The Diary Of A CEO with Steven Bartlett
Longevity Debate: The Truth About Weight Loss, Muscle, and Creatine!
27 Oct 2025
Chapter 1: Why does muscle matter for women?
So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors. And the first question is, why does muscle matter as a woman in particular?
Muscle matters because it helps your brain produce more neurons. And that's super important for brain health.
As far as protection as we age, it's directly correlative to the amount of muscle that we have. And if you have something like PCOS or endometriosis, it's even more important for you because building muscle is going to fight insulin resistance and inflammation.
Of
two questions to ask should women exercise differently across the menstrual cycle and what is the reason why women hear what you guys say and they don't do it i'm so glad we're having this conversation we're back with the leading voices in women's health to unlock the specific insights data and tools needed to combat the growing challenges women face throughout their lives
For women, forever it was all about aesthetics. I'm healthy, I'm thin. Because they are under the assumption through sociocultural ideas that a woman is coming to the gym to lose weight, not to get strong, not to gain muscle.
But what we've ended up with is an epidemic of osteoporosis and frailty and really dementia.
Where 40 to 50% of women will have low bone density, 70% of all hip fractures happen in women. And when you have that, 30% of the time you have a chance of dying in one year.
Because most of it is based on male data. And I see a large number of women trying their hardest to be healthy. But what they are choosing to do is actually having a negative impact on their hormonal health. And it's not your fault. And this is where we have to educate. And it starts now.
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Chapter 2: Should women exercise differently during their menstrual cycle?
I know you might not think this conversation's for you, but more than 50% of this planet are women. You have a tremendous advantage in your relationships, at work, and just being a human being going through life if you understand the majority of the population. And for so long, women's health...
Women's bodies, women's anatomy, their psychology and physiology has been a mystery because there hasn't been the same amount of scientific research done to understand them. So in this conversation, we're going to demystify all of that so that you can understand your wife, your partner, your daughter, your colleague, your mother, your grandmother even better.
So in this part of the conversation, I want to talk about exercise, nutrition, fasting, lifestyle, sleep, environmental factors, and all the things that we kind of alluded to when we were referencing hormones and menopause, but in a more actionable sense.
And I guess the first question is similar to the first question in part one, which is, why does it matter for us to have a conversation about women in this context versus fitness generally or nutrition generally?
Sport and exercise science in itself is a small subset of sports medicine and medical research. And most of the research has been done on men. So if we look inherently at most of the recommendations of exercise, recovery, nutrition, it's based on male data. And we established earlier that that's not generalizable. Right.
So when we really want to get into the nuances of how do we create an adaptive stress for women, we have to look at it differently. We have to look through the female lens, understand the female physiology, and acutely how hormones can affect adaptations and how women respond to different environmental cues than men.
Yeah, our hormones distinctly control a lot of our environment and our other cells that are not what we think of as our hormone cells work with our hormones.
So if we think about the gut, we think about the liver, our immune system, a lot of this is so hormonally derived, but it's a two-way street, meaning your hormones influence what is happening in your gut, but your gut influences what is happening in your hormones. And because women have different hormones than men,
as far as what's predominant and when they are, we have to come at this and approach it a different way.
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Chapter 3: What is the impact of estrogen on muscle health?
I think it's important that, you know, building muscle, using muscle consistency is a huge part of effectiveness when it comes to exercise or to building strength.
And so one fear we have when we say do this in one phase of your cycle and do that in another phase is that if, you know, 15% of patients are not ovulating or they have no idea when their follicular and luteal phases are, are they then doing overall less because they're waiting on this directive to tell them what?
What is not untrue, though, and how I frame this to patients is that strength and resistance training should be the core of what you're doing, regardless of the phase of the cycle you're in, regardless if you're pregnant, regardless if we're doing fertility treatments, building muscle, using your muscle.
Now, what you do on other days is where you should allow yourself to say, how do I feel this day? What do I need this day? And be OK with giving yourself the grace that that may look different. on your period, in your follicular phase, in your luteal phase, and saying doing something and moving your body is still ultimately, we're all going to agree, better than sitting on the couch.
Many women will say they have more energy in that late follicular phase. And so if you are looking at your workout structure, this is a day I want to try heavier weights or more reps. It can be smart to put that in a time where you have a higher chance of being successful. That's how I explain it. I'm like, if you have...
your own data and you know which days you feel really fantastic that's where you want to put your higher intensity your heavier lifting because you know that you're going to hit those training metrics what we don't want is for someone to go in to do a high intensity session on days they feel flat because then they won't hit the metrics that they need to to get the stimulus we're after can you explain this to me like i'm a 10 year old in terms of where in the cycle typically women will have more energy and really be able to push themselves
Right here, five to seven days before ovulation. Some women feel really great around ovulation. Some have a transient where they'll feel really awful on and around ovulation and maybe 24 hours later, they feel really fantastic. Most women are variable through the early luteal phase.
So if we think about day 6 to 14, that's when we see women feel really robust and strong and feel like they can take on the world.
Because estrogen is rising. Yeah, exactly. And you see the physiologic changes, heart rate variability, resting heart rate.
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Chapter 4: How can women prevent osteoporosis through exercise?
You can access carbohydrate a lot easier. So you have more availability for fueling to hit high intensities. Then when we see with ovulation, like I said, some women feel really fantastic right around the time of ovulation because of the estrogen surge. Some have transient where they don't feel so great.
When that follicle ruptures and the egg is released, the granulosa cells that are surrounding it, which is what actually makes estrogen, get disrupted. And so some women feel that transient breakage and their estrogens dropping before it reforms to become the corpus luteum and make again. So you have this...
high peak estrogen and then some women are really sensitive to these hormonal changes and they feel that drop so that ovulation day may not always be your very best feeling day which makes women feel like it should be and like something's wrong with them on a side note we did um
survey on women experiencing pain on ovulation because it's something that was never talked about.
Middle schmertz. Yes, exactly. Middle schmertz. Middle schmertz. We had, so you can feel the follicle rupturing and that's called middle schmertz. So it's German for in the middle because it tends to happen in the middle of your cycle when you ovulate.
And it's painful.
It's a pain.
It can be.
It's just a pain. It's like a cyst bursting inside your body.
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Chapter 5: What role does brain health play in women's fitness?
It is such a tremendous stress, you know. And so our motivation, my sister and I, is like, we don't want to do this to our daughters.
Yeah.
Exactly. The other thing I want to bring in is the brain health component, right? We talk about Alzheimer's and dementia. And one of the reasons I really preface doing high-intensity work is the lactate production. Because we're finding more and more research coming out showing that part of the development of dementia and Alzheimer's and the plaque is a misstep in brain metabolism.
So when we're looking at brain metabolism and the brain uses a lot of glucose, it also uses lactate. Now, for women, we have less of the glycolytic or lactate-producing fibers, and we tend to lose those with age. Men are born with more, tend to hold on to them more, so it's not necessarily as big an issue for lactate production. Men need to spend more time in the low-intensity being able to
produce more of our fat burning capacity. But for women doing that high intensity work and being able to produce lactate to then allow the heart and the brain to use that preferential fuel feeds forward to reducing the misstep in this
brain metabolism component that occurs and it's such a sex difference when we're seeing a change in glucose metabolism in and around perimenopause into menopause so it's a lactate production that i it's kind of the offshoot of the high intensity work that's super important for brain health
When you look at glucose metabolism in the brain, I'm talking specifically coming out of Arizona and from Lisa Moscone's work, and they looked at glucose utilization in the brain, especially the forebrain, through the transition. It's wildly different based on what phase of perimenopause, menopause, and postmenopause. And it's absolutely astounding.
And they're seeing patterns that can give clues that may be the women who are headed towards the dementia route versus those who aren't.
And women are significantly more likely than men to develop dementia and Alzheimer's, largely because they have certain unique biological risk factors and also because they live longer than men.
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Chapter 6: How does lactate production affect women's metabolism?
You're laying down grain pathways and neural fibers. Think about it like the bone, but you're creating pathways in your brain to make you healthier.
More resilient to dementia. But they're also going to have more stress.
Build a stronger brain younger.
Are they not going to have more stress if they're working more hours?
Fascinating study, and this one shot me out of a cannon. emotionally, was if you choose to become a caretaker of a parent with dementia, you have a 60% increased risk. Now, there's a genetic component, but when they took the genetics out of it and they feel like it's the stress of caregiving for that parent, you are signing your own death warrant because now you are increasing your risk of death.
Yeah, because I'm right in thinking that women are still both caregiver and now in the corporate world.
Yes. Yes. That's right.
So it's both.
Yeah. Stress from both ends. Lactate production for the win.
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Chapter 7: What are the best strategies for weight loss in women?
And so... Not in my house. Yeah. And so as a culture, there's this worry that all this time on the phone and these dopamine hits, but not creating stories in your head and reading for pleasure at night. A lot of women are on their phones now before bed rather than developing that neuroplasticity that we get from storytelling.
I did something at 24 years old that has had a profound impact on my life. I set myself the challenge of posting every single day on my social media channels. And at the time I was doing it to grow my following, but it had this profound impact on my life. And two remarkable things happened when I did that.
I managed to learn faster because every single day I'm capturing what is happening to me and trying to distill it down into something that I can share with the world. But more remarkably, it led me to building a following of many millions of people. And that's the basis that I used to launch the Diary of a CEO. And that's why I want to tell you about our sponsor today, Adobe Express.
They are the platform that I use to make all the posts across my LinkedIn and across my Instagram. It's a couple of clicks and you don't need to be an expert. And that is why I love using it because I'm not an expert in graphic design. It's accessible to use for all of us, even if we don't have the technical prowess to design great things.
So if you want to start compounding both your reach and your knowledge like I did at 24 years old, then head to adobe.ly slash Stephen and get started with Adobe Express. That's adobe.ly slash Stephen. The next question that came in from the audience, we asked a thousand women to submit their questions. The next one is, what's the best and healthiest way for a woman to lose weight?
Lift weights. Lift weights. And eat. And eat, yes, absolutely. And you could have a very slight calorie deficit towards the end of the evening.
Running?
As a way of burning calories? The problem is people think that they can out-exercise a bad diet. And you can't.
Composition of your diet matters immensely.
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Chapter 8: How can women effectively manage menopause symptoms?
But let me put it in context. Yeah, go run. You're going to burn 100 calories a mile. Three Girl Scout cookies, three thin mints, U.S. favorites, is 180 calories. So you have to run two miles every day. To eat three cookies. Most of us, if you're going to eat cookies, don't eat three thin mints. You eat the whole sleeve, right?
To your point, it is impossible to out-exercise food unless you're a high-level athlete who's burning a thousand calories.
And even then, no. And we see that endurance athletes who use a lot of high sugary type carbohydrate, like the gels and the sports stuff, they've interrupted their gut microbiome so much that they have sugar alcohols. Yeah. Well, it's not even that. It's the phyla change. We're seeing a decrease in the diversity, even though they're exercising.
And we see the exercise increases the diversity of the gut microbiome. It's what they're eating during the training with the heat and hypoxic stress. Wow. That is creating the growth of the firmicutes phyla that's associated with obese outcomes. So that's... It changes the gut, the gut bacteria.
If they are...
So we have this misconception that if you're an elite athlete and you're burning all these calories, then you're just eating to fuel, right? But it's not. It's the quality of the diet. If we want to perform well, whatever performance means, if you're an Olympic athlete down to recreational person who just wants to accomplish a 5K, the composition of your diet is immensely important.
What about Zempek? Everybody seems to be on a Zempek GLP-1s. I prescribe it.
And our clinic is all perimenopause and menopause. And so we always start with, let's see how you do with lifestyle changes first. So we give that three to six months. When they come back, every time they come back, we're doing another body composition change.
And for probably 50% of the patients, lifestyle plus or minus HRT, their body composition changes, they're happy, they're much healthier, everything's moving in the right direction. So now we're left with the people who are doing all the things.
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