Ep. 462 Protein, Hormones, and Midlife: What You Must Know with Dr. Stephanie Estima

Today, I am thrilled to connect with my dear friend and colleague, Dr. Stephanie Estima. Dr. Estima and I have similar audiences with many of the same concerns, so we decided to join up for a special episode where we can provide accurate answers to questions from the women in both our communities. 

In our discussion, we dive into several topics we often get asked about on social media, including weight gain, insulin sensitivity, and how to identify where we are in terms of peak fertility years, perimenopause, or menopause. We discuss the significance of protein, looking at ways to increase our protein intake, the benefits of intermittent fasting, and when to consider doing that. We also explore how stress and hormones affect us in middle age, and we unpack some relevant research on fat loss and ways to fuel ourselves for exercise. 

You have much to learn from today’s insightful and empowering conversation with Dr. Stephanie Estima!

IN THIS EPISODE YOU WILL LEARN:

• How the fear-driven content in wellness circles can cause anxiety instead of providing solutions

• Why previously effective diets may need to change during menopause

• Vilifying carbs and negative consequences if a keto diet or fasting is maintained long term

• How menopause impacts the gut microbiome

• Perimenopause and menopause are just natural stages of life and not indicators of decline.

• Strength training and why it’s never too late to start

• Benefits of eating protein first in meals 

• Practical advice for managing health challenges during menopause

• Acute stress vs. chronic stress

• Will fasting intermittently before exercising burn more fat than fasting afterward?

• The importance of adopting a balanced approach to exercise and nutrition

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“It does not actually matter whether you train fasted or fed, in terms of fat loss."

-Dr. Stephanie Estima

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Connect with Cynthia Thurlow  

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Connect with Dr. Stephanie Estima

• On Instagram 

• On her weekly podcast, Better! With Dr. Stephanie

Transcript:

Dr. Stephanie Estima (00:01.088)

All right, and we're live. Welcome to... So good to see you too. I know we've been just gathering before we got recording. I was like, all right, this is so good. We should just start. These are our She Said, She Said episodes, which I love the name. I love spending time with you. And I'm so happy that we get to do this.

Cynthia (00:03.836)

So good. Yeah. So good to see you.

Cynthia (00:21.508)

Absolutely. Best way to start a Monday.

Dr. Stephanie Estima (00:23.948)

Best way to start a Monday, I love it. So we thought that we, like you and I are always talking over text. We have very similar audiences with very similar concerns. It's usually a perimenopausal woman trying to figure out intermittent fasting, perimenopause, the hormonal change, the body composition stuff, the sleep changes, menopause. And we get so many questions and we can start doing this maybe even more formally, but so many questions come in to you and into me that are similar. was like, why don't we just, and you and I were just like, why don't we just meld our minds together on a show, or we can actually spend the time to really elaborate on some of these questions. Because sometimes on Instagram, I'll get these questions on stories all the time, and you just have like a 15 second frame to put in like a little bit of stuff. But this is really where the nuance and like the real, I think that we can really answer these questions properly. What do you think?

Cynthia (01:17.666)

I totally agree. And I think for on so many different levels that there's a lot of noise in the space right now. There's a lot of good information from, you know, well-meaning clinicians. And then there's a lot of what I will affectionately refer to as voices that should be henceforth muffled because a lot of what they're stating I think can be harmful or can cause more anxiety. And I think we as women put enough stress on ourselves to, you know, be a great partner and be a great mom or be a great coworker or be a great friend. And so I think in many ways, our viewpoints are so much in alignment in terms of like finding the right balance and cadence to help women navigate the perimenopause to menopause transition in a way where they feel empowered and they don't feel fearful and they don't feel scared and I think that I feel truly grateful for our friendship and being able to share our perspectives with both of our communities because you know we're stronger together you know that's the one thing that I can say within this space is that we are so much stronger and we are unified and together and speaking out and helping women and doing it in a way that is sustainable and healthy and not just healthy from a physical perspective but also an emotional spiritual perspective as well.

Dr. Stephanie Estima (02:36.59)

So eloquent, I love to hear. I could just listen to you talk. I'm like just little hearts are just coming out of my eyes as you're talking. I love that. And actually, I just wanted to just double click on something you said, which I think is really important, which is we are actually wired to respond to fear, right? So you have like, let's just call it, I'll call it out. know, the shirtless bros at the grocery store telling you like, you know, this vegetable is gonna kill you, oats are stealing minerals from you, blah, blah, blah, blah, blah. We're actually wired.

Cynthia (02:39.474)

Aww.

Dr. Stephanie Estima (03:06.242)

to listen to fear messages like that and pay attention to them more so than a new, like, you know, a scientist who's going to say, based on the literature, this may or may not be true. That is the, you know, for the human brain that is very much primary, like primarily concerned about survival, something like, hey, oats are stealing from you. If you eat them, they're gonna run, like the, you know, the phytic acid is going to steal your minerals. You're gonna listen to that more so than,

hey, know what, the literature doesn't support that and in fact consumption of oats is related to a healthy body composition and better performance in the gym. you know, like one of them you're gonna pay attention to, cause like, no, if I'm eating oats, I'm going to, you know, die or insert negative outcome here. So I just kind of wanted to highlight what you said. I know you said it in passing, but I think, you know, just highlighting your brilliance a little bit there in that we are very much wired to listen to fear versus a more maybe less energetically or emotionally charged message that provides a bit of nuance. So that's key as well.

Cynthia (04:12.316)

That's such an important message. And it's ironic because when I started probably eight, nine years ago, pivoting from traditional allopathic medicine, I used to be the person in Whole Foods and in Trader Joe's and I would identify like cleaner foods. But actually I feel like I have now gotten out of the habit of being in the grocery store and doing those kinds of things because I think there's so much negativity and fear in reaction to whatever the message is. And I think for so many people, it's all about sustainability and it's all about finding things that you can do long term. And let's be clear, if you are trying to clean up your diet, let's just say for as an example, and you're trying to eat less processed foods, it's going to be a journey. It's not a race. And so I think in some ways, those I'm sure well-meaning influencers, I'll just find that reframe, those well-meaning influencers who probably unintentionally are evoking fear in so many individuals, they would actually be more effective. But I think that they're not looking to be more effective. I think they're just looking to incite fear and divisiveness. They would actually be more effective if they changed their strategies a little bit to make it more accessible for the average person. In fact, I think about one individual who will remain nameless who for a long time only ate meat, which is fine. I understand there can be therapeutic benefits to eating a carnivore diet for a period of time. But now I'm watching this individual kind of changing their narrative a bit and they're incorporating more fruit and now they're eating honey. And so I think it just speaks to the fact that at any stage of life, we are allowed to change our minds and course correct. But you are absolutely correct that especially on social media, the algorithm loves fear driven content.

And so more often than not, that's what gets pushed in front of us. And so we have to be conscientious about what we choose to view, watch, bring into our kind of periphery of our lives. And I think that I just, I just find it fascinating if you're on social media and you look at what is trending more often than not, is the social media influencer talking about someone who had bad plastic surgery, the social media influencer who's talking about, you know, some fear mongering topic.

Cynthia (06:28.122)

as opposed to like kittens and puppies. Like I'm the person that dives down the rabbit hole and loves to watch all the animal antics. I could sit and watch that for hours because it's pleasant. But in more instances, that's not what actually drives content on social media and is pushed in front of us. Sorry for that tangent, but I felt like it needed to kind of be, needed to be said.

Dr. Stephanie Estima (06:45.774)

No, that's great. Yeah, no, it just underscores the idea that it is important to be mindful. Sometimes we can. We're going to talk about fasting today. There's a lot of questions around fasting, I think we'll get to, but sometimes a social media fast. That's also another. I have really gone into the habit of unfollowing individuals who I feel are pushing out this, yeah, just fear based narrative because it's sort of like eye roll.

Even honestly there's been individuals who have had on the show and sort of watching the stuff that they're putting out and I'm like, I don't love this. I don't love this message. It's very divisive. And I think people, think you sort of learn, unfortunately, like you said, the algorithm loves you know, it loves fear-based stuff, but I think that us as content creators, we also learn, well, if I put out more fear-based stuff, I'm gonna get more eyeballs, so that's a good thing, and then you just start putting out more content like that. So don't become the algorithm. That's the, don't let the algorithm dictate your life. There's certainly ways to do it ethically, but let's dive into some of these questions. There's some really, really good ones. This came in from, these are questions mainly from your community.

Cynthia (07:44.028)

Yeah.

Dr. Stephanie Estima (07:59.091)

And going forward, I'll make sure to pull mine as well. Where did you want to start, Is there ones that you want to jump into right away that are speaking to you?

Cynthia (08:08.06)

Well, you know, it's interesting life kind of imitates art and this post menopausal weight gain. So women that are already in menopause, this seems to be without question, the greatest concern. Complaint symptom of this perimenopause to menopause transition without question. And I think that a lot of women are doing the right things. And this is why I was like, let's start the conversation there, because I think this is a particular topic that is relevant, timely, and also of great concern. And I don't say this from the perspective of the aesthetics. I think people are frustrated and they're trying to look for ways to circumvent this weight gain. And this is a question that came in from Mary. So she's talking about she's in menopause. Why is a keto lifestyle and cardio exercise not giving the desired results? And so presumably the results are the menopausal weight gain, and I can't think of a better person that I'd love to hear the response from than you.

Dr. Stephanie Estima (09:12.654)

Yeah, I mean I I gotta I gotta agree with Mary first it doesn't feel good like when we're weight when we're gaining weight You don't like when your clothes don't fit you just you're just miserable, right? You know, you have this, you know favorite jeans or favorite shirt or favorite whatever when you're you know There's this sort of thickening of them of the waist that a lot of women will complain about it's like accumulation of belly fat or this disappearance of the waist that a lot of women think about and or experience and so I just want to throw some empathy there. I totally can understand how frustrating that is. And I think that we have to look at keto and the intermittent fasting. So for transparency, I wrote a book on female centric ketogenic diet. It's called the Betty body. And it's, you know, the whole book is like menstrual cycle literacy, like ebbs and flows of the menstrual cycle, but then how you can sort of pair different food, you know, diet types with where you are in your cycle. And I gotta take some responsibility here because when I wrote that book, I still stand by the principles of the diet there, but what I found happened and I didn't put this, the messaging wasn't clear enough. in second and in future iterations of this book, I am going to, there's gonna be some modifications that I'm gonna make. And that is to say that the diet that heals you,

Okay, so if you are insulin insensitive or you're gaining belly fat or you know, your clothes aren't fitting the way that you want, a ketogenic diet or a protocol for intermittent fasting, let's say, is a wonderful intervention for you to start with, right? So the ketogenic diet, really, really good literature on helping reverse insulin sensitivity, improving brain fog, improving sleep, improving things like waist circumference to hip circumference, all this kind of stuff. The issue is what I found after having thousands of women go through the book and running programs, is women started to vilify carbohydrates. So was like, so ketogenic diet, low carb. So that means that carbs are the enemy. I must never consume carbs again. And it's like, God, I don't know how I missed that. As a doctor, literally, I beat myself up about this, truthfully, because

Dr. Stephanie Estima (11:28.75)

It's a great intervention to pull back on the carbs temporarily. That is what healed my problem, like my menstrual cycle issues, my insulin sensitivity, my estrogen dominance, and then the clients and the patients that I cared for. Yes, pulling back on carbohydrates temporarily, double underline, highlight, bold, temporarily helps. And then once that diet is no longer serving you, you have to move on from it, right?

In the same way that you might outgrow a friendship, right? Or you might outgrow a business relationship. Like it was serving you for a while and now you've sort of ridden that area under the curve, let's say. This is like nerd speak for like you've of, you've exhausted the benefit of that diet. You no longer need it. And you now move on to something else. Where I think. women have missed the mark. And like I said, I'm taking some responsibility for this is that they stayed in Ketoland for too long. And so then we start to see denigration of thyroid function. Then we start to see insulin sensitivity actually decline. We start to see the weight coming back. And then what do women do instead of saying, hey, maybe I've out like maybe I've passed the sell by date, right? Like the expiration date on this diet is done. We start to say, I should fast longer.

I should eat even less carbs. should whiten up. I should do keto harder, right? So my overall message here is I, is a, in order to heal metabolism and sex hormones and some of the things that she's talking about, I do think a therapeutic intervention of intermittent fasting and the ketogenic diet is great and you shouldn't stay there forever. And so.

That's sort of the long and the short answer. I don't know how you feel about that. Thoughts on that? I know you're known for intermittent fasting and millions and millions of views on it. Do you agree with that, disagree with it? Any context you'd like to add?

Cynthia (13:31.591)

Yeah, no, I would say that we are designed as human beings to evolve, shift and change throughout our lifetime. And so what you're really speaking to is that if there's a particular strategy or strategies that have worked well for you at a particular time in your life, you may come to a point where you find it is no longer effective. Now, I have spoken very transparently, so I'm going to dovetail and just say that personally, I've worked very diligently over the last almost year to build muscle. Well, as you can imagine, and menopause, your hormones, yeah, your hormones are a little bit working against you. And so it is much harder to build muscle, not impossible. But what that has looked like for me personally is not as much fasting, more carbohydrates. So I can, actually do better on a higher protein, higher carb diet. And I was someone that for many years, carb cycled, really tight fasting windows, really tight rules around what I ate in a fasted state, if anything. And I've learned to relax that quite a bit. And what I found very humbly that I think is really relevant to this conversation is that I invite you if something is no longer working to shift gears, maybe you need a little bit more therapeutic carbohydrate. And when I talk about carbohydrates, it could be more vegetables, it could be some fruit. I do very well with fruit. I don't do as well with grains, but I do have some grains in my diet now.

I am dedicated gluten free because I have several autoimmune conditions that are in remission. But what I think is important for people to understand is that I went from a 16 eight, know, 16 hours fast with an eight hour feeding window to now having effectively a 10 or 12 hour feeding window to get enough protein in. I eat more carbohydrates now. I am leaner now than I was a year ago, although maybe with clothes on, might not look any different, but you know, with body composition. Yeah.

Dr. Stephanie Estima (15:22.286)

But your body composition's different. Yeah, yeah.

Cynthia (15:23.922)

My bioimpedance scale information has been very helpful. So when women say, you know, this strategy is or strategies are no longer working, it's like, okay, your body is inviting you to change gears. And that's the role of hormesis, like hormetic stress in the right amount at the right time. And it could be that you need to adjust your strength training. You may need to back off on fasting. And I think it is human nature that when something is no longer working to your point that you already made more carbohydrate restriction, more exercise, more fasting. And we think that that's the right strategy to get us out of it. And I think it seems counterintuitive, but for many of us, it is backing off on the intensity of what we are doing and perhaps changing things up. The other thing that I think is interesting and relevant because the ketogenic diet has therapeutic benefits is that the research demonstrates that depending on the composition of our gut microbiome, which we know takes a hit, in that perimenopause to menopause transition, largely from the loss of estrogen. Estrogen is very important, very fundamentally delicate dance between that and the immune function, the gut microbiome. As we are navigating perimenopause and menopause, those changes in the microbiome are so significant that we may no longer have the right balance of microorganisms to facilitate a higher fat adjusted protein intake. And so that is the other thing

that I remind women if they say to me, I went on a ketogenic diet and they're doing it right as they identify what their macros are and I gained weight on a ketogenic diet. And the first thing I'll ask is, well, how much fat are you consuming? Because a stick of butter and five avocados a day is not going to work for any of us, at least not the women that I know and I interact with. But helping them understand that sometimes it can be a reflection of what's going on in the microbiome.

And to kind of bring this full circle, men and women's microbiomes as children are very similar until we go into puberty. And it's puberty when we start having these changes in sex hormones that starts to differentiate the gut microbiome of men and women. It comes full circle and in menopause, women's microbiomes more resemble men's than in any other time in their reproductive years. And so just understanding that in and of itself helps women understand like

Cynthia (17:44.851)

Your hormones are not per se working against you. It's just, have to navigate things and consider this is why I like diagnostic stool testing. This is why I think it's so important. If you're stuck, this is a great opportunity to shift gears, change what you're doing. Think about some gut microbiome testing, working with a practitioner who's knowledgeable. And when I say knowledgeable, not someone that's done like one, you know, 12 hour class one day and thinks they're going to go out and save the world. But I think for a lot of individuals, it's understanding that shifting gears is just part of navigating middle age and not in a bad way, in a very proactive way, just say, okay, this is no longer working for me. This is no longer serving me, but it may work for someone else. You know, case in point, intermittent fasting, carbohydrate restriction, et cetera.

Dr. Stephanie Estima (18:26.422)

I love that. Yeah.

Yeah, that's so good. And I think just as a I mean, you can speak to this more than I, but just as a function of aging, that single cell epithelial lining of the gut is just going to get trashed. Right. It's just going to it's going to age. Right. There's going to be more disorganization there. I actually had a question for you as you were explaining that. Do you do you take digestive enzymes or do you like digestive enzymes or is you do? Yeah.

Cynthia (18:48.018)

Mm.

Cynthia (18:53.138)

I love digestive enzymes. make an enormous difference. And I think for a lot of us, you know, not everyone needs necessarily support with hydrochloric acid. We know we produce less of that as we get older, but digestive enzymes for a lot of women, like as an example that they tell me they're constipated, they struggle to have a bowel movement every day. I'm like, girl, we just need to get you on some good digestive enzymes because for many people it's helping break down the carbohydrates, the fats, the protein that'll get things moving along and literally moving forward.

I love my digestive enzymes. think that they are an integral part of my supplement regimen. And definitely one of those things that I think can make a big, big difference in how women feel because so many of us deal with bloating. Like that seems to be a very common issue in middle age and digestive enzymes can be very beneficial. Do you take any yourself?

Dr. Stephanie Estima (19:36.28)

Yeah.

Dr. Stephanie Estima (19:43.021)

I do, I just started actually. I was interviewing Wade Lightheart from Bioptimizers. Great interview and he basically gave us like a master class on digestion and he was talking about, and this is actually what made me switch. I was like, yeah, yeah, yeah, digestive enzymes probably need it. But then he was like, listen, you are buying all this protein, consuming all this protein, like make it work for you girl, you know? And I was like, my God, of course. So you can actually more effectively, as we're losing some of our own natural enzymes, you know, can more effectively break down and absorb the protein that you are consuming. And for me, it's like, you tell me that I can get gains in muscle mass by taking digestive enzymes. And like, I'm bought, I'm bought. I'm like, show me where, where's the checkout, you know?

Cynthia (20:27.021)

Yeah.

Dr. Stephanie Estima (20:31.756)

So yeah, I just started. So for me, I feel like it's a little too early to tell, but yeah, I'm really excited about it.

Cynthia (20:37.926)

Yeah, and I think that's the other thing is we can eat really healthy food, but if we can't break it down and assimilate it, that becomes problematic. So I do think digestive enzymes, getting a good quality one. For full transparency, I use masszymes. I think that masszymes is by bio-optimizers, and they were podcast sponsor for a while. I believe fervently that

Dr. Stephanie Estima (20:54.668)

Yeah, that's the one I'm using.

Cynthia (21:03.824)

That is the digestive enzyme that works really well for me. There are other companies and brands that are out there, but that's the one that I personally take, because that's usually the other question I get is, what do you take? And I always say, this is what works for me, but maybe try a couple brands out and see what you like.

Dr. Stephanie Estima (21:12.78)

Yep. Yep.

Yeah, and this is same. So I'm taking the mass times and they do they make my favorite magnesium of all time. So I love their magnesium product as well. All right. So I think that she that question she got probably more than she bargained for. But this is what these podcasts are for is the nuance and the tangents. Where do you want to go next, my friend?

Cynthia (21:31.324)

Hahaha

Cynthia (21:39.674)

I guess just, this is literally, I think we could answer this question in one or two sentences, criteria for when you have ceased your last period, when do you become menopausal or post-menopausal? And so I understand the confusion because this terminology gets used interchangeably.

Dr. Stephanie Estima (21:47.796)

yeah.

Dr. Stephanie Estima (21:58.127)

You're either premenopausal, perimenopausal, or menopausal. Like, that's it. You don't ever get beyond, you're not like never in this post-apocalyptic menopausal. Like, once you're in menopause, you're there for life. Like, you're there. You're in the after party, you're there the after party, you stay there, right? So that's how I like to think about the nomenclature. You know, premenopausal would be anything under 35.

Perimenopausal would be like 35 to up to the point where you have 12 consecutive months without a period. And I know that some women are going to be like, how dare you? I'm 35. Like I am not old, you know, because we sort of associate this peri. Yeah, we're very age sensitive, right? So it's like perimenopause. I'm 36. Like, you know, do you look at me? You know, I'm not, you know, because I think that there's this sort of cultural stigma that, you know, once you're anything menopausal, perimenopausal or menopausal, you're like dried up and you're

Cynthia (22:36.21)

They're age sensitive.

Dr. Stephanie Estima (22:53.07)

you know, hair is gray and you know, you're only wearing cardigans and you know, like, don't, I don't know. Nothing, nothing is cardigans. I have some, but you know, I just think that there's this sort of like, your life is over kind of like, you're not useful anymore. So yeah, perimenopausal 35 to about 51, 52 for most women. So it's like 15, like good chunk of your life, right? Like 15 ish years. And then after, you know, you don't have a menstrual cycle anymore.

You're menopausal and you stay there. There's no post menopause. There's no after menopause.

Cynthia (23:28.594)

Yeah, it's interesting because when I hear others describe menopause and after menopause, some people say menopause is one day in your life. I'm like, I don't really believe that. think of it as, you know, we have these buckets, your puberty, you know, peak cycling years, then perimenopause, then menopause average age in the United States is 51. It's similar for most westernized countries. What's interesting, though, are the people that are in the in-between. And by that, I mean they're on long

acting reproductive products like IUDs, people that have had Depra-Provera or medications that are, they're not yet menopausal, but they're not actually getting a cycle. So the little dovetail caveat is always, unless you've had a total hysterectomy, removing your uterus and your ovaries, some people just have their uterus removed and they're no longer getting a cycle, but they're not yet menopausal. So that is actually a large percentage of women.

Having said that, I think at some point they will change the nomenclature to incorporate, you know, this kind of in-between. I call it the in-between because they're not yet menopausal. If you look at lab work, they're still, you know, they still got, you know, low FSH. It's not over 25. They're maybe cyclically having symptoms throughout their cycle. They're just not having a menstrual flow and therefore helping them understand like where they are. So if you're 47 with an IUD, you very likely are probably not at menopause yet. But for those of us that have gone 12 months without a menstrual cycle that are not part of that long, they call it larks, the long acting reproductive contraception in some instances. If you're not part of that larks community, yes, you are very much in the peak fertile years, perimenopause, menopause, and I call it menopause and beyond because it's like menopause. the, you know, third of your lifetime is spent in menopause. It's a long time.

Dr. Stephanie Estima (25:21.218)

Yeah, yeah, and lots of time to make things happen. It's never too late. You're never too old. You're never behind. You you can start, you know, starting a gut protocol. You can start, you know, there's this woman that I follow on Instagram. You probably know her. It's train with Joan is her handle. She's I don't know how old she is. 80 maybe 85. She's squatting, dead lifting, and she only started a couple years ago.

Cynthia (25:36.082)

Yes, she's amazing. I think she might be 80. She's incredible.

Dr. Stephanie Estima (25:47.683)

I wrestle with this too. Sometimes I'm like, I'm not helping enough people. I'm not doing enough. I'm not reaching enough people. I'm not I'm behind. You know, I have that sort of feeling, this feeling of lack of time. And then I look at Joan, who has, you know, in the last year, graced I think she was on Women's Health magazine. And, you know, she's this icon, at least for me, for what's possible at any age, like any age you can start you're never behind you're exactly like where you are.

Right now is exactly where you're supposed to be. I was actually having this conversation with my son for a separate reason. But I was saying to him, like, how would you how would you be showing up? Like he was having a situation like an issue. I said, how would you show up to this situation if you knew that everything was going to be fine in the end? Like it turned out exactly the way that you wanted. And I actually give that advice to myself sometimes when I feel like I'm behind the ball. I'm not doing enough. I'm not good enough, I'm not putting out enough content, I'm not helping enough people. It's like, what would it look like if it's actually, it turns out exactly the way that you want in the end? Like you help enough people, you get enough women lifting weights, whatever it is, right? So I would just offer that to any of our listeners here as well. Like you are exactly where you're supposed to be, you're not behind. If you haven't started yet, that's okay. You can start today. Your future is still within your control.

Cynthia (27:12.474)

I love that message. think it's important and it's certainly, you know, as someone that I look to in the health and wellness space, high integrity, great content, positive influence. I think we all have days like that. I mean, I just finished a book manuscript and I, you know,

Dr. Stephanie Estima (27:27.288)

Yeah.

Cynthia (27:29.042)

It sounds like my publication date will be April of 2026. And in my mind, I'm like, there's not enough time. There's so many things I want to do. And I finally just told myself I needed to get out of my head and just realize all the things will fall into place. You are a planner. You have the right resources. All the things will fall into place. So I 100 % agree with you irrespective of where you are in life stage.

You have the ability to shift and pivot and change throughout your lifetime. And I love that you brought up Joan, because she's someone that I really look to as an incredible example of what is possible.

Dr. Stephanie Estima (28:00.194)

Yeah, love her. All right, so we didn't do it in two sentences.

Cynthia (28:04.786)

I don't think, I don't think we ever do it in just two sentences, but be concise. Well, I can tell you, the cardiology group that I used to work for, they Valley as men, cause it was almost all male cardiologists and the NP service. They expected us to be as concise as possible. Well, that ruined my writing skills because I had to think about what are the 15 things I have to put into the sentence and make it as concise as possible. And so I, I need to just reacquaint myself with some of that.

Dr. Stephanie Estima (28:08.94)

We should try to challenge ourselves, like answer this in one sentence. Exactly.

Dr. Stephanie Estima (28:35.766)

Love it. Well, we can be, this is what I feel like Instagram is sort of like science light. And the reason why we push people to the podcast is where you can get the full answer, right? Like I want, I want people listening to this to feel like they have a seat at the table, like you and I are, you know, if, this will be soon, we will be doing this in person. But in the, before that, I want people to imagine that we're all having coffee together and you're just sort of listening in on a great conversation and there could be tangents and there could be nuance and there could be details.

Cynthia (29:06.672)

Yeah, absolutely. Absolutely. I've got a great question here from Karen about protein. As a menopausal woman, I hear your message to be sure to eat enough protein. I'm finding it hard to get more than 90 grams per day while still getting enough other micronutrients as I get too full from eating my veggies.

I think of my 89 year old mother who I am encouraging to eat more protein, however, her appetite is lessened, which is so common and other nutrients are important too. I'm looking for tricks to get in protein and everything else for good health.

She asked about some other things incomplete protein like collagen peptides. How do you answer this question as so many of our listeners are dealing with the same issues. They're watching aging parents were in the sandwich generation. They're struggling to get enough protein in. I know that we probably have interviewed guests that have had varying opinions on this as well. Like Mark Sisson as one example he talks about this very openly. What are your thoughts? How do you encourage women to get enough protein in and how do you deal with older men and women who probably don't have as much appetite and aren't as physically active, aren't hydrated, all those things contribute to that appetite regulation too.

Dr. Stephanie Estima (30:17.742)

Yeah, there's a lot of factors here. I would say that I would get in touch with your inner protein shake. So I would say that that is basically a food group in our home is protein shakes. So that is a very easy way, like one scoop of most proteins, whether it's a vegetarian or whey based protein is going to give you somewhere between 25, 20 to 25 grams of protein.

Cynthia (30:25.042)

I had one this morning.

Dr. Stephanie Estima (30:46.674)

per scoop, which is really, really easy. And when you are consuming something in liquid form, it's not quite as filling as, let's say, five ounces of chicken plus the vegetables plus the rice or whatever else is on the plate. So it's a little easier to get in your protein sometimes in liquid form. It's also a little easier on the digestive tract, just sort of looping back to what we were talking about, because the work has sort of already been done for the digestive system, right? You're not like the mastication and the breaking down from a solid into like a bolus into like liquid and extracting. All of that's already kind of been done for you with the Vitamix or whatever mixer you're using. So I would say love shakes as a way to get in more protein. The other thing that I've been experimenting with lately, because I actually get this comment not even just with like 89 year old moms, I get this comment from 45 year old women that are like, how much meat? or how much tofu do I actually need on my plate? I'm actually having, you know, to this person's comment, I'm having such a hard time getting more than 90 grams of protein. I actually think that baking with protein is, at least that's been like a big secret for me and my family, because I always don't just wanna have meat. I eat meat, I'm a meat eater, love meat, but I love to have dessert, and I'm not going to give up dessert.

Cynthia (32:05.773)

Hahaha!

Dr. Stephanie Estima (32:07.278)

Like that's the other, that's my hard boundary is like, I still want to enjoy dessert. So I have been experimenting with protein brownies and chocolate mousses and you know, cottage cheese and Greek yogurt usually make up the bulk of those recipes. You know, I made one just the other day. It was a protein brownie and it was basically like Greek yogurt. I put some collagen, I put protein powder in there, put some cocoa and I think I put some sugar, like mix it all up and threw it in the oven. I'll provide, I'll give you the recipe if your listeners are interested. And it was so delicious. And it felt like I was having a brownie. tasted like, you know, sometimes you bake something with protein and you're like, this tastes awful. Like I can taste the chalkiness. It tasted wonderful. So I would say baking with protein and then liquid forms of like a protein shake are easy ways to help the digestive capacities of someone who doesn't have that digestive faculty anymore that maybe is having trouble breaking things down and absorbing them. The digestive enzymes that we've already talked about. then I think that for me, she was saying something about like she gets too full to eat her veggies. I would start with, if she's having a solid meal, let's say, I would start with the protein.

And then you can move on to like the rice or the veg, like, you know, whatever the carbs or the fat are. But I would eat the protein first to make sure that you're getting in the protein because your hunger signals takes about 20 minutes or so, depends on the person, but about 20 to 25 minutes between the signal in the stomach that you're full to kind of get up to the brain. So 20 minutes into eating, you've probably consumed the protein, maybe you've gotten into the fat as well.

And then I would leave the carbs for last. So those would be sort of my action items there. Anything that I missed or that you'd like to add?

Cynthia (34:03.14)

No, no, I love the creativity because I think that's that's key. What I typically find is giving women some type of a sense of what 30 grams of protein looks like, because more often than not, it is not this massive portion of protein. They are underestimating their protein. So tracking macros to get a sense of how much protein you're eating is number one, because then you can build awareness around that. Number two, I 100 percent agree with you about the protein shakes. And for me, that's really how I when I went from having a tight fasting window to two meals to three meals. I worked it up with two meals and then a protein shake. And now probably I'm having a protein shake twice a week. I really can now manage that third meal. I think it's all about finding what feels good to your body. For me, I'm very much a red meat person. I like bison. I like beef. like elk. I don't love chicken. I will occasionally eat chicken. And when I say occasionally, like maybe twice a month.

But more often than not, will have some fish or some selfish. It's finding what is sustainable and easy. And I love that you brought up having some protein powder incorporated into some protein options. And for me, sometimes I'm just, I train on Monday afternoons. And so by the time I get home from the gym, I'm not really interested in having a big meal. Usually lunch on Mondays is my big meal. And then I'll have something smaller. Sometimes it's a protein pancake that's made with

you know, whey protein, a part of a banana mushed up. it usually may incorporate an egg and you know, it ends up being like enough protein that it's reasonable and feasible. It tastes delicious. And it's just a different way to eat eggs and whey protein together and do it in a way where the eggs are safe. Cause I fervently believe I have a teenager who will eat a dozen eggs in a sitting. He'll just break them open and chug them down. Cause he, he's kind of a machine.

Dr. Stephanie Estima (35:56.066)

Wow.

Cynthia (35:56.243)

But that's just not the way that I like to consume eggs. Having said that, first of all, measure what you are consuming so you have a sense of how much protein you're consuming and then start slowly increasing it. What I can tell you about older patients is that they've gone many years with a lot of muscle mass loss. So their metabolism shifts after the age of 60. I find that their sense of taste is changing. Sometimes they don't want to just cook for themselves anymore. So I think sometimes you have to find the things that they like and enjoy and help them capitalize on that. My mother-in-law is both visually impaired now, unfortunately, she's sharp as a tack mentally, but visually has some deficits, has some mobility issues. And my husband and my sister-in-law will cook for her, freeze things for her, and then she can defrost it and she gets bored really easily. And so I think when we're talking about older adults,

It's finding things that they like and maybe helping them prep ahead so that they don't spend a lot of time cooking. That may also help them be more interested in getting that protein in. But I can tell you from my own experiences with my mother, who is 79 years old, she is stubborn and she wants to eat her one meal a day and that's what works for her. And we've just kind of left it. I've told her I'm de-obligating myself from worrying about her protein consumption. I just gently keep reminding her that maybe add some collagen, maybe have some essential amino acids, which is something I know we didn't talk about. For some of us who are trying to buffer that protein intake when I travel, sometimes I'll take essential aminos, but it's not something I do every day. And I only use it in very rare instances where I'm concerned about buffering that protein intake. But there's lots of different things you can do. It's what is feasible and reasonable and then working from there. And if 90 grams is what you can do consistently,

Dr. Stephanie Estima (37:26.156)

Yeah.

Cynthia (37:49.074)

Please don't beat yourself up about it. That's a lot more than most women are consuming. I think the averages I've looked at have been maybe 45 to 50 grams at best.

Dr. Stephanie Estima (37:56.675)

Yeah, yeah, I've read 50 to 60 grams on a date and it's like 90 grams is, you you're already sort of in the top percent, top 10 % there. Yeah, you're still winning and maybe it's a little bit of collagen or protein and you're blended in your morning coffee. I know that, and your point around the elderly being stubborn, it's like they are just set in their ways, right?

Cynthia (38:04.304)

Yes, you're still winning.

Cynthia (38:17.766)

Yes, they are.

Dr. Stephanie Estima (38:18.72)

So we also have to understand that because one day too, we're gonna be there and our children are gonna be like, mom, the latest stuff says this. And you're like, nope, I want my protein brownies. I don't want nothing else. There's gonna be some new science in 30 years that I am not gonna be willing to listen to. So we also have to just, we also have to love them a little bit for where they are too.

Cynthia (38:41.124)

Absolutely. Without question. Couple more questions I'd love to try to tackle. We know that stress is without question. There's no stress free existence. I'm sure even monks in Tibet probably have some degree of stress that they experience. This question is there is a theory that fasting puts too much stress on the body, which isn't good for health. What are your views on this? This is from Zelda. Now we talked about hermetic stress, beneficial stress, right amount.

I'd love to get your perspective on this because I have no doubt that we are very unified. When you're talking to women online or in programs, how do you address this type of question?

Dr. Stephanie Estima (39:24.006)

My, this is I'm probably going to upset some people, but here we go. So I think that I think that there's this pervasive theory. Well, first, let me let me back up and I'll just say that I'm not sure this applies in many different facets, but I'm not sure where along the lines we were taught to fear our own hormones. We're taught to fear estrogen because it causes X and Y, breast cancer and heart attacks. We are taught to fear cortisol because, you know, it does, it's, know, with fasting or any type of hormetic stress, things raise cortisol. Coffee raises cortisol, therefore coffee's bad. I think that there's this idea that our hormones are somehow working against us and that there's lack of nuance in terms of their understanding. So I just want to talk about cortisol specifically. We could certainly talk about estrogen, but I hear this a lot from women. It's like, isn't the sauna or the cold plunge or the fasting or the coffee or the workouts, the intense leg days, doesn't that raise cortisol? It's like, yes, it does. So just, you know, the reason why you wake up every morning is because your cortisol raises in the morning, right? It's like, should you stop sleeping? Should you stop exercising because cortisol raises? No, that is a normal response to the stimulus, right? If you are doing an intense leg day, or back day or whatever, even like high intensity interval training, that is going to raise your cortisol. But that is not necessarily a bad thing. Cortisol is working in this instance to actually mobilize fuel for your muscles, right? So cortisol is one of its jobs is to actually make sure that the, let's say it's the glucose or the amino acids doesn't, that it actually stays in the blood so that you can preferentially throw it to the muscles, like the musculoskeletal system, right? So it's a fight or flight. This is for the fighting or the flighting, right? This is a good thing, right? Stress in and of itself is not bad, right? Acute stressors can be things like leg day, can be things like a cup of coffee, fasting. It's just when the stress, like if I just said, okay, you're gonna do leg day for the next 24 hours.

Dr. Stephanie Estima (41:42.787)

You know, that's when it gets, that's when it becomes problematic. You can't sustain that amount of, you know, you can't sustain that amount of stress for that long. Or if I said, hey, now you're gonna fast for 96 hours. Like that's when it starts to, where we start to get some of these diabolical consequences, right? It's like the chronicity is what makes the stress good or bad, right? Exercise, obviously short-term acute stress makes us stronger over the long-term because we have the,

the adaptations that happen as a result of it. Fasting, same thing. Coffee, like you're to take coffee out of my cold, dead hands. Like I am not giving up coffee. Same with, you know, cold plunges and saunas. These all raise cortisol. But it's just what I find is that people are so concerned about raising cortisol that they're not actually engaging in the healthy, like they're ignoring the areas where they could have a meaningful impact on chronic low grade cortisol, like being in a job that you hate or in a relationship that isn't working or enduring some kind of toxic behavior or malignant behavior from someone without setting any healthy boundaries for yourself. These are areas where you can actually meaningfully make progress in terms of that subclinical low grade stress or resolving residue that resides on your nervous system from when you were a young girl or a young adult, some maybe maltreatment as a child or something. We've all, it's just like part of life, we're gonna endure things that are difficult. So I would say working on that stuff is less sexy. It's less tangible because there's no start and stop, right? We don't know how long it's gonna actually take us to get good at setting boundaries.

So we turn to things like leg day or fasting or things where we're like, oh I should I be fasting 16 eight anymore? Should I should it should it be 12? You know, we sort of try to find other ways and so I applaud the effort but I would say that You know glad that there's awareness around around this but it's the chronic

Dr. Stephanie Estima (44:02.452)

stuff that's that's really getting you. It's not whether or not you're fasting for 16 hours. I mean, maybe if you're fasting for 16 hours and you know, and you're starving and you're denying your own hunger signals and you've been doing that for years. OK, now we have a chronic low grade. We have a chronic stress that you haven't addressed. But I would say looking at some of the things that are. Messier, uglier, that's where you're really going to get the more bang for your buck in terms of lowering your stress.

And you should never skip leg day. Like friends don't let friends skip leg day. I'm not gonna let you skip leg day. You're not gonna get out of it. But you shouldn't be doing high intensity interval training like six days a week either, right? So you should be selectively doing that one or two times a week. So I know that that's a bit of a convoluted answer, but I would say don't be afraid of your own hormones. Cortisol is not your enemy. There's a difference between good stress and bad stress, you stress distress, and then acute and low.

Cynthia (44:35.12)

Ha ha ha ha.

Dr. Stephanie Estima (45:00.876)

like acute and chronic stress, have to also differentiate between as well.

Cynthia (45:04.362)

I think there are so many good points there. And I think just to really kind of reaffirm this is that we can have this very kind of duality of good, bad, there's nothing in between. And I always say most of us exist in the gray, meaning that a little bit of stress is beneficial, too much stress is not. And it's determining as we are navigating this perimenopause to menopause transition, what is right for us? Like as an example, I will give you an example.

And I think Sarah Gottfried even talks about this. I don't like cold, but I will be the first person to say doing a little bit of cryotherapy, a little bit of cold shower is good for me, but sticking me in a plunge pool would probably do detrimental for me personally, detrimental things to me personally, because that would be too much stress. But to someone else that might be great. And that might be a lot of beneficial stress. So I think for each one of us, it's having that conversation about how lifestyle is influencing our stress levels, and then also honestly having a conversation with yourself that if you are not taking a pause, so perimenopause, menopause, pause is an important word here. If you are not reflecting on what is working for you or not working for you at this stage of life, you're missing an opportunity. My life looks vastly different than it did 10 years ago. I am 53, I will be 54 this year.

10 years ago, I was in the midst of perimenopause, I hit a wall. And so I openly talk about how many changes I had to make to be able to navigate the rest of perimenopause into menopause in a way that supported my hormones, some of which were starting to falter and support my lifestyle. And so I think you brought up so many good points about the lifestyle piece, not being fearful of hormones. We've been fear mongered around hormones for over 20 years. Thankfully, things are coming back around now and we're starting to get better information. But I think that we have to take a very nuanced approach to these conversations and then just being honest about what's working for you. There are probably people listening that can still do more intense exercise and they don't feel depleted. And then others may feel like, you know, I went from doing, would say crossfit ish type classes in my late thirties, early forties. And then afterwards I was like that degree of stress and intensity no longer works for me, but I can lift heavy and I can do hit or jump training twice a week and I do it in a short window and that works really well. So I would just say consider what is serving you within your personal life and make adjustments accordingly.

Dr. Stephanie Estima (47:41.666)

I love that.

Cynthia (47:45.777)

Last question, do think we have time for one more? Okay, this is a question from Erica. She mentions, was able to lose 130 pounds in my early 40s using intermittent fasting. At that time I was just starting perimenopause. Now I'm hearing that it is dangerous for menopausal women to fast this way and that we should not work out fast if we eat before and after due to cortisol. Is this right? I'm still maintaining my weight loss using intermittent fasting and fasted workouts. Great question.

Dr. Stephanie Estima (47:48.013)

yeah, we got time for one more.

Dr. Stephanie Estima (48:13.23)

Ooh, good question. First of all, congratulations. My God, what did say? How many? How much? 130, that is a person.

Cynthia (48:15.826)

Yes, it's amazing. 130 pounds sustained, 130, yes, 130 pounds sustained. That's incredible.

Dr. Stephanie Estima (48:26.232)

Good for you. Okay, so this question I think is getting the heart of it is like fasted cardio or fasted training versus not fasted cardio or fasted training. I will say this, if intermittent fasting is working for you, clearly it is, you can continue doing that. The literature is pretty clear. It doesn't actually matter whether you train fasted or you train fed in terms of fat loss, right? So if you train, let's say you do your cardio or your training,

Fasted you burn more fat during the activity. So let's say you're on the treadmill or you're lifting weights or whatever You burn more fat during that activity because your body's trying to mobilize again cortisol is rising trying to mobilize some Substrate for your muscles to be able to work But once the activity stops you actually burn less fat over the next, you know 24-hour period if you train Fed right so you eat something beforehand

you will burn less fat during the activity, but your fat loss is going to be augmented or higher after that activity stops. So it's like it evens out, right? So whether or not you train fasted or not, in terms of if the goal is fat loss, there's no difference, okay? What does seem to matter is total protein intake, obviously. We've talked about this, you've talked about this on your show, I talk about this on the show. In that 24 hours following the training,

Or the activity that you're replenishing both the protein and the glycogen lost in the muscle in order to do that activity Whatever the activity was So I would say like keep at it girl like if you like to train fasted and that's fine where I do think that there is a difference with Fasted versus non fasted is performance in the gym. So what I find? Personally during the week like this morning. I I go to the gym I don't have the stomach to fully eat something. Okay, so depending on the time, I'll either have protein and oats, which I lovingly call prots. So it's just like some oats. It goes so well together, right? So prots, so some protein powder and oats before. I find that that is easy for me to digest. I have it 20 minutes in, and then by the time I get to the gym, like I'm ready to rock. Or the other thing, it's super early, like there's a couple days in the week where...

Cynthia (50:29.541)

Hahaha!

Dr. Stephanie Estima (50:47.338)

My kids have early training, I just, if I don't get to the gym at like an ungodly hour, at like 5.30, then my workout for that day is just not gonna happen. So I get to the gym and what I'll do is I'll have ketones instead. So ketones are just basically like a drink. Shout out to Ketone IQ, who, one of the sponsors of my show anyway. I absolutely love their stuff. So they come, it comes in like green apple and peach, whatever. So I'll take a shot of that.

And that gives my muscles and my body substrate, enough substrate for me to get through the workout and then I'll come home and then, you know, drop the kids off and then I eat and I have like a nice big breakfast. So that would be how I would respond to it. So if it really comes down to the goal, if the goal is fat loss, the literature seems to be pretty clear. It doesn't really matter. It's kind of whatever you prefer to do. If you are looking at performance in the gym, some kind of substrate prior to the workout does seem to augment. It just seems to help with your endurance. It seems to help with your ability to push further. You know, just it's fuel for the nervous system because a workout is a nervous system endeavor. So that's how I would answer that.

Cynthia (52:03.282)

That's absolutely perfect. So I think for anyone listening that feels like they are trying to navigate this and, and I had a Dr. Stacy Sims on and she was talking about how she doesn't like fasted exercise, you know, based on her research. And so I encourage anyone just to do some degree of experimentation. Like on Mondays I have an afternoon workout. I've had two meals before I go to the gym. I can push way harder than I do at 9 a.m. on Wednesday morning, which is my other concerted, like dedicated time to be in the gym and lifting. And on those days, I will actually have a piece of fruit en route to the gym. And sometimes I will have a protein bar because it just depends on how hungry I am. And yes, you can find some protein bars. Now, I usually will say eat beef jerky, but I don't want anything salty in the morning. For some reason, that is not what appeals to me. I do find on Mondays, I can push myself way harder. That's usually when my trainer will push me way harder than she will on Wednesday morning.

Dr. Stephanie Estima (52:51.0)

Hmm, yeah.

Cynthia (52:59.248)

And that has been an N of one experiment for me personally. So I will have two meals. I'll work out at four o'clock, four to five. And then I go home and I eat a small dinner because I don't really want to eat much at six o'clock at night. With that being said, I was surprised to see how differently I could show up and work out with more food on board. And I still work out hard on Wednesday morning. I just don't work out. Like I can't push myself quite as hard without having a little bit of fuel. And that doesn't mean that my body can't access stored fuel. It's just.

I've noticed that my performance, that's not the morning I want them to try to have me do a dead hang for a minute and a half. I'm like, no, it's not happening.

Dr. Stephanie Estima (53:35.021)

Right. The other thing that's actually interesting about that is maybe one of the reasons that you're you're finding that your performance is better on the Monday in the afternoon is your core body temperature is also higher. Right. So you've had the two meals, like you've said, you've probably been moving around somewhat. Joints are nice and lubricated. And you're also your core body temperature is elevated. So that also does seem to influence performance in the gym as well.

Dr. Stephanie Estima (54:03.962)

And that doesn't mean that if you like if you have to work out at 530, like you just got to get it done. Right. So this is just another comment to say there's optimal times to do things like when Cynthia is working out on Mondays, she's basically like if there was like a perfect to do like a checklist that like she's followed it. Right. So it's like two meals, some gentle movement, core body temperatures elevated. That's when she can push herself because your nervous system has been primed. You have fuel.

Dr. Stephanie Estima (54:30.786)

But on the Wednesdays, let's say, when your workout's at nine, core body temperature hasn't peaked yet. Our core body temperature peaks usually around noon-ish for most, like if you're based on, like you're waking up, assuming that you're waking up at, you know, you're on a circadian rhythm where you're waking up when it's, waking up when it's light, going to sleep when it's dark. 12 to one is usually when our core body temperature peaks. But you're working out at nine because that's the time that you have that day, right? I work out some, like some days at 5.30 in the morning with ketones because I don't have time for fuel. I haven't had my core body temperature. I'm still cold, so I gotta make sure I really do some mobility drills before I really pushing. But the point is, there's some times when you're gonna get it like perfectly right, it's gonna be super optimal. And then other times it's going to be less than that, but you're just gonna find a way to get it done because that's life. Life is not perfect. Things are gonna be messy. know, it's somewhere in the messy middle that we often find ourselves.

Cynthia (55:25.806)

And I think it's important. You know, there were definitely many years where my kids swam in the morning and we were up at four. I was up at four to get them to the pool at five. And that was my time to work out. And I look back now and I cringe. But, you know, there's only so many years we have with our kiddos before they get launched out of the house. And so I think we have to work with what we have. And certainly many years where I had to be in the hospital at seven thirty in the morning. So I was in the gym early because that was the only time I could actually get that done.

Dr. Stephanie Estima (55:35.064)

Yeah.

Cynthia (55:54.621)

So I think for each one of us, it's figuring out what works for us, what makes our bodies feel good and actually embracing that. Because I think for some people, when they start experimenting, whether it's with different times, different types of modalities, maybe working out from home versus in the gym, finding out what works best for you, I now have become a work, like a home, homebody. Because I actually really prefer working out at home, because I don't care what I look like, I don't have to match, I don't care if my socks match.

When I go to the gym, I have to have a couple extra things like, do I match today? I have a puppy who likes to chew up socks. So I have a lot of unmatched socks right now for the gym, which is a source of never ending humor slash frustration. But I think for each one of us, it's figuring out what is working for us and what is not. And don't be afraid to course correct, just like this entire conversation. Maybe working out in the morning has worked for you really well, and then you start figuring out you work out better midday or in the afternoon.

Dr. Stephanie Estima (56:21.59)

All right.

Dr. Stephanie Estima (56:33.133)

Yeah.

Cynthia (56:50.386)

I'd be the first person to say you could have knocked me over with a feather. I never would have imagined that I could push myself so hard late afternoon. In fact, I kind of demotivate myself sometimes. I'm like, I'm going to the gym, I'm getting in the car, I'm not as motivated, but you always feel better after the fact. Even if you're not feeling particularly motivated, get the workout in.

Dr. Stephanie Estima (57:07.298)

Yeah. And even there's some days when I get to the gym and I feel so tired and then I just end up having the best workout. And then sometimes the opposite is true, too. I do all the right things. I've slept like a beast. I've had my pre-workout. I'm ready to go and I don't have anything to give. And I just give what I just leave it all. Like whatever I have to give, I do. And sometimes I have to modify. So all of it is like all of it. All of it counts. You know, that you showed up is like 90 percent of the game.

So, yeah.

Cynthia (57:38.25)

I'm curious. So what pre workout are you doing? Are you doing like coffee as your pre workout? Or do you have like a formal pre workout?

Dr. Stephanie Estima (57:44.997)

I do both. So coffee early in the morning. have a I'll have like a shot of espresso if it's like my super early 530 morning when I work out at a bit more of a reasonable hour. Like today I was at the gym at about 630. I'll have my cappuccino. I have like my cappuccino in the morning. But I do have I will sometimes I will also take like a formal pre workout, which has you know, has all the things that it has caffeine in it. has all the things. Yeah. Beta-al and all the things, the things that give you like the sort of

Cynthia (58:09.82)

beta alanine.

Dr. Stephanie Estima (58:13.966)

I get a little bit tingly. My face gets a little bit tingly. I'm like, okay, so now I get to talk to God. Well, I'm doing my squats and my face is tingling and I'm looking up for mercy. like, all right, I'm gonna have conversation now. So yeah, so take pre-workout. I usually do the pre-workout on the weekends because my weekend gym schedule is a little bit more lax. I typically go later in the morning or if my kids have a game, then I'll go after the game which is usually in the afternoon. again, like you had a couple meals in, had some coffee and like I'm ready to go. So the pre-workout usually comes in on the weekends.

Cynthia (58:50.502)

Yeah, I'm always asking other women like what they do and what works well for them. I am not a coffee person, but the more I read the research, the more I should be a coffee person. So I keep trying to find ways because I find it too bitter. That's my biggest issue is it's I'm a hyper taster. So things to extremes. I'm like when I used to eat cheese, like even eating the strong cheese has never appealed to me. Probably TMI. But I do drink iced green tea. That is the way that I get it down. I'm like, I know it's beneficial.

Dr. Stephanie Estima (59:04.846)

Cynthia (59:20.144)

And that's what I do. I usually, other than water or creatine electrolytes, that's usually all I do.

Dr. Stephanie Estima (59:25.166)

Okay, so the thing I'm gonna tell you, so what I love to put in my cappuccino is a sugar-free syrup. It's like a salted caramel flavor. I'll send you the link, we'll put the link in for the show notes for anyone who wants to, I forget the name, it's like Matthews or Mateos or something. I mean, I just pick it up off of Amazon. And it's like a salted caramel shot and I'll put the coffee in it, because coffee can be bitter.

Cynthia (59:26.904)

Hahaha

Dr. Stephanie Estima (59:51.82)

But even when I have the especial shot, I'll put like a little bit of that salted caramel and it's, mean, maybe there's like, they have a thousand flavors. They have like, know, maple and they have, you know, English toffee and hazelnut, like they have all different flavors, but that I find makes the coffee bit more palatable. There's no sugar in it. It's like a sugar alcohol. So I'll share that one with you and you can, you can let me know. Let me know if you like that one. Yeah.

Cynthia (01:00:13.36)

Yeah, definitely, definitely. I'm always open. In fact, I came back from a functional med program that I'm doing and I was like, dang, I got to try coffee again. I'm going to have there's just so many health benefits to it that I'm like, all right, we're going to try. We're going keep trying.

Dr. Stephanie Estima (01:00:24.398)

Yeah.

Dr. Stephanie Estima (01:00:28.738)

Well, I'm gonna send you that link and then next time we meet up, this is a good cliffhanger, next time we meet for the she said she said, you can tell me if you've tried it and then we can talk about coffee a little bit.

Cynthia (01:00:37.424)

Yeah, absolutely. Lots of benefits.

Dr. Stephanie Estima (01:00:39.808)

Awesome. It's always good connecting with you, my friend. And till next time.

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