#104 - Women's Health with Dr. Carla DiGirolamo: Underfueling, The Importance Of Strength Training and PCOS

Interactive Transcript

spk_0 Welcome back to The Nutrition Made Simple Podcast, powered by Healthy Substitution.

spk_0 At Healthy Substitution, our mission is to help 1 million people take control of their health

spk_0 one step at a time to prevent and reverse chronic disease.

spk_0 We believe that something as fundamental as nutrition shouldn't be complicated, which

spk_0 is why we focus on a simple, habit-based approach when working with clients.

spk_0 We know that helping you become the best and healthiest version of yourself isn't just

spk_0 about what you eat or going to the gym a few hours a week.

spk_0 We have to look at a holistic approach.

spk_0 Addressing nutrition, stress management, mindset, sleep, support system lifestyle, all of

spk_0 these factors that are influencing nutrition and health decisions.

spk_0 In order to become the best and healthiest version of yourself, you really need this holistic

spk_0 approach.

spk_0 My name is Nicole Cohen and I am the founder of Healthy Substitution, home of CrossFit

spk_0 HSN and HSN Mentoring.

spk_0 I am so excited about today's podcast guest.

spk_0 Her name is Dr. Carla.

spk_0 She is a board-certified OBGYN and reproductive endocrinologist.

spk_0 She is over 20 years of experience and was named in Boston Magazine's Boston's Top Doctor

spk_0 from 2019 to 2024, all of those years.

spk_0 She is a wealth of knowledge and she's transitioned to this concierge type of practice where she

spk_0 works with women, specifically pre-menopausal menopausal, to help them understand a little

spk_0 bit more about their hormone health and help them become the healthiest versions of themselves.

spk_0 We work with a lot of her clients and I absolutely have really enjoyed getting to know her,

spk_0 learning from her, and I'm super excited for you to learn from her in this episode.

spk_0 We will get to this episode right after this message.

spk_0 One of the things that we talked about in this episode was CGM and using continuous glucose

spk_0 monitoring with clients that have been diagnosed with PCOS, polycystic ovarian syndrome.

spk_0 CGM allows you to get a deeper understanding of what's going on in the inside of your body,

spk_0 specifically if you're noticing that your fasting blood sugar is high or your borderline

spk_0 diabetic, but not get diagnosed with diabetes.

spk_0 Maybe your A1C, three month average of your blood sugar, is going up and you want to figure out

spk_0 what is going on to take control of your health.

spk_0 Our blood sugar specialty program could be a really good option for you.

spk_0 This is where you get 30 days of CGM you work directly with one of our registered

spk_0 dietitians on staff at Healthy Substitution to gain a deeper understanding and learn how

spk_0 to apply what the numbers mean to create an actional plan to help you take control of your health.

spk_0 It's one of the programs that I'm super passionate about because I know how valuable it is to

spk_0 help prevent and reverse chronic disease specifically around blood sugar, irregular

spk_0 regulation issues like diabetes that leads to many other chronic diseases.

spk_0 So if you'd like to more information, make sure you click the link in the show notes

spk_0 to apply for coaching and book a discovery call at Healthy Substitution.

spk_0 All right, let's get to this episode with Dr. Carla.

spk_0 In this episode, we talk about the importance of strength training, underfueling PCOS,

spk_0 all things related to women who are trying to get a deeper understanding what's going

spk_0 on in the inside of their body so that they can take control of their health.

spk_0 Enjoy.

spk_0 Dr. Carla, welcome to the Nutrition Made simple podcasts.

spk_0 I'm so excited to have you here today.

spk_0 Thank you so much Nicole for having me.

spk_0 I'm excited about today too.

spk_0 Oh, awesome.

spk_0 Well, gosh, we've got connected over the past few months more recently through the

spk_0 Global Health Project and we were talking and I was like, man, you've got to come

spk_0 on the podcast.

spk_0 You're such a wealth of knowledge for those of our listeners who haven't had an opportunity

spk_0 to listen to you yet tell us a little bit about your background.

spk_0 So I am a reproductive endocrinologist in the way you become a reproductive endocrinologist

spk_0 as you train in OBGYN.

spk_0 So I'm board certified in both of Stetrics and Gynecology and reproductive endocrinology.

spk_0 And for many years, for about 18 years of my career, I was practicing as a fertility

spk_0 specialist at a big practice called Boston IVF up in New England.

spk_0 That's where I'm originally from.

spk_0 And I recently made a shift in my career because it was becoming so apparent to me what

spk_0 in need there is for women's health specialists in my field for active and athletic women.

spk_0 As women go through their lives, it seems that they're falling through the cracks in some

spk_0 ways because the doctors either don't understand menopause where they might be or their athletes

spk_0 and the doctors don't quite know how to deal with the athletic woman.

spk_0 So there was quite a niche to be had there.

spk_0 And so I decided to make a career shift, go out of my own and be a specialist consultant

spk_0 for clients who want some medical care for their reproductive endocrin care through telehealth,

spk_0 which is easy to do for this field.

spk_0 And I also do a lot of consultation with other group practices for their females who need

spk_0 endocrin services.

spk_0 I'm also a certified, a menopause society certified practitioner as well.

spk_0 So I have some expertise in the older age groups.

spk_0 Awesome.

spk_0 I know you're super passionate about all things hormone health and helping women really

spk_0 understand how to fuel their bodies.

spk_0 You also are a CrossFit trainer, which is actually how we originally got connected.

spk_0 I looked at the CrossFit Medical Society directory and I was like, oh my gosh, there's

spk_0 a doctor that's on this directory that's right near us.

spk_0 Let me connect with her.

spk_0 So you've been doing CrossFit, like you understand the importance of the lifestyle factor.

spk_0 What brought you to CrossFit?

spk_0 So I've been a recreational level athlete my whole life.

spk_0 From the time I was a young child, you know, up through high school.

spk_0 And college I didn't do much with athletics except, you know, do a lot of gym stuff

spk_0 because I was, you know, in pre-med and that's really difficult.

spk_0 I wasn't one of those super smart people who could, you know, be a competitive athlete

spk_0 and go to medical school at the same time.

spk_0 But so I kind of took a break from there, but I've always played team sports.

spk_0 I've always been very much into fitness my entire life.

spk_0 And then when I was 45, I needed to level up.

spk_0 I was like, you know what?

spk_0 I'm in doing group fitness.

spk_0 I was a less mills body combat instructor, body pump instructor.

spk_0 And that was really super fun.

spk_0 But I needed more because, you know, I was midlife at that point and I was ready.

spk_0 So I found CrossFit.

spk_0 And that was so eye opening for me.

spk_0 It was incredible.

spk_0 I loved it.

spk_0 I loved the variability and, you know, getting surprised by work out every day

spk_0 and just the general physical preparedness that CrossFit trains was very, very appealing.

spk_0 And then about two or three years into it, I was recruited to do the CrossFit MD Level One training.

spk_0 The CEO Greg Glassman at the time was recruiting physicians who did CrossFit.

spk_0 And I had the opportunity to go to a Romas California where CrossFit began and do my level one training there.

spk_0 And that had to be probably the single most inspirational thing I have ever done in my career.

spk_0 And that was a huge catalyst for me making this career shift.

spk_0 And then, you know, it was just history from there.

spk_0 I've been doing CrossFit for about nine years now.

spk_0 I'm a certified Level One trainer.

spk_0 I don't actually coach classes, but that knowledge really helps in caring for athletic women.

spk_0 Oh, that's awesome.

spk_0 Let's just start with strength training.

spk_0 You know, so many doctors, you know, you go into your general practitioner's office

spk_0 and they're talking about all these sorts of things they might mention exercise,

spk_0 but they're probably not talking about strength training.

spk_0 From a medical standpoint, when should you start doing strength training?

spk_0 Why is it important and should you ever stop?

spk_0 I think as early as possible myself, I started when I was 15 years old.

spk_0 That was back in 1985 when girls were not in the gym.

spk_0 But my father was a semi pro football player.

spk_0 And so he knew the importance of smaller, physically smaller athletes being in the gym

spk_0 and making sure that they take advantage of their athletic potential

spk_0 by just, you know, being as strong and fast as you possibly could.

spk_0 So I at least had that support from my father.

spk_0 But, you know, a lot of women in my generation really aren't accustomed to strength training,

spk_0 you know, because back then it was all aerobics and stuff.

spk_0 Fortunately, though, with the younger generations,

spk_0 there's been a real appreciation for collegiate teams to get women in the gym early

spk_0 to start to build that base of muscle mass.

spk_0 Because it really improves athletic performance.

spk_0 It's really super important.

spk_0 So building that base of muscular function, muscular mass and power early in life

spk_0 is so, so important because when you get to the later phases of life in perimenopause and menopause

spk_0 in your 40s and 50s, there's a decline in muscle mass as we age and with those hormonal changes.

spk_0 And that can lead to frailty, it can lead to injury, it can lead to, you know, all kinds of declines

spk_0 in your independence. So if you can build that base early, then you will be set up for life.

spk_0 And with the habits as well, if you, you know, if you're used to strength training early on in your life,

spk_0 you'll like be more likely to continue those habits later on.

spk_0 So as early as possible, pick up that barbell.

spk_0 I love it. And so many people don't know, you know, I remember going to college,

spk_0 cheering at University of Florida and they sent us all to the strength conditioning on football coach.

spk_0 And that was the first time I went to a gym and I was like, oh, there's weights that you have to

spk_0 lift beyond just going on the stair master and going on a treadmill. And learning, I don't even

spk_0 know that I really learned the proper mechanics there, but it wasn't until CrossFit that I actually

spk_0 learned like, okay, what are the proper mechanics? How do you love to barbell? Well, how do you

spk_0 get lift? Well, and you know, keeping good form and really building muscle because we know the

spk_0 research shows that we lose three to eight percent of our muscle mass every decade. And as we age,

spk_0 it gets more and more. And no, if you are starting with a smaller base, and as you age it, you're losing

spk_0 more muscle mass, you're going to, just as you said, have such increased risk for broken bones and

spk_0 issues that come with lack of muscle, which is we know the organ of longevity. So strength training

spk_0 important, anything else you want to add about strength training and getting in the gym for

spk_0 women listening to this podcast episode. Just that it's never too late, you know, if you're

spk_0 in your 40s or 50s, you can still make gains in the gym. I just hit a PR two weeks ago for a squat.

spk_0 And you can still make really good gains even in your 50s. I coached a woman who was in her 60s

spk_0 formal collegiate basketball player and she was able to literally transform her body in her 60s.

spk_0 So it's never too late to start. Those benefits are real no matter when. So don't be discouraged

spk_0 if you're 40 plus 50 plus 60 plus there's still a benefit to be had there.

spk_0 Women that say, I don't want to lift weights because I'm going to get bulky. What do you have to say

spk_0 about that? I'll tell you, I'm trying to get bulky right now because of that muscle loss. A bulk

spk_0 is beautiful to me because when you get to this point, it's really hard to maintain that muscle mass.

spk_0 So I'm shooting for the bulk at this point. And I don't know, to me, I think much of

spk_0 they're beautiful. I mean, we're beyond 1985 and 1995. I think if it's an aesthetic thing,

spk_0 some of the most beautiful women in the world are CrossFit athletes and muscular women. So

spk_0 it's consistent with good health and your healthiest self is your most beautiful self.

spk_0 I love that. What you're visioning, like a, you know, someone that's a bodybuilding contest is not

spk_0 what happens by doing strength training. So, you know, start doing it and see how you feel

spk_0 and see the power that you have and the increased confidence by learning to lift weights. Well,

spk_0 one of the things that people struggle with who want to lose weight and start exercising is

spk_0 underfueling. You've actually referred some clients to us over, you know, the past few months of

spk_0 people who are underfueling their bodies and not eating enough. Let's talk a little bit about that.

spk_0 Yeah, that's an onion with many layers for sure because a lot of the underfueling that I see

spk_0 in my clients is related to this ordered eating body image issues and just what we were taught

spk_0 culturally that of what we should eat. I mean, there's something about the 1200 calories a day

spk_0 that is still persistent even today. I mean, I've had marathon competitors coming to me saying,

spk_0 you know, I can't lose this jiggle from my midsection and oh, by the way, I'm training for the

spk_0 Boston Marathon on 1200 calories. Well, it's because your body is hanging on for dear life for fuel

spk_0 because you're not getting enough. That's not nearly enough. But there is still this sentiment

spk_0 out there and it's still in, you know, I don't know if it's a curriculum or what it is, but

spk_0 but you know, there is still nutritionists out there who are trying to achieve these incredible

spk_0 caloric deficits in these athletic women and these women come to me frustrated that it's not working.

spk_0 And so, you know, there's a lot to unpack with just the what we know about fueling women, which I

spk_0 think, you know, with a lot of the work of Dr. Stacey Sims, we've learned a lot more about fueling

spk_0 women because historically all we went on was the studies on men and, you know, what works for men

spk_0 doesn't work for women. We're very, very different and also the body image issues and disorder

spk_0 leading histories. So it's a lot to unpack and that's why an individualized approach to each client

spk_0 to understand their barriers and their needs is really important. Absolutely. And just an initial

spk_0 assessment, figure out, all right, where are we at right now? I've seen so many people not

spk_0 get enough protein. And we talk about strength training. You have to prioritize protein to be

spk_0 able to build the lean muscle mass. And when we talk about under fueling, it might not just be

spk_0 the calorie deficit. It's probably the fact that they're not getting enough protein to be able to

spk_0 build the muscle that they're working really hard for in the gym. So if you're finding yourself,

spk_0 I talked to people all the time. I've been going to the gym, you know, though I was just talking to a

spk_0 guy who lives up actually where he used to be. He's in the Boston area, been going to the gym for

spk_0 the past six months. I'm not seeing any results. I'm like, okay, well, the gym by itself is not going

spk_0 to help you change your body composition. We have to look at the other factors. We have to look at

spk_0 nutrition. We have to look at sleep and all these other factors that are influencing your nutrition

spk_0 and health decisions. Anything else you want to talk about in regards to let's talk about this

spk_0 under fueling, not getting enough calories and the impact on hormone health.

spk_0 That is that is a great topic. And it's a fun one for me because I'm a hormone geek. That's why I

spk_0 became an endocrinologist. But what's really interesting about being an endocrinologist in a

spk_0 stand how evolution programmed us. And it's really fascinating because the two biggest driving

spk_0 forces are survival and procreation. And what's interesting is the way women are designed

spk_0 is that we are very sensitive to fueling balance. So when we see in puberty, we know that if you're

spk_0 an athlete and your body fat mass is very, very low and you won't catch period. You know,

spk_0 you hear about the gymnast, the better gymnast there, they're in their younger ages there,

spk_0 going through puberty late because they're just not in a fueling balance. So the body detects,

spk_0 okay, there's not enough fuel in the environment. It would not be a good idea for a baby to come along

spk_0 because that's what menstruation is for. Right? A menstruation is to, you know, to create a baby,

spk_0 the potential. And so Mother Nature has this clever way of saying, okay, if the conditions aren't

spk_0 right in the environment, then I'm going to shut off the menstrual cycle. And this isn't happening

spk_0 right now because that's not going to promote survival. So we know that fueling balance is incredibly

spk_0 important for the initiation of mencies. And then during reproductive life, we always hear about

spk_0 women losing their periods. They're training for a marathon, they're training for a high

spk_0 rucks of interval, what have you. And they lose their periods. Again, there's a fueling

spk_0 imbalance. Mother Nature is like, no, no, no, we can't have periods going on with the potential

spk_0 to conceive when there's not enough fuel in the environment. So we are exquisitely sensitive

spk_0 to this as females. And we just don't see the same sensitivity in the male population because

spk_0 they're not the ones carrying the pregnancy. They don't have a menstrual cycle, etc. So that

spk_0 sensitivity becomes front and center as an endocrinologist because what's happening is is that

spk_0 fuel balance is targeting the endocrine system that drives reproduction and also the stress

spk_0 response. So enter in the stress response. So when the body is under fueled, it perceives it as

spk_0 a stress or a threat. And so when that happens, the stress response endocrine or hormonal pathways

spk_0 talk directly to the reproductive system. So again, the stress response system, that responds to,

spk_0 okay, there's a bear in the woods that's ready to eat me. Not a good time to be having a baby.

spk_0 So again, Mother Nature kind of programs stress and fuel as to big things to reflect physiologic

spk_0 balance that says the coast is clear for being able to procreate and have a child. So understanding

spk_0 that innate wiring that we that we have as females really carries over into a lot of the hormonal

spk_0 things that I see going wrong in reproductive age women and also in menopausal women as well who

spk_0 no longer have their menstrual cycle. But that stress response system is getting really activated

spk_0 by that underfueling and then that creates inflammation and stagnation in in performance.

spk_0 Awesome. So, you know, using your menstrual cycle as a great health check. Am I fueling or am I

spk_0 not would be, you know, an easy first step that you can self-regulate? Absolutely. Absolutely. I

spk_0 think every woman should be in tune to her menstrual cycle. So if you're a reproductive age,

spk_0 you know, this doesn't mean that you have to get every fancy app that tracks ovulation to the day

spk_0 and keep track of every single day. But you don't have to obsess about it. Really, it's just

spk_0 get a calendar. Okay, today I got my period. And then next month, okay, what day do I get my period?

spk_0 And if you just track the regularity of it, that gives you an incredible amount of information

spk_0 because like, what if the next month's like, oh, usually I get it on the second or the third of

spk_0 a month, but it didn't come to the 14th this time. All right. Well, let's just keep an eye on this.

spk_0 And then if you start to see your change, it's like something's changing and then you see your doctor,

spk_0 your coach, your trainer and say, hey, something's changing here. What is it? And it really is a great

spk_0 vital sign. I like to call it the fifth vital sign for assessing physiologic balance.

spk_0 I love that. Okay. Easy, actual thing that our listeners can do. Let's talk a little bit about

spk_0 PCLS. What is PCLS? Oh, this is a great topic. Great segue too, since we're talking about

spk_0 menstrual cycles and regularity. So PCOS stands for polycystic ovarian syndrome. And it's a hormonal

spk_0 imbalance where essentially there is too much male hormone being produced in a woman's body

spk_0 that creates some like static interference where the hormonal communication between your

spk_0 pituitary gland and your ovaries, which is what normally happens for your menstrual cycle to happen

spk_0 regularly, those those increased male hormones create interference with those signals in periods

spk_0 become irregular or even absent. So how does this happen? And this is a big subject of debate of

spk_0 debate, you know, the chicken or the egg question. Sometimes we see we actually do see PCOS much

spk_0 more commonly in obese individuals. So did this hormonal imbalance create the obesity or did the

spk_0 obesity create the hormonal imbalance? And I think that we still don't have an answer to that.

spk_0 We do know that if people can manage weight loss, that their PCOS symptoms can be improved.

spk_0 But still it's not clear exactly, you know, what causes what? Because there's also maybe 15% of PCOS

spk_0 patients who are lean, who do not struggle with obesity, but they do struggle with these elevated

spk_0 levels of male hormones that are interfering with their cycles. So that is in a nutshell what PCOS

spk_0 is. It does exist along a huge spectrum. So it's not black or white or white. You can have, you know,

spk_0 a soft call, that's what I like to call it a soft-called PCOS, it's like, okay, you have irregular periods

spk_0 and maybe your ultrasound of your ovaries shows some follicles, but that's it. You don't have any

spk_0 other symptoms. And then you have other people who have so much hair growth that they actually have

spk_0 to shave their face. They have laboratory evidence, it's a stosterone and adrenal hormones.

spk_0 They have insulin resistance and, you know, they have the full gamut. So PCOS exists along that

spk_0 that spectrum, but it is in general due to an imbalance of male to female hormones.

spk_0 How would people be diagnosed with PCOS? So the most commonly used diagnostic criteria for PCOS

spk_0 is called the Rotterdam criteria. And you have to have two out of three of the following.

spk_0 One is irregular menstrual cycles. That's when you have about three months worth of periods that

spk_0 are not coming monthly or absent periods for three months. So irregular periods is one.

spk_0 Laboratory or clinical evidence of elevated male hormones. That means if you draw blood test for

spk_0 testosterone or adrenal hormones like DHAGS, if those are elevated, that serves the criteria or

spk_0 if you have clinical hair growth on your face, on your chest, your buttocks, and it's usually

spk_0 coarse dark hair in the midline of the body. So either one of those would meet that criteria.

spk_0 And then the third thing are ultrasound, ovarian ultrasound findings. So when you do an ultrasound

spk_0 of the ovaries, the ovaries have this pattern of follicles. Those are the little saxophluid that

spk_0 contain the eggs in your ovaries and they tend to be clustered around the periphery of the ovary.

spk_0 On an ultrasound, it looks like the string of pearls. It's called the string of pearl sign.

spk_0 So two out of three of those will land you the diagnosis of PCOS.

spk_0 There are other signs too. You know insulin resistance is not a diagnostic criteria PCOS,

spk_0 but it is commonly seen. When you check hormones like follicles, stimulating hormone and LH

spk_0 hormone certain ratios that tend to be seen, but not technically diagnostic criteria. So there

spk_0 are other signs too, but the Rotterdam is really what most clinicians use as the diagnostic tool.

spk_0 If someone is diagnosed with PCOS, what are some of the things that you would typically work with

spk_0 them on? Well, first are they a lean PCOS or are they an obese PCOS? So for women who are obese,

spk_0 weight loss and nutritional consultation is very important because these women tend to have

spk_0 a predisposition toward insulin resistance and glucose intolerance because there's some

spk_0 crossover between insulin growth factor type pathways and the reproductive hormone axis.

spk_0 And there seems to be some aberrations there. So I usually like to have them work with a nutritionist

spk_0 who has experience with PCOS so they can focus on low glycemic index foods. Maybe they wear a CGM

spk_0 or a continuous glucose monitor to see just how their body reacts to certain things that they eat.

spk_0 So that's really important. An acetal is also a supplement that many people with PCOS use and that can

spk_0 give some relief to some of the hair growth and some of the symptoms that women experience with PCOS.

spk_0 It's particularly good if women are trying to get pregnant. We put almost everybody on an acetal

spk_0 when they're trying to conceive. And also exercise because glucose intolerance goes along with that,

spk_0 this predisposition, if you are moving your muscles and regularly exercising, that's also going

spk_0 to help with glucose control. So it's a multifaceted approach of fitness, medical care,

spk_0 depending on their goals, and fertility consultation, things like that, and exercise nutrition is huge.

spk_0 I love that you stress the lifestyle factors so much and it's not as common when you talk to

spk_0 physicians to really directly guide you to like, hey, you really need to dial in your nutrition.

spk_0 Even just mentioning the CGM, I know we've had off the podcast conversations about the CGM and it's

spk_0 so empowered when people realize what's going on on the inside of their body. And typically CGMs

spk_0 were only used for people that have diabetes. And now they're becoming more accessible for people who

spk_0 aren't technically diagnosed with diabetes, but to help them understand what's going on to baby

spk_0 die the tact, the insulin, glucose intolerance sooner so that we can take control of it,

spk_0 understand what's going on, make some dietary modifications, and really take control of our health.

spk_0 Also the strength training and helping people get active, even just going for 15 minute walk

spk_0 after meals helps with your body being able to digest the food and with being able to regulate

spk_0 your glucose. So those would be some simple tips that people with PCOS are just in general,

spk_0 would be a good option. Anything else you want to add with clients, patients that you've worked with

spk_0 that have PCOS? I think, you know, as you underscore the lifestyle factors, they are important for

spk_0 disease prevention because people with polycystic ovarian syndrome also have an increased risk of

spk_0 something called metabolic syndrome. Metabolic syndrome is a constellation of high blood pressure,

spk_0 high cholesterol, and diabetes. And so the best way to prevent that is with nutritional support and

spk_0 regular exercise. So that becomes particularly important for PCOS, even of the lean subtypes,

spk_0 to be active in exercise and manage the nutrition to prevent those predispositions down the road.

spk_0 I love that. Anything else that you want to add and we definitely need to let our listeners know

spk_0 where they can find you and we can add some links in the show notes as well.

spk_0 I have a blog that on PCOS, and it's in Performance Edge. Blog, it's on Substack is Performance Edge,

spk_0 all one word, dot blog. And I have a pretty thorough PCOS post there. So if your listeners want to

spk_0 check that out and learn a little bit more, they can check it out at Performance Edge. Blog.

spk_0 Where people can find me, my website is the best place, most up-to-date place to see what I do.

spk_0 It's www.drcarlady.com. And I'm also on Instagram at dr-unterscore-carla-unterscore-d.

spk_0 And I'm on Facebook. You just search me by name and I will pop up.

spk_0 Awesome. How do you work with patients? Let's say I was interested in working with you. How does it

spk_0 work when people work with you? So the website is the best place to go. There is a contact button

spk_0 where people can just send me an email. That email comes directly to me.

spk_0 I manage all the emails that come into my practice and that's the best way to contact me

spk_0 through my website. Awesome. Well, I want to thank you for your time today. You're such a wealth

spk_0 of knowledge. We will definitely have you back. I appreciate all that you do and really

spk_0 bringing so light, all of the different factors that are influencing women's health and not just

spk_0 the medical care but really tying in the lifestyle interventions to help improve patient

spk_0 outcomes. So thank you for all that you do and really leading the way. Well, thank you for the

spk_0 opportunity to reach your listeners. I hope you enjoyed that episode with Dr. Carla. Three things

spk_0 that stood out to me. The first one is it is never too late to start strength training. We know that

spk_0 as we age, our muscle is diminishing. We lose about three to eight percent of our muscle mass

spk_0 every decade as we age after the age of 30. So if you're not 30 yet, make sure that you're getting

spk_0 into the gym to build that solid foundation of strength. And if you are over 30,

spk_0 still getting into the gym to combat the muscle that we are naturally losing is really important.

spk_0 It is never too late to start strength training or get back into the routine. If you are local

spk_0 to South Florida in Deerfield Beach, we love you to join our gym. We prioritize strength training

spk_0 and getting a community of people together who are all prioritizing their health. You can go to

spk_0 CrossFitHSN.com to learn more about our gym. The next thing we talked about was the issue of underfeeling.

spk_0 I see this so many times with clients that we're working with who have been put on GLP ones as

spk_0 known appetite, appetite, suppressant. They're not getting enough fuel which is causing them to lose

spk_0 weight, lose muscle really rapidly, which is not good. Yes, the number might be going down on the

spk_0 scale, but body composition is also changing in not a good way. And when they get off the medication,

spk_0 their basal model, metabolic rate is going to be lower. So make sure that you're fueling your

spk_0 body properly to maintain the muscle that you are working really hard for. The last thing that we

spk_0 talked about was PCOS and some things that people that think they might have PCOS, some diagnostic

spk_0 criteria, but then what would you do? Focusing a lot on those lifestyle factors, strength training,

spk_0 and exercise dialing in your nutrition. I love that she mentioned CGM, continuous glucose

spk_0 monitoring. I think it is a really good way for people to gain a deeper insight and understanding

spk_0 on what's going on in the inside of your body. Because realistically, most people don't get that

spk_0 knowledge until they have that diabetes diagnosis or through our blood sugar balance program,

spk_0 you can gain a deeper understanding of what's going on on the inside of your body. With this

spk_0 program, you are working with one of our registered dietitians directly with you have calls every

spk_0 single week to review what your blood sugar has done. Make some tweaks so that you can ultimately

spk_0 take control of your health. Lots of information in this episode. I hope you really enjoyed it.

spk_0 Remember, if you are looking for nutrition coach, you can go to HealthySepSnutrition.com to hire a

spk_0 HealthySepSnutrition coach near you or to work with us directly at our HQ location. Hope you

spk_0 enjoyed this podcast episode and we'll see you back here soon.

#104 - Women's Health with Dr. Carla DiGirolamo: Underfueling, The Importance Of Strength Training and PCOS

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