PCOS 101

September is PCOS awareness month and so for today’s episode, I wanted to do a quick deep dive into some basics about PCOS. It is actually the number one hormonal imbalance condition among reproductive-aged women and sadly, the leading cause of female infertility. So, this condition affects a lot of women and like many other hormonal issues, it can take a long time to get a proper diagnosis. So I want you to be informed about what PCOS is, what some of the common symptoms are, and if you or someone you love has PCOS, what we can do to help with it!

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PCOS is a common hormone and metabolic condition that affects up to 15% of reproductive-age women. It is associated with a higher risk for long-term health issues such as heart disease, diabetes, hypertension, sleep apnea, and infertility. Higher instances of insulin resistance, IBS, and depression/anxiety are also reported with PCOS. 

Symptoms often associated with this disorder are absent or infrequent menstrual cycles, excess weight gain or inability to lose weight, excess facial or body hair, head hair thinning or loss, severe acne, and often (but not always) insulin resistance and polycystic ovaries. 

PCOS is the most common form of hormonal imbalance and while experts know that it is rooted in inflammation and insulin dysregulation, what actually triggers PCOS is not understood. There seems to be a genetic factor, as women with moms or sisters diagnosed with PCOS are likely to have it as well. Also, as with any hormonal condition, gut health plays a major role. Some believe that it can possibly be linked with a combination of imbalanced gut flora and increased intestinal permeability, which leads to increased inflammation in the body. This can cause cells to become rigid and unable to receive the signal from insulin to let glucose into the cell (which leads to your pancreas continuing to pump out more insulin, and left untreated eventually becomes insulin resistance). Although ovaries do not become insulin resistant, when bombarded with insulin, the ovaries can respond by secreting testosterone. An excess of insulin can also inhibit the secretion of sex hormone-binding globulin (SHBG) which is the protein that binds excess sex hormones like testosterone and estrogen. This creates a perfect storm for these common PCOS symptoms.

PCOS is a clinical diagnosis, which means that it’s based on having a grouping of some PCOS symptoms and ruling out other diagnoses. Often a physician may want to perform an ultrasound to check the ovaries for cysts, but it is important to note not every woman with PCOS will have polycystic ovaries (despite the name). Most women with PCOS do have insulin resistance, but again - not all. It’s important that you work with your physician and be informed on the recommended lab tests that can be helpful for making a diagnosis. Functional medicine practitioners recommend a full thyroid panel, a full hormone panel including estrogen, testosterone, DHEA, SHBG, progesterone, prolactin, LH, FSH, and AMH, as well as a lipid panel and fasting blood glucose and insulin, and A1C. There may also be other tests as well as research about PCOS continues to be published. 

Once someone receives a PCOS diagnosis there really aren’t a lot of great conventional treatment options. The most common option is to take hormonal birth control and while that can help with symptoms, unfortunately, it doesn’t do anything to actually heal the cause of the symptoms. Not only that, but some believe that it may actually worsen the condition over time. Metformin is also a common medication given to women with PCOS. Just be sure to research and speak with your doctor about the common negative side effects that can be associated with it. 

While there is no cure for PCOS, there are things that a woman diagnosed with PCOS can do to help with symptoms as well as target the underlying known contributors to PCOS - blood sugar dysregulation, poor gut health, and inflammation. 

When I work with clients who have PCOS the first two things that we work on are supporting balanced blood sugar and healing their gut. So let’s talk about some foods, supplements, and lifestyle modifications that can help with those things.

When it comes to food, the first thing to remember is that your body needs to feel safe and know that it can count on adequate fuel throughout the day. The best way to do this is to eat a balanced meal (meaning fiber, protein, and fat) about every 3-4 hours. So that typically looks like breakfast, lunch, dinner, and at least 1 snack, maybe 2. You don’t want to eat continually or fall into grazing throughout the day, but also don’t skip meals or go long periods of time without eating. 

Some specific foods that can help:  

• clean sources of protein: wild-caught, omega-3 rich fish such as salmon, cod, trout or sardines; bone broth, grass-fed beef

• High fiber carbs:  cruciferous veggies, pumpkin, beans, rice, berries, goji, cherries, onion, parsley, garlic, freshly ground flax seeds 

• Healthy fats: walnuts, coconut, olives, 

• Herbs, spices, teas: cinnamon, turmeric, ginger, decaf green tea, Holy Basil tea, liver support teas - like milk thistle or dandelion 

There are some supplements that may also be helpful. I do just want to remind you that everyone’s body is different and may respond differently to herbs/supplements. It’s really best to work with a practitioner who is knowledgeable about these supplements and your particular healthy history. With that said, Vitamin D and methylated B-complex can be helpful because a lot of women (in general), especially with PCOS, are deficient in these. Herbs like Vitex, Dong Quai, saw palmetto, nettle root, and licorice can help with some of the common PCOS symptoms. Inositol is another common supplement given to help with insulin sensitivity and other common issues with PCOS.

There are also some lifestyle recommendations and alternative therapies that can be helpful as well. We all know that regular exercise is good for us, but especially for women with PCOS daily movement is vital for reducing inflammation, balancing blood sugar, and supporting gut and liver health. It’s also important to participate in weight training at least 2x per week (either bodyweight or added weights) which has been proven to help increase insulin sensitivity, allowing it to be more useful in the body. It’s also recommended that women with PCOS prioritize getting 8-9 hours of sleep each night and commit to stress-reducing routines like daily walks and downtime from social media and other emotional stressors. Acupuncture can also be helpful. Many women have also found seed cycling to be helpful - and that probably needs its own episode but essentially is eating certain types of seeds in the follicular phase of your cycle and then switching to other seeds in the second type of your cycle. This can help the body get rid of excess hormones more efficiently and may support more balanced hormone levels. It also provides a great source of fiber which is helpful for gut and liver health  

Ultimately, if you or someone you love has PCOS it’s important to know that even though there isn’t a cure, symptoms can be managed and your body can be supported in such a way that the condition doesn’t have to take over your life. Make sure to get a good team of healthcare professionals on your side that can help you with all aspects of your health and really take the time to learn about PCOS and about how your own body responds - what works for you and what doesn’t. 

Friends, I hope that this episode has been helpful for you. If you’re struggling with PCOS know that you aren’t in this alone and that there is help available for you. Start with some of these things that I’ve mentioned today and build a team of people around you that can support you in this journey. As always if you have any questions, you can send an email to info@yourhealthforward.com. 

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Intermittent Fasting: Helpful or Harmful?

Hi friends! Today we are talking about Intermittent Fasting (IF). It’s been a buzzphrase in the health and wellness industry for a while and there are wildly different perspectives and opinions on it. In this episode, I want to look at exactly what IF is and what are the ways it can be helpful, as well as how it can be harmful and who may not benefit from it.  I’m also going to throw my own opinion into the mix and share why I haven’t adopted this practice for myself. Let’s get into it! 

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What is Intermittent Fasting (IF)?

Intermittent fasting is a term used to describe a certain approach to eating that includes abstaining from food for short periods of time. Time-restricted eating Is the most common method of intermittent fasting. For this type of in a minute fasting you eat during a shortened window of time during the day, which extends the amount of time you’re not eating overnight. This can be anywhere from a 12 hour fast to a 16 - 18 hour fast, and often includes skipping a meal either breakfast or dinner. You can choose to eat three meals while using this method but they will be closer together than usual. 

How it can be helpful:

A quick search on Google or Pinterest will list out multiple health benefits from intermittent fasting. Things such as helping with weight loss, burning fat for energy instead of glucose, lowering insulin levels, improving insulin sensitivity, benefiting cognitive abilities, and supporting the circadian rhythm and leading to better sleep.

Sounds amazing, huh? Well, before you decide to skip breakfast forever, let’s look at some of the ways IF can be harmful. 

How it can be harmful:

While it’s true that some people to do well with intermittent fasting, it’s also true that certain people may not do well with it, particularly women. Fasting, while possibly having short term benefits, can also lead to long-term ramifications. IF leads to higher amounts of cortisol to be produced in the body, which again can be good short term (like as in exercise), but in the long-term can lead to chronic inflammation (just as in exercising too much). This spike in stress hormones can cause the body to feel unsafe. Our bodies thrive and function their best when they feel safe. Food is a signal of safety to our bodies - that’s the way we are wired. So when we go longer amounts of time, or even days, without eating that can signal to our bodies that something is wrong and that we aren’t safe enough to eat. Again, this can lead to chronic inflammation in the long term, which is the exact opposite of what we’re trying to achieve. 

For this reason, IF can have negative effects on women’s hormone health and fertility. When a woman’s body does not feel safe, having a well functioning reproductive system is not a high priority. Some studies have shown that by simply extending the fasting window to 14 to 16 hours, or quickly reducing the amount of food that someone takes in during the day, the body can start to shut down some of the communication between the brain and the reproductive system. 

Also, while some say intermittent fasting can help with insulin resistance and blood sugar issues, the flipside to that is that it can also lead to blood sugar dysregulation in the long term. 

An increase in stress hormones can lower  insulin levels, but also increase blood sugar (glucose) levels. Insulin is the hormone that allows our body to use up glucose or blood sugar, so having an increase in glucose while also having a decrease in insulin can lead to having higher blood sugar levels overall - which again is the opposite of what we are wanting. 

The other issue that can sometimes happen with intermittent fasting is that because you’re eating your meals closer together, in a shorter window of time, this can sometimes lead to not having enough space in between meals for proper digestion and good gut health. 

In a healthy gut, the MMC (migrating motor complex) - sometimes also called the housekeeper of the gut - sweeps through the small intestine, moving any food or waste along into the large intestine for further digestion about every 90 minutes (Think of it as our gut’s clean up crew). The problem Is that any eating or drinking of something that has calories (even a cup of coffee) can interrupt that process. Ideally we would be spacing our meals apart about every 4 hours, but that becomes very difficult to do in an 8-hr or shorter window. 

When this mechanisms can operate as it should, it can create an environment for Dysbiosis, SIBO, and overall poor gut health. 

So as you can see, there are both possible pros and cons to intermittent fasting.

Why I don’t practice IF, personally: 

Personally, I’ve chosen not to practice structured IF. As a woman who has an inflammatory condition- an inflammatory hormonal condition, at that, the risks outweigh the possible benefits for me. I also don’t recommend it to most of my clients, as most are women also dealing with underlying chronic inflammation, gut issues, and hormonal imbalances.

Also, an Interesting note - an ISSA article states that most of the studies done on Intermittent Fasting have been done on men. It states that *“Out of seventy-one studies found in Harvard’s database for intermittent fasting, only thirteen include women at all. Beyond that, absolutely none of the controlled studies focus on the female population in general. There are no controlled studies that allow us to draw intelligent conclusions about how intermittent fasting affects the female population.” 

The article goes on to say that women are less likely to lose weight or experience positive health benefits from IF and seem to experience the best health when they maintain an unchanging flow of nutrient intake throughout the day. 

This is what I recommend to my clients and implement in my own life as well. I think a 12:12 model can work really well for women - a 12 hour eating window and a 12 hour fasting window at night. That pretty much follows our natural circadian rhythm of eating while it’s daylight. I advise my clients to eat a balanced meal that includes carbs/fiber, protein, and fat within an hour of waking - and then ideally eating balanced meals every 4 hours. I also think it’s important to listen to your body and follow your hunger cues. Again, it’s important to make your body feel safe, and restricting food will likely have the opposite effect. 

At the end of the day, remember that food is nourishment and fuel for the body. It’s not something to restrict and/or reward yourself with.

*https://www.issaonline.com/blog/index.cfm/2018/this-hot-diet-trend-is-not-recommended-for-women

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Strength Training Benefits for Women with Cassidy Tipton, CPT

In today's episode, Certified Personal Trainer - Cassidy Tipton shares with us some of the many benefits of strength training for women's health. Whether you would consider yourself to be a beginner or an experienced athlete, Cassidy offers simple and practical tips for incorporating strength training into your everyday life.

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Alaina: Welcome back to the Health Forward Podcast. Today we have a special guest with us, Certified Personal Trainer Cassidy Tipton. Cassidy, welcome to the podcast! We are so happy to have you.

Cassidy: Hello. Thank you so much, Alaina, for having me. I'm so excited to be here.

Alaina: Yes - so I know you from our time working together at a local hospital here in Knoxville. We did that for a couple of years, but for people who don't know you, can you tell us a little more about yourself and your background?

Cassidy: Yes. Absolutely. So a little bit more about me. I kind of fell in love with strength training my sophomore summer of high school. I was one of those people while other girls were sitting there reading magazines like Vogue and Teen Spirit and all that stuff, I was sitting there reading magazines on, I don't know if you remember, the Oxygen magazine. I was a full subscriber to that. I loved it! I was engulfed in all of that. I loved the way those women looked - it was something so new to me. And so I was just taken in by that. I got started with strength training because I played softball in college and in high school, and so I needed to do strength training to help me get stronger with that. So that's where I fell in love with it. In college, I majored in exercise science, and it's funny because I literally changed my major four times when I was in college, and I always kept coming back to exercise science because that was what I truly loved. But other people are like, Oh, you know, you need to do this or that. Of course, I listened to them, but then I always came back to it. And so I did graduate from Carson Newman with an exercise science degree. Then after college, I started my first personal training gig, and I was there for about four years and loved every minute of it. During that time, I fell in love with lots of different types of strength training - working with different special populations of people, not just athletes, but people who were literally just wanting to better their lives, being able to do things with their grandkids. Then I received my ACE Personal Training certification as well as a CrossFit Level one certification. So I dabbled in CrossFit for a while and then also got my USAW Sports Performance certification, with which I competed nationally in Olympic lifting (fun fact for you guys)! So, I've kind of done all different spectrums of strength training.

Then, as Alaina said, we worked together at UT Medical Center - I loved it there! Now, I am currently not doing anything in the fitness realm and I miss it so much! Because of that, I had this strong pull to serve people in that aspect, so, I really started being active on my social media and just really pouring into people and serving people - showing them my workouts. I'm just trying to give that free stuff to people to help others since I don't do that anymore, but I miss it so much and I know that I have the tools and the background that I can help people with it So that is a little bit about me.

Alaina: Yeah, that's great! And you're a mama - you have a little girl. How old is she now?

Cassidy: She is two going on 20. It's like everybody else.

Alaina: I can't believe she's already two. When we stopped working together you had just had her!

Alaina: So, in today's episode, we're talking about strength training - specifically, as it relates to women's health. I think there's a lot of questions and stigma about women doing strength training. So, we are happy to listen to your expertise on this, both in your education and then in your life experience in it as well. So, can you tell us kind of an overview, what is strength training? Are there different types? What are those different types?

Cassidy: Yes, for sure. So strength training (you can also call it Resistance Training) is basically when you are performing some type of physical exercise in which you are working your muscles against some type of opposing force. Now, that force can be something like weights, resistance bands, or gravity (as in just using your body weight). So there are so many modalities of strength training that you can use with the sole purpose of building strength and endurance. Often, when we think of types of strength training, we think of pull-downs, resistance bands, and dumbbells, but it is a totally different meaning inside of strength training that is more of a form of weight training. Then, as you said, you can do plyometrics, barbells, so many different modalities. But when it comes to specific types of strength training, there are seven different types of strength training. I do want to preface what I'm about to say by saying that it's important that we do try to find a program that is encompassing all seven types of strength training just to help get a very well-rounded program. I'll also mention that, women sometimes gear more towards one type and forget others, so be mindful of that. I'll run through these really quick.

So, the first one is going to be agile strength. When we think of this, we think of football players cutting back and forth. We think of things that are very explosive and agility-type movements. So that's gonna be things like shuffles, shuttle runs, and skaters. What's cool is that we can incorporate those types of movements even when we say, "heck, there's no way I can do shuttle runs or skaters", you can still do different versions of that type of training.

The second type is one that women tend to often veer toward - endurance strength. This is where we have the ability to move lighter loads for longer periods of time. So it's more like that 12 - 20 rep range. What's great with endurance strength is this is gonna help us increase the amount of time before we fatigue, while not only exercising but in everyday life. So endurance is so important just to help us as we age so that we can keep doing the things we enjoy. As I said, I do feel that a lot of women, especially when they're starting out with strength training and are worried about the weights and stick to more of the endurance area. There's nothing wrong with that because that is still great. We need that endurance for our muscles and to help us get stronger.

The third type is going to be our explosive strength. So basically, this is going to be your muscle's ability to exert its maximum amount of force in the shortest time possible. This is along the lines of Olympic lifting, box jumps, and burpees. This type of strength is really important as we age because we can build this strength faster than any other. This is especially helpful for elderly clients. For example, in explosive strength we think of the box jumps but we alter them and work on sitting to stand, but doing them explosively. Even with different variations, you can still get that explosive benefit.

Next is maximum strength. This is going to not really be for just the normal everyday average person just wanting to work out, and better their life. This is gonna be more for someone who is trying to lift a single rip at the heaviest amount of possible weight. So this is going to apply more to athletes. However, we can do a variation of this where we're doing higher weight and lower reps - like the 2 to 6 rep range. So we can still get the benefits of what maximum strength that way.

A couple more - next is speed strength. That's basically just how fast you are. You know, this is going to be more useful in sports, but it is good to help us improve how quickly we can react to something. Because as we age, our reaction is something that declines, so it is important that we still are able to react quickly, whether it's when driving or being aware of our surroundings.

Then there's something called starting strengths. Starting strength is what you would see in a track runner in starting position. They are trying to produce as much force or quickness as possible out of a standstill position. We use this same type of strength by sitting up and getting out of a chair. As we get older, we see we see a lot of people struggle to do this - rocking back and then trying to stand up. When we focus on starting strength with compound movements like squats, lunges, etc., it can help build that kind of strength.

Then last, but not least, is relative strength. This is the strength to weight ratio. So, pound-for-pound, how strong you are compared to someone else. So my husband is gonna laugh - my husband is a big man. He is like 230# and very strong, but when we were doing Olympic lifting and I was at my prime, pound-for-pound, I was technically stronger than him. He doesn't like for me to admit that to too many people because he is known for his strength and being very strong. Strength is important but like I said, those are just a lot of different types of strength training.

A great program is going to have a little mixture of kind of each of those types of strength training.

Alaina: So you mentioned this a little bit, especially talking about aging, but how do those things translate into kind of our everyday lives? Where can we see a lot of those benefits - both in our endurance, our ability to move, agility, and things like that as we age, but also from a health side of things?

Cassidy: So a couple of these are beneficial not only just for the everyday person, but especially for women. Number one is definitely going to be that these things are going to build and maintain our muscle mass. So, fun fact for you (well, fun/scary fact), as females our muscle mass decreases 3-8% per decade after the age of 30. This rate declines even more after you hit 60. Okay? And so what stinks about that is this is what leads to an increased risk for falls or the loss of independent living as we age. Strength training is the number one thing that can help slow that process down of losing muscle mass. It also protects our bone health. So as women, we know that we are a lot more susceptible than men to developing osteopenia and osteoporosis. So doing strenth training with any kind of external resistance or weights will help lower our risk for that. Also, if you do already have some form of osteopenia or osteoporosis, it's gonna help slow that process down. Unfortunately, you cannot reverse those factors, but you absolutely can slow it down. My grandmother is an example of this - she has osteoporosis pretty bad. I started helping her with strength training and the slowing down of the process has been huge. So great that when she's gone back to the doctor, there's been a couple of times it's only changed like a fraction, whereas before it was a very big decline each time she went back in my check. That's a big deal because I know a lot of people worry about that as they get older and I don't think that's a commonly known fact that strength training builds bone mass.

Also, for women, strength training is going to help support weight loss and weight management. So when we lift weights, it's going to help us burn more calories and stored energy or fat more efficiently. One way it does that is by increasing lean muscle mass. So we have all heard that muscle burns more energy at rest. Your BMR (basal metabolic rate) is the number of calories you would burn if you sat on the couch and watched Netflix all day. This number is higher if you have more muscle than fat. I think it's one lb. of muscle burns, 3% more than one lb. of fat. Muscle mass helps us to be efficient by increasing our metabolism and helping us burn more while we're literally doing nothing. So who doesn't want that?

Also, I am going to say this, I know that a big stigma around lifting weights for women is that a lot of women are scared that they're gonna get bulky. This is just a myth. The facts behind it are that the hormone testosterone is what makes that happen in the body and we have only about 10% of testosterone that men do. So there is physically no way that when we are lifting that we are going to get bulky as a man could.

We know that there are great benefits of strength training for everyone - better sleep, better energy, just more focus. It's going to help with blood markers like cholesterol and blood sugar. All those good things.

Another one that I think for women, especially and especially for moms is, it's gonna help increase our mental and emotional health., I know for me, working out is so much more than, than just how I look. But when I don't work out, within a few days, I can tell mentally. It is my one time that I can escape from everything else that's going on in my life and focus on me. It can help you have more mental clarity and give a good serotonin boost.

Alaina: Yeah, that's great. I think so many people don't know so many of those things. You know? They know that they'll feel better., but they don't really get down into knowing those details. So, I love that you shared that. I've talked a lot about how it helps from a hormonal health side with blood sugar and insulin sensitivity, but that mental-emotional component is so important too.

I think part of it, too, is that we feel stronger. When we're going to do a strength training workout, and we actually do it, not only are we physically stronger, but we walk away with more mental stamina as well, because it's like "I did that!", you know? So, I think that helps so much when you are facing chronic health issues or you are facing just normal life stress. It just gives you a little more confidence that you can manage things.

Cassidy: 100% agree with you for sure. Yeah, for me, it's just that feeling of going in and lifting just gives me that sense of accomplishment. I feel like if I can do this, then I can tackle anything, right?

Alaina: Exactly. So there are some common questions that come up when it comes to strength training. So I'm gonna ask you a few of those.

How many times per week? What is the goal when it comes to strength training versus overall exercise? We know the overall general recommendation of roughly 30 minutes a day, at least five days a week, but how much of that should be strength training?

Cassidy: Yes, so with strength training, it always depends on whether you are new to it as well as your goals. So if you are someone who is brand new to strength training, you've never done it before, and you're wanting to start off it is recommended that in conjunction with your cardio (75-250 minutes a week of moderate to high intensity) that you want to at least start with twice a week of a full-body workout - every other day type deal. You want to make sure you're hitting each major muscle group in that 10-15 rep range. Even if you are not new but say you just are wanting to maintain what you have, twice a week is what can give you results. You're not necessarily going to see the physique benefits at that frequency, but you're more going to see the benefits of improving your cholesterol, helping your joints, helping your bones, and those types of things. I

Now, depending on your goals and depending on if you are really wanting to change your physique, or maybe you have a specific sports goal, then I would say you need to start ramping up the days that you are in the gym doing your strength training. So I would say you need to be in the gym doing more of like a 4-5 day a week type thing and doing more of what's called a split in your workout. Maybe one day you come to the gym and do an upper-body routine. The next day you do lower-body. Then the next day you rest and then repeat the process. You could get even more specific and focus on only two muscle groups at a time, such as the chest and triceps. Then the next day would be back and biceps... next day legs, or something like that. And then obviously there's some abdominal work in there a couple of days a week too but that is just going to depend on your goal.

So, for example, when I was training for Olympic lifting, I was in the gym six days a week, two hours a day. And there is no way that I would do that right now because I don't have the time and that's not my goal. Now in the gym, I usually try to get some sort of strength training workout four days a week, and I'm doing more of a split style. I also really like doing more of a full-body workout to like more of a CrossFit type style workout, where I'm in my strength and my cardio kind of together. It's important that you are doing the right amount of days and everything, but the main thing is that you find something that you enjoy, because if you don't enjoy it, you're not going to do it and you're not going to show up.

So even if it's something that maybe is not ideal, who cares? The main thing is that you're there and that you're showing up. So whether it's Pilates, Barre, CrossFit, or just weightlifting, find what you enjoy and mix it up. Consistency is where you will get the results.

Alaina: Yes, I love that, and I love that you mentioned those different kinds of workouts. I think that's confusing for people. Sometimes they think strength training only means using machines or only using a barbell. You can incorporate strength training and a HIIT workout. You can incorporate strength training in Barre, Pilates - all that stuff. So, just like you said in the beginning, it depends on what your goals are for that and what you will stick to.

So, a couple of other questions? What would you recommend for someone who says, "Okay, I've tried strength training a few times, and every time I do it, I get very sore, and then I can't do it for three or four more days, and then I kind of just stop".

Cassidy: Absolutely. So, that's a great question. So what I would tell that person or what I would want to look at first is going to be some of their lifestyle factors. So with strength training, you know that is just one piece of the puzzle. But if they if that person is not getting enough sleep, if they're not getting 7 to 9 hours of sleep, if they are not drinking enough water, if they are not fueling their body properly - especially enough protein and carbs to sustain that can be an issue. We also want to make sure that there is a good balance of fuel for the workout. Carbs are glycogen for our muscles and they are going to replenish and refuel our muscles after we work out. If they aren't eating within the first two hours after their workout, let's try throwing in a protein shake. How strength training works is that we do not get the benefits of strength training when we are doing the strength training. It's during our recovery process. So, if we are not going through that recovery process, then yes, we're going to be sore all the time. And so how it works is when we're working out, we create these tiny, small, little micro-tears in our muscles and our body, when we are at rest it goes through something called protein synthesis to repair our muscles. That requires both glycogen and protein. So if we are not giving our body enough protein there's no way we can repair properly. That often leads to injury and it can lead to chronic soreness.

Also, are they sleeping? Stretching? Stressed? When our cortisol is elevated, it can lead to injury, and it can lead to soreness because our body is not going to be able to go through that inflammation process of cleaning all that out and just repairing our muscles and everything. Also, making sure that we're drinking lots of water, you could even throw in some electrolytes in your water as well. One of my tried and true methods for soreness is foam rolling. So on your off-days, foam rolling your muscles will help get out that lactic acid build-up out and help your muscles go through that process of cleaning all the stuff out.

Alaina: Gotcha. That makes a lot of sense. I think that's a huge missing piece - the recovery. People think, "I did my work out - I'm done - I'm going to go on with my day", and then they don't give any thought to that recovery. So follow-up to that is, would you say, within 30 minutes or within an hour? What's that time frame that we need to make sure we're getting that good protein, protein, and carbs, but definitely protein?

Cassidy: So they call it "The window of gains". It is within an hour of your workout is typically what they're recommending, and they usually say you want a complete source of protein. They have done a lot of studies saying that the most quickly digested form of protein is going to be like an isolate or whey protein, but or any type of isolate type protein. So that's going to be something from like a protein shake. Now I know a lot of people might be sensitive to whey protein, so I mean any type of protein shake you could do, and I think that's going to get to your muscles a little bit quicker than a piece of chicken would. Now, if you come straight home from your workout and eat a well-rounded meal, that's still going to be fantastic for you. Sure, it just might not be quite as bioavailable as quickly.

Alaina: Now, what about collagen? Where does that come in because it's not an isolate?

Cassidy: So yes, to make a full, complete protein there have to be 21 essential amino acids in that protein. I think that collagen doesn't have every one of them - I think it's like 19 or something. So collagen is something that you could definitely put in your post-workout shake because it has great benefits, but it wouldn't be something that I would just put in water. It's not going to be sufficient by itself. Yes, but that's a great question.

That kind of brings me to the other point is the complete protein. So there's a lot of sources of proteins that are considered proteins, but are not full, complete proteins. It is important that after our workouts were looking for something with a complete protein, so that's gonna be found mostly in animal sources, right? So just be conscious of that.

Alaina: Cool. Okay, well, are there any resources that you would recommend for people? Maybe who are just starting out their new to strength training? Would you suggest they get a trainer? Are there programs they can do at home?

Cassidy: Yes. So my two favorite resources are going to be ACSM.org and then acefitness.org. That is who I got my personal training certification from, so both of those are the two I trust the most. They are the gold standard when it comes to health and specifically fitness and working out. They do a lot of studies, and they're just they are kind of the cream of the crop. I know specifically, ACEFitness has lots of blogs you can literally type in, "strength training for beginner" and there are thousands of articles that come up that have workout programs in it.

Another thing you can do is getting a personal trainer. I think that's a great idea as well. On those two websites, you can search their database for personal trainers in your area that are certified through them.

Alaina: Great! So if people would like to follow you online where you've been sharing a lot of your workouts and some tips, where can they find you?

Cassidy: Yes, So, on Instagram, they can find me at cass_tipton.

Alaina: I'll put all of that in the show notes so that people can easily find you and then also those two resources as well. Well, thanks so much for spending some of your day with us and sharing all this information with us. It was so helpful!

Cassidy: Yes, you're so welcome! Thank you so much for allowing me to do this and just share some stuff that I love.

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What to Know About Women and Heart Disease

Did you know that heart disease is the number one cause of death for women in the United States? Surveys show that over half of us are unaware that heart disease is such a risk. We tend to think of things like cancer being more of a risk, and while we definitely need to be thinking about that, research shows that for most American women heart disease is the number one cause of death. 

In addition to the risk of Heart Disease being somewhat unknown, it’s also not well known that the signs and symptoms of a heart attack or another cardiac-related event can be very different for women than they are for men. 

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There are many factors that increase your risk for heart disease:

• High blood pressure 

• High triglycerides and low HDL

• Diabetes 

• Metabolic syndrome (Combination of high triglycerides/ low HDL, high blood pressure, high blood sugar, and excess fat tissue around the waist. Harvard med says this is the biggest risk factor)

• Dysbiosis / poor gut health (Research shows that the gut microbiome influences many health parameters, including cardiometabolic health. One study provides evidence that certain families of gastrointestinal bacteria can either positively or negatively affect cardiovascular health. The microbiome is also known to affect metabolism and may contribute to insulin resistance and metabolic syndrome. Other studies found a negative correlation between certain gut bacteria and arterial stiffness.)

• Smoking / Oral Birth control meds

• Chronic high inflammation levels or inflammatory disorders

• Sleep Apnea / poor quality sleep (Poor sleep quality was related to lower HDL-c and higher triglyceride levels in girls, suggesting the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.)

• Family history 

Not only are the risks different for heart disease but the symptoms of a cardiac event, specifically a heart attack, are different for women, as well. While it is still common to have chest pain or pressure, some women never experience that. Other common symptoms include:

• Pain in jaw, neck, back, or upper arm

• Nausea or stomach pain 

• Dizziness or light-headed 

• Sweating

• Shortness of breath 

How can we minimize our risk or work to reverse some of the health issues we may already have?  

The good news is that a lot of the chronic health conditions that I listed above can be significantly improved or even reversed with lifestyle changes. We can do things to...

• Regulate blood sugar levels

• Lower triglycerides levels

• Increase HDL

• Improve microbiome

• Decrease inflammation

This leads you to ask me how - how can we practically do those things?

• Eat regular balanced meals throughout the day. No skipping meals / no stand-alone carbs or proteins (keep blood sugar levels stable)

• Eat lots of plants + omega -3 fats (decrease inflammation, feed good gut bugs, increase HDL, lower LDL) 

• Reduce artificial foods, trans fats, and refined sugars (decrease inflammation, lower triglycerides) 

• Exercise 30 min day (2 days strength at least - decrease inflammation, helps with sleep, improves gut health, decreases stress, helps with insulin sensitivity, increase HDL) 

• Deal with stress (breathing + exercise, talk it out, adaptogens - lowers inflammation, improves sleep, improves gut health, helps with adrenal function and hormone balance) 

• Prioritize sleep (deal with underlying issues, good sleep habits - inflammation, healing and restoration, cell turnover, mental health, stress) 

• Add quality supplements to fill in gaps (whole food multi, omega 3, probiotic + collagen/bone broth) 

So it’s easy to see how what we might consider just basic healthy lifestyle behaviors can really affect our long-term health over time. We tend to want to do the more extreme things, the more trendy things or to just take a supplement or whatever new product is on the market, but really when it comes to the optimal functioning of our bodies and our long-term health, the simple, basic steps really do make a difference. These are mostly the same behaviors and lifestyle changes that I talk about often - when talking about hormone health or gut health - just about any health issue, really. These are the fundamentals, the foundation, for good health, both now and when we are in our 80s. They matter and they make a difference.