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Tag: blood sugar

Mini Pause #26: Fasting vs. Caloric Restriction: Which One Really Wins?

Posted on by stephanie-estima

TL;DR (Too Long; Didn't Read)

Fasting, it seems, is a very effective tool for caloric restriction. What it does not appear to be is a goal you should aspire to be able to do, say for 16 hours every day, just because the cool cats are doing it. It needs to be discussed so that you can choose whether fasting is an effective tool for you for the purposes of caloric restriction.

WHY

Fasting has been one of the premier topics in weight loss circles for years now. And there have been some extraordinary claims on its benefits.

Most women come to fasting as a tool for fat loss. But it doesn't seem to be the fasting in and of itself that is the trick, but rather fasting can provide a tool for you to reduce your overall calories.

A recent randomized control trial [*] concluded that fasting in and of itself did not confer improved blood sugar management when compared to caloric restriction. Meaning–it isn't the fasting (or the fasting window) that confers benefits to body composition changes–but rather that fasting allows for a reduction in caloric intake in a time-restricted feeding window.

Here is the conclusion of the authors:

“In the setting of isocaloric eating, time restricted eating (TRE) did not decrease weight or improve glucose homeostasis relative to a usual eating pattern (UEP), suggesting that any effects of TRE on weight in prior studies may be due to reductions in caloric intake.”

WHAT

The subjects were 93% women, with an average age of 59 years old.

The researchers split them into two groups: The first group ate throughout the whole day, and the second group consumed 80% of their calories before 1 p.m., with a maximum of a 10-hour eating window (or a 14-hour fast).

It is significant to note that both groups ate the same amount of calories with the same nutrient content. The only difference was when the calories were consumed.

After 12 weeks, there was no significant differences between the two groups in:

  • Bodyweight
  • Fasting glucose
  • HOMA-IR (a measure for insulin resistance)
  • Response to an Oral Glucose Tolerance Test
  • Glycated Albumin

HOW

Now, while this may seem damaging for fasting, we don’t want to throw the baby out with the bathwater.

Fasting can be an effective tool for some for reducing calories. If that is you, then you do you, boo! But I think it might be time for us to stop pretending that fasting has magical powers other than its ability to help restrict calories.

I also think there is something powerful psychologically about fasting. Many of us mindlessly eat and do not sink into our bodies to really see how we’re feeling. Fasting can certainly help with that, especially when your stomach is gnawing at you.

Now, do I think everyone should be fasting? No.

If you are a woman in perimenopause, your primary physical objective should be to build muscle. That means feeding your body proteins in the morning to stave off the catabolic effects of sleep and to make sure you are getting enough total calories to build strong bones and muscles. So for most women in their 40s and beyond, fasting until noon is a terrible idea.

In your 40s, you need to get AHEAD of the net muscle protein breakdown and the net bone loss that accelerates as we age. So caloric restriction, especially the aggressive kind, is not going to bode well for this kind of body recomposition.

That means you have to eat in the morning and sufficiently through the day to meet your caloric and macro requirements.

NOW

If you have found fasting to be an effective tool for controlling your calories, then keep on doing what works for you. No shame in playing the game that works for you.

Fasting is a boss at helping you reduce your calories, which can give rise to many benefits if you need to reduce your calories.

But, let’s stop pretending fasting is the only way we turn over cells (autophagy) and the magic for clearing up every ailment under the sun.

Question of the Week

Q: What time of day do you typically lift weights?

This question came in from withtanya on IG and it’s one I get pretty frequently.

My personal preference has always been to lift in the morning. A few reasons for this:

  • I feel accomplished first thing in the morning
  • Nothing for the rest of my day is going to be as grueling or as difficult as my workout, so it sets up my work day for better productivity, mood and focus.
  • I can close off the “mental tab” of my workout needing to be completed and doesn’t weigh on me over the course of the day and allows me to work on other aspects of my health that can fall by the wayside (like my steps!)

Now, is this the ideal time to workout? Research seems to agree that the ideal time for a workout is sometime between 12 and 4 p.m. This allows for your core body temperature to rise, and for appropriate lubrication of joints and tendons through natural movement. There’s also the likelihood you’ll have eaten one or two meals by that point, which allows for appropriate substrate to fuel your workouts.

I just make it work when I can make it work, and for me, that is the morning. Is it ideal, according to science? No. But it works for me.

I tried working out one day this past week at 2 p.m. because I wasn’t able to get to the gym in the morning. I had a good workout, but truthfully, I struggled. For no reason other than psychologically, I felt like I was “behind,” and it felt like a break in my cognitive rhythm of the day.

So for me, I have figured out that the morning works best with the commitments I have as a mother, and I have some marginal flexibility to move it if need be.

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at support@drstephanieestima.com.

What I Recommend

Annmarie Gianni Skincare

I frequently receive requests from my Bettys for natural skincare products that work hard for you and work with all skin types. Now, I’m so pleased to welcome you to Annmarie Gianni skincare!

I rotate through products of several brands depending on the time of year, where I am in my cycle, my skin condition due to stress or tiredness, and a host of other factors that contribute to what’s going on with my skin at any given time. I know you can relate!

Annmarie's products are clean, organic, and wild-crafted. They nourish skin and are full of supportive activated ingredients. They’re third-party certified through MADE SAFE®, which means their products have none of the more than 6,500 substances prohibited or restricted from use in MADE SAFE® Certified products.

Since summer offers unique skin challenges, Annmarie put together a Clean Beauty Trial Kit for you that includes Aloe Herb Cleanser, Anti-Aging Serum, Anti-Aging Facial Oil, and samples of Sun Love sunscreen and antioxidant lip balm. Click here to try it! You’ll find the ingredient list, botanical infusion process, and videos on how to use each product. Here’s to a summer of great skin!

P.S.

Requesting input from the Bettyverse! We're midway through the year with this newsletter and I'd love to hear if you find the information valuable and how you're using it. Also, what topics would you like to know more about, focus on, or have me dig up research on? Send your thoughts and ideas to support@drstephanieestima.com.

Mini Pause #2: How Cold Plunge Benefits Women

Posted on by stephanie-estima

Welcome to the The Mini Pause!

This is your weekly roundup of the BEST actionable steps for women 40+ who want to gain control of their hormones during perimenopause and menopause.

Last week we looked at oats and how they can be effectively used as a pre-workout fuel. If you missed it, you can read it here.

Cold Plunge: Is It The Same for Women?

TL,DR (too long, didn't read)

Cold plunges are a great tool for recovering from muscle soreness post-exercise and there is some evidence it may help with the appearance of cellulite. There are a few considerations for women to keep in mind if you are jumping on this ‘cool' trend (see what I did there?). Irrespective of the temperature, you want to stay in the water until you start shivering. Interestingly, women may not need to cold plunge at extreme cold temperatures to reap the benefits on metabolism and immune function.

WHY

Cold plunging has myriad benefits and one of the ways it shines is as a recovery tool. When you submerge yourself in cold water, it triggers several physiological responses in your body, such as:

  • constricting blood vessels,
  • reducing inflammation (which helps with muscle recovery), and
  • reducing swelling.

Anyone with an autoimmune condition or an arthritide like osteoarthritis knows how “hot” joints and tissues can get during a flareup and how welcome the cold can be. Women who run hot in the luteal phase of the cycle, or those who suffer from hot flashes, also may find cold plunging a welcome relief and a help with thermoregulation.

Cold plunging aids muscle recovery. This is incredibly important if you lift weights!

  • In the short term, cold plunges help with recovery from high-intensity exercise and endurance activities.
  • In the long term, it helps with muscle strength, muscle power, and even jump performance.

Another benefit of cold plunging is its stimulatory effects on metabolism. While you are in the cold tub and immediately afterward as your body brings your core temperature back to normal, you will burn more calories to heat up. Cold plunging liberates stored triglycerides from your fat depots and uses them for energy as you are trying to warm up.

Now — a word of caution — some online influencers have claimed this is the “single best way to get fat off your body.” This is simply not true. We are all subject to the laws of energy consumption irrespective of whether we cold plunge or not! And frankly, I'd argue that building muscle tissue is the single best way to burn fat.

I've estimated using this calculator that I burn about 35 calories while in the cold plunge. Using this estimate, a 35-calorie burn (and then a bit extra to bring your core temperature back up) is going to burn about 3.6 lbs on an annual basis.

In aggregate, this can contribute to fat loss when calories are controlled in your diet.

And finally, cellulite. While harmless, it's often the reason women don't wear the short shorts, the short sleeves, or the bikinis. While I think life is too short NOT wear what you love, there's some emerging evidence that cold plunging can help with the appearance of cellulite.

WHAT

For those of you wanting to better understand the science of cold plunges, the process by which cold plunges impact metabolism is by activating brown fat.

When brown fat is activated, it generates heat by disrupting energy production. The technical term is called “uncoupling” oxidative phosphorylation. This uncoupling is being driven by Uncoupling Protein 1 (UCP1), which is present in the mitochondria of brown fat cells. UCP1 uncouples (or disrupts) the electron transport chain from creating ATP, causing the energy produced through cellular respiration to be dissipated as heat rather than used for ATP generation.

When heat is being created, your brown fat utilizes stored triglycerides as a fuel source. It breaks down triglycerides into fatty acids and glycerol. Then, those are transported to mitochondria to be oxidized for heat production. This process results in the release of energy in the form of heat and the consumption of stored fat.

For cellulite, during a cold plunge the cold temperature is absorbed by the fibrous connective tissue, leading to the collagen being more soluble. This solubilization promotes the removal of the tight, non-elastic network that often contributes to the appearance of cellulite. As a result, the skin’s pitted texture diminishes, creating a smoother and more even complexion. The activation of fibroblasts in response to collagen solubilization stimulates the production of new, more elastic collagen and further enhances the skin’s overall quality.

So at what temperature do you set your cold plunge and how long do you have to stay in to get these benefits? Like most things, there are sex differences when it comes to cold response.

Generally speaking, women are more intolerant to cold than men:

  • Women get colder faster
  • Women start shivering at higher temperatures
  • The neurotransmitter and immune benefits seem to be slightly lower for women. That doesn't mean you don't receive a benefit — it just means your response is smaller than what occurs in men.)

Where you are in your cycle also affects your tolerance to cold temperatures and how long you can be in cold water immersion.

  • Generally, women tend to run warmer in the luteal phase of the cycle — from ovulation through to the first day of your period. Cold plunging may be a welcome relief during this time.
  • In the follicular phase (bleed week through to ovulation), you're typically more resilient to stressors. This can be a good time to play with longer plunges or colder temperatures.

HOW

Here are a few ways you can incorporate cold plunges as a recovery tool. I've outlined strategies at different price points for you to consider:

Cold Shower: This where my cold plunging journey started. I would take my regular shower and then the last minute, I would turn off the heat and stand in the freezing water for a minute. I may or may not have been screaming, crying, or both.

Ice Bag Baths: The next step in my cold plunge evolution was my bathtub. I would fill it up with cold water then top it off with ice from the gas station to get it extra cold. This was a better solution for a while. I could immerse myself in the water completely rather than being limited to the size of my shower nozzle. Over time, I did find the trip to the gas station cumbersome, and it was hard to control the exact temperature this way. If I over did it with the ice, I had to wait for the water to warm up.

Coldture Cold/Hot Tub: I invested in a cold tub when I knew it was a recovery practice I wanted to do several times a week for help with muscle recovery from my training sessions. I know I sound like a broken record, but in perimenopause, it's all about the recovery!

For those of you wondering, I purchased the Coldture Classic tub with chiller. I decided on this tub because:

  • The tub is portable and I can move it outdoors in the summer if I want.
  • The tub DOUBLES as a hot tub! The temperature range on the chiller goes from 3C- 40C or 37F to 104F.
  • I can turn it on and off from my phone.
  • The chiller gets the exact temperature.
  • The two-step filtration system keeps my water clean.

There are other cold plunge options without a chiller. I went with this because I like to have control over the temperature. (If you decide to check out Coldture, use code DRSTEPHANIE to get a discount.)

I have the temperature set at 13C / 55F and I’m in there for 11 minutes, or until I start shivering. Depending on where I am in my cycle, this can be anywhere from 8 to 12 minutes. As I continue to build out cold tolerance, these numbers will change.

The main point is this: irrespective of your method or duration of cold water immersion — you want to stay in the water until you evoke a shivering response.

NOW

Choose your cold adventure (cold shower, ice bath in your bathtub, or cold plunge) and ignore the voice in your head telling you to avoid discomfort. That's where all the growth, grit, and resilience happens!

Research on women and cold plunging is almost non-existent (surprise, surprise), but here are a few general guidelines for you to follow. Also, let your intuition guide you.

  • Aim for 10-12 minutes per week to start. If you are plunging 3x/week, that will be anywhere from 3 minutes to 4 minutes per session. Stay in until you elicit a shiver response.
  • Aim for the temperature to be 10C-16C / 50F-60F to start.
  • Towel off when you get out, and if time allows, don’t get dressed right away. Let your natural shivering response warm you back up. Truthfully, I'm only able to do this on weekends when I have a bit more time. I usually find my shiver response to last anywhere from about 15-30 minutes after the cold.
  • Note where you are in your cycle (if you're still regular). You might find cold plunging a welcome relief in your luteal phase. That's when you tend to run hotter and your tolerance for longer sessions is lower. During follicular phase plunges, the water may feel relatively colder, and you may be able to tolerate longer sessions.

Question of the Week

Q: I'm in menopause and my cholesterol and blood sugar have both gotten worse. Why?

 

Excellent question!  Let's tuck into it.

EVALUATING

Menopause, from a strictly hormonal perspective, can and should be viewed as an estrogen deficiency. Estrogen has a direct effect on our lipids by directly acting on the liver to reduce total cholesterol, to reduce LDL cholesterol, and to increase HDL cholesterol.

In menopause and in perimenopause you have marked changes in estrogen levels. This means that in an environment of reduced estrogens, total cholesterol and LDL cholesterol will rise, and HDL cholesterol will lower. And the jump is significant — most women will see a 10-15% rise in their lipid levels in their post-menopausal years.

In my podcast with Ben Bikman, he called women “metabolic superheroes” prior to menopause because of of this lipid-balancing effect estrogen has. Once you're menopausal and not taking hormonal replacement therapy, you can absolutely see a rise in total cholesterol and thereby increase your risk for cardiovascular and cerebrovascular disease. In fact, the female risk of cardiovascular disease in women who are 10 years into menopause tends to square off with the risk in men!

Our blood glucose similarly has a similar fate through a different path — your muscle. Skeletal muscle is the largest organ in the body by weight and is one of the primary regulators of glucose balance and homeostasis. Skeletal muscle is responsible for 80% (not a typo) of the glucose that circulates post meal.

As you age, the muscle desensitizes to the insulin signal from the pancreas, which has a net result of increased circulating blood glucose. Now, pair this with menopause, where you have a lower concentration of anabolic hormones like estrogen and testosterone, and this insulin insensitivity is amplified.

NEXT STEPS

The good news here is that you can always do something about it.

Women with a healthy weight and normal to high muscle mass are much less likely to experience the glucose dysregulation and dyslipidemia I described above. Maintaining or building your lean muscle tissue can be achieved through dietary or mechanical means.

Consuming protein (at a minimum of 1g/lb of body weight) is ideal for stimulating muscle growth. (There's a lot more to say about what kind of protein, dosing of protein, and % of protein targets in the diet. Look for that in a future newsletter.)

Mechanical stimulation is what you might have guessed — regular resistance training! You have to give the muscle a reason to grow! Lift weight as heavy as you can with as close to perfect form as you can.

I will be diving into far more detail on form and type of exercises in coming newsletters and podcast episodes. I have spent the better part of 30 years mastering this and, as you might imagine, have a lot to say about it!

Nutrition plays a role here too — specifically your fibre consumption. Women who consume 25-35g per day will positively impact cholesterol levels, and can offset excessive weight gain.

YOUR TURN!

I'll be answering your questions every week right here in the Mini Pause! Let me know what's on your mind. I'll be checking for both questions and feedback at support@drstephanieestima.com.

What I Recommend: LMNT

Healthy hydration isn’t just about drinking water. It’s about water AND electrolytes. You lose both water and sodium when you sweat. Both need to be replaced to prevent muscle cramps, headaches, and energy dips. This is especially true in winter, when your hydration needs actually rise.

I'm loving the new LMNT limited-edition Chocolate Medley for hot drinks. All three flavors, Chocolate Mint, Chocolate Chai, and Chocolate Raspberry taste great on their own or swirled into my favorite recipes. And the Chocolate Caramel rounds out the hot-drink flavors.

Visit drinklmnt.com/drestima to receive a free LMNT Sample Pack with any order.