of those sports, but I thought it was amazing. And then two weeks later, 60. Do you change your exercise as those numbers change or? I look at it as how do you feel, right? So if you felt amazing at 170, go, go hit it hard.

5:37And if you felt amazing at 60, go hit it hard. Cause again, you're tracking over time. And then it's like, when did your period come in that? Cause some women will never look recovered the week before their period starts. And that's just because of the wearable is not picking up on the change of your natural responses to endogenous hormones. So this is where it brings it back to what we were talking about before is you have to really understand how your body feels. And if you wake up and your HRV says 170, but you feel like shit, you're not going to

6:10go hard, even though it says maybe you can.

6:14So changing and tracking change seems to be important. And I thought we would wait to talk about this, but it aligns something we were chatting about with was hormones and the impact on body composition and exercise performance. Gabrielle, maybe giving us some insight of, you know, integration of exercise and a lot of this noise around hormone therapy. With pleasure.

6:41Hormones change. Menopause comes, it's kind of like tax day, Christmas, I don't know, New Year's, it's coming. It just is. The reality then becomes, what do you want to do about it? Do you decide that you want to go on hormone replacement? Do you feel as if you need to change your nutrition and lifestyle? I will say this, how you enter transitions in life will in part determine your feasibility and ease of those transitions.

7:12The fitter, the stronger you are, the better your body composition is going through these changes. Great. But let's say you were super fit and amazing and then all of a sudden you go through menopause and maybe, you remember in high school when you're on the Twinkie diet? I mean, maybe you guys were not on the Twinkie diet. The Twinkie diet? Yeah. Like, tell me you ate perfectly in high school. No. No, I was in the days of carbo-loading. But, right, when you would- I was hanging out with ballerinas at Twinkie. Yeah. Okay. Well, for many of us, we would go to the local fast food restaurant for lunch off campus.

7:47It was such a big deal. If I ate like that now, it would not be ideal. It would not be a good look. You would be a completely different person. I would be, it would be a completely different look. Let's just say that. But when you're young, there's a lot of anabolic drivers. We are very nutritionally flexible. It seems that there's a period of time where it's much easier to build muscle, although you can always build muscle, regardless of your age. The transition between diet and exercise somewhat changes.

8:18And here's what I mean by that. When you're young, like our young kids, they are much more driven by activity and protein, bolusing is much less important. Obviously, they need good nutrition, but then as we age, we go through menopause or manopause, which is not really a thing, but you know what I'm saying. Nutrition becomes really important and also dialing in your training for the outcomes that you're looking for. We do. And I, you know, I really, you know, I try not to speak in absolutes.

8:49There seems to be a change in muscle. I don't know if it's aging. I don't know if it's a change in training with things like insulin sensitivity. Over time, it seems as if we become more insulin resistant. If, again, is it an aging phenomenon or is it a lack of activity phenomenon? But the question that, the original question was, what about hormones?

9:13Is hormone replacement therapy a treatment for body composition? No, it's not. Would hormone replacement therapy potentially have a role in protecting bone, heart, brain? Totally.

9:29Do we seem to sleep better when our progesterone levels are better than non-existent? Yes. All of these things play into the role of how you're going to go out and execute. And so that's how I would think about that in terms of, again, what your belief systems are. Do you feel like there's this idea of, okay, we're going to do it all natural? You can totally do that, right? It's body autonomy. People get to choose.

9:56So. I have to say also, when I think about this coming, sort of coming into this, then it's like we never give the respect to the layers added into our lives as we do get older. So we say to ourselves in our inner talk, oh, it's because I'm older. It's like, well, no, because now you've added a practice and now you have two children and now you're running in 50 directions instead of 20 directions. And I think part of this thing that doesn't get measured is how we process stress and manage

10:28the extras and also not a touch. If I forget something at this time in my life, I'll go, oh, am I heading towards a cognitive dysfunction or some kind of versus when I was 25, it's like I forgot their name. And so I think the other part of this with the technology, though, is really checking yourself how susceptible you are to buying into some narrative. It's like, that's just how it is. You're getting older. It's like, well, no, that's how it is when you're spinning 50 plates, whether you're a male or a female. And then the stress that comes with that, and then the impact of the stress, I think

11:02sometimes that becomes this invisible variable that none of us can get our arms around to go, where do I put this so it doesn't take me down? And one way to summarize is to exercise. Yeah. I mean, the one thing you can do. That's my medicine. Right? Yeah. I think a lot of people don't actually see it that way. It's a burden or it's hard to get started. And one thing to follow up with what Gabrielle said with aging and youth, can we define that? Meaning there's a lot of things that happen with age, but it does seem that things are

11:36accelerated, usually starting in your 30s, meaning that it's really important to take the time to prioritize things like exercise in your health. We talk a lot about our 20s. Maybe I don't want to go back to my 20s, but the 30s and into the 40s, into the 50s of really prioritizing exercise can have a dramatic impact for the time menopause or menopause comes. And then I would follow that up by saying in terms of what you guys have seen in your research, how do you give an exercise prescription?

12:09If you were going to say, okay, this is the bare minimum that you need to do to not be worse than yesterday. Um, not necessarily, we're not even talking about performance. We're talking about how do we maintain our physical functions? Does it always have to be harder? It kind of does, right? I mean, there has to be. So if, let's take Stacey. If Stacey's level is at a nine and a half, then she needs to do nine and three quarters and a 10 of difficulty, I'm asking, to get that next benefit.

12:41Does it always have to be harder in a strategic way? Not harder, I beat myself up, I crush my joints. Just harder in a, in a strategic kind of thoughtful way. I mean, physiologically, no, it's all about consistency. Oh, yes. So the more. This is good news. Well, and I mean, I think we are at an advantage and privilege of we've trained for many years. So now you don't have to put as much in to maintain. Now, if our goal is performance, a little bit different. So no, consistency is where I would start. So go back to your question of doing something if you haven't done anything.

13:15And if you do something every day, maybe a little bit harder or more volume. Yeah, I always look at training history. If someone's like, oh, I do this, this, this, this, this. And I'm looking, I'm like, okay, what's missing? And a lot of people are just doing way too much volume at not a good intensity. So if you can take the volume down and increase the intensity and making it harder but less volume, then they start to see change. And my question would be for the listener, for the viewer, what are things that you would recommend that is, okay, this is the outcome for VOT max or this is the outcome for muscular strength.

13:48You know, as exercise physiologists, which you, you know, you guys are, what advice would you give to the general population? I, you know, bring it back to the just starting to move. It's like I always look at it, and I've explained this before, where you have four areas where we look at the mindfulness or the awareness of being present. You have sleep, you have physical activity, and you have nutrition. And if you're not paying attention to your stress, then your sleep suffers.

14:21If your sleep suffers, you can't really make any kind of change. So if we're talking about physical activity and how we get started, it's not about the measurement of strength. It's about, okay, how does what you do improve your sleep? Because if we're improving our sleep, then we can make mindful changes because we have a better stress resilience. And I think this is where people are like, oh, we have to look at VO2 max from a lab point of view. I always look at VO2 max as quantifying participants. Are we at the same fitness level?

14:51And now what's out there is everyone needs to boost their VO2 because there's some evidence to show the higher VO2, then the more resilient you are to stress, the better that you live. It's like, but how can you really measure VO2? You can't unless you push yourself really, really to your absolute max under controlled lab conditions. So I wouldn't tell someone you need to go measure your VO2 max unless they're being a lab participant. As strength, it's like, okay, well, what can you live today? And then what can over consistency do in three months? So again, it's a tracking thing.

15:22Every little bit of strength that you increase and the better aerobic outcome you have or anaerobic outcome, the better you are at stress resilience. And that's what it comes down to. How do you measure those outcomes, aerobic and anaerobic outcomes? Oh, you can do a basic time trial on the treadmill, right? You can see, okay, what's my 5K pace? And it could be walking, it could be running, or what's my gradient? How high can I go before I tap out? So there are individual markers that you can put down. So if I'm not a runner, I'm not going to do a 5K run on the treadmill.

15:54Maybe I'm going to see kettlebell swings. Like how many can I do at 16 kilo? Oh, I'm really good. I can do 25 nonstop 16 kilo. How many can I do with 20? I can do 5. Okay, well, I'm going to move up and work to see if I can move up to doing 20 or 25 with the 20 kilo. So there's those variables within, and you're going to be able to measure your anaerobic capacity because doing 25 kettlebell swings is that top end and it's hard. I love that.

16:26You said something that I want to double down on for just a second, which was exercise as a prescription. And I've been looking at a lot of the trends in spend on Ozempic and other obesity drugs. And then the cost of obesity, obesity is higher than it's ever been before, mental health worse than it's ever been before, which is terrifying in the world. And the thing that I'm excited about is things like TruMed or using pre-tax dollars for fitness. Are you all seeing this come through in your various practices with people knowing that they can use that to get started?

17:03Meaning, I feel excited because I think that if people can have low to no cost of entry in fitness, they'll get started. But maybe that's a farce. I like it from an economics perspective. Are you seeing any impact on that where people are actually looking at exercise as a prescription? I think that people that are interested in body composition and longevity always do. I don't know if we have great answers. I mean, I'm curious as to what Abby says. When our patients come through, we want them doing some kind of resistance training.

17:35Three to four days a week, it's non-negotiable. If you want to have a good metabolic profile, we need you to have healthy skeleton muscle. Period. End of story. And that would be a prescription. That's like, okay, well, we want your blood pressure to be 120 over 80. Let's rock and roll. Then, you know, from our perspective, what we believe the next step would be would be some kind of high intensity, maybe zone, I wouldn't say zone five, but some kind of thing where people are breathing heavy for a period of time.

18:06And I think the data is really good. Again, we do not typically recommend long endurance unless you love it. I mean, my husband is now into running marathons. Oh, really? Which by the way, yes. What happened to high rocks? Oh, that's his next thing. But he wants to do all the marathons. So he's doing Chicago next, his Germany. The big seven. Yeah. He's doing something like that. They just added Sydney, which... Don't tell him. Just please. He can still get the six without the seven on there. But again, endurance, this whole zone two moment, the moment, I think that there's other

18:38ways to get to that outcome. And I think the data would support that. Resistance training, some kind of high intensity, whether it's breathing heavy. And then, you know, I'm happy with those two things. I'm sure that there are other things like various planes of movement and all these other things. But that's what I want. Yeah. For non-negotiable. Yeah. And I'll say one more thing. Progressive stimulus. Yes. There is, yes, progressive overload. But for example, my 72-year-old mom, I don't necessarily need her to push another plate

19:10on the sled. I might want her to increase her volume or, I don't know, increase her rest periods or whatever or increase another day. It doesn't just have to be load and be creative. Yep. I think you mentioned something important, and this will come in with nutrition. But if anyone's saying only do one mode of exercise or remove others, it's a bit of a red flag. And when we think about, yes, everyone should be doing resistance training and doing some sort of aerobic work, I also agree that, you know, prioritizing higher intensity is going

19:43to give us a bigger bang for our buck. But we also have to remember feasibility. So if you enjoy running, then run. I think it's that other. If you don't enjoy resistance training, I would still say lift. Yeah. Yeah. Learn to love it. Well, again, I mean, have you ever done a workout and said, oh, I wish I didn't do that? Yes. I know. I think that I probably have. We probably could do it too after. Yeah. Yes. What you've realized, too, on all of this is that no matter what you're going to do, with the exception of running, because I think a lot of times it's people's alone time,

20:16they get to huff and puff, they're outside typically, so they're in commune with nature. I think there's so many things that are impacting runners that they don't realize that are impacting them. But as somebody, for example, who I don't want to run a long distance anymore, I've done a lot. Nor do you have to. And my lover, I mean, I have a fake knee. It's like there's a whole bunch of things. And it's understanding, okay, there's ways to huff and puff for a long period of time not doing that. But ultimately, a lot of you can get it done on your own, but I'm still going to go out on a limb and say that each of us still has an ally, or you recruit allies.

20:51Like, hey, there's days you have to do it alone. But if you're just starting, you're never going to work as hard when you are alone, and you're never going to really push it. So I think on that, no matter who you are, you still have to have that community. Even if it's just someone in the space with you, I think that's what can be good about a gym. If you go into the gym by yourself, but there's people around you kind of working hard, you think, man, I don't have it, but they're doing it. I'm going to do it. I'm going to represent myself. Even if you have to use ego, I'm going to represent myself well and show up here and

21:23do it. But it's that reminder. People think that they can do this in an isolated way. And there's very few people, very few, that can really do it alone. And so in that, no matter what you're measuring or gamifying, unless you are a real serious runner, I think it's, I mean, you meet people at the gym, you have someone eyes on you. I don't train by myself unless I absolutely have to. So let me ask, because I feel like, so I unfortunately train by myself for way too long.

21:54You're like an anomaly. No, but I think I'm thinking part of this collective, right? So we inspire others. Like you don't have to be in the same place, but I think you can do that too by, like, I'd like to know what you do for your training as a former elite athlete. What do you do now? I do when I can get in the pool three days a week of a pretty rigorous ballistic training, but it's in water, in deep water. So I can be explosive and not crush myself. It also creates an environment where I can do a lot of hypoxic training, you know, hypoxia

22:25training. So I'm, the other interesting thing for me about water, and I know a lot of people don't have a great relationship with water. I coach a lot of people in water. I've seen a lot of things is the most objective feedback that you're going to get because there's, there's environments, there's drills in the water that the only difference of me getting there and back with no breath is this. It's the width of my eyes. It's the amount of tension of holding your dumbbell. So it's so nuanced, but it's always objective. It's not like, you know, I really like Stacy, so I'm going to give her, you know, good job.

23:00You know, it's, it's like, Hey, this is where you're at. So I like that environment for that. It is very stressful, but yet not so physically. So I get to tap into the human organism. And then I do a form of HIIT training three days a week. So I'm, you know, jumping off and getting some impact, lifting some weight, working on one leg, trying to be fatigued and then coordinated. And that's pretty much all I have time for realistically. So I think people think you, like you said it earlier, you have to kill yourself.

23:31Yes. There's kind of pockets in there that, man, you got to be like, Whoa, that's hard. And then it's really about being thoughtful and creating something that you can get done. What, what is ballistic and hypoxia? So when, a lot of times what happens is we either never start jumping or doing sort of really hyper explosive things. And as we get older, we have less opportunity, whether it's the environments we're in or, or whatever. And then we, then it hurts. So we stay away from it. And so for me, this is a really important part.

24:04It's like why they like resistance training, being explosive. These are connected and intertwined. And so jumping and moving in this way, but it's hard on land. And so that's why I like the water. It's, it's an adaptation to how do I do this till I'm 80, 90 and beyond. And also, you know, people getting it done is definitely one part of it, but sometimes being in a different environment that makes you feel good while you're doing it. And so that's why, like when you're running and looking at trees or, you know, going on

24:37your mountain bike and you're seeing all the rocks and doing that, this has an impact on our system that is hard to quantify, but it's so real. So the water, also the blue, I can go down 11, 12 feet and I look up and I'm surrounded by water. It's pretty interesting on the system. There's something you said too. There's a really important functional outcome that happens as we age. We lose our type two muscle fibers, those inability to kind of attract those larger motor units that you get from that type of training, which is really important for just quality of life,

25:09being able to, to move, prevent a fall. And so, you know, for. And brain health. And brain health. Yeah. But so like for those of us like that, like to run, you also need to do some of that explosive work just for longevity, health, fall prevention, mental health. Yeah. I think that's where the community comes into because like Stacey led a crazy two hour weight lifting session yesterday, which was absolutely amazing, but I wouldn't have done that without a partner or a community or a recommendation.

25:41And I like that. I had one question on that though, because we were talking about this walking out of the gym where I said, I feel like I have more confidence than I've had in weeks. And it was just after tons of weights. And you said that there were some differences in that. Yeah. Because I mean, when we look at resistance training, the whole action of nervous system is involved in a way that isn't when you're doing metabolic, like aerobic type work. So we're looking at resistance training and creating a stimulus of neural pathways and what we call neuroplasticity, where the brain's learning these pathways or learning how to recruit

26:16more fibers for muscle contraction, it creates an environment in the brain where we have an increase in dopamine and serotonin because it's like, oh, I'm under stress, but I need to do this. So how do I counter that incredible amount of stress in the brain? So when people leave and they've worked really hard from a central nervous system standpoint, they don't feel that same complete exhaustion that you get from a high intensity interval training or really long run because it's not as metabolically taxing, but you feel that

26:49elation and that I can do this because one, you've pumped up all your muscles. So you have that part of you, I feel swole, but the other part is the aspect it has on the physiological responses of the brain and how the brain is changing to encounter that stress. And this is why I'm talking about like brain health, not only is it mental health, but when we're looking at increasing the neuroplasticity, increasing lactate production that women need for brain metabolism, those are two key things for attenuating Alzheimer's and dementia.

27:25And so when we're looking at what are we doing for exercise? Yeah, we can talk about how physiologically it makes us feel or look better. But for me, it's about brain health and looking at how can I improve the utilization of everything around and in the brain? And that's the strength training component. Can I go back to something you said? You said you guys did a two-hour workout. Maybe that's why my guns don't look like yours. Oh, we'll quantify it. The first was some TRX stuff and we misinterpreted the workout.

27:59No, no, that's great. And then the second part was just a little bit of a circuit. So we were in the gym for two hours, but we didn't work out. Yeah, not back to back. Well, so let me ask you this, like maybe we can go, how often, how long do you train every day or most frequently? Because I know I do not have two hours. Gabrielle, how long do you train? Three to four days a week for an hour. And then the other days I do something, at least 30 minutes. What's the other? What's the other when you say that? So three to four days, typically three days a week are solo, full body movements.

28:35Saturday, I have more high intensity interval stuff like the airdyne. Maybe I'll throw in some skier, just some really fun stuff, maybe some bag throws, just things that are really fun. I probably will get myself injured, so I try to just do that on Saturday. The other days, for example, yesterday my schedule was crazy. I did 30 minutes of cardiovascular activity. But I will also say that I incorporate physical movement into my day. What does that mean?

29:05When my kids come home or we're at home, we're doing yoga together, we're playing with kettlebells, we're doing things that are in motion. It's not this isolation. This is exercise and this is life. I think that's super important. Yeah, we're going to go walk. I don't know. Maybe we'll throw on a weight vest. Maybe we'll go do something. If it looks ridiculous, we'll probably do it because it's just fun. We're going to have to come back to the weight vest. I know. The girls want to talk about the weight vest. You want to help you do everything. Yeah, but still I want to hear how long do you train every day.

29:36Oh, so when I'm at home, super busy, right? So Monday, Wednesday, Thursday is all strength training. So I go to a class that's strength development and that's kind of my people. And then Friday is a metabolic conditioning. And then Saturday is usually a long, really slow gravel ride or mountain bike ride. And then Sunday is arbitrary. So the strength class is usually about an hour? Yeah. Okay. Yeah. And I'm curious, are you doing more high intensity or are you doing squats or how are you loading

30:13yourself? How's it structured? Yeah. So I was looking at yesterday's program and we had three by five and two by six for squats. So is it CrossFit-ish? No. Okay. Well, it's in a box type gym, like it's in a functional fitness place, but it is about proper strength training and periodization. And so you have the major focus of squats and then you have two separate workouts that complement what you've done.

30:43So all up, you might finish with a high intensity 30 second on one minute off kind of thing, or maybe it's six minutes as many rounds as possible of three different exercises. So it's a full strength focus and then it finishes with a little high intensity work. I'm glad I asked and I'm sure you guys were all thinking that because in my mind I'm thinking, okay, is it Orange Theory? Is it? No. Right. See? And I knew it wasn't going to be. And I think it's important because I'd love for you guys to speak on the idea, do we – and I don't want to open up a can of worms, but I think that it's the listener and the viewer

31:16needs to understand, do women have to – or men have to lift heavy versus could they, as long as their volume was good, let's say they don't want to lift heavy but they want to put on muscle, could they lift lighter, not hurt themselves? It's age dependent. We see like in younger women, I'd say you can get away with almost anything. You can play around. But as we get older and we have more of that anabolic resistance, you can look in – I know we've talked about science previously, but if you lift a failure, you'll get some

31:51hyperplasia, so you'll increase your lean mass, but it's not strong. Whereas if you're working specifically on strength, you're going to get that central nervous system and that strength response and some lean mass growth. So if we're talking about bang for buck, I'm always pushing women to lift heavier and lower volume because you're going to get both. Whereas if you're doing too fatigue, yes, you're going to increase lean mass, but it's not a strength component that you want. Have you also found that? I would say, yeah. I mean, we think about it maybe slightly different.

32:22For muscle mass, it does include some volume that's required. And some people can't lift heavy every single day. And what does that mean? So even integrating a heavier day with some volume more frequently or periodizing it a little bit is important regardless of age. And there's good data that says lower weight, higher volume can be helpful. I don't have time for that. Um, some people don't, and we have to do worry about joint, uh, on the same opposite end of

32:53lifting heavy, sometimes lifting heavy, if you do it incorrectly can cause some back injury, et cetera. So I think I know as a scientist, I really want to define what is heavy and what's that minimum threshold. I do think it will depend on someone's training age and how long they've been lifting and experience, um, but also helping to not do the exact same thing every time. Like that load and variability can be really helpful. Yeah. I often, like I get questions about that all the time because I'm notorious of saying lift

33:24heavy shit and I don't ever want someone to say, oh, I heard that I have to go lift heavy and they go and they get injured. I was like, it's a phase in. So maybe you do have to start with 10 to 12 reps and learn how to move the body and learn how to lift. Cause really it takes a year to 18 months to learn how to lift heavy properly. And it is a learning curve and it's like, okay, well first, how does your body move? What's your range of motion? Where are the sticky points? How are you going to get injured?

33:55Well, we don't want you just to do body weight. We want you to add load. So as you're learning how your body moves, you're also adding load and periodization like you're talking about. What about cluster sets? People are like, what are cluster sets? It's like, okay, well maybe you do two and a pause, two and a pause, two and a pause. Then that's six under heavier load than you would have been able to do if you were trying to do a straight six. So there's ways of manipulating to get what you want, but trying to have a blanket statement of you have to do X on Monday, X on Tuesday, X on Wednesday, it's totally off the table

34:30because you can't. Another practical takeaway we've used in the lab a lot is using six to eight repetitions as our goal. And if you do up to 10, then adding more resistance or load so that as your muscle adapts is, I mean, there's a lot of ways to approach it, but how do you quantify heavy? Well, six to 10 reps, you shouldn't, if you can do more than that, then the load might not be heavy enough, would be heavy. Do you use reps in reserve at all? Because every day someone comes in, they feel a little bit different?

35:02Yeah. Or we track that. So then if they have additional or can do additional reps, we would increase the weight. Can you explain what that means, reps in reserve? So it's a way of quantifying what that load is on your body on the day. So if you go in and I say, I want two reps in reserve, so that means you do six and you could possibly do two more at that load with proper form before you're taxed out. So that's a heavy load. If we say we want five reps in reserve, maybe you're doing six reps and you're like, yeah,

35:36I can do five more without a problem. But it's a way, it's kind of like sessional rating of perceived exertion, but for quantifying load, because people will go in and say, oh, I couldn't deadlift that 100 kilos today. Why couldn't I? Well, what could you do? Could you do 90 with two reps in reserve? Yeah. Okay. Well, that's a heavy load and your body's going to respond appropriately. Somebody said this to me once and I thought it made sense that the body doesn't know the number, it just knows the load. Right. And I think that's super important. And I actually would say that to men more than even women.

36:08They get so caught up in the number, it's like your body only knows work. And that's, I think, really important to go in with that feeling of don't worry so much about the numbers. The only other thing in coaching a lot of people is most people, and I'm always navigating this, don't have correct form. Nobody, very few people, it's like why I love Kelly Starrett. I'm like, you know, F you and your squat form. You know what I mean? Like very few people have that, you know, spine or yeah, it's like, okay, congratulations.

36:43So I think what I'd love to hear from you guys is for people who aren't even aware they don't squat correctly, what's the best integration of that? Because as you load, that's really where you want to be dependent on that good form.

36:58Well, before we do that, I really want to understand. So the, from what I hear that you're saying is that heavy is relative, right? Is that what I'm hearing you say? That it's, that we could, because I come from the geriatric, so I did my fellowship in geriatrics. So I was always thinking, okay, well, what is the data for this group? Maybe some of them have trained, some of them haven't trained. And the, what we saw was whether they could lift heavy, which would be relative to them,

37:29but they could also lift with higher volume, lighter weights, and they would still get the same result. And I think that there was this strength hypertrophy continuum. So how do we, how does a listener think about it? Because they're at home thinking, okay, so I have to lift heavy, but do I, or couldn't we just, you know, wouldn't 10 reps be adequate for if their outcome is maintaining or building mass? Like maintaining strength, maintaining muscle mass, or even building.

38:03I also look at the brain component in the older population, right? So like I was saying with the strength training, if you're working central nervous system, which are the, the heavier loads, lower reps, then it, it does play in the neural pathways. And it really does help with the dementia and the cognitive decline. If we start going higher volume, lower load, then it's not as taxing for the central nervous system. So you reduce that neuroplasticity. So if we're looking at what are the outcomes, yes, we want mass, but for older individuals,

38:34it's so important now with cognitive function that if we start implementing a dual aspect of the exercise to improve the neural capacity and the neuroplasticity, as well as developing the strength, then I'm always going, okay, let's go to the heavier weight, lower load, because I want that central nervous system response. And we see in some of the research coming out in the older populations where they're all like, can't lift heavy. It's scary that given the opportunity with proper guidance and machines and the relative

39:09heaviness that they actually do a lot better and have better cognitive function if they're lifting the heavier loads and not as many reps. And you, but you're saying you came back to like, we're talking about like optimization versus maintaining. And so you asked 10 repetitions. Can you get benefit from that? Absolutely. Like resistance training is anabolic. So I feel there's a lot of nuance, but at the end of the day, picking up weights and with some proper form is going to be really important. Yeah. And that's where I think the machines, because I was always, I wouldn't say opposed to machines,

39:43but you know, you're always kind of guided away from them. But I'm not sure one, I think it was you maybe who would have told me years ago, like, hey, if that's the better, safer starting point. It's all high ground. And that comes from Dr. Pat Davidson. Yeah. We use machines all the time. Yeah. And we use machines in research. I don't know if you guys, but we... I'm not making anyone squat in the lab. Now I'm going to put them on a machine or a leg press. And they're really, and right now we, there seems to be this influence that machines are

40:14bad. You have to do, you know, in my mind, all training is functional training. It's, you're not trained to become better at exercise. We're trained to become better at life. Yeah. Whether it's machines or you name it, squatting your kid, fine. But machines allow for proper form, very low injury risk, risk mitigation. Only if you can get the machine to fit you. I was just going to ask that. And that's the problem. Where most of the machines have been designed for a six foot tall, 180 pound guy.

40:48I put in the booster chairs all the time. Yeah. There you go. But that's not readily available. That's the thing. I mean... I'm too long from a lot of the machines. Yeah. It's always interesting. I get pinched on some of my angles for sure. So you just work to give it a workaround if you're on the other sides of the... Yeah. On the other spectrum. Yeah. I mean, I've said this before. It's like, I'm not a huge fan of Planet Fitness, but I am a fan of the fact that it's a low barrier to entry because the cost is low and they have machines. There's no real free... Well, they have dumbbells, but there's no lifting platforms.

41:20They might have a Smith machine, might not. But it's allowing people to get in and experience resistance training in a very safe gym environment, which then opens up the doors to, if they are interested, to move forward in that resistance training. But I like the gym analogy and the gym piece too, because you can ask people to help. Hopefully people ask. There's so many people that want to tell you what to do in a gym. Yeah. There's so many coaches. Sometimes it's the wrong people. Yeah. Well, that's why I like working out with a buddy. It almost feels like a play date at the gym a little bit.

41:52But I do think it's important to ask and ideally ask someone who works there how to use it. Because to your point, there's a lot of people who want to tell you what to do and they might not always be right. But my son would kill me for sharing this, but his buddy just flew off backwards off of a roll machine because he didn't know how to use it. All he had to do was ask and it would have been way safer. It will never happen again. Is that a 15-year-old boy? Yes. Yeah, I think that explains a lot.

42:24Well, you know, like my daughter's experience now, like she's seen me and strength training and she's always like, I want to be strong. And she's not, well, she's strong, but she's not that way inclined to be in doing stuff. But for a work project, I have her now enrolled into a strength training program that's being coached by one of my friends that she idolizes, as well as another girl who's very similar with sport. She came back from the first session fizzing. Oh, I love it.

42:54It's so fun because I got to work out with a friend. Yeah. And it's a community thing. It's the friend part. I was just going to say that. Did you guys hear Dr. Stacey Sims and Dr. Gabrielle Lyon pay someone to help work them out, which I think is really important. Even when you know what to do, it's that community. Absolutely. Yeah. And speaking of paying for things, something that would be helpful is to pay someone for some guidance. You mentioned you use a weighted vest. I feel like everyone is buying those things right now. I use weighted everything. So that's not fair. I know. I can buy weighted clothing.

43:25You guys need to be able to wear that. Yes. They have those workouts. I'm not joking. I have that too. You're also a little different. So what would you tell your patients to first step buy a weighted vest? No. I mean, the first step would be – She's setting you up. Oh, she is? No, I'm not. I wanted you to ask all of it. I don't mind you because we're definitely going to close out, I think, on what you feel is the best because I do believe that that's really important in terms of training. I believe that moving with load should be just part of every day.

43:58I mean, whether it's with a weighted vest or you're carrying your groceries, I don't care. Just bring it. The first thing that I would tell someone to do is you have to resistance train. A weighted vest is not going to do what we need it to do. Just like – by the way, people hate when I say this – walking isn't going to do it either. Right. Walking will maintain your type 1 muscle fiber, but it's nothing for what we are looking at for aging. That doesn't mean to say walking is bad, but is it going to maintain the mass that you need, the strength that you need?

44:30It's not. Now, but yes, please buy me weighted vests in all different colors. I will take them. I will take rucksacks. To close this out, what do you feel if you were to give a recommendation for the general population for exercise, for the beginner, and the continuum training? What does that look like? I mean, I would start with do anything that will help you prioritize exercise. And maybe that's paying for a class or a personal trainer. Figuring out a way to add it into your day-to-day.

45:02And then there's lots of approaches, but definitely add some resistance training. Does that mean you have to pay for a gym membership or someone to teach you how to squat? Maybe. And then adding in some sort of aerobic exercise, usually intensity. I would ask yourself, are you breathing heavy and are you sweating? And if you're not, you probably need to do that. And one final question, do you care about the lifts? Should it be full body? Should it be sprinting for high intensity? Can it be airdyne?

45:33Take me through kind of the actual movements for the resistance training component. So this is just one view, one opinion. I mean, it doesn't really matter. I would say if you can get the larger muscle groups, that's what you want to do. And you can do that in a lot of ways. So arguably full body is the biggest bang for your buck. If you only can train a couple of days a week, then that's what I would recommend. And the high intensity interval training, do you care if it's jump ropes? I don't know, sprinting, I don't sprint.

46:04No. Barodyne, yeah. Barodyne, yeah. Barodyne. Anything that will, yeah, will motivate you or get you. What's the gentleman, he does the jump rope, but he has a system where he actually has just handles for people who don't know how to jump rope because it gets you to shift your weight and coordinate your patterns. So there's some interesting tools out there if you want to start jumping rope. Which is a low cost entry. It is. You can do it in your office. That's right. And Abby was talking about when we were talking offline that really one strategy would be a

46:37minute on, right? You go for a minute and then, I don't know, is it followed by a minute rest? Yeah, a lot of our work has looked at a minute on, a minute off for 10 times just because it's very feasible and very effective. You can do anything for a minute. So yeah, a minute hard, something that you couldn't sustain for a minute and 20 and then rest a minute. And that seems to be very doable and lots of different populations. I think that's great. So basically, the summary here has been train. There's no excuses. It doesn't have to be perfect, but you have to get it done. With a friend, I guess.

47:08With a friend. With a swim buddy. That's right. With a swim buddy. Swimming. And making sure that you're doing resistance training three to four days a week. Doesn't matter how. Can I ask you one last thing to put in this wrap up? And this is for you as well. A lot of times you'll hear, we've talked about this, when you're a young woman, it's better to work on skills before loading up. What age is it like a decent starting point to start to really explore adding load and lifting? And I know it's going to, you know, change one year or two.

47:40And if you have athletes, they have to do what they have to do. But in general, when is it kind of a safe time to start loading up the body for a male and for a female? For a girl, we see so many biomechanical and physiological changes that occur at puberty. I mean, it starts at around eight years old. And no one tells us about how girls' bodies change, which is a reason why girls drop out of sport. Because they feel ungangly. All of a sudden, their arms and legs are a lot longer.

48:10They're putting on body fat. They can't run as fast. They can't do the monkey bars. So I really try to implement, quote, functional, but kind of functional training where they're relearning how to move in their new bodies. And maybe that's with resistance bands. Maybe it's with a dumbbell. Maybe it's just body weight. But as they start to learn how to move in their new body, then you can start adding load. And again, it's individual age and maturity is very individual. For little boys and boys going through puberty, they don't have the same biomechanical changes.

48:44So you're adding load as maturity dictates. Great. I mean, I am not an expert in any kind of pediatric training at all. But I will tell you what, for our kids, we let them pick up heavy weights, heavy relative to them. Is their form great? No. But they seem to be very pliable. And I would rather have them. They're going to know what to do. I mean, I believe. And, you know, as far as sports go, we have them in jujitsu, three and five.

49:16Perfect. Five-year-olds could, three-year-olds, yeah, not so much, but he'll get there. And that way, they're just figuring out how to move their body. But I will say one more thing. As parents and just the landscape of children growing up, nobody thinks twice about a kid on the iPad. I know. Or eating Doritos or any other stuff. But then when you let your kid work out, you're thinking, oh, my gosh, I cannot believe you're going to stunt that kid's growth. I'm like, my kids are going to be short anyway. But, you know. But it goes back to your question. There is no too young of an age.

49:48Yeah. It's just all perspective. And humans are really interesting. When we hear a narrative over and over again, it becomes truth, whether it is or not. So don't allow kids to strength train until they're 16 because you'll affect their growth plates. Really? Where's the research for that? Like, there's so many of those myths. There isn't any, to be clear. There is not. There isn't. Yeah. Well, thank you, ladies, so much. I know that this is going to be invaluable for the public.