Mini Pause #20: Caloric Deficits Are Ruining Your Gains. There. I Said It.

TL;DR (too long, didn’t read)

Constantly being in a caloric deficit will eventually eat up your muscles, your performance in the gym, and will castrate your happiness. Need I say more?

WHY

I am so tired of this persistent idea that women need to be small and skinny. So many women tell me that they’ve been on one diet or another for most of their lives.

Think about that for a second. Think about how colossally f**ked that is. For women to be on an eternal quest to be small.

I’d like to make a strong (pun intended) case for eating to build muscle as the place to start (and dare I say, stay) so that you can fuel your growth. Not only your body composition growth but your mind as well. Your brain needs good energy. Stable and consistent energy for your metabolic and hormonal production, and just to think.

Strong over skinny.
Resistance training over reduction.
Speed training over starvation.
Anabolic over catabolic.

And if that fails to land, just remember that people don’t write songs about abs. There are, however, numerous songs about big juicy glutes. So there’s that.

WHAT

When embarking on a fitness journey, I’m invariably asked: “Can you build muscle and lose fat?”

There is a long and a short answer to this. Technically you can, but the progress on both goals simultaneously is likely going to be so slow that you might be inclined to erroneously conclude that something is wrong with you, rather than the approach you are taking.

Imagine if you had an important meeting at work and you were about to close the deal of a lifetime. And you brought along your playful dog, your inquisitive child, and decided to scroll on Instagram during this meeting. Could you focus on all of them? Probably. Could you focus on all of them WELL? You know the answer here, friend. And if you are not sure, check out this study [*].

My preference is to separate these two goals, and I prefer to start with muscle building.

Starting with muscle building means typically figuring out what your current maintenance calories are, and looking further at your macronutrient composition (how much protein, fat, carbs) and your hunger patterns.

If you are someone who’s been trying to lose weight forever and restricting calories, this becomes harder the longer you are in a deficit because your total daily energetic expenditure also lowers [*]. Meaning, that you naturally move less, your digestion slows, and your metabolic rate slows, too, as your wily body begins to conserve energy and calories.

When you want to build muscle, you need to eat. Muscles need substrate (food!) to build and grow, and it becomes difficult to grow muscles in a restricted state. It also compounds for women in perimenopause and menopause because you are naturally–as a function of aging [*]–more resistant to muscle growth.

You also, around the age of 40, begin to see a degradation of your muscle fibers and total loss [*] of volume of muscle fibers.

So when you’re not consuming enough calories because you (and every other woman on the planet) have been told that you need to be as small as possible AND you’re working out, lifting heavy, you’re simply not going to have enough energy to support your physical goals. You won’t have enough energy for your bones, organs, or your hormones either.

AND you’re putting yourself at risk for injury.

So while I completely get the appeal of trying to be “good” and eat under your caloric requirements, it’s simply not serving you in the long run.

HOW

Determining how many calories you are consuming relative to your energy expenditure is going to become important.

Exercise is not just the time you spend in the gym. It’s time spent walking, cleaning up the kitchen, and your general movements like hand gestures and toe-tapping. The first step is always getting a sense of how much energy you’re taking in to support not only the gym but also your life.

If building muscle is the goal, you typically want to set the protein target around 1g of protein (the methionine kind I mention in Mini Pause #19) per ideal pound of body weight.

Then, figure out what your maintenance calories are. I find women fall into two groups: 1) chronic caloric deficit (which is the focus of this issue), or 2) they think they are in a deficit but are eating way more calories than they think.

In either case, getting a sense of your caloric intake is essential.

Calculating how many calories you need at maintenance is the next step. I quite like this calculator [*] to help do this.

Now that you have a sense of your maintenance (and how shocking this number might be for you), this is the springboard from which to develop meal planning for muscle building and, if there is interest down the line, caloric restriction for an event or a transient amount of time.

It’s also an option to eat at maintenance without the need to bulk or cut. Shocker, but it’s true! This is truthfully where I am most of the time. Eating a normal set of calories without looking to cut.

NOW

  • Track your calories as they are now for one week (including weekends).
  • Figure out your calories using this calculator [*] and contrast with the data set from the above action item.
  • Take stock of the difference: are you eating too many calories? Too little? How long has this been going on?

Whether you have been over- or under-consuming calories, there can be a slow calorie shift towards your maintenance calories as you are simultaneously working toward building muscle.

Question of the Week

Q: Is exercising in the morning (cardio) going to affect your cortisol and hormones?

IG follower nomad_ad asks a question many women grapple with.

The short answer here is yes, exercising–irrespective of whether it’s resistance training or cardio–will affect your cortisol levels. Exercise any time of day–not just the morning–will do this.

Cortisol along with other catecholamines are released for your performance during activity, and come back down after the activity is finished.

Cortisol is not the big bad hormone it’s made out to be online with influencers who don’t understand basic physiology. It’s those same people teaching you that glucose spikes should never happen, insulin is the root cause of all your problems (not just one but ALL of them), and the reason you cannot lose weight is you have a “broken” metabolism.

Exercising, in addition to “spiking” cortisol also will cause:

  • a transient decrease in thyroid hormones
  • a downregulation in immune system activity
  • an increase in blood pressure and heart rate
  • transiently raised blood lipids
  • a spike in blood glucose.

Does that mean you should never exercise?!

It’s easy to make something look inherently bad if you don’t fully understand it. Many people who have demonized glucose spikes, cortisol, and insulin are simply scientifically illiterate. Either that or they are peddling some magic supplement to quell said evil glucose spikes, cortisol, or whatever they are demonizing.

Here are some great things cortisol does in the body:

  • Helps provide your muscles with energy by increasing the availability of glucose.
  • Decreases your perceived exertion, which will positively improve your ability to stay with your endurance activity of choice.
  • If you are lifting weights, cortisol decreases the perceived load and allows you to lift heavier weights for longer.
  • Helps to regulate your sleep-wake cycle.
  • In short spurts cortisol is ANTI-INFLAMMATORY. I apologize for the all-caps, but this is worth noting. Sure, long-term chronic stress does the opposite, but in the short term, cortisol decreases inflammation. It is what corticosteroid creams and injections work to mimic.

The kicker of course–with respect to exercise stimulus–is your recovery. The transient stress catalyzes change, but you must allow the body time to adapt to the change before you go at it again.

So should you do HIIT training for 45 minutes 5x/week? Probably not. It’s because of the lack of recovery and runway for adaptations that’s causing the dysregulation. If you were to cut the frequency of the HIIT in half and double your recovery, there wouldn’t be an issue.

Cortisol is your friend–when you balance her with your other bestie: recovery.

Forward this to someone you love, and let’s fall back in love with what cortisol helps us with.

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.

Mini Pause #18: Deload Weeks & Physical Breaks: Rest=Progress

You Must Squat Before You Jump: Deload, Take a Break, and See Even More Gains

TL,DR (too long, didn’t read)

Deloads are a necessary part of training hard [*] when you are chasing all those gainz. They are often a welcome relief when you have accumulated sufficient stress and fatigue in your training regimen. This happens somewhere between four to eight weeks of intense training and allows for proper recovery.

Deloads can be a drop in weight or volume in your regular program, or you can choose to take a week off altogether. This week I am opting for a reduction in both volume and weight to help with my own (very overdue) deload week.

WHY

I’ve been feeling kind of run down and tired lately, and I’ve been trying to put my finger on what it is. I’ve been sleeping well (better than I ever have, truthfully, consistently hitting new PRs at the gym, and my nutrition is no different than it normally is.

But somehow, I’m exhausted, recovery is taking longer, and I’m even dreading the gym.

Now y’all know something is off when I am not excited about gym time. That’s my happy place!

I took a look at my volume and my progression over the last six months and then it hit me like a 1 Rep Max sumo squat. I’ve accumulated too much physical fatigue, and I failed to schedule a deload week [*].

When I first wrote about training around your cycle in The Betty Body, I naturally built a deload week into Week 4 of the cycle of training with lighter weights than usual. Although it wasn’t intentionally programmed as a deload week in the book, for cycling women it’s a nice anchor to be able to think about a lighter workout in the late luteal phase of your menstrual cycle. This helps to reduce the physical and often psychological stress that accompanies this time of the month.

I find I require a lighter week either on Week 4 or Week 8 of steady training. But for whatever reason, I’ve trained 16 heavy weeks in a row. That explains my current disdain for the gym and poor recovery recently. I’ve been noticing I have been much more sore than normal, taking at least a day longer than I normally do to recover. From leg workouts, specifically.

WHAT

Everyone who’s lifting weights close to failure can and should be thinking about building in regular deload weeks to reduce physical and mental stress and fatigue and to help you push in the next cycle of lifting. For my Type A Boardroom Bettys where I can ALREADY see your brains working (“Maybe I don’t need a deload! I should continue to push despite what she is saying!”), deloads are a necessary part of any intense training regimen. It doesn’t mean you’re broken, failing, or not making gains. By contrast, it’s how you make EPIC gains. In recovery.

Deloading is a crucial part of any well-rounded fitness routine to help reduce overall fatigue, reduce the risk of injury, and help your lifting become stronger in the following weeks. In the same way, you need a break from your diet now and then, the same is true for your physical diet.

When you are training hard, there is a predictable accumulation of stress and fatigue. There is nothing to fear about this, as this is how you get better and improve your energy levels, body composition, and strength.

But when you have accumulated too much stress and fatigue over several weeks or months of training, you can and should actively reduce it so you can facilitate recovery and get back to progress the next week.

Generally speaking, you know you are ready for a deload week when you have had two or three workouts of the same body part where you are either not making any progress, your recovery is longer than normal, or worse, you are regressing in your program.

Let me illustrate with an example.

Let’s assume you train legs on Tuesday and Friday. On both those days, you’d experience substandard workouts in the absence of any other explanation (jet lag, a child was sick, a stressful time at work, etc.).

And even if it were the case where your psychological stress was acutely through the roof, I’m going to gently remind you that psychological or mental stress also accumulates in the physical realm. This would be your cue to lighten up.

HOW

The No. 1 rule about a deload week is KISS: Keep it Simple Smartypants.

Once your strength is not improving by your typical measurements (weight, volume, etc.) for two or three consecutive workouts, it’s time to take a break and amp up recovery.

Here are a couple of ways you can structure a deload:

  • Reduce weights
  • Reduce volume
  • Reduce weight and volume
  • Do absolutely nothing (not a typo and a perfectly reasonable option)

Typically when I deload, I reduce both weight and volume by about 50 percent.

Yes, by that much.
Yes, it seems like a lot.
Yes, these workouts are easy.

So let’s say I am regularly squatting 135 lbs for 10 reps for 3 sets. I might structure a recovery week in the following way:

  • Deload Leg Day 1: 3 sets, 10 reps, but the weight will drop to 67.5lbs (this includes the bar at 45lbs, so using gym math that is 22.5 lbs of weight on the bar, so I usually just round up to 12.5 lbs per side)
  • Deload Leg Day 2: 3 sets, 5 reps, 67.5 lbs (weight and volume drop)

So you can see that I initially just dropped the weight, but kept the volume consistent. On the second leg day of the week, I dropped both the weight and the volume. It feels like an easy workout. And that’s the whole point. You’re training easier this week so you can better recover.

When I structure my deloads so that the workouts are progressively easier for the week, I’m absolutely itching and ready to get back at it the next week. This is because I’ve dropped the stress of the workouts considerably, allowing for my body’s recovery processes to get ahead of the stress I have accumulated. I always find that in the weeks following a deload, I often hit a new personal best.

The important takeaway? When you structure your deload weeks this way, you can still work on your technical skills with the lighter weight.

And in total transparency–about once a year–I simply need a complete break from the gym. A 100% complete drop in volume and weights for at least half a week, and often a full week.

I just get to this place where I don’t want to be in the gym at all, and I honor that. So I will get in a lot of walking, sleep in, spend lots of time in the sauna, and do cold plunges. (I’ve linked my heat and cold recovery tools here for you to explore. Use code DRSTEPHANIE for each to receive an exclusive discount.)

For me, this week I am opting to drop weights and volume on all workouts all week long.

NOW

If you have been noticing your workouts suffering and an inability to progress with at least two workouts feeling like they were crappy, decide to take the next week to amplify recovery. Here are two possible approaches:

  • Reduce your volume, your weights, or both while still training at the same frequency.
  • Take the week off completely. Go for some walks, do some yoga, practice mindfulness, sleep in, and allow your magical body to do its thing.

Prepare your mind for the deload. It isn’t a failure, a setback, or anything of the sort. Think about jumping. Usually, the lower you can go into a squat, the higher you can jump. Think of deloads this way. The squat part of the jump.

Question of the Week

Q: I know rest days are important when working out. I’ve heard women in perimenopause and postmenopausal women should have more than two rest days a week. What are your thoughts?

Thank you to reader Gina G. for asking this question that fits in so well with today’s main topic on deloading!

I am not one for hard rules that apply across the board, so I will say that you should take as much rest as you need. And when you are fully recovered–get back at it!

If you are regularly training legs, let’s say, you can aim to train them twice a week, but if you feel like in between those sessions you are not sore, have the energy, and can easily fit in another workout, you should definitely try it out and see how you respond!

I typically take one full day off and my shoulder days are lighter in terms of energetic output. Sometimes I’ll throw in one or two leg exercises at the end of a shoulder day. Not all the time–just when I have the energy.

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.

Mini Pause #16: Smart Changes to Increase Your Muscle Mass

Try Long-Length Partial Repetitions for Muscle Gains

TL,DR (too long, didn’t read)

Long-length partials are a great addition to your already established weightlifting routine. The literature seems to agree that long-length partials–when the goal is muscle hypertrophy (increase in muscle mass)–seem to be at least equivalent to a full range of motion.

They are great to use if you are injured (and cannot perform full range of motion exercises), or as a finisher to a set, or for variety to combat boredom.

Oh, and I have never been so sore. It hurts so good!

WHY

Recently at the gym, as I was peeling myself off of a leg machine, my husband was looking at me, somewhat amused, and I knew what he was thinking so I answered the question before he asked it.

“I’d rather endure the pain of this exercise than the pain of staying the same.”

It was one of those “damn I need to remember that line and tell more people” moments.

There are many reasons why I like to push beyond my comfort zone in the gym. To the point where I am riding the line of pain and excruciating pain. If we ever get to train together, you will find me often shaking my head no as I descend into yet another squat, mentally overriding my desire to stop.

Because staying the same, never growing, and never challenging myself feels like death to me.
Maybe I was a huntress in a previous life, but I find extreme satisfaction in the hunt. In this case, the hunt for hypertrophy.

So on a recent Friday night, I was nose deep down a muscle hypertrophy rabbit hole on PubMed (as one does on a Friday) and came across some interesting meta-analysis on long-length partials compared to full range of motion and their effect on muscle hypertrophy. I was so excited I started rabidly consuming several studies, and have now incorporated them into my training routine and have noticed some exciting preliminary changes in my strength.

WHAT

Long-length partials are essentially a half rep focusing on the lengthened portion of the movement.

For an easy visual, think of a bicep curl. Where the bicep muscle is most lengthened is when the elbow is straight. A half rep would be bending the elbow to about 90 degrees of flexion, rather than bringing the weight to your shoulder.

  • For a pull-up: It would be when the arms are straight, and you pull up halfway.
  • For a squat: It would be at the bottom of the squat and lifting up halfway before going right back down again.
  • For a chest press: It would be when the bar or weight is closest to your chest, with the pec muscles stretched out.

The literature agrees that long-length partials, when the goal is muscle hypertrophy, seem to be at least equivalent to a full range of motion (ROM).

This study [*] looked at women performing knee extension exercises at various ranges of motion varying from full ROM to long-length partial extension to shortened-length partial extensions. They found partial ROM training in the lengthened phase of the knee extension promoted greater relative hypertrophy in certain muscle regions than training in other ROM configurations.

It holds true for the entire body. This study [*] looked at muscle hypertrophy in the bicep muscle, again in women, and found an identical result.
This meta-analysis [*] concluded full range of motion or long ROM enhanced results for most outcomes (strength, speed, power, muscle size, and body composition).

HOW

So, should you swap out all your full ROMs for partials? No! They’re a useful tool in the proverbial tool belt but by no means a total replacement for full ROM.

Where you can, proper form and full range of motion should be performed. This preserves muscle movement at all angles and is conducive to range of motion and proprioception at the level of the joint as well.

Where I think long-length partials (LLPs) may be handy:

  • When you are injured and cannot perform a full ROM. This can be useful as a rehab tool for getting back to full ROM and preserving muscle tissue.
  • When you have a condition like rheumatoid arthritis, adhesive capsulitis/ frozen shoulder, or bursitis and cannot perform full ROM without pain. Again, LLPs can preserve tissue, and act as a stepping stone to full ROM.
  • When you are close to completing a set but can no longer move the weight through the full range of motion, you can begin using long-length partials. I have found I can punch out five or six more reps this way.
  • When you want variety and are combating boredom. I have been playing with alternating a full ROM repetition with a LLPl rep in many of my leg and upper body days.

NOW

For your next workout, choose to incorporate LLPs in one of the following:

  • All sets and all reps are LLPs
  • Full ROM reps until you cannot anymore, then switch to LLPs to really finish the muscle you are working
  • Alternating between a full ROM and a LLP

Which one are you going to try?

Also a word of warning–it might be the novelty, but I have never had such an amazing pump and ensuing soreness the next day! Have your favorite recovery tool at the ready.

A few of my go-to recovery tools include: Coldture cold plunge, Sunlighten sauna, Bon Charge sauna blanket, and Bon Charge massage gun. (Curious? You can use code DRSTEPHANIE to get special discounts.)

Question of the Week

Q: I’ve noticed on Dr. Stephanie’s IG that she tends to use machines rather than free weights/barbells during her strength workouts. I’m very interested to learn her recommendations for women around this—the difference between using free weights vs. machines.

Thank you to April who sent in this question that I get asked a lot! I use a combination of all of the above.

For legs, I often use a Smith machine (which is a barbell with a fixed range of motion), a barbell for deadlifts or squats, walking lunges with dumbbells, Bulgarian split squats, and then machines like abduction and hamstring curls or leg extension.

Same goes for back days and shoulder days–it’s usually a combination of free weights, some type of axial loading with a barbell, and machines.

There is no right way or wrong way to train.

Machines have a predetermined line of drive, so in a sense, they are more stable because you do not need to create the stability yourself. There is an inherent trade-off to this. We want stability when we’re focusing on strength because the less stable the surface, the less strength you generate. But we also want to endogenously generate stability with accessory muscles and joints. So, I often use certain machines for six to eight weeks and then switch it up.

As long as you are going close to failure (making ugly faces, grunting noises, and getting to a place where you can no longer perform a full range of motion rep and drop down to long-length partials)–truthfully do whatever you love to do.

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: Tips for nutrition, hydration, sleep & stress

I love hearing from my Bettys! When you write in, DM me, or comment on my socials, consistent themes emerge, like: Ways to keep your nutrition on point, how to stay hydrated, what to do to get good sleep, and how to handle stress. Here are some simple choices I make that you may find useful.

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SLEEP:

  • Hello NED: A unique combination of CBN plus full-spectrum hemp and botanicals (non-addictive). Check out the Sleep Blends. On April 29 & 30, all Sleep Blend tincture + capsules will be buy one, get one free with code DRSTEPHANIEBOGO.
  • Qualia Night. Help your nervous system naturally wind down, starting after dinner. Learn more about how this supplement works differently here. If you try it, use code ESTIMA15 to save 15%.

STRESS: The Apollo wearable uses the gentle vibrations of touch therapy to promote stress resilience. (My kids use it, too.) Explore its features and use code DRSTEPHANIE to save $50.

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Disclaimer: The information included in a newsletter, email, or on drstephanieestima.com is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on drstephanieestima.com, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.

Mini Pause #15: Creatine Essentials for Women

Why You Need Creatine, Especially in Perimenopause & Menopause

TL,DR (too long, didn’t read)

Creatine is one of my absolute favorite supplements for women over 40. It helps with brain fog, cognition, and performance in the gym and makes your muscles look full and beautiful.

WHY

Creatine can offer several benefits like augmenting performance, slowing down your fatigue in the gym, and amping up muscle mass and recovery. It has also been shown to help with cognitive capacity. Yet, perhaps perplexingly, myths around creatine persist. I want to address some of these in kind, with some actionable items for you to try in your own life.

WHAT

Myth 1: Creatine Causes Water Retention

Of all the myths surrounding creatine, this is the most common one I encounter from women. Most of us have likely already experienced the annoyance and inevitability of water retention in the luteal phase of the cycle, with rings not fitting, and our pants feeling just a little too snug for our liking.

So it comes as no surprise that if a woman is presented with the slightest inkling of water retention, she will avoid it.

The only issue is… creatine does not cause water retention in the extracellular matrix, but it does so in the intracellular one. There’s debate in the literature as to whether that is short-lived.

Creatine is an osmotically active substance and is taken up into muscle from circulation by a sodium-dependent creatine transporter. [*] Since the transport involves sodium, water also will be taken up into muscle to help maintain intracellular osmolality.

What does that actually mean? The water retention is not outside the muscle, which would lead to more puffiness and inflammation. The water retention is inside the muscle, which only makes the muscle look fuller and more defined.

And even if that is not your jam (full defined muscles), there are several studies that suggest long-term supplementation of creatine does not affect increases in either total body water volume, extracellular water volume, or even intracellular water volume! [*][*]

Although there is some disagreement about this in the literature, [*][*][*] the take-home point is that creatine is not going to make you puffy.

At worst, there is no change in water volume after long-term supplementation, and at best, you increase the water and sodium in the muscle cell which is important for muscle transcription and hypertrophy.

Myth 2: Creatine Is Just For Gym Bros

Much like lifting weights and eating meat has often been ascribed as phenotypical male behavior, creatine is not just for guys. There is ample evidence to suggest creatine supplementation is incredibly useful for women.

Hormone-driven fluctuations can alter your ability to synthesize and transport creatine effectively because creatine synthesis is affected by both estrogen and progesterone levels [*]. And so your ability to make and use creatine will be particularly affected during bleed week, perimenopause, and menopause [*] where we see drastic changes in concentrations of these hormones.

Creatine in the female frontal lobe has also been shown to be lower [*] than our male counterparts. So supplementing with creatine, particularly for women [*], can also help to reduce depression and anxiety.

And ladies in perimenopause and menopause, creatine has been shown to help with almost all measures of improving muscle mass and bone density [*] and reducing inflammation. Inflammaging, as the cool cats call it, is the epicenter of all chronic disease and accelerated aging.

HOW

Grab yourself a bag of creatine monohydrate. It MUST say creatine monohydrate in the ingredient list. No proprietary blend BS. I am asked all the time for recommendations and I absolutely love the Creatine with Taurine from mindbodygreen. (Visit mbg and use code DRSTEPHANIE for 15% off.)

The simplest way to start on creatine is to add 3-5g to your morning smoothie, your water for your workout, or even your coffee. It is flavorless so it will dissolve in just about any liquid and you won’t notice it.

Do this daily and just make it a part of your habit stack. No need to cycle on and off it, just take it consistently. Forever.

Although I find many things wrong with the fitness industry (unrealistic beauty standards, women getting so lean they don’t menstruate, filtered photos, etc.) one thing we can learn from them is their behaviors and habits toward tissue preservation. When fitness competitors are getting stage lean they undergo extreme caloric deficits, but their main goal is to preserve as much muscle as they can. So their protein intake never changes and they never stop taking creatine.

I think that’s more than telling in terms of the value creatine plays in muscle appearance and function.

NOW

  • Order your first bag of Creatine with Taurine here. (Use code DRSTEPHANIE to save 15%.)
  • Add one scoop to your morning smoothie, workout water, or cup of coffee daily
  • After a few weeks, ask yourself if you are noticing changes in your endurance and performance at the gym. Can you go harder for longer? What about your mood? Sleep? Recovery? If this is the only change you make over the next few weeks, you will likely notice several of these markers improving for the better.

Q: Do I take creatine before or after working out? Or does it even really matter when you take it?

Ahhhh, this is SUCH a good question with the possibility of going down several rabbit holes of nerdom. Thank you bltaillon who sent this in via IG. Let’s tuck into this without going TOO overboard, and give you a tangible answer.

So the TL;DR version of this answer is, based on the literature, it doesn’t seem to matter whether you take it before or after exercise. It seems strength gains and hypertrophy gains are all comparable.

For my medium- and dark-roast Bettys who want a little more detail, the largest study to date [*] on the topic of creatine timing involved a 32-week resistance exercise training program. They also had a placebo group so they could monitor the effects of strength training alone.

Thirty-nine healthy, older adults completed the double-blind placebo-controlled design, and were randomized into three groups: “Cr-Before”, “Cr-After”; or placebo (corn starch maltodextrin immediately before and immediately after resistance training).

Following the 32-week intervention, both creatine groups exhibited similar strength gains, with changes greater than the placebo control group.

The best answer here is: just take it when you can easily do it consistently!

I typically take it before training, but that’s because I make my proats (protein powder + oatmeal) and the creatine bag is right beside my protein powder. So they are stacked together for me. I scoop out of one and then just scoop out of the other.

Suggested for You: Another creatine option comes from Equip Foods. Take a look here at the PureWOD Pre-Workout. It includes creatine monohydrate.

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.

P.S.

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.

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!

***

Disclaimer: The information included in a newsletter, email, or on drstephanieestima.com is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

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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.

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  • Support bile flow and fat digestion*

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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 #10: How to Grow Muscles Without Lifting Heavier

Injury Prevention, Part 2

TL,DR (too long, didn’t read)

In last week’s Mini Pause #9, I talked about ways you can maximize muscle growth and simultaneously prevent injury. Today’s issue continues to explore how to maximize muscle growth without lifting heavier.

Full range of motion—defined as your range of motion that is not restricted and is pain-free—is one of the most effective ways to maximize muscle gains and future-proof your body for injury. Other variables like increasing volume (both in rep and set number), as well as decreasing the time in between sets, are other ways to increase the intensity of the exercise without lifting heavy weights.

WHY

In Mini Pause #9, we discussed the similarities between injury prevention and muscle hypertrophy, and, like most things, it turns out I have more to say about it.

In addition to doing a sport-specific warm-up, working the eccentric and the longest point of the muscle there are a few other variables I’d like to discuss that will help you on your muscle-building journey to becoming comfortable with lifting without injury.

We often hear online that women should lift heavy sh*t. I agree. And, I recognize that many women our age grew up on cardio machines and may not have the neuromechanical integrity or muscle memory to do this well without getting injured.

We must think about improving our strength before we work on power [*].

So, here are a few more ways you can think about growing muscle without adding on weight.

Your goal, eventually, is to progress and lift heavier with time. The key word is eventually. There is no rush, and you can take your sweet time learning. Learn the movement pattern the right way the first time and you will enjoy muscle mommy injury-free status.

WHAT

Full ROM

Building on Mini Pause #9’s idea of working the muscle at its weakest point, your range of motion both for the muscle and the joint is an imperative tool for staying in the gym. You want to get all those muscle gains and prevent injury.

Said another way, if you cannot perform the full range of motion as God and your joints intended, you are missing out on a lot of potential muscle gains [*], as well as future-proofing your body for injury.

This isn’t rehab my Bettys; this is even better. It’s prehab—getting the movement patterning right the first time so that you evade injury and grow the muscle in a safe and controlled way.

If you are dealing with osteoarthritis, rheumatoid arthritis, or any other arthritide [*] for that matter, full range of motion to preserve the joints [*] in question is the absolute name of the game.

In treating my patients with rheumatoid arthritis, the weight on the bar was the least important aspect of working out. It was not important at all. My focus was all about answering the question: What range of motion can this person do without restriction and pain? Then, building on range from there.

Whether you’re a beginner in the gym or someone with 10,000 hours clocked, exploring your range of motion can be how you tweak your routine to stimulate muscle growth AND improve capsular and joint integrity.

Let’s explore this with shoulder training.

Photo 1: Dumbbell lateral raise parallel.

If you’re like me and want glute-sized delts, most of your shoulder work should be focused on the side deltoid muscle, because that is what gives presence to the shoulders when looking at them head-on. (Plus, if you’ve set up your programming correctly, your front and rear delts are going to be hit during chest and back days).

What does full range of motion look like for the lateral deltoid? This is going to, in part, depend on the health of your shoulders.

Let’s assume this is a dumbbell lateral raise. If you are dealing with an injury, you might aim to lift them to about parallel. Something like photo 1.

As you nurse the injury, or if lifting to parallel becomes easier and you feel ready to progress, instead of graduating to a higher weight, keep the same weight, but lift it higher than parallel.

In photo 2, my arms are abducting now to greater than 120 degrees. This is incredibly difficult, and in doing this, you may even need to drop the weights to do the motion properly.

You can continue the movement arc to the top. You want to think about the range of motion for the muscle, and not just simply the movement. You lift until you don’t feel your delts anymore, and it’s all upper traps (this will usually happen north of 120 degrees of abduction with the elevation of the arm shifting from primarily the deltoid to the traps).

Photo 2: Dumbbell lateral raise abduction more than 120 degrees.

Volume

Another way you can accelerate injury recovery and muscle growth without lifting heavy weights is through increasing volume [*]. Meaning, either increasing the repetitions per set or increasing the total number of sets performed.

When intensity is equated [*], we see similar gains in both individuals repping out heavy weights for fewer reps or sets compared with lighter weights with more reps and/or sets.

The signal to the muscle is similar [*] when lifting heavy weights vs. lifting lighter but for many more reps. As long as you get close to failure, you’re going to achieve a similar result.

I often do this in week 4 of my cycle. In my book, The Betty Body [*], I talk about reps in the 15- to 30-rep range with lighter weights to accommodate some of the inflammation many women feel around their cycle.

Truth be told, I will also do this when I haven’t slept well or just am not in the mental space to lift heavy.

Rest Time Between Sets

Another way to manipulate the intensity of your workout without adding weights is to decrease the rest time in between your sets. This works well (read: you will feel the burn!) if you are increasing your volume of the reps in the set.

The burn you feel in the muscle toward the end of a set is an accumulation of metabolic debris and stress. We often rest between sets to allow for this debris to clear and for the muscle to be fresh and ready for its next set.

There’s a lot of discussion about the ideal time to rest between sets, but generally, here are a few good indicators:

  • Your heart rate has returned to baseline or near baseline (I use a polar heart rate monitor for this).
  • Any accessory muscles used in the movement also feel good (e.g., the lower back muscles during a squat, the biceps during a pull-up, or the triceps during a chest press).
  • The target muscles themselves feel ready to work again.

This is probably going to fall in the one- to five-minute range depending on the recovery items above. Decreasing your rest time is another way to elevate the intensity [*] of the workout.

HOW & NOW

  • Keep your training program the same—no need to change anything!
  • Drop the weights (and your ego telling you not to try anything new!) and explore your current range of motion with every movement. Your range is going to be defined as the most movement through an arc that is not restricted or is pain-free.
  • Work your current range of motion with lighter weights while dialing up your volume. Increase your reps from anywhere from 15-30 reps. For example, if your current reps are 15, bump it up to 20. You also can add one more set to your current set split. If you’re currently doing three sets, make it four.
  • One more way to ramp up your intensity is to decrease the rest time between sets. To do this, use your phone as a timer and just see what your current rest time is with your workouts this week. You can start by decreasing this time by 30 seconds next week.

Question of the Week

Q: How can women avoid dyslipidemia during menopause?

If you are starting to see your lipid levels start to climb in menopause, there are a few ways to help improve this. First, we can think about the variables we can control and then perhaps the variables we cannot.

VARIABLES YOU CAN CONTROL

In the Mini Pause #6, I discussed the changes we see in body composition in our 40s through menopause. Some of the suggestions I outlined were:

Consider the composition of your calories.

  • In my book, The Betty Body, I detail a female-centric ketogenic diet for women looking to lose weight, and more specifically, lose visceral fat.
  • The ketogenic diet (high fat, moderate protein, and low carbohydrate) has been shown to improve all measures of body composition including body weight, body mass index, waist circumference, fat mass, fat-free mass, lean body mass, visceral adipose tissue, and body fat percentage

Lift weights with the intention of putting on muscle mass.

  • As we have been discussing, you can lift heavy, or you can lift lighter while controlling the eccentric, increasing the volume of reps and sets, and working the weakest part of the muscle to maximize muscle gain.
  • Work until the muscle is done like dinner.

Exercise snack your way through the day.

  • We are designed to have a lot of low-grade activity throughout the day. If you are someone who sits at a desk for several hours a day, consider investing in an under-desk treadmill and a convertible desktop stand to be able to get some consistent walking through the day. It doesn’t need to be fast: 1.0 to 1.5 mph is plenty!

For improving lipids specifically, I have a few more recommendations that have a good amount of robust literature to support them:

  • Consume phytoestrogenic foods [*]. Once demonized, phytoestrogens are a great choice for peri and postmenopausal women alike. Phytoestrogens can potentially reduce atherosclerosis and atherosclerosis-related diseases through multiple mechanisms like regulating lipid metabolism, lowering cytokine levels, and improving the coagulation/fibrinolysis system.
  • Dose up your Omega 3s. It’s well established that Omega-3s are anti-inflammatory, cardioprotective, and sensitize the body to insulin [*]. I like a minimum dose of 2g, and I often take experimental doses much higher than this. (Check out BodyBio, my new favorite Omega 3s. Use code DRSTEPHANIE for a discount.)
  • Take antioxidants like dark berries and green leafy vegetables to combat oxidative stress. The highest antioxidant content is found in almonds, artichokes, blackberries, blueberries, cherries (sour), chocolate (yay!), cloves, coffee (double yay!), cranberries, grape juice, cranberry juice, pomegranate juice, pecans, raspberries, spinach, strawberries, and walnuts.

VARIABLES YOU CANNOT CONTROL

For the things you cannot control, this is most obviously going to be the amount of sex hormones you produce as you age. Specifically, estradiol.

During a woman’s fertile life, the average level of total estrogen is 100–250 pg/mL. Estrogens are produced primarily in the ovaries via a process that uses low-density lipoprotein cholesterol (LDL-C) as a substrate. In menopause circulatory LDL-C can no longer be utilized to synthesize estrogen. This is, in part, why menopause is associated with increased blood LDL-C levels and enhanced cardiovascular risk.

Speaking to your doctor about hormone replacement therapy is a great (dare I say necessary) option for regulating lipids in our postmenopausal life.

I can tell you with certainty that when my hormone levels begin to drop, or I am symptomatic, I will be seeking this out in addition to the lifestyle factors I teach and write about.

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.

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P.S.

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Mini Pause #9: Focus on Muscle Movement Patterns to Avoid Injury

How to Prevent Injury While Lifting Weights

TL,DR (too long, didn’t read)

Injury prevention and muscle hypertrophy science surprisingly have a lot in common. Most of us are leaving the most effective parts of our weightlifting regimen on the table and losing out on potential progress while simultaneously setting ourselves up for injury. Doing sport-specific warm-ups, manipulating the tempo of the exercise, and training the muscle in its most elongated position is a way to maximize muscle growth and prevent injury.

WHY

One of the more contemptuous/common reasons for women shirking away from lifting heavy weights is the fear of injury. Especially women who are new to lifting and are unsure of their form and technique. I agree with this fear insofar as women in perimenopause don’t heal as quickly as they once did. When ligaments and tendons are injured it can take more time than skeletal muscle to heal because of blood flow variations to these tissues.

So, you want to avoid injury AND maximize muscle gains at the same time. And it’s entirely possible.

I want to talk to you today about maximizing muscle hypertrophy and avoiding injury and the commonalities of these two strategies.

WHAT

Before you start lifting any weights at all, think about how you can best direct neural attention to the muscles in question. You want to ask: “What are going to be the best movement patterns to prime the muscles for my weight workout?

Anatomically, nerves and blood vessels travel beside each other through the body, so where (neural) attention goes, energy (blood) flows.

Warm-ups have classically been thought of as five or 10 minutes on the treadmill, which isn’t a bad idea–it just isn’t a great one if you are going to be lifting weights. A good warm-up up is specific to the movement patterns in question.

Muscle-Specific Warm-Up Sets [*]

Let’s say it’s leg day and you’re going to be squatting with weights today. Irrespective of the kind of squat or the machine you might be using, you want to prime the body for the squatting motion.

What better way to prepare your body for squats than… well… with squats?!

Body weight squats, Smith machine squats (with no weight), or back squats with a barbell with no plates on it are EXCELLENT choices for a warm-up if weighted squats are on the menu.

If you’re scheduled for some pull-ups, why not start with assisted pull-ups on a machine?

If you are going to be deadlifting, why not deadlift just the bar?

Make your warm-up sets the same movement you’re planning to do with weights. This is going to reinforce the neuromechanical patterning needed to execute the movement well, and you’re more likely to perform the movement properly with little to no weight.

The other objective of a muscle-specific warm-up set [*] is to get you sweaty and ready to work. So typically I like to perform three or four sets of a warm-up before the weights get serious. I progressively add on a bit of weight each time.

Because these sets are lower in weight, you can execute them with higher repetitions. I like to add a bit of weight to each set to gradually increase the intensity of the exercise. We are not trying to go to failure, simply ramping up the neural stimulus for when you’re ready to lift heavy.

Sample warm-up set for leg day

  • Walking Lunges, bodyweight only: 20 reps per leg
  • Walking Lunges, 10 lbs: 15 reps per leg
  • Walking Lunges, 25 lbs: 12 reps per leg

Sample warm-up set for back day

  • Assisted Pull-Up Machine, 130lbs: 20 reps
  • Assisted Pull-Ups, 70 lbs: 15 reps
  • Assisted Pull-Ups, 45 lbs: 10 reps

(Remember, the assisted pull-up machine is “easier” the heavier the weight, so as the weight gets lighter, the harder it gets.)

The pattern you may already be noticing is to start with little to no weight and rep out as many full range-of-motion reps as you can with excellent form. Each progressive warm-up set gets slightly more difficult. When your warm-up is complete, you should feel warm, slightly dewy (aka you’re sweaty!), and ready to work.

Tempo / Time Under Tension

Another important consideration for injury prevention is that you can replicate the effects of heavier weights by manipulating the tempo of the exercise [*].

Specifically, by elongating the eccentric phase of the movement.

One of the biggest mistakes I see in the gym–whether it’s squats, bicep curls, or shoulder exercises–is the focus on the concentric phase of the movement.

People often just focus on when the muscle is shortening (and even count the rep on the concentric) and short-change themselves on the eccentric phase of the motion [*].

An easy example here is biceps. The concentric is the first part of the movement when the muscles are shortening; the eccentric is when you’re lengthening the muscle back to the starting position.

Now be honest, how many people have you seen only focus on the first part of the curl, only to drop the weight back down and completely ignore the eccentric lowering?

Now be even more honest–does this sound like your form?!

In the spirit of truth and transparency, I always used to do this too!

I made it all about how much weight I could curl or squat or deadlift and who gave a flying fish about lowering it slowly!! I’d slam it on the weight rack to let everyone know I was there, thank you very much. This is known as the ego running the show.

Let’s come back to squats because I know my Bettys like to work on their juicy peaches. The eccentric is the first part of the squat: the descent. The concentric is getting back up. So many of us shortchange ourselves and don’t think about lengthening the time of the eccentric as a way to build muscle [*].

But you can absolutely (and often by necessity have to) use lighter weights when slowing down the weights so you can focus on the eccentric part of the movement. It’s the harder part of the movement because you’re elongating the muscle and at the same time increasing the force production to get the muscle back up again.

For those of you who like to load plate after plate on a bar, or derive a lot of satisfaction from lifting heavy, take note that slowing down the tempo and focusing on the eccentric is going to humble you in some surprising ways.

I actually would cry when I started training this way because I thought “I was not working hard enough.” This was my ego dying a hard and brutal death, friends. To save yourself some gym heartache, lighten up the weight, master the eccentric, and watch your gains go through the roof!

Work the Weakest Point of The Movement

One of the best ways to prevent injury is by training up the weakest point of the movement [*] [*] [*]. It also happens to be the best position to drive muscle growth, which is why full range of motion is so important for both injury prevention and technical skill to grow muscles.

In all cases, this is when the muscle is stretched and at its longest. NO exceptions.

  • Squats: It’s at the bottom of the movement.
  • Lunges: It’s at the bottom of the movement.
  • Pull-Ups: It’s at the bottom of the movement.
  • Chest Press: It’s at the bottom of the movement.
  • Push-ups: It’s at the bottom of the movement.
  • Bicep Curls: It’s at the bottom of the movement.

I hope you are seeing a pattern here! When the muscle is stretched the most, it tends to be the weakest. It’s where the movement sucks the most.

This is why the full range of motion matters. If you’re squatting to 90 degrees of knee flexion, it is ok, but not great at tensioning out the glute as much as if you were dipping below 90 degrees.

And if full range is an issue (maybe there is a foot or ankle mobility issue, or an arthritic condition), then keep the weights light and work on restoring full range of motion. Go see your chiropractor or physio, and for the love of Cleopatra do the mobility exercises they are giving you!

It’s here, in the last few degrees of motion, where you leave so much of your goals on the table. If you could set your ego aside, tempo your workout to focus on the eccentric, and get into the longest position possible–all while using lighter weights–I’m confident in saying that you will make extraordinary progress in your muscle pursuit AND prevent injury.

HOW & NOW

  • Whatever your current program is, keep it. You’re just going to modify the tempo and depth of movement a bit.
  • Add in a warm-up set before you start adding any weights.
  • Shift your attention to the eccentric (lengthening) part of the movements in all your exercises. Slow it down by counting in your head. Start with a four-count descent.
  • Try to execute all your exercises with full range of motion: go all the way down, and then (and only then!) shorten the muscle again to come back up.
  • Compare and contrast the fatigue and pump you generate by simply priming the nervous system, changing the tempo, and working the weakest point of the muscle.

Question of the Week

Q. What is your approach now to IF (intermittent fasting)?

I’ve modified my stance on fasting somewhat over the past few years. I still think it’s a good tool for caloric restriction, weight loss, and overall health.

I typically fast for about 10 to 12 hours a day, with the bulk of that being sleep (I sleep for nine hours of that).

WHAT DO WE KNOW FOR SURE?

What I take issue with is how it has been perversely distorted as the ONLY tool that can help women, and how women are punishing themselves with this tool. It seems to be masquerading as a socially acceptable eating disorder.

Online influencers like to talk about autophagy as a hallmark of fasting, with autophagy of course being just the equivalent of your roomba vacuuming up cellular junk in the body. The problem with this is we have no real way of measuring autophagy.

Does 16 hours of fasting raise autophagy levels more than a 12-hour fast? If so, by how much? We have no idea, and anyone who tells you 16 hours is better than 12 is straight-up lying.

They have no idea of how to quantify “better” because we cannot measure it. And let’s pretend we could measure autophagy–is more always better? When do we move from beneficial to harmful? And how does this apply to women?

WHAT’S THE END GOAL?

What I know with certainty is that women feel like they must do more, more, more. Which coincidentally and ironically comes from a place of less. Does fasting for 24 hours make sense for most women?

I think a lot about the pressures on women and it’s always: Get thinner! Be Younger! Do More with Less!

I wonder if fasting culture is just a version of that. A wolf, disguised as a health influencer, hiding in sheep’s clothing. Telling you IF is the tincture to solve your problems, and in the end, you do lose: your period, your hair, and the joy that comes from eating food with others.

Women don’t eat enough as it is. I have seen way too many women fast for 16 hours only to complain about belly weight that won’t budge, weight loss that won’t happen, losing their hair, and yet still terrified of calories.

My current approach includes eating when I wake up. I front load the majority of my calories so that I’m finished eating by about 5 pm. The only “rule” I try to follow is I try to stop eating 3 hours before bedtime so it doesn’t affect my sleep.

If I am paying attention, this usually means I’m eating for about 12 hours. When I’m in my luteal phase, I eat for more like 14 hours, fasting for 10. But I’ve stopped paying attention to it. I just kind of naturally fall into this rhythm of eating.

IS IT THE BEST TOOL?

Fasting is one of many tools, and like many tools, it can be taken to the extreme and become a distress. So I like it, but put an asterisk on it. Not everyone should be fasting, especially if it feels overly restrictive and you hate it.

Patients with obesity and other chronic diseases can tolerate longer fasts with good results but most women with a normal BMI should not be engaging in any kind of 24-hour+ fasting practices. Especially if you want to build muscle.

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: Jaspr

Did you know that modern homes trap indoor pollutants from cooking, personal care and household products, allergens, pets, and mold? The air can be up to 10 times more polluted than outdoor air!

What you’re breathing inside your home affects your sleep, energy, and overall health. I recently invested in an air purification solution with commercial-quality HEPA filtration and real-time air quality monitoring with Jaspr and the effects on how my family feels inside our home have been profound.

Listen: Don’t miss my conversation with Jaspr founder Mike Feldstein on the Better! podcast. We cover a lot of ground, including the critical link between air quality and cognitive health.
Read: This week’s bonus article on drstephanieestima.com looks at the links between air quality, sleep, and hormonal balance.
For You: Visit Jaspr and use code ESTIMA to get an exclusive discount.

P.S.

FREE WORLD SLEEP DAY WEBINAR-LIVE!

Topic: Women & Sleep: How Hormones Affect Your Rest and Recovery

Join Us! Friday, March 15, 9:30-10:30 a.m. Pacific Time

What: Join me and Dr. Dave Rabin, M.D., Ph.D., co-founder and Chief Medical Officer of Apollo as we discuss one of the most-requested topics from our communities: how women’s hormones affect their sleep and how women can best support their health through life’s transitions. We’ll talk about cycles, infradian and circadian rhythms, how to improve your sleep at every life stage, and much more.

Bonus! Get YOUR personal questions answered.

Can’t Make It? Be sure to register even if you’re unable to join live to receive the recording in your inbox.

Register Here! World Sleep Day Webinar

Win! One webinar registrant will win a free Apollo wearable!

2024 HORMONE SUPER CONFERENCE

When: March 18 to 24, 2024

What: In this online event, you’ll learn how to identify and heal hormone disruptions and imbalances so you can improve your physical, mental, and emotional health

  • Day 1: Women’s and Men’s Hormones
  • Day 2: Thyroid and Adrenals
  • Day 3: Nutrition and Weight
  • Day 4: Nervous System Dysfunction
  • Day 5: Mental Health
  • Day 6: Functional Medicine
  • Day 7: Self Empowerment

Who: I’m thrilled to be one of the featured presenters among 40+ interviews with doctors, psychiatrists, psychologists, researchers, scientists, functional medicine experts, acupuncturists, and bestselling authors. They’ll be presenting effective, science-backed ways for you to foster hormone health.

Register Here! 2024 Hormone Super Conference

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.