Live Long and Master Aging
The Live Long podcast is devoted to health optimization and mastering the aging process. Peter Bowes discusses lifestyles and science-based interventions that promote a long healthspan - i.e. the number of years that we enjoy the best of health, delaying chronic diseases for as long as possible. We are pro-aging, not anti. Growing older is a privilege and we approach it with ambitious but realistic expectations. Enjoy every minute.
Live Long and Master Aging
Empowering women through biology | Dr. Stephanie Estima
Dr. Stephanie Estima is on a mission to empower women by unlocking the potential of their biology. For too long seen as “smaller archetypes of men” she says there is now a growing understanding of the “cadences of women” and their distinct health journeys. In this interview we explore the significance of tracking cycles, understanding the different stages in life, including menstrual and perimenopausal phases, the impact of dietary choices, the profound effects of resistance training and importance of mitochondrial health.
Dr. Estima is a doctor of chiropractic with a special interest in metabolism, body composition, functional neurology, and female physiology. She is the author of The Betty Body: A Geeky Goddess' Guide to Intuitive Eating, Balanced Hormones, and Transformative Sex and host of the podcast, Better! With Dr. Stephanie.
This episode, recorded at the 2024 Longevity Fest meeting of the American Academy of Anti-Aging Medicine, in Las Vegas, is a co-production with Time-line, the Swiss longevity biotech company which is pioneering a new category of clinically validated dietary supplements, called mitoceuticals, to support healthy aging. Mitopure deliverers Urolithin A which has been shown to enhance cellular energy, muscle strength and the health of our skin.
Visit our website for additional show notes
Recorded at the 2024 Longevity Fest meeting of the American Academy of Anti-Aging Medicine, in Las Vegas.
Timeline
This episode is a co-production with Timeline, the Swiss longevity biotech company, which is pioneering a new category of clinically validated dietary supplements called mitoceuticals, to support healthy aging. Mitopure deliverers Urolithin A which has been shown to enhance cellular energy, muscle strength and the health of our skin.
Time-line is offering a 10% discount on its Mitopure products - Mitopure Powder, Softgels, Mitopure + Protein and skin creams - which support improvements in mitochondrial function and muscle strength.
Use the code LLAMA at checkout here:
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...
Listen on: Apple Podcasts Spotify
The Live Long and Master Aging (LLAMA) podcast, a HealthSpan Media LLC production, shares ideas but does not offer medical advice. If you have health concerns of any kind, or you are considering adopting a new diet or exercise regime, you should consult your doctor.
People who lift weights they often want is like they like to tell their age to everybody because then people are like, what? You're that age, I can't believe it. But also they tend to it has improvements on their skin. It has improvements certainly in their esthetic and how they function, how mobile. They are flexible. They are all the things it has knock on effects on metabolism and even for, you know, coming back to women again, full circle on menstrual health as well.
Peter Bowes:Hello again. Welcome to the Live Long podcast, I'm Peter Bowes. This is where we explore the science and stories behind human longevity. The goal is to optimize our healthspan and master the aging process.
TIMELINE:This episode is a co-production with the Swiss longevity biotech company Timeline. We're in Las Vegas at a forum, the annual Longevity Fest meeting of the American Academy of Anti-Aging medicine.
Peter Bowes:Doctor Stephanie Estima is an expert in brain health, hormones, and body composition. A best selling author, her book is The Betty body. We'll find out who Betty is in a moment. Doctor Estima has a background in chiropractic care and neuroscience, and I think it's fair to say she is passionate about empowering women to harness the power of their biology. Stephanie, good to talk to you.
Stephanie Estima:I'm delighted to be here. Peter. Thank you for having me.
Peter Bowes:Harnessing the power of your biology. What do you mean by the power of your biology?
Stephanie Estima:Well, I think when we think about men and women, I think for far too long. And I think that the landscape is now changing. We've often looked at women as sort of smaller archetypes of men. So whatever we have studied, it's been with men, and we've just sort of titrated that down to a smaller version for women. And I think when women can attune to their own different cadences. So we have circadian rhythms, as I know you've talked about on the show before, women have infradian rhythms, which are rhythms that are longer than 24 hours. So the menstrual cycle is one that pops up. The most obvious one. We are very different over the course of our 28 day cycle in terms of hormones, in terms of desire, in terms of mood, in terms of sleep. All of these different things fluctuate over the course of the month. So I think that when a woman can attune to her own biology, so the ebbs and flows of, let's say, her hormonal landscape in her fertile years, then she can really live a life that is true to her, and she can make decisions that are better for her rather than just, you know, same, you know, different day, different shirt, you know, trying to like, do the same thing every single day without without an appreciation or love or reverence for how she's different all the time.
Peter Bowes:Well, I want to dive into all of that with you. First of all, though, you haven't always yourself enjoyed the best of health.
Stephanie Estima:That's right.
Peter Bowes:And that to some extent, your own personal story is an inspiration for what you're doing now.
Stephanie Estima:Yeah. So this A lot of my work is born out of my own n of one my own struggles with my menstrual cycle. I'd spent probably decades real feeling like it was a curse. I mean, I know that's one of the nicknames of your menstrual cycle, but I really did feel like every month. it was very. It weighed very heavily on me. I often will talk about when I reflect. Now, I usually had one good week, you know, like, maybe one good week out of the month that was the week after my period finished and then the sort of after that ovulatory, that ovulation piece. And we can talk about follicular and luteal phase if, if we want to go there. But the luteal phase, which is the second half of the cycle, the last two weeks, like 12 to 16 days, let's say, of a woman's cycle, for me, I really struggled with that. I was very inflamed, lots of sleep disturbance, lots of mood and emotional disturbances. And then of course, when the menstrual cycle, when the bleed week started for me, very painful. Lots of like too much prostaglandins. Very Dysregulated, um, hormones. And I struggled with it for years. Um, and I mean, very truthfully, almost felt like a fraud because I was in healthcare. I was in my I was doing professional schooling to become a doctor of chiropractic. I was and then in practice, in private practice, I was also counseling patients on how to eat and how to move, and what are the biomechanics and how's the rehab and the prehab and all these different things related to my profession.
Peter Bowes:A fraud because you felt as if you weren't living the perfect life yourself?
Stephanie Estima:Because I was struggling with my health, because I hadn't figured that piece out yet. And so it was very and this is, you know, maybe a part of my personality where I'm very much a high achieving person. It's very easy for me to look at my patient base or my, you know, the patient in front of me and say, do you know what you need? You need X, Y, and Z. And it's very difficult for someone who's very driven to be. Well, at least now I think I'm different. But at the time it was very difficult for me to be very reflective and say, oh, I also actually need those things that I'm not necessarily I'm telling all of my patients to do, but I'm not necessarily living that and living in alignment with that.
Peter Bowes:But I would have thought also maybe having with hindsight and thought about it, you're human as well.
Stephanie Estima:Yes, I am part of the human race. Yeah, begrudgingly.
Peter Bowes:And I guess it's good to convey that to a patient. Yeah, you know that you're living the same life and the same issues and the same problems and in some cases, struggling to find a solution as they are.
Stephanie Estima:I really appreciate that, and I can appreciate that now. I think that I thought as a young doctor, that my job was to present the perfect picture of health and there could be no deviations from that. Yeah. And I was very hard on myself, and that was part of the problem. I think as you age and you mature, I think there's a hopefully there's a softening that happens and a grace that can kind of you can give yourself the same grace that you might give your patient or your friend. I always sort of call it the best friend test. You know, if I come to you with a problem and you say, hey, Stephanie, it's totally fine for you to be feeling this way, it's totally normal. Here's what I think you might do. Or you might, you know, you might give me some counsel on what you think the best course of action is. Um, you. If I were to do that to you, let's say I wouldn't in the past give myself that same benefit. Yeah. So I was very stringent. And any deviation from that was very I was very hard on myself.
Peter Bowes:So in terms of the, the career path from chiropractic specialization to what you're doing now, and that is in large part focusing on women's issues. Yeah. And obviously with your own personal story in the background. But what was the the thought process there in terms of transitioning to, to what you're doing now from what was quite a tight specialty?
Stephanie Estima:Yeah. So my as I, as we've been talking about chiropractic is the study of the Neuromusculoskeletal Musculoskeletal system. So my first love is neurology and mechanics. Um, and that's actually a lot of what I still talk about today, but it's more female focused. So, um, what I noticed in private practice, I would run programs for we'd run nutrition programs, fitness programs. And very early on it was very clear, especially when there was a husband and wife couple doing the program together. We would often see very different outcomes between the men and the women. Like the men, their testosterone would go up, their fertility markers of fertility would improve, they'd lose weight, they'd feel great. They'd be sleeping, you know, sleeping better. And then the female, the the wife, you know, same environment. She's doing the same interventions. And her results were very different. So orders of magnitude worse and so I was very curious about that. And then I started thinking about how can we play with, um, you know, nutrition interventions and biomechanical interventions and fitness interventions that match a woman's cycle and see if that can help, you know, Ameliorate some of the differences in in outcomes that we were getting. So it sort of naturally evolved from there. And if you look at my work today, it's still based on some of the fundamental principles that chiropractic was founded on, which is move well, eat well and manage your stress. Right. Those are sort of the three main verticals that I still talk about.
Peter Bowes:In fact, they're key pillars of general longevity.
Stephanie Estima:Well that's right. I mean that's right. So I still talk about that. But now my my focus is on getting that message and driving it home to women. But it's no longer this like bro stuff. It's no longer just like the bros at the gym with the tank tops and their orange, and, you know, they're making all these weird noises like it's not just them anymore. Even though we can learn and have have a lot of reverence for them as well, because they've paved the way for women to be in the gym and doing some of the things that that I've learned, I've learned a lot from from male mentors as well. But women need to know this stuff because in many cases is life saving.
Peter Bowes:Exactly. So let's I like to try to pare things down to the basics and to to really explain. So when we're talking about hormonal fluctuations throughout the life of a woman and that they affect her well-being at different stages in her life. Can you break that down? For me, in broad terms, what are those hormonal fluctuations and what are they doing?
Stephanie Estima:Sure. So when we think about the big arc, like the overall arc of a woman's life, we have puberty, maybe there's pregnancy and then we have perimenopause and the eventual menopause. Right.
Peter Bowes:So just give me a quick definition of those two. Then perimenopause and menopause.
Stephanie Estima:So perimenopause peri means around. So around the time of menopause. So let's start with the definition of menopause. And then we can round out the perimenopausal definition. So menopause is 12 consecutive months without a menstrual cycle. It's technically a retroactive diagnosis because you need to go through the year first in order to qualify. Okay. But it basically is one day in your life where you qualify to be menopausal and you no longer are in your fertile years, like this is the end of your fertility. Perimenopause is the 5 to 15 years preceding that. So before menopause, and I'll say the average age of menopause is about 51/52 for most women. But it can happen as early as 45 and then even earlier. There are other reasons why someone might go into premature menopause. There might be chemotherapy or oophorectomies or primary ovarian insufficiency, which is different and perhaps beyond the scope of the definition for most. But 45 and up is considered, you know, a time where you might go through that menopausal transition. Perimenopause, as I mentioned, 5 to 15 years before menopause. And a lot of people will say, oh, it's the hot flashes and it's the irregular cycles. And while that's true, that does tend to be a very late sign of of perimenopause. So what many women will notice is sleep disturbances. So that's really the big one. You'll also see a lot of women complain about body composition changes. So the things that they are doing now in their 40s, you know, what worked in their 20s and 30 is no longer serving them. It's no longer working anymore in their 40s. A lot of women will complain of more belly fat. And we can certainly talk about the different types of fat. So there's subcutaneous fat versus visceral fat. We tend to, if we're not being strategic, talking about what we eat and how we move and managing our stress, if we're not being strategic there, we can actually accumulate quite a bit of visceral fat, which is absolutely deadly. It paves the way for inflammaging, which is a portmanteau of inflammation, inflammation, and aging. So you can accelerate your aging because you're in a state of inflammation. It also lays the groundwork for cardiovascular disease and cerebrovascular disease and type two diabetes, and metabolic syndrome and Alzheimer's disease. Et cetera.
Peter Bowes:And that's men and women.
Stephanie Estima:That's men and women. That's right. But women, because we have higher amounts of estrogen in our fertile years. It is very much cardioprotective. It helps with the pliability and suppleness of our arteries. It helps the vasodilation and the vasoconstriction. It helps with management of our lipids. And once we lose estrogen, we become there's actually when we look at the onset of cardiovascular disease in men, women actually start to very quickly catch up to them after menopause. So before menopause, even in perimenopause, because we still have more estrogen, we have that cardioprotective effect. Once we've gone through menopause, we actually reach the same risk level as men do after about 5 or 10 years, which is tells you how much estrogen. Estrogen is our is our hormonal superpower in many ways.
Peter Bowes:Yeah. And the sum total, if you like, of the risk factors at different stages in life. That's what will affect potentially your longevity. Absolutely. And your health in 60s 70s 80s that everything is you join the dots. Everything is connected.
Stephanie Estima:Yeah. And the number one killer for women is not breast cancer. It's it's heart. It's heart disease. It's cardiovascular disease. And I think that I think not that we shouldn't focus on cancers and breast cancers, because that's very scary. And I've had family members and I know what that looks like. But cardiovascular disease is the number one killer for women. And it is a preventable disease. It is almost entirely preventable.
Peter Bowes:And so what are the, let's say, the modern day lifestyle factors that influence these problems? And are they different now to what they were, say, 20 or 50 years ago?
Stephanie Estima:Oh, that's a good question. I think that it is different markedly different now than it is 20 or 50 years ago. I think that aging is just a natural risk factor. So the older you are, Unfortunately, that does increase, but things like smoking and being obese and accumulating that visceral fat that we were just touching on before, that accelerates your risk. I think when you are not able to manage your stress this is one of the hallmarks of being a perimenopausal woman. You need to get a you need to wrangle in and become a master at stress management. It's not enough to say, I'm going, you know, I'm just going to, you know, you know, punch it out, push the stress somewhere and just forget about it. We have to figure out how to metabolize it and release it.
Peter Bowes:So I mentioned your book in the introduction,
The Betty Body:A Geeky Goddess Guide to Intuitive Eating, Balanced Hormones, and Transformative Sex. So who is Betty?
Stephanie Estima:Betty is the name of my fans of the podcast. So my podcast, like you, I have a podcast. It's called Better! with Doctor Stephanie. And so we actually had listeners of the show just start calling themselves Betties. And I was like, oh, that speaks to my vintage heart, you know? The Betty Davis and the Betty Boop and the Betty White and all the Betty's that, you know, I've sort of grew up and have, like, cherished and loved. So the name of the book, The Betty Body, is just named after the fans of the show. So it's really how my Betty's and we call it, you know, we call it the Betty-verse. And, you know, my Bettys can figure out menstrual cycle literacy. So that first book I hope will be in a series of a few, is all about how to optimize for your fertility in your in your years of reproductive capacity.
Peter Bowes:So that's the main takeaway. You're hoping that people will get from the book?
Stephanie Estima:I hope when people read the book, I hope the first thing that I hope is that they start tracking their cycle. Like that's the one. You don't even have to buy the book. Just like that's what you should do if you're female. Track your cycle and then through the book, I teach you how to eat in accordance with your cycle. So when there's different, you know, hormonal environments when great times for fasting are, caloric restriction. What? You know, what times should we be pushing the protein if we want a carbohydrate restrict? What are times in the cycle that that is appropriate for. And then the same is true for exercise movement. So what types of and my bias is resistance training. So every movement program that I've ever designed has a base for resistance training. That's the that's everybody has to be training. But then the way that you train over the cycle will also change based on how much estrogen you have and how much burst training you do will also change based on where you are in your cycle. When we look at female athletes, for example, and I talk about this in the book, the number one injury that they have is an it's an ACL injury. And so this is a ligament in the knee. And ligaments are very susceptible to estrogen. So as we see estrogen surging in the cycle which typically happens around day ten. And then there's a ... a suming it's a 28 day cycle sort of mid in mid way through the second week. And then there's another secondary rise in the luteal phase. But that primary rise in the follicular phase you'll find that most athletes will injure themselves especially if they're doing things like basketball or they're sprinters. Anything where there's like explosive type of movements or like a lot of lateral movements, you'll you'll typically see a lot of injuries there. So I talk about how you can sort of avoid that type of movement pattern and energy requirement for you in that in that second week.
Peter Bowes:Are women generally less attentive to tracking themselves?
Stephanie Estima:Yes.
Peter Bowes:Than you would like to see?
Stephanie Estima:Yes, 100%. That was really the goal of the book. Like if there's like I said, you don't even have to buy the book. Just track your cycle. Because when you're talking to your primary health care provider, if you have data, if you say, hey, I've been tracking my cycle now for a year, two years, five years, and I know that every month it's 29 days and I know I ovulate, you know, this time because, you know, cervical you know, cervical fluid. You know what that you know how that changes over the cycle as well. You're going to get better care because now your your doctor, your caregiver, your care provider has the same information that you do. Right. And then there can be more collaboration there. So I would say that is by far the most important thing, that every woman who is in those fertile years should be doing.
Peter Bowes:So it's providing data for your doctor.
Stephanie Estima:100% And for yourself.
Peter Bowes:And for your for yourself, ultimately for your own health.
Stephanie Estima:I mean, if there were four other women in this room, we would all, you know, all have a menstrual cycle if we're of a certain age. But there's going to be variances, right? There's going to be there's there's different rhythms that we all have.
Peter Bowes:Right? Yeah. So how attentive generally are doctors to requesting data from their patients.
Stephanie Estima:I would say this much like probably zero. Yeah. Because I and I think my hope is that that changes. I think that, you know, we're talking about perimenopause and menopause. I think that's having a moment. I would also like to see menstrual cycle literacy seep its way in to the medical establishment, where that is one of the I mean, they will ask you, you do have things like date of your last period. They do. You are asked that very, very often when you're going into to see your medical doctor, but they're not necessarily talking about what was the how long did you bleed for? What was the color of your blood? Like what did you see clots and if so, how big were the clots. Like you're not you're not getting that kind of detail. But this is why it's no longer just a luxury to delegate your health to your your medical provider. You also need to. As a woman, I feel very strongly that a woman should be also part of that conversation, and so she can also provide some of that. She can color that in for her provider, for her doctor, so that you both can make better decisions together.
Peter Bowes:So a little digression here. To what extent do you think AI is going to help in this process of sharing data between patient and doctor. Now, clearly there are certain data. It might be difficult at the moment to collect through artificial intelligence, but with the rapidly evolving efficiency of AI, I can see a time when it could with the wearables that we all gravitate towards, that it could help in that respect.
Stephanie Estima:Well, I actually think that that might already be happening. Like there's so many apps where you are just entering your in your data every day of your cycle, and then it will spit back to you. Oh, you might be ovulating in the next few days. And what's your emotional landscape look like? What is your cervical fluid look like. And then that can all be sent to Apple Health. Or, you know, the garments or the the watches, you know, the rings and all the things, the hoops. So, I hope I think that a lot of people are scared of AI. I think that there's some things that are just uniquely human that will, like, I will never be able to touch. But I do think that that data accumulation and relaying of that data is very exciting to me.
Peter Bowes:Yeah. And one thing you mentioned already, the importance of sleep, and certainly AI is big on sleep in terms of measuring our sleep, our deep sleep especially, and REM. How often do you talk to your patients about sleep and how important is that conversation?
Stephanie Estima:It's the number. It's maybe the number two thing I talk about. So I will ask all the questions about the menstrual cycle. And then the second line of questioning has to do with sleep.
Peter Bowes:And what are those questions. Maybe the top three.
Stephanie Estima:Yeah. Well if I will, if they're not, if they don't already have a sleep journal or hopefully they have a sleep journal and I can ask them length of time and if they have wearables, I will look at that data. So how much deep sleep when is your HRV look like? These are all really questions that are that help give me an insight an into nervous system function, balance of sympathetics and and parasympathetics with which the HRV does. And then deep sleep is also telling. Like how much deep sleep that patient is getting also is going to tell me, how rejuvenated they are and how metabolically sound they are. We know that when someone is not sleeping well, even just by an hour, we can start to see, start to see some of those inflammatory pathways start to ramp up again. We tend to crave more sugars. Our inhibitory processes in the brain are also, you know, part of the one of the beautiful things that sleep does is it helps strengthen, the neocortical, something called the prefrontal cortex, which you've probably talked about again here on the podcast, quite, quite often. And part of the job of the prefrontal cortex. So we talk about it as an executive function area of the brain. Where are you thinking about the future. And it's strategic and you're planning. But the other role of the frontal lobe generally is to inhibit lower brain centers. Right. So that's the piece that often doesn't get spoken about as much, but it's also super interesting. So if your frontal lobe is well rested, you are able to properly inhibit some of the more primal areas of the brain, like the lizard brain, the limbic system, you know. So we are when we're sleep deprived, it's very easy for us to get irritated, agitated and angry quicker. And we're also very likely to make poor decisions around our health. We are going to we're going to reach for the cookies and the chips and the crackers versus the, you know, the protein and the kale and the salad and everything on the side.
Peter Bowes:So that's why I put it at number one, because you sleep badly, you're more inclined to make bad choices in terms of your diet and less inclined to exercise. And if you don't exercise good diet, it's all entwined with each other. You mentioned HRV, heart rate variability. I think a lot of people are just discovering what it is. And the fact that, again, our wearables can measure it. Why is it important to know and how can it help us?
Stephanie Estima:Sure. It's just a measure of the balance. So we have something called the autonomic system, which sounds like automatic. So just think about you don't actually have to do anything like your nervous system is already doing it. And the autonomic system has generally two branches Sympathetic and Parasympathetic. Your sympathetics are what people classically refer to as fight, flight, freeze. And then the parasympathetic is the rest and digest stay in place. So this is where we feel very relaxed. This is where we feel very happy and satisfied. And so HRV is basically a measure of the inputs of both of those nervous systems into the heart. So when we think about the heart, the heart rate variability is basically how variable is the heart rate. The heart is a unique muscle in that or a unique organ. I'll say more accurately in that it has both parasympathetic and sympathetic inputs to it. I mean, all organs do, but this is where we can really measure it. And so if you are someone who is chronically stressed, you're not sleeping well, you're not exercising in the way that you should, and you're not choosing healthy foods. You are very and you do that on repeat for weeks, months, and decades. You are very likely going to be sympathetic dominant, which means that your variability. So the input of the parasympathetic system is not going to be as robust as, let's say, the input from the sympathetic system. So your heart rate is going to be much more stuck. It's going to be very similar. And we actually want the heartbeat to be quite variable. So we think oh we should beat once a second, but it should really be like 0.7 seconds and then 1.2 and then 0.8 and so on and so on. So heart rate variability really tells us about how well we are managing our stress. Now, I will say just to add a little bit more nuance to this. I do think that there is some and I don't I don't have any literature to back this up yet, but I do feel strongly or I have a hypothesis that there is some genetic component to HRV because some people, no matter how well they're moving and eating and all of that, their HRV is very low, chronically low. So I think that, it's a useful tool to tell us, broadly speaking, like painting broad you know, brushstrokes how well we are balancing our stress. And if you're someone who always has an HRV of like 20 or 30 or 40 or whatever, don't beat yourself up about it too much. Right. Because there may be and I think that there is a genetic component to it.
Peter Bowes:Right. And it does decrease with age.
Stephanie Estima:It does. Yeah. It does decline with age as well.
Peter Bowes:And I think and I don't think again, there's much data to back this up. But I think seasonal changes, daylight changes, clock changes. All. n equals one. My own experience. Seems to affect HIV in terms of taking a dip and then maybe getting used to the new season, the winter season. It does seem to affect it in some way, I think would be fascinating to have a large scale study to to really gather some data there.
Stephanie Estima:I love that idea. And if I may just put my two cents in , I wish we would stop changing the time.
Peter Bowes:Oh well, that's a whole other podcast.
Stephanie Estima:Is a whole other podcast. But yes, I think that.
Peter Bowes:It's hugely disturbing to your life.
Stephanie Estima:Hugely disturbing. And you can actually see in if you look at data sets from spring and fall, when typically we either fall at spring forward or fall back in the spring, there's actually more. When we lose that hour of sleep, judges are more likely to lay very you know, their their rulings are much harsher than they otherwise would be in the fall when they're an hour slept. There's more car accidents. There's more heart attacks in that first week of that change, because it is so stressful to the body to wake up just all of a sudden wake up an hour earlier.
Peter Bowes:If you were in control of that, would you like a steady time zone that increased light in the evening or in the morning?
Stephanie Estima:I like the standard time, so whatever the standard, it's usually the fall. Like the, you know, when it fall backs because there's a really funny meme. I see it every year in the fall. It's like, did we do it? Did we save the daylight? You know, it's like daylight savings time is more of an antiquated practice for farmers when they really did need the sunlight and they really did need to maximize and profit from extended sunlight. But we're very much like farming is very, you know. Unfortunately, and fortunately is very much industrialized. It's very much automated. We don't like the images of farmers sort of towing the fields unless it's a regenerative agricultural practice, like most of its indoors. And even the way that many animals are raised, it's like all indoors. Doesn't matter if there's light or not outside.
Peter Bowes:Interesting. I want to ask you about something that I've seen you talk about before, going back to hormonal changes throughout life and differences between men and women, and comparisons with the sun and the moon. And I thought it was a really fascinating way to describe the difference between men and women and what we go through during our lives.
Stephanie Estima:I'm so happy that you asked this. You're asking really great questions. So this was my sort of poetic way of describing the differences between men and women. So I would say, and I still say, you know, men are very much like the sun, and women are very much like the moon. So if we think about the sun. You know, it has a 24 ish, you know, 24.5 hour cycle. And men are very much the same when we think about the hormonal constitution of a man wakes up. Lots of testosterone in the morning, you know, get up and go. Go and slay the day and, like, go get the prey, kill it, bring it back to the tribe. And then as the day goes on and I'm talking more tribally. But we also see this in corporate culture, right? We see, you know, you're very much rewarded when you're at the office early and doing your, you know, you get there before everybody else in the office. And then as the day goes on, a man's testosterone begins to drop. And he's actually more I would call it more estrogenic . So he's more chatty, he's more social. And this is like the 5 to 7, you know, happy hour or, like, cocktail hour that you that you often see or where, you know, people will take, you know, men will take their clients out for dinners and things of that nature. And, you know, in the corporate world, and that's very much men are very simple, like simple and elegant, right? So we just men will repeat the same pattern over and over. Women are also circadian, right? We have certain hormones that are higher in the morning, like cortisol for example. Men and women higher in the morning. Much more insulin sensitive in the morning. But then we have this overlay of the menstrual cycle, which is about the lunar cycle, which is about 28/29. The lunar cycle is about 29 days. And actually, that's the average length of a woman's menstrual cycle is about 29 or 30 days. And so actually the word lunatic, just if you're someone who's into words, is someone who reveres the moon, right. So women have this circadian rhythm, but they also have this lunar rhythm on top of that. So I and I compared the two sort of planetary bodies because I wanted to really make the difference. I really wanted to strike the difference between men and women or highlight the difference between men and women in that we're, you know, there's different functions that there's, you know, the sun brightens up the daylight sky and the light illuminates the moon illuminates the night.
Peter Bowes:Do you think there is a lot to be done in terms of men and women, therefore understanding the other person, let's say a couple understanding the other person's cycles throughout the day and what's causing them and what's affecting their mood and attitude and, you know, strength and quietness or chattiness do you think more could be done? And I don't know who the emphasis needs to be on to try to get women and men to understand each other a little bit better in that respect.
Stephanie Estima:Well, I always say that my work is not just for women, but also the men who love them. Right? So I think that and I joke my husband, I often will say, like, my husband knows more about menstrual cycles than most women do, you know? So he knows every single day that he knows luteal, follicular ovulation, all the things. So I think that it provides another bridge of communication between men and women for women to be able to articulate what's happening for them. If they know where they are in their cycle, they're going to be better able to articulate that to their partners. And then the partner, you know, we're assuming a heterosexual relationship. Of course, there are many different configurations for partners, but if we have a heterosexual relationship and the male is able to identify, you know, maybe what's happening for her before. She might even have awareness around i t. Can also provide g race a nd understanding and maybe a little bit more patience is not the right word, but just like, okay, I get. This, she's going through this.
Peter Bowes:That's what I'm getting at. Let's talk about diet and food. I know you don't necessarily believe in there being good foods and bad foods. Yes. But with that, with that belief, therefore, how do you formulate the optimum diet? And I know we're all different. And the best diet for you isn't necessarily the best diet for me. But with that sort of basic principle, don't rule anything out. Don't rule anything in. How would you advise on the optimum diet?
Stephanie Estima:Well, I'll say that, you know, I am not ever advising anyone to just have Doritos or to just have cheesecake, right? So it's always like there's going to be some through lines for everyone.
Peter Bowes:Within reason.
Stephanie Estima:Within reason. Absolutely. So there's going to be we're going to have primarily Whole Foods. It's going to be protein forward. You know your carbohydrates you're getting lots of fiber in your carbohydrates. Hopefully the green leafy vegetables. We're not demonizing fruit. We're having lots of fruit. And then, yeah, the occasional cheesecake and Doritos and whatever Haagen-Dazs flavor, whatever floats your boat, I think is also very much part of a healthy diet. So I will pre-frame it with what you just said. There's so much individuality, right? So my answer to that is the best diet for anyone who's listening here is the diet that you can do long term. Right, right. So I can say to you, you know what you need? You need to do the Mediterranean diet. But if you hate Mediterranean food, this is not going to work well for you over the long term. So I like to take into overlays of cultural, you know, cultural backgrounds and of course, food preferences that come from that. And then we can, like every culture in the world, can eat healthy. You can eat healthy anywhere, that anywhere that your parents come from, anywhere that you come from, irrespective of where you live now. I think that we can all you can, you can create a diet or, you know, foods that you are regularly consuming that are going to achieve your health goals and also give you that cultural satisfaction that I know many people love and crave. So I can say to you, you know what you need? You need a ketogenic diet. And that means you can never have carbohydrates again. But you're Italian. You know, that's not really going to work out so well over the long term, because we know Italians and many Europeans love their bread and they love their pasta and all the things. So we just have to think about what are the whole foods that you love to eat. So what are the. I tend to really prefer animal based proteins, but certainly many Asian cultures are vegetarian, and you can certainly get your protein requirements if you're vegetarian. You just have to. You have to really do your due diligence and make sure that we're getting sort of the full spectrum of amino acids. And, you know, we're not overdoing the carbs and all of that, but, you know, you're getting your protein, an appropriate amount of protein. And that's sort of the first thing that you eat. And then if you're building a plate, we have the protein and then we have the greens, and then maybe for dessert or afterwards, it's like the fruits and the and maybe yogurts and, you know, whatever, whatever we're deciding to build.
Peter Bowes:So with that in mind then and we're in Las Vegas, and I don't notice that many people eating healthily in this city in the last 24 hours. What needs to be done to resolve the crisis in people's diets? We live in an increasingly obese society, not only here in the United States, but across large parts of the world.
Stephanie Estima:The Western World.
Peter Bowes:And it's getting worse year on year.
Stephanie Estima:I think it's a I think it's multifactorial. I think it starts in the home. So I can speak to so there's there's environmental considerations. There are obesogenic environments. There are food deserts. There are foods that are being grown, that are sprayed with all sorts of stuff that, that, that are absolutely endocrine disrupting chemicals and are debilitating to us. So there's all of that that I know exists, and I won't speak on that, because I know that you'll probably have other experts who can speak on that. What I can say is that eating well starts in the home. So eating if you can, eating local. So finding farms, many cities and communities put on farmers markets on the weekend. Or even if you if that's not available to you, you know, just go to the grocer and, you know, prioritizing your budget around making sure that the food that you're bringing home is usually along the perimeter of the store. So that means the meats, the fishes, the fruits, the veg. And then maybe you can sort of wander into the aisles for some bread, pasta or whatever it is that you like to, you know, build your, your meals with. So I think it starts in the home. The other thing I'll say, and this is for the women who are listening, is that sometimes you also have to fight for it and what I mean by that is you can be a good person. And I would assume that many of your listeners are if they're listening to this show, and you can't expect people to just hand things to you because you're a good person, sometimes you have to fight for things, right? So you can be good and kind and you can fight you can go to you can speak to the grocer, you can speak to the farmers. You can you can fight for the things that you want and feel like you need in your immediate, you know, family. So I think that it needs to start in the home. And sometimes it's not even about eliminating. I eliminating. I think that a lot of people think, okay, if I'm gonna eat healthy, that means I can never have a soda again. If I eat healthy, it means I can never have chips again. It's like, well, why don't we just. If you have a soda habit, like if you're having ten sodas a week, why don't we just go to seven? You know? So it's not that you have to jump over this enormous hurdle and go through all the withdrawal of now not having in this case, soda. We are just pulling it back a little bit. So it's it's the least amount of pain. Right. Because change is really hard. We also want to just we also want to, you know, acknowledge that change is really difficult for most people. And so if we can just slowly with a gradient, with a gentle gradient start to bring people in the direction of the goal, you don't have to go A to Z, you just have to go A to B and it just has to. Not ten sodas, it's seven and then in a month's time it can be five. And then all of a sudden you've cut your soda intake by half, you know.
Peter Bowes:And what would you suggest should be the primary incentive for people to want to do that. Now it seems obvious you want to be healthy.
Stephanie Estima:Health. You want to be healthy.
Peter Bowes:But that doesn't seem to cut it sometimes. And it doesn't seem. Some people say, well, I just want to live and let live.
Stephanie Estima:Yeah, totally. Yeah. And it's elusive, right? Like what is even healthy? What does that mean? Are we talking about mitochondrial function? Are we talking about esthetics like you know. So it can get convoluted that way I would say. I mean, I'm a health care provider, so always like I've always been obsessed with health. So that's a really easy sell for me. But if someone. The other thing that I think about is taking the long lens on things. So, right now I am at the time of this recording, I'm 46. I think about when if I have the opportunity to become a grandmother, I hope I'll be able to enter that club. One day. My children will decide to, you know, have have children of their own. And I want to be the favorite grandmother. I want to be the, you know, the grandma on the floor playing with the baby, you know, being able to get up off the floor. That's a really like mobility, right? As an 80 or 90 year old becomes really a big concern if you're not training that, I want to be able to take my grandchildren to the park and play with them and run after them and put them in the swings and take them out of the swings and all the things. So for me, what I have found very useful when I'm counseling people is to really take a long term view. So maybe right now, maybe right now you don't care so much about your health. You're like, who cares? I can still walk. I'm having all these chips, and nothing's like I just take this drug, the statin, and my, you know, my cholesterol levels are fixed. But I would, I would say just take a longer delta, like, take a longer view of your life and think about maybe the, you know, the, the last 30 years. What do you want that to look like? And for me, I know I want to be a vibrant grandmother. I want to be able to travel. I want to be able to put my bag my, you know, my carry on bag in the overhead bin in the airplane and not have to ask someone to do that for me.
Peter Bowes:You've hit the nail on the head there. Because in asking variations of that question to people, almost everyone, Certainly people in your position will eventually refer to children and two grandchildren, and to being around for their offspring and being part of their lives and sharing your wisdom with them. Your acquired wisdom during your long life that you can maybe share to make their lives a little bit easier. It is a very strong common theme, and I think probably one that resonates with with most people.
Stephanie Estima:Yeah. And, you know, being at my son's weddings and I think about all of those things, those joys, moments that any parent or anyone, any family member sort of looks forward to. So sometimes it doesn't have to be as complicated as well. Your mitochondria is going to function. You know you're not going to have the cell signal and danger signal. It's like, no, no one cares about that. I mean, I care about that, but nobody cares about that, right? People care about like, how am I going to be there for my my daughter's wedding? Am I going to be. Am I going to meet my grandchildren? Am I going to burden my children in my old age? And they're going to I'm going to have to be in, you know, hospital and medications and all and live a miserable life.
TIMELINE:This episode is brought to you by timeline, the Swiss longevity biotech company, which is pioneering a new category of clinically validated dietary supplements called mitoceuticals to support healthy aging. Mitopure delivers Urolithin A, which has been shown to enhance cellular energy, muscle strength, and the health of our skin. To find out more, go to the show notes for this episode.
Stephanie Estima:So, mitochondria, you know, if you remember from your high school biology, this is the powerhouse of the cell. So this is where ATP or adenosine triphosphate is made. This is just energy. It's like just the currency is energy. As we age, if we're not being strategic we are going to lose mitochondria the or the mitochondria. We're going to lose them. But we also the mitochondria that are still around are not going to be as efficient. Right. So there are several things that we can do to keep our mitochondria working as efficiently as possible to get rid of the ones that are sort of, you know, not doing their weight, like not pulling their weight. Resistance training is one of the best ways that you can actually have cell turnover. And of course the muscle, the musculoskeletal system. So the muscles of the bones by weight are the biggest organ system in the body. And there's a lot of like bidirectional communication between muscles and bones, always through hormones and growth factors and all the things and even just mechanical strength and tensile strength and stuff. If you are someone who is resistance training, male or female, but especially the ladies, this is not just for the guys. The rate of cell turnover that you can experience from, from resistance training is going to help with that mitophagy and which is just a fancy word for saying like getting rid of the cells that are not the mitochondria, that are not pulling their weight, and also the birth of mitochondrial biogenesis. So the birth of new mitochondria, which are going to be young and hungry and eager to produce energy for you. And this is why you often see people who lift weights they often want is like they like to tell their age to everybody because then people are like, what? You're that age. I can't believe it. But also they tend to it has improvements on their skin. It has improvements certainly in their esthetic and how they function, how mobile. They are flexible. They are all the things it has knock on effects on metabolism and even for, you know, coming back to women again, full circle on menstrual health as well.
Peter Bowes:Yeah. And also it's a it's a great way I come across people in their 70s. There was one woman I'm thinking of in particular who was very unhealthy, extremely unhealthy, overweight, retired, took up weightlifting in her early 70s and radically transformed her training.
Stephanie Estima:It that trainer Joan, are you thinking of trainer Joan?
Peter Bowes:No some I know peersonally.
Stephanie Estima:You know personally?
Peter Bowes:Personally? Yes. And she became, in her age group, the powerlifting champion of the world.
Stephanie Estima:Oh my gosh. I bow down to her.
Peter Bowes:A great she's called Sue. She's a wonderful role model and but it just shows that at any time in life you can change things and change things radically.
Stephanie Estima:Yeah. Hat tip to you, Sue. That's that's incredible.
Peter Bowes:I love the way you explain things. And I want to talk a little bit about your podcast and why you do it. Oh, sure. Why I do this and ask these. Some might think relatively simplistic questions, because I want to get simple answers, and I want to explain things in a way that will resonate with everyone. And I think a key factor for, for all of us in this sphere is the explanation and is breaking down subjects as to why they matter and what can be done for ordinary, everyday people. And I know that's what that's one of your approaches, isn't it, with your podcast that you really want to get through to people in a way that it will make a difference in their lives.
Stephanie Estima:In a way that's relatable and meaningful? Yeah. So thank you for that. I appreciate that very much. And for me, the podcast serves two purposes. One is everything that you just described. So how can we get this information to the masses? And I always felt even when I was a student, I'm like, why doesn't anybody know about. Why don't more people know about this? And so that determination to make health care accessible to people, I think is a driving force for me, because, yes, there are even medical language can be its own language, you know, like mitochondrial biogenesis and mitophagy. These are very fancy big words with lots of letters in them, you know, and most people don't have the desire or inclination to look up what those words are. So if we can sort of break down medicalese, if you will, right. Like the medical language into everyday street language or everybody can understand, then we can have mass understanding. Right. And I think when you start with why, when you understand why it's important, then you can start to pull 1 or 2 pieces of wisdom from a podcast interview like this and start to start to apply it in your life. That's the first thing that it serves. The second is my own insatiable curiosity about a whole breadth of different health subjects. And I'm an eternal student and learner. So my greatest honor is when I have, you know, scientists and thought leaders and clinicians who have just accrued so many reps in their space. They are absolutely, you know, an expert in their subject matter. And I have the opportunity and honor to sit with them and unravel and sort of deconstruct everything for, I mean, for the listener, but also for myself. So it's sort of serves two things there for me.
Peter Bowes:And do you detect that there is this kind of exponential increase in interest in longevity and self-care and an understanding of what healthspan is all about? It seems to have exploded to me. Yeah, I've been doing this podcast for about eight years, but during that time I've seen a rapid increase in in interest and understanding not only an involvement of health professionals, but members of the public who are discovering what longevity is all about.
Stephanie Estima:Yeah, I definitely agree with you. That has been my observation as well. The longevity space has really exploded. I would say in the last five years there's been a very big uptick in it. I would say I'm I am, and I'll just sort of state my bias. I am not interested in living to 180. I don't I don't think I will.
Peter Bowes:That was going to my next question.
Stephanie Estima:And I don't I don't think I want to. What I do want is I want to have the privilege to age well. So for me, what's more important when I think about healthspan or longevity, it's how many years of my life are spent healthy versus in decline. If I'm, you know, my, grandmother she was 93/92 on my mother's side. 92. When she passed and then my on my father's side, she was a little bit younger, but she was also morbidly obese as well. So for me and I saw her suffer medications and pain and joints and all the things. So for me, I, I want to live a healthy life with however many years I'm blessed with, however many years I got, I want to make as many of them healthy versus not.
Peter Bowes:Which i s Healthspan.
Stephanie Estima:Which is healthspan. Yeah. So I'm really focused on Healthspan. And do I think that you can add a couple of years at the tail end if you lift weights and do the do all the things? Absolutely I do.
Peter Bowes:I think the key years are sort of 60 to 80. Those are the years that we can I think we've proven that we can be active and and very healthy and keep on living like we were at 40 and 50, maybe a little slower, but we can still enjoy our life. And then this rapid decline that people often talk about from, from that point to the point that you die, in other words, you don't have a long spell of time when you're in hospital or nursing care.
Stephanie Estima:I just want to die. I just want to be healthy and then go, like, I just want to fall asleep and not wake up. That's just what I want.
Peter Bowes:Yeah, exactly.
Stephanie Estima:Because I don't want to lay. I don't want to belabor it, you know. The suffering on my end, the suffering from the family, all that. And I'm sort of seeing that now as a woman in midlife, where you're seeing your family members lose their health and lose their mobility and lose their cognition and balance. And I don't know how this will sound, but I'll just I'll just say it. I think that the the dying part, you know, that slow, insufferable decline is the worst part about dying, right? It's the being dead. It's like it's done. Right. And even the people who now have lost a family member, they can grieve it and they can say, okay, she's found or he's found peace now. Right, right. But the dying part sucks. Like, the dying part is awful. It's the loss of mobility. It's the loss of continence. It's the loss of balance. It's the loss of, you know, your mind. And so I really want to...
Peter Bowes:Compressed morbidity, isn't it, that people talk about? You compress that period of time?
Stephanie Estima:Yes.
Peter Bowes:Of the suffering that. Yes, that you're referring to.
Stephanie Estima:Yeah.
Peter Bowes:So in closing, what are you most excited about in terms of longevity science, the progress that's being made. Again, we're at this conference where there's a plethora of all sorts of new interventions, many of which I hadn't heard of before as well. What excites you in terms of doing your work as you look to the future? We talked about AI, which I personally find quite exciting. It can be a little worrisome, but I think there's a lot of good stuff there. What interests you?
Stephanie Estima:I am really excited about perimenopause and menopause, and I will say that I feel like it's having a moment now. I think there's been a full on generation of women who were denied hormones. We were told that it's going to give you heart attacks and breast cancer and all the things. The Women's Health Initiative, sort of back in 2002, really did move women's health back like 20 years. And now we're about 20 years after the date that that study was published. And now we're starting to really see the the flaws in the design, the way that they were looking at the numbers and doing their statistical analysis. And so I'm really excited about perimenopause and menopause because I think for far too long I saw, you know, women in my family suffer, suffer, suffer with like the decline in hormones and the hot flashes. And, you know, they were told, well, you should just have your uterus out. I mean, that's that's what should happen now and then looking at her, I'm thinking of an aunt in mine looking at her post op hysterectomy like the pain this poor woman was in. So I. So for me, I feel like there are so many women who suffered unnecessarily. And I really hope that with the conversation around hormone replacement therapy, removing some of the stigma and shame around it, and getting women on hormones in perimenopause, like you don't have to not have a period anymore to consider progesterone and or estrogen and testosterone. So that's what I'm really excited about. And I hope in the next ten years we'll see a lot more progress for medical doctors across there's many now that are speaking up about it, but we still have a lot of work to do. So that's that's kind of where I that's where I am now.
Peter Bowes:Yeah. Stephanie, this has been a fascinating conversation. We could probably talk for another two hours.
Stephanie Estima:We could.
Peter Bowes:But we'll wrap it up now. Really good to meet you. Thank you so much.
Stephanie Estima:Thank you. It's been just a pleasure. Thank you for taking the time with me today.
Peter Bowes:The Live Long podcast is a Healthspan media production. I'm Peter Bowes. You can contact me through our website, livelong Podcast.com, where you'll also find show notes for this episode.
DISCLAIMER:This podcast is for informational, educational and entertainment purposes only. We do not offer medical advice. If you have health concerns of any kind or you are considering adopting a new diet or exercise regime, you should first consult your doctor.
