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

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 #25: Try MyoReps for a Time-Saving Strength Routine

MyoReps: The Answer for Muscle Hypertrophy When You’re Short on Time

TL;DR (Too Long; Didn’t Read)

When you’re in a pinch for time, structuring your workout in MyoReps is an efficient way to build muscle. They are intense! And for the majority of the session, they work the muscle close to muscle fatigue. These were lifesavers for me on a recent trip to Europe where I was pinched for time, jetlagged, and needed to get in a good working session.

WHY

MyoReps add variety to your existing routine and keep you working out when your time constraints don’t allow for luxuriating in the gym.

The theory behind the technique is that it helps athletes to do more effective reps. This method puts the muscles under high metabolic stress to help with hypertrophy and increase muscle growth.

WHAT

MyoReps are designed to be high in intensity and short on time. Here’s the way they are typically structured:

  • Pick a heavy weight for your working set sufficient enough to approximate muscle failure. This means that by the end of your set, you might be able to–if asked–execute 1-3 more reps.
  • Wait 5-10 seconds.
  • Then start your second set. Do as many reps as you can until you’re approximately 1-3 reps from failure.
  • Wait another 5-10 seconds.
  • Begin set 3, again, aiming to do as many repetitions as you can until you fail.
  • Continue until you have executed your desired number of sets.

You can see with this shortened rest period that the accumulation of metabolites does not have sufficient time to clear, and the muscle does not have much time to recharge before starting up again. Beginning subsequent sets when the muscle is already fatigued provides a big stimulus for hypertrophy.

HOW & NOW

For your next upper body day (I do not recommend trying this with legs initially because of the sheer intensity of the workout!), try the following:

  • SET 1: Heavy weights for a set of 8-12 until failure
  • Rest 5-10 seconds
  • SET 2: Same weights as set 1, trying to get as many reps as you can before muscle failure. Aim for 8-12.
  • Rest 5-10 seconds.
  • SET 3: Repeat Set 2
  • Rest 5-10 seconds.
  • SET 4: Repeat Set 3

And voilà! That exercise is now complete. Move on to the next exercise in your program and repeat this pattern.

Question of the Week

Q: When you say ‘lift heavy,’ what does that mean exactly?

This came in from heyrachelej on IG and echoes a sentiment I get asked a lot.

Heavy means choosing a weight that, for your given repetitions in a set, you approximate muscle failure.

So let’s break this down a little bit further because most of us are not training to failure or even close to it.

You know you are approximating failure when one or both of the following happen:

  • Your velocity of the reps starts to slow down significantly.
  • The perceived weight starts to exponentially increase.

This is how you should be selecting a weight that is “heavy” and one that is appropriately heavy for you so that it approximates muscle failure.

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: BON CHARGE Red Light Therapy

As I’m experiencing perimenopause like many of my Bettys, recovery, healing, and skin health have become non-negotiables. I discovered the Australian company BON CHARGE last year and have found numerous products that are useful within my daily routines and support my health goals.

If you’ve read my mentions before and been curious, now’s the time to learn even more and invest in devices that offer you so much direct benefit. And if you’ve already tried one product, consider adding another to your routine.

Simply click the links below and the discount will be automatically applied. There are a variety of price points for all budgets. And for those of you who have health insurance HSA or FSA accounts, BON CHARGE products are all HSA/FSA eligible. Follow a few easy steps to obtain these tax-free savings.

Whether you’re still cycling, in peri or meno, a competitive athlete, or at any point in your health and fitness journey–these are my go-to’s I hope you’ll consider:

  • Infrared PEMF Mat Max: I underestimated just how much I’d love this product. The Pulsed Electromagnetic Field (PEMF) harnesses electromagnetic wavelengths and red light therapy. I find it hard to relax–no shocker there–and this mat grounds my body and calms my mind every time. (It’s also low EMF and flicker-free.)
  • Red Light Face Mask: Red light and near-infrared light combine for powerful skin benefits. It’s now my 10- to 20-minute morning habit!
  • Red Light Neck & Chest Mask: If you’re playing catch-up with taking care of the skin on your neck and chest, this mask pairs well with the face mask to heal, firm, and smooth.
  • Infrared Sauna Blanket:  For my Bettys who want to experience all the benefits of a sauna without the monetary or space investment, the sauna blanket offers a great alternative. This one soothes my muscles after a hard lift day and helps me get to sleep.
  • Cold & Heat Therapy Massage Gun: This “hurts so good” device targets muscle soreness in the usual (and most unlikely!) areas of your body after an especially intense workout. The cold and heat combination gives you the flexibility to customize your recovery practice–genius! It’s portable, too, so you can pack it in your gym bag and use it right after working out instead of waiting until you get home.

Mini Pause #14: Common Cardio Mistakes & How to Fix Them

What You’re Getting Wrong About Cardio and How to Make Simple Changes for Big Results

TL,DR (too long, didn’t read)

Cardio is a good thing. But you don’t need it to lose weight. And doing too much of it and to the exclusion of other forms of beneficial fitness just doesn’t serve you. Choose the type, intensity, and duration of your cardio wisely and based on your goals. Timing matters, too. If you’re strength training (and I know you are), you’ll want to save cardio until after your lifting. Cardiopulmonary health is especially important in perimenopause and menopause, so you’ll want to do cardio smarter, not harder, and definitely not longer.

WHY

I am a fan of cardio work, but not for the reasons you might think. One of the biggest misnomers for integrating cardio into routines is that it’s required for fat loss. Spoiler–it isn’t!

Cardio is important for cardiovascular health (this is especially true as we age and lose estrogen). Just as importantly, cardio facilitates work capacity for your resistance training workouts and for your recovery because of a better ability to deliver nutrients to repairing muscles.

When your cardiorespiratory fitness is good, you will be able to work hard during leg day and recover in between sets.

The other thing to note is that individuals who engage in some type of regular cardio are also generally setting up good habits so that when they lose weight (through diet and weight lifting) they are more likely to keep it off. You are more active, so your caloric balance has a better chance of staying balanced.

As important as cardio is in a balanced exercise regimen, I want to explore some common mistakes with cardio, with the assumption that you are looking to build muscle and lose fat.

WHAT

Mistake 1: Cardio As Effective As Diet

In a word, no. Cardio is not at all required for fat loss. Not even one bit! The biggest determinant of whether you will lose weight is your balance of calories in versus your calories out. If you are in even a mild caloric deficit, you will lose weight. This can be achieved without cardio entirely.

If you’ve ever looked at calories burned on your typical cardio equipment (even when they are likely overestimating it), it’s pretty discouraging. I clock in somewhere between 400-600 calories when I’m on the bike for an hour. An hour!!

By contrast, I can easily pack away 700 or 800 calories of food in a few minutes.

When we’re thinking about caloric deficits, it’s way easier to eat your calories than it is to burn them! It’s unfair, cruel, and unfortunately true. So a better strategy is to think about the calories you’re eating (and often the hidden calories from dressings, the bit here and there, and the mindless snacking) that is leading to a caloric surplus.

Now, don’t get me wrong, if muscle building is your goal, a caloric surplus is a great idea, as long as you’re putting the energy to work by lifting weights.

Relying on cardio for fat loss is a losing scenario, because it’s far easier to eat your calories than it is to burn them.

The other thing to remember is that if you’re overdoing it on the cardio, your body is a wily minx and will compensate by driving up hunger cues and metabolically adapting by decreasing your overall caloric expenditure. That means you will likely start moving less, your digestion will slow down, and even the calories you burn during subsequent cardio sessions will decrease.

The more you rely on cardio as a fat-loss tool, the more the returns diminish as you burn fewer calories overall and reduce non-exercise activity thermogenesis (NEAT).

Cardio should supplement your fat loss goals, not be the main event.

Mistake 2: The Timing Of Your Cardio

If fat loss and muscle gain are the goals, you also want to think about when you engage in cardio relative to when you lift weights.

There’s a well-established interference [*][*][*] between developing the aerobic endurance pathway and the muscle hypertrophy pathway.

This means, your muscle goals may be impaired if you do your cardio before your training. Some studies suggest that strength is compromised for 6 to 8 [*] hours after an intense cardio session.

This is especially true for high-intensity interval training (HIIT) [*]. HIIT may be less of a time commitment and it can be more fun than a Zone 2 workout, but putting your HIIT workout ahead of your weight session is likely going to catabolize your performance because you’re already going to be pretty gassed.

And HIIT and weight training have a lot of physical features in common anyway: the explosive power and recruitment of type 2 fibers. By combining these two, the activity that comes second likely will suffer.

Also keep in mind that the recovery demand for a HIIT session is much higher than a Zone 2 workout. You’ll need more time to recover from a HIIT workout before you should do it again.

HOW

Think about your cardio as a way to keep your overall fitness level high:

  • The cardioprotective benefits it extends in perimenopause and menopause.
  • The way it augments your performance on heavy lift days.
  • How it helps establish healthy lifelong habits.

Cardio isn’t required at all for fat loss. It should never be used as your primary fat loss tool. Fat loss happens in the kitchen, not on the treadmill.

If your goal is fat loss and muscle gain, the timing of your cardio can be after a training session, or even on separate days altogether.

I typically lift weights in the morning, and if I have trained my upper body, I’ll jump on my stationary bike in the evening for a Zone 2 ride. If I have trained legs in the morning, I’m doing no cardio that day. Instead, I’m sitting on the couch, going for a sauna, or going to bed early.

Zone 2 training can be a great way to train your base level of cardiopulmonary health. Aim for a 30-45 minute session, several times a week. Remember, there are a lot of ways to get into your Zone 2! Rucking, cycling, walking, and swimming are wonderful, low-impact options.

HIIT training can be done once or twice a week, and probably shouldn’t be longer than 15 to 30 minutes.

For more ideas, I wrote about different ways to train the top end of your cardiopulmonary fitness in Mini Pause #11 and Mini Pause #12.

NOW

  • Reframe your thinking around cardio to be an adjunct for living well (and helping with leg day!)
  • Ensure your weightlifting is done first. If you want to do Zone 2 that day, it can go immediately after weights, or later that day.
  • Limit your HIIT workouts to 30 minutes or less one to two times per week following weight workouts. (And probably not on leg day unless you are a maniac.)

Question of the Week

Q: How to navigate perimenopause with a low budget? The must-dos!

This is such a great question from vykteran on IG! There are many  low- and no-cost items that make a major difference in our experience with perimenopause.

Here are the top 30 things I feel measurably move the needle when it comes to feeling great in perimenopause. Take your pick!

  • Watch the sunrise / early morning sunlight: Get outdoors (rain or shine) for 10 minutes every morning.
  • Watch the sunset.
  • Snack on exercise: for every 1 hour of sitting, get up and move for 10 minutes. (Read more about exercise snacks in Mini Pause #3.)
  • Mouth tape at night (can be a piece of surgical tape on the mouth).
  • Clean your house with vinegar, water, and a few drops of essential oils (I use orange or lemon).
  • Keep your phone and all electronics out of your bedroom.
  • Keep your room cool, dark, and serene.
  • Use only floor lights or candles after sunset, no overhead lights.
  • Lift heavy at least 3x/week. This can be weights at the gym or odd-shaped rocks and objects you find in nature.
  • Sprint 1-2x/week. Grab your trainers and hit the road! Run as fast as you can for one minute, then walk until your heart rate recovers. Do this cycle 5x.
  • Aim to get at least 7,000 steps a day. Your phone likely has a pedometer built into it.
  • Drink 3L of water daily. Add in sea salt or electrolytes.
  • Moisturize your skin after a shower or bath with olive oil.
  • Absolutely no alcohol.
  • Set boundaries and stick to a consistent bedtime and waketime every day (including weekends).
  • Aim to get a minimum of 30g of protein at each meal.
  • Chew your food 20 times on each side of your mouth.
  • Stop eating 2-3 hours before bedtime.
  • Open your windows!
  • Practice gratitude for people, things, and events in your daily life.
  • Tell people why you love them: send a voice note or a written note about what you are grateful for and what you notice about them that you admire.
  • Watch comedy and let yourself laugh!
  • Sing or hum along to music (opens the throat chakra; the humming is calming for the nervous system).
  • Oil pull for oral health.
  • “Close and clean” your work and personal spaces daily. Have a proper work shutdown: tidy up your desk, and shut down your computer. Put dishes in the dishwasher, and wipe down countertops so you can walk into your kitchen the next day without seeing clutter.
  • Celebrate your efforts, not only the outcome.
  • At the end of the day, reflect on how awesome you were with at least one specific example.
  • Make a desire list and dream about what lights you up. A desire list can be anything: from material items you want, experiences, relationships, properties, lifestyle, etc. Just allow yourself to dream again.
  • Practice forgiveness. For your parents, for ex-partners, coworkers, friends, or anyone who has wronged you. It is not that you are letting them off the hook for what they did, but that you are setting yourself free.
  • Sit on the grass, on the sand, or anywhere in nature. Gaze off into the distance. Let your mind wander.

Ok, that’s just a preliminary list! What did I miss?

YOUR TURN!

Let me know what you’d add to this list of low-budget perimenopause must-dos. Send in your favorites to support@drstephanieestima.com.

WHAT I RECOMMEND: BodyBio

You know I’m a big proponent of optimizing my nutrition and lifestyle to promote healthy aging, and I love a product that achieves multiple health goals at once.

That’s why I’ve incorporated BodyBio PC, a phospholipid complex, into my daily routine. Not only are phospholipids essential for cellular health, especially as we age, they also:

  • Promote mental clarity and memory*
  • Support a healthy gut lining (no more leaks!)*
  • Encourage liver detoxification*
  • Support bile flow and fat digestion*

Visit BodyBio.com to learn why PC is considered  “the foundation of your cells.” Use code DRSTEPHANIE to save 15% sitewide.

Bonus! If you missed my April 8 BETTER! podcast with Jessica Berman, you may want to take a listen this weekend. We talked about seed oils (misunderstood), omega 6s & 3s (essential) and how they impact your body’s composition and overall health. As an executive leader at BodyBio, Jess is continuing the legacy of the membrane medicine work her grandfather, scientist Ed Kane, spent over four decades researching.

*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Benefits for My Bettys

In these newsletters, I often share the products, devices, and equipment that I use in my own life regularly. I only mention items I feel are worth highlighting and that I believe may provide health and wellness benefits to my Bettys. I encourage you – pressure-free! – to explore and then determine if any of the items fit YOUR health needs, fitness goals, lifestyle, or budget.

Today’s issue includes the following items. Use code DRSTEPHANIE with the links below to receive a special discount.

You’ll find more resources in my online HEALTH TOOLKIT. I’ve compiled these for my Bettys who are still cycling, experiencing symptoms of perimenopause, or managing the transition to the other side of menopause. Take a look!

Mini Pause #5: What’s Better: Fasted or Fed Workouts?

Fasted or Fed Exercise?

TL,DR (too long, didn’t read)

Most evidence suggests that fuelling before a workout is better for performance in the gym, and has the same outcome on body composition as fasted workouts. That is not to say that working out fasted is pointless and ineffective. As long as you are fuelling appropriately in the peri-exercise time around your lifts — your body is a genius and knows what to do with the stimulus.

WHY

There are so many of you who struggle with not only what to do in the gym, but what to do in the window that surrounds your workouts.

Fasted or fed training?
Fasted or fed cardio?
What to eat?
When to eat it?
How much to eat?

With conflicting evidence abounding, it can get overwhelming really fast. And based on the comments from a recent Instagram post, you’re also trying to figure out what works, too.

Personally, I used to train fasted (both my lift sessions and cardio) for years, and have since changed my approach.

At the beginning of my fasting journey (when I was completely discounting the fact that I was female) I would work out in the morning and then continue my fast until noon. Needless to say, I was starving, and angry, and as soon as noon came around, I had a very large meal. Larger than what was necessary. The same continued at each subsequent feeding. It was hard for me to admit, but fasting until noon was not working the way I had hoped and the way it seemed to be for many others (mainly men) I admired and respected.

Over time, begrudgingly admitting this was not working well for me, I shifted my fasting window to eat immediately after my workout. I was still fasting for long lengths of time, but the phasic shift to earlier in the day was helpful. This worked well for me for years.

It was only until one of my kid’s soccer practices was moved early in the morning on the weekend that I changed things up again. Since I wasn’t able to get to the gym before his practice, I had the opportunity to experience fed training sessions.

I had breakfast, took him to practice, had another snack, and worked out afterward.

I was shocked at how well I performed. Was it the food? That I had more time to limber up my joints? My core body temperature? I wanted to figure this all out.

WHAT

So in examining this topic, let’s review the literature on the effectiveness of fasted versus fed workouts. Is there a difference?

Fasted Workouts

This meta analysis looked at several studies where the intervention was either:

  • fasted exercise with a standardized post-exercise meal
  • fasted exercise without a standardized post-exercise meal
  • fed exercise with a standardized post-exercise meal
  • fed exercise without a standardized post-exercise meal

What they found was the second intervention (fasted exercise and no post meal) appeared to be the most effective strategy to produce a short-term decrease in energy intake. But there was a catch: it also resulted in increased hunger and lowered energy expenditure afterward.

This is known as metabolic adaptation. If you have a higher energetic expenditure but are not fuelling properly either pre -or post-workout, you might be able to temporarily decrease caloric intake. But, the body will compensate over time by increasing hunger and/or lowering your total energy expenditure. This is the “calories out” part of “calories in, calories out.”

Said another way, aerobic exercise performed in the fasted state with no post-workout fuel induces higher fat burning WHILE DOING THE EXERCISE, but will then correct for energy output after the exercise is finished. This means, there is nothing inherently superior to fasted workouts.

Another study looked at 20 healthy young females and looked at the difference between fasted exercise on body composition. They kept calories constant between the two groups and either gave them a meal before exercise or had them work out fasted and fed them after the exercise was completed. Again, no significant difference was noted between the two groups in terms of body composition. They both demonstrated equivalent weight and fat loss.

Fed State

So here is where it gets interesting! Even though body composition seems to be agnostic to whether you are in a fed or fasted state, there’s a significant difference in performance and repair of muscles when you are fed before exercising.

Specifically, when you consume carbohydrates and protein before a workout, this positively affects muscle glycogen stores. This is going to give you the oomph you need to maintain energy and execution during your lifts. It’s also going to improve the repair of muscles and help to improve the short-term and long-term adaptations to training.

Said another way — being fed before a training session helps with the performance during that session and the repair afterward. I would argue that this speeds up changes in body composition over the long term because it is going to favor muscle tissue performance and repair. The faster you can put on muscles, the better your body composition is going to be.

For those of you wanting to go even deeper, check out this article on nutrient timing, and listen to one of the authors of the paper, Alan Aragon, on my Better! podcast.

HOW

If you want to try fueling before a workout and have been training fasted for years, start small!

Here is a short list of pre-training meals you can experiment with:

  • Add protein to your coffee. I often add a Core Power to my coffee, or I will blend Equip Foods or Schinoussa protein powder into my coffee.
  • Have a banana. It is light enough to avoid that “brick in the stomach” feeling.
  • Have a Protein Shake. (½ banana, scoop of whey protein powder and water)
  • My overnight oats recipe (check it out here)
  • Greek yogurt with some honey and walnuts
  • A few rice cakes with peanut butter and jelly

Personally, I am a creature of habit so it’s either my overnight oats or I add one scoop of whey protein to oats and mix. I eat either one of these options before every lift. When it’s leg day, I will also add a banana into the mix.

This clocks in somewhere between 350-400 calories, which is about right for the length and intensity of my workouts. I would say the bare minimum calories should be around 200, especially if you just starting to experiment with food intake early in the morning.

Many of you work out early, and I do as well. I eat my oats and protein of choice almost immediately after waking and then I get dressed and get to the gym. This buffer gives me about 30-45 minutes from the time I eat to the time I am in the weight room. Precisely about the time those glorious amino acids and glucose are spilling into the blood so I can drive them into my muscles to werk. Not work. WERK.

NOW

Decide on what small meal you are going to try. Tomorrow (or your next planned lift session), wake up and march into your kitchen to eat. Naked if need be — we’re talking about better muscle performance and recovery here! Then go about your regular morning schedule and head to the gym.

Be patient with yourself. It may take a few weeks to adapt to eating on a new schedule. I would choose one food and just have that before your workout for two to four weeks to see if you notice a difference in your performance at the gym.

It may or may not work for you. Either outcome is fine. That you are willing to try different things is what makes you the champion you are.

In this article, I mentioned my two favorite protein powders. Take a look and choose the one that’s right for you: Equip (use code DRSTEPHANIE to save 15%) or Schinoussa.

Question of the Week

Q: What does it mean when I’m spotting before my period?

Spotting outside your bleed week can be unsettling and there are a few explanations for it.

Before we dive in, consider your age, where you are in your cycle, and if you could be pregnant. And a word to the wise: I’ve had several friends in their late 40s get pregnant, so this is something to always rule out!

EVALUATING

Menstrual Cycle:  

  • Ovulation: Not all, but some women will notice some light pink blood mid-cycle around the time of ovulation. The pink color most likely is a mixing of the blood and cervical fluid. It should not be heavy enough to warrant a tampon, a cup or a pad, and this is considered uncommon, but normal.
  • Luteal Phase: This is most common in perimenopause when we see falling levels of total progesterone and estrogen. Lowered progesterone is unable to maintain the endometrial lining and premature shedding of the tissue can occur as it becomes ischemic and dies. Discussing hormone replacement with your provider might be in order here.
  • The spotting prior to bleeding might also be due to an estrogen deficiency or luteal phase defect where the luteal phase is shorter than the follicular phase. Typical diagnostic criteria consider 10 days as a luteal phase defect coupled with elevated FSH and LH. This can be confirmed on a blood test.

Hormonal Birth Control: If you have recently started on any kind of hormonal birth control like pills, patches, injections, or intrauterine devices, you may find you are spotting for the first few month as your body adjusts to its new hormonal environment.

Implantation Bleeding (Pregnancy): If you are pregnant, implantation bleeding often happens in the six- to eight-week mark of your pregnancy. This is right around the time you “should” be getting your period. The fertilized egg is burrowing itself into the womb and can cause noticeable spotting. This is normal, although you might mistake this for your period!

Sex: Penetrative sex can cause some spotting afterward, especially if you are experiencing vaginal dryness. This happens most commonly in perimenopause with declining levels of estrogen leading to reduced lubrication. The friction from sex can cause microtearing in the walls of the vagina. So, either ramp up the foreplay, grab some lubrication, or both.

You can also see some post-coital bleeding from cervical polyps. These are benign growths on the muscular wall of the cervix.

In all of these cases, keep a log of what is happening so you can discuss the specifics with your doctor. You’ll want to note where you are your cycle, how much, how consistent, what colour, and duration of the spotting.

TESTING & NEXT STEPS

I love to run lab tests on myself and patients every six months. This is ESPECIALLY true in perimenopause when your sex hormones can drastically change from visit to visit.

YOUR TURN!

‘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: Living Libations

As your hormones fluctuate in mid-life and your skin begins to change, you want products that deeply nourish.

Best Skin Ever-Rose is crafted to bring all skin types into balance and uses Rose Otto to replenish your skin. Use it as a cleanser, a gentle exfoliator, or a luscious face and body moisturizer.

It’s been a favorite face oil of mine for YEARS and for good reason. It is pure luxury. This is my “special” night oil when I want to up the glow and dewiness of my skin.

I also love the lightweight Rose Glow Serum that’s rich with ingredients like jojoba, seabuckthorn, and geranium. It makes my skin feel silky soft while soothing and protecting.

Visit Living Libations link and save 15% off. (The discount is automatically applied at checkout.)

P.S.

MISSING LINK: In last week’s Mini Pause, I included a link to a hand-held vacuum I like to use on my mattresses, but the link wasn’t functional. Here it is!

HEALTH TOOLKIT: I’ve put together a toolkit for you on my brand new website. I designed these resources for my Bettys who are menstruating, experiencing perimenopause or have gone through menopause. There are commonalities between the categories and also specifics for each one. Everything I recommend, I use myself. That’s my rule. I invite you to take a look!

Mini Pause #3: Add ‘Exercise Snacks’ To Your Movement Menu

Exercise Snacks: An Easier (Better?) Way to Stick to Your Goals


TL; DR (too long, didn’t read)

Exercise Snacks (exercising in small 5- to 10-minute increments through the day) yield the same, if not slightly better, results than one big session at the gym.   

And we are not just talking about waistline — exercise snacking demonstrates improvement across fasting insulin, fasting glucose, lipids, and cardiorespiraory fitness. They also show a slightly better outcome in body weight and LDL cholesterol!  

WHY

January is a busy month for gyms. If you’ve just joined a gym, or even if you’re a seasoned muscle mommy like me, you may be feeling some of your original New Year’s goals already falling by the wayside. But have no fear — if you’ve set a goal and are having a hard time keeping up with an aggressive gym schedule you’ve set for yourself — I have a solution for you!

Simple exercise snacks.

Since the pandemic, more and more people work from home either permanently or have a hybrid model working from home and being in an office. What has emerged are new work norms that allow you more freedom to find opportunities in your day for movement.  

I’ve always said moving consistently through the day trumps one big workout followed by sitting for 12 hours. And there’s robust scientific evidence to back this up.

WHAT

This meta-analysis looked at 19 studies with a total of 1080 participants. They were looking for studies that evaluated whether one bout (continuous) of exercise was better, worse, or equal to the same exercise broken into smaller pieces through the day (cumulative or what I am referring to as “exercise snacking”).

They controlled for intensity of the exercise, duration, and type of exercise. Said another way: they were looking for the exact same workout either 1) completed in a single session, or 2) broken up into smaller chunks over the course of the day.

Results showed that the exercise snack group and the single bout group both reduced their total body mass, but the exercise snack group fared slightly better. The exercise snack group and the continuous exercise group both improved their LDL cholesterol, with the snackers faring slightly better here as well.

Both groups improved their total cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting blood glucose, and fasting insulin.

Bottom line: both a continuous session at the gym AND exercise snacks can yield comparable results.

There’s mounting evidence that exercise snacks have incredibly positive benefits on your health:

  • like this study looking at exercise snacks on blood glucose levels after a meal
  • or this one on how exercise snacks lower blood lipids after a meal
  • This study showed that 1 minute of all-out sprints (broken down into 3 x 20-second sprints, bookended by 2-minute warmup and cool down) improved cardiometabolic and mitochondrial health AS MUCH AS individuals doing cardio for 45-50 minutes. That’s five times less time and volume!

Pretty compelling, right?

Exercise snacks also alleviate the pressure to get in a big exercise session every day. If you’re able to replicate a 1-hour workout in smaller pieces through the day, the results seem to be equivalent at worst, and superior in terms of body mass and cholesterol levels at best.

HOW

You’ve got two options on how to implement exercise snacks. You can use either option or a combination of both.

  • Option 1: Replace your Gym Session with Exercise Snacks


In order for this to work, you have to think about the intensity and duration of your regular workouts. You’ll want to match your regular, continuous workout by breaking it down into smaller bits.  

So, if you are working out for 60 minutes, your exercise snacks should add up to 60 minutes over the course of the day. That could be 6 x 10-minute sessions, or 12 x 50-minute sessions. And you MUST match the intensity of your regular workout.  

Intensity is subjective, but you can think about it on a scale of one to 10: One being pretty low intensity, and 10 being all out. If your continuous workout was an eight, the exercise snacks also have to be an eight.

This is a GREAT option if you struggle with the time commitment for a bigger gym session, if you travel frequently, or if you’re the family chauffeur driving kids to after-school activities.

  • Option 2: Keep Your Gym Session and Incorporate Exercise Snacks


In full transparency, this option is what I like to do. I’m one of those people who actually enjoys going to the gym. But after researching this topic for this week’s newsletter, I’m going to incorporate more exercise snacks into my day — even on days I get in a workout.   

Exercise snacks are a blessing on travel days, when I’ve slept in and don’t make it to the gym, or for hectic days when I’m just not getting to the gym that day. It’s reassuring to know that these days aren’t a regression, but a progression.

And frankly, these exercise snacks are one of the few reasons I get my sprint training in on my CAROL Bike. I can pop on it and in 5 minutes, I’ve done 3 x 20 second all-out sprints — and haven’t broken a sweat! (If you find you’re interested in a CAROL Bike, you’ll get a discount using code DRSTEPHANIE.)

NOW

Here are some of my favourite exercise snacks. I encourage you to try these and be creative with your own based on how you like to exercise.

  • While I’m making dinner: 20 pushups, 20 air squats, 20 switch lunges
  • While I’m waiting for a plane: walking lunges back and forth near the boarding gate; wall sits; decline pushups at the gate chair
  • When I have 10 minutes before a meeting starts: CAROL Bike sprints (30-second sprint, 90-second recovery, then repeat 3x), or 30 box jumps on plyo boxes I have at home.
  • When I can opt for walking meetings : I’ll take a call and go for a walk around the block. Pro tip: if you have an iPhone, put the “Voice Isolation” mode on. This prioritizes your voice over background noise. I have taken calls at loud airports and at my kids’ soccer games where people are screaming. The lucky caller on the other end of the line cannot hear anything but me.
  • When I’m on soccer mom dutyI alternate lunges on the side of the pitch while my boys practice, and in the summer I sprint around the track (if there is one). This helps me feel less like an Uber driver.

Submit Your Exercise Snacks!

Let us know if you already have some great exercise snacks. Or, if you’re inspired to create new ones, share those, too. Reply to this email and we’ll compile some of the best ideas from you in a downloadable PDF!

Question of the Week

Q: What do you eat after one of your workouts?

I’m preparing a bigger newsletter for you on peri-exercise fuel, but here are some guidelines following a workout.

RESISTANCE TRAINING & CARDIO

I always follow any lift session or cardio with a combination of protein and carbohydrates.  On mornings when I exercise early, this will be breakfast. One recent morning I had five egg whites + one whole egg omelette on a piece of sourdough toast. On the side was 1/4 avocado and some fruit. I also treat myself to a cappuccino with whole fat milk. Not a Starbucks triple grande venti purple long short with sprinkles and foam (or whatever the cool cats are drinking these days) but a regular 3/4 cup-sized cappuccino cup.

If I am about to get my period, I’ll also add in one scoop of protein in water as my “drink” instead of water. I do this because I know I’m going to be hungrier in week four of my cycle, and I preempt that with more calories and specifically more protein.

(If you want to learn more about eating around your cycle, check out my book, The Betty Body.)

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: BON CHARGE

Sometimes all the “steps” for skin care can feel overwhelming. I like efficiency, and I prefer a simple daily routine that doesn’t take a lot of time. I also want great skin.

When I found the Bon Charge Red Light Face Mask, it checked all the boxes and more. It combines red and near-infrared light to diminish fine lines, scars, and blemishes. No matter what your skin type, you can experience a brighter, healthier complexion and firmer, more youthful skin using this mask. I love the results I’ve gotten.

I keep this mask beside my desk and work with it on because it molds comfortably and easily to my face. I can choose the intensity and wear it for as little as 10 minutes and still get all the benefits.

I invite you to visit Bon Charge to learn more about the Red Light Face Mask. Use code DRSTEPHANIE to save 15% sitewide.