Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / Staying Active, Starting Again: Exercise in pregnancy and postpartum

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Staying Active, Starting Again: Exercise in pregnancy and postpartum · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: This is parent data. I'm Emily Oster.
• 0:07
  Speaker 2: I ran my first marathon earlier this year, and someone
• 0:10
  Speaker 2: asked how comparable that was to labor, And of course
• 0:14
  Speaker 2: I had an answer, which was that labor is more
• 0:18
  Speaker 2: physically painful, but you can't stop, so you're not forcing
• 0:23
  Speaker 2: yourself to continue, whereas the marathon is really painful and
• 0:26
  Speaker 2: you have to decide to continue. This is all to say,
• 0:31
  Speaker 2: I'm very interested in running, I'm interested in pregnancy, I'm
• 0:35
  Speaker 2: interested in parenting, and I'm often interested in how they intersect.
• 0:39
  Speaker 2: I get a lot of questions from people about how
• 0:42
  Speaker 2: they can continue a movement practice and that could be running,
• 0:46
  Speaker 2: but it could be orange theory, or it could be walking,
• 0:49
  Speaker 2: or it could be yoga. How they can continue that
• 0:52
  Speaker 2: when they're pregnant and afterwards. And it's not just and
• 0:56
  Speaker 2: in fact, it's almost never because people want to stay
• 0:59
  Speaker 2: in shoe or lose the baby weight.
• 1:01
  Speaker 1: It's because people feel like themselves when they engage in
• 1:06
  Speaker 1: these things, and it's one of.
• 1:08
  Speaker 2: The many things that we can often feel like we
• 1:10
  Speaker 2: lose when we have kids. My guest today, Megan Roche,
• 1:14
  Speaker 2: is a researcher at the Stanford Center on Longevity. She
• 1:17
  Speaker 2: has a focus on bone health and the genetic predisposition
• 1:21
  Speaker 2: to injury. She also spends a lot of time thinking
• 1:24
  Speaker 2: about what makes the female body different from the male
• 1:26
  Speaker 2: body in athletics and how little we know about women's
• 1:31
  Speaker 2: bodies in sports and in general. She is also, i
• 1:35
  Speaker 2: will say, just an absolute machine as a runner. She's
• 1:39
  Speaker 2: a five times trail running champion. She's a six time
• 1:42
  Speaker 2: member of Team USA. She's a running coach. She hosts
• 1:45
  Speaker 2: the Some Work.
• 1:46
  Speaker 1: All Play podcast, which I love.
• 1:49
  Speaker 2: Megan and I are both athletes, and we realize not
• 1:52
  Speaker 2: everyone listening is, but I think that this conversation is
• 1:55
  Speaker 2: universal for anyone who thinks about or has had the
• 1:59
  Speaker 2: experience of having pregnancy just completely knock you sideways.
• 2:03
  Speaker 1: You think you know what your body is, you think
• 2:04
  Speaker 1: you know what.
• 2:05
  Speaker 2: It can do, and all of a sudden, it's different
• 2:08
  Speaker 2: and you've got to learn it again.
• 2:09
  Speaker 1: And the good news is that often you come back
• 2:12
  Speaker 1: and learn it and it's even better than it was before.
• 2:16
  Speaker 2: We talk about bodies, our relationships with our bodies, some
• 2:19
  Speaker 2: thoughts about getting active, and.
• 2:21
  Speaker 1: We hit Meghan's extra spicy take.
• 2:24
  Speaker 2: About running strollers after the break Megan Roche.
• 2:33
  Speaker 1: Megan Roche so nice to have you.
• 2:36
  Speaker 3: It is so amazing to be on here, Emily. I
• 2:39
  Speaker 3: read the Parent Data newsletter all the time, and so
• 2:42
  Speaker 3: it brings me great joy to be on here.
• 2:43
  Speaker 1: I love you. I love your podcast. I want you
• 2:46
  Speaker 1: to tell everybody here who you are.
• 2:49
  Speaker 3: Thanks, thank you for listening. It's such an honor. Oh
• 2:51
  Speaker 3: my gosh. So yeah, we host my husband and I
• 2:53
  Speaker 3: host the some Work I'll Play podcast. It's a lot
• 2:56
  Speaker 3: of running and jokes and humor on there, but also
• 2:58
  Speaker 3: some science and hopefully some strong data mixed in there.
• 3:01
  Speaker 1: Emily.
• 3:02
  Speaker 3: As you say you listen to it, I'm like, I
• 3:03
  Speaker 3: hope it's rigorous. I hope, I hope it's strong.
• 3:05
  Speaker 4: It's good.
• 3:05
  Speaker 1: It's good, full of science.
• 3:07
  Speaker 3: Perfect. But in addition, I'm actually a researcher at Stanford.
• 3:10
  Speaker 3: So I work for the Stanford's Female Athletes Science and
• 3:13
  Speaker 3: Translational Research Program, which is part of the Goodsy Human
• 3:16
  Speaker 3: Performance Alliance, and so I do research on female athletes
• 3:20
  Speaker 3: a lot of things related to bone health and menstruation
• 3:23
  Speaker 3: and pregnancy, and so this is a really fun topic
• 3:25
  Speaker 3: for me today. And then I'm also an athlete and
• 3:28
  Speaker 3: a coach myself, and so I work with athletes of
• 3:30
  Speaker 3: all backgrounds of all disciplines, primarily track road ultra athletes,
• 3:36
  Speaker 3: and then many pregnant athletes as well. So this is
• 3:38
  Speaker 3: a fun conversation.
• 3:39
  Speaker 1: I am excited.
• 3:40
  Speaker 2: Okay, So we're going to talk today about science, data,
• 3:43
  Speaker 2: women in sports, and a movement in general. I have
• 3:47
  Speaker 2: kind of three areas that I want us to touch on.
• 3:50
  Speaker 2: So I want to talk about pregnancy and postpartum exercise activity.
• 3:54
  Speaker 2: I want to talk about some of the research on
• 3:57
  Speaker 2: utterfueling and REDS, which I know is part of what
• 3:59
  Speaker 2: you were and I think people will.
• 4:01
  Speaker 1: Be interested in. And then I want to talk about
• 4:03
  Speaker 1: this general question.
• 4:04
  Speaker 2: Of like why isn't there more research on ladies in
• 4:07
  Speaker 2: sports and other areas? And I will say, you know,
• 4:10
  Speaker 2: I think that obviously I really like running. People who
• 4:14
  Speaker 2: listen to this know about my love of running, but
• 4:17
  Speaker 2: I actually think there are huge lessons here for people
• 4:20
  Speaker 2: who aren't, you know, trying to run like trail ultras
• 4:23
  Speaker 2: like you run because many of these issues of like
• 4:26
  Speaker 2: how do I return to whatever I was doing movement
• 4:29
  Speaker 2: wise postpartum, or how do I think about movement and pregnancy?
• 4:32
  Speaker 2: These are just like many people have these, even if
• 4:35
  Speaker 2: they're not trying to run one hundred miles.
• 4:37
  Speaker 3: I love that point. I also too, so I struggled.
• 4:41
  Speaker 3: Actually in pregnancy, I had my orcarditis in my heart,
• 4:44
  Speaker 3: and so I went through several long periods of time
• 4:46
  Speaker 3: where I couldn't exercise or train, and coming back to
• 4:49
  Speaker 3: exercise or train for the first time, it was so
• 4:51
  Speaker 3: eye opening to me, like what how different it felt
• 4:54
  Speaker 3: coming back for the first time. And I think it
• 4:56
  Speaker 3: gave me that the compassion empathy for anyone out there
• 4:58
  Speaker 3: starting exercise how amazing it is, but also simultaneously how
• 5:02
  Speaker 3: challenging it is too. And so it's kind of fun
• 5:03
  Speaker 3: to speak to all different audiences of women just starting
• 5:06
  Speaker 3: exercising and athletes out there that are like training for
• 5:09
  Speaker 3: one hundred k fifty k races. It's almost ubiquitous in
• 5:12
  Speaker 3: terms of like what we feel. And I think going
• 5:15
  Speaker 3: through that, going through that return to run journey myself,
• 5:17
  Speaker 3: gave me so much compassion.
• 5:18
  Speaker 1: For that totally.
• 5:20
  Speaker 2: Okay, So let's start with the pregnancy postpartum. So when
• 5:23
  Speaker 2: I talk to people in this space, I think the
• 5:24
  Speaker 2: science is very confusing because you kind of simultaneously get
• 5:28
  Speaker 2: the exercises really important in pregnancy.
• 5:30
  Speaker 1: It prevents gestational diabetes.
• 5:32
  Speaker 2: It has all kinds of other things, and then the
• 5:34
  Speaker 2: piece that's like don't don't lift anything or let your
• 5:37
  Speaker 2: heart rate go above one forty. And people often be like,
• 5:39
  Speaker 2: but that's what happens when I exercise, Like, of course,
• 5:42
  Speaker 2: my heart rate is above one forty. And I want
• 5:45
  Speaker 2: to think about you know, what do we actually.
• 5:47
  Speaker 1: Know about this? Yeah, what do we know about this?
• 5:51
  Speaker 3: That's a great question. Well, the one forty is a
• 5:53
  Speaker 3: curious heart rate measurement that came back from nineteen eighty
• 5:56
  Speaker 3: five from the American College of Obstructis and Kinecology. And
• 6:00
  Speaker 3: it's curious to me because I feel like, whenever I
• 6:01
  Speaker 3: hear a number, I'm like, where did that number come from?
• 6:04
  Speaker 3: And one forty seemed awfully convenient. It was like this
• 6:06
  Speaker 3: just round number that we're going to toss out there
• 6:09
  Speaker 3: into the universe.
• 6:10
  Speaker 2: Everything in science of this where you're just like, well,
• 6:12
  Speaker 2: how could it possibly be exactly fifteen hundred grams or
• 6:16
  Speaker 2: exactly something in the world works like that.
• 6:18
  Speaker 1: How could it be exactly at thirty five? Your fertility
• 6:21
  Speaker 1: falls off a cliff? That seems wrong?
• 6:23
  Speaker 3: Yes, exactly, Plus it's wrong. And plus in pregnancy, heart
• 6:27
  Speaker 3: rates are so variable, so like resting heart rate goes
• 6:29
  Speaker 3: up in pregnancy and maximal heart rate goes down, and
• 6:32
  Speaker 3: so a pregnant athlete is also totally different than a
• 6:35
  Speaker 3: regular athlete. And so back in nineteen eighty five, that
• 6:38
  Speaker 3: one one forty heart rate recommendation, which is kind of
• 6:40
  Speaker 3: this like number out of the sky, They're like, Okay,
• 6:42
  Speaker 3: this feels reasonable, let's start here. Unfortunately, the ACOG has
• 6:46
  Speaker 3: backed off of that one forty recommendation now with the
• 6:49
  Speaker 3: idea of okay, let's keep let's keep exercise feeling reasonable.
• 6:53
  Speaker 3: Let's think about like conversational efforts, let's go by generally
• 6:56
  Speaker 3: effort more than heart rate. And it's been refreshing to
• 7:00
  Speaker 3: see that that back up in terms of like let's
• 7:03
  Speaker 3: rewind from one hundred and forty beats per minute. But
• 7:06
  Speaker 3: I think there's still a lot of work to be done,
• 7:08
  Speaker 3: and there's still there's a lot of confusion in the
• 7:10
  Speaker 3: space of like, Okay, what is what is safe to
• 7:12
  Speaker 3: do as an athlete? And I think for me as
• 7:14
  Speaker 3: a coach, I just want athletes to feel empowered to
• 7:18
  Speaker 3: be in pregnancy and feel like they're moving their body
• 7:20
  Speaker 3: and enjoying it and not having it be an additional stressor,
• 7:23
  Speaker 3: because there's enough stressors as there is in pregnancy, and
• 7:25
  Speaker 3: it's like, let's have exercise be you know, this this
• 7:28
  Speaker 3: place of embracing mental health and embracing that we can
• 7:30
  Speaker 3: do without all these like additional vague stressors.
• 7:33
  Speaker 1: Yeah, and without stressors on either side.
• 7:35
  Speaker 2: I mean, I think this is a thing which can
• 7:37
  Speaker 2: come up and can be there in both directions sort of.
• 7:40
  Speaker 1: I know it's really important to do, I.
• 7:42
  Speaker 2: Guess, but also that's like somehow there's no there's like
• 7:46
  Speaker 2: no way to come to a happy medium, except there
• 7:49
  Speaker 2: is a way to come to a happy medium, which
• 7:50
  Speaker 2: is to do what feels appropriate and you know, think
• 7:54
  Speaker 2: about like not injuring yourself exactly.
• 7:57
  Speaker 3: Yeah, And so are where I start with athletes is
• 7:59
  Speaker 3: I think so current recommendations right now is if you
• 8:01
  Speaker 3: can get one hundred and fifty minutes of aerobic exercise
• 8:03
  Speaker 3: in per week, that's amazing. And when you break it down,
• 8:06
  Speaker 3: that's like thirty minutes five times a week. And I
• 8:09
  Speaker 3: think for athletes that are just building into exercise, that
• 8:11
  Speaker 3: can be something that can be attainable to work to
• 8:14
  Speaker 3: during pregnancy. So you can build up to that incrementally
• 8:17
  Speaker 3: and then for earlad athletes, there's often tends to be
• 8:19
  Speaker 3: this more nuanced conversation of you know, what is safe
• 8:23
  Speaker 3: to do? And I think those individual conversations with coaches,
• 8:27
  Speaker 3: with athletes, and with doctors are really important just to
• 8:29
  Speaker 3: allow elite athletes to also feel empowered that this is
• 8:32
  Speaker 3: not a nine month shut down of the body, that
• 8:35
  Speaker 3: we can keep training and building and progressing forward, because
• 8:38
  Speaker 3: in reality, so many elite athletes go on to actually
• 8:40
  Speaker 3: have really strong performances postpartum, and it can be a
• 8:44
  Speaker 3: really beautiful time to like build a foundation of strength
• 8:46
  Speaker 3: and resilience within the body during pregnancy.
• 8:49
  Speaker 2: But it feels again, it feels like all of these
• 8:51
  Speaker 2: things during pregnancy where we're somehow we're looking for an answer.
• 8:55
  Speaker 1: We're looking for like a one.
• 8:56
  Speaker 2: Size fits all, like Okay, you can do this, or
• 8:59
  Speaker 2: you can do that, or with no nuance, And exactly
• 9:03
  Speaker 2: what you just said was, you know, if you are
• 9:05
  Speaker 2: someone who never exercises, there's going to be one answer.
• 9:08
  Speaker 2: The answer isn't going to be like this is the
• 9:10
  Speaker 2: best time to train for your first marathon, because there
• 9:13
  Speaker 2: are reasons why you know, you might be more likely
• 9:15
  Speaker 2: to get injured. Your ligaments are looser, Like you're not
• 9:18
  Speaker 2: going to want to run one hundred miles a week
• 9:19
  Speaker 2: if you've never done that before.
• 9:21
  Speaker 1: But if you're someone who does run one hundred.
• 9:22
  Speaker 2: Miles a week, you know, maybe you don't have to,
• 9:25
  Speaker 2: you know, cut down. You certainly don't have to cut
• 9:27
  Speaker 2: down to nothing.
• 9:27
  Speaker 1: So it's like somehow we're looking for an exact answer,
• 9:31
  Speaker 1: and what we're finding ourselves is that probably is no
• 9:33
  Speaker 1: exact answer, but there also isn't enough data to tell
• 9:35
  Speaker 1: us what the tell us what the answer is. This
• 9:38
  Speaker 1: comes up exactly not just not just an exercise.
• 9:41
  Speaker 3: Yes, Plus it's also really hard if you think about it.
• 9:43
  Speaker 3: I actually extend a lot of compassion to researchers that
• 9:45
  Speaker 3: have studied women in pregnancy or postpartum. Is most of
• 9:49
  Speaker 3: the data that we have, most of these data that
• 9:51
  Speaker 3: we have come from retrospective studies, so we're looking back
• 9:54
  Speaker 3: at what pregnant women have done. Very few of the
• 9:56
  Speaker 3: studies have been done looking forward or evaluating athletes or
• 10:01
  Speaker 3: people that are currently going through pregnancy, and so it
• 10:04
  Speaker 3: also becomes very tricky to parse out what's what. And
• 10:06
  Speaker 3: I think when I get down to it, it's I
• 10:09
  Speaker 3: think these conversations need to be really unique and nuanced
• 10:13
  Speaker 3: for each athlete, for each person that's thinking about exercising.
• 10:16
  Speaker 3: And I think the more it's hard because it's like
• 10:19
  Speaker 3: when we're trying to ascribe data or recommendations or guidelines,
• 10:22
  Speaker 3: we have to start somewhere. But I think going forward,
• 10:25
  Speaker 3: I would love for there to be okay, like here
• 10:27
  Speaker 3: is a guideline, and I think we're at that spot
• 10:29
  Speaker 3: of like let's think of like reasonable exercise, let's think
• 10:32
  Speaker 3: of conversational piece. But I also think there needs to
• 10:35
  Speaker 3: be room, wiggle room and more discussions surrounding elite athletes
• 10:38
  Speaker 3: and surrounding other alternatives and just provide just that nuance
• 10:42
  Speaker 3: that you know, every pregnancy is going to be different,
• 10:44
  Speaker 3: and also every pregnancy within an individual is going to
• 10:46
  Speaker 3: be different too. I've seen some athletes train beautifully through
• 10:50
  Speaker 3: the first pregnancy, and then the second pregnancy is so
• 10:52
  Speaker 3: hard and it's just impossible to predict, I think until
• 10:55
  Speaker 3: someone goes through it.
• 10:57
  Speaker 4: Yeah.
• 10:58
  Speaker 2: So then so there's the fancy piece, and then there's
• 11:01
  Speaker 2: this postpartum piece. And actually I would say I get
• 11:07
  Speaker 2: in pregnancy, I get this one question, which is like
• 11:10
  Speaker 2: what about one hundred and forty that's like one hundred
• 11:12
  Speaker 2: percent of the questions are what about one hundred and forty?
• 11:14
  Speaker 2: But the postpartum piece is is much is a much
• 11:18
  Speaker 2: richer set of questions because there are everyone effectively goes
• 11:24
  Speaker 2: to zero. So whether you are you know, like an
• 11:27
  Speaker 2: elite athlete or you're someone who just like occasionally gets
• 11:30
  Speaker 2: out to walk or ride your bike or swim egage
• 11:32
  Speaker 2: or whatever it is, you are going back to zero.
• 11:35
  Speaker 2: And then people want to figure out like how do
• 11:37
  Speaker 2: they build back to something? And I also think we
• 11:42
  Speaker 2: don't know anything about.
• 11:43
  Speaker 3: This, oh for sure. And I think we're not really
• 11:46
  Speaker 3: collecting data on this either because if you think about
• 11:48
  Speaker 3: the system, I mean I remember going in so I
• 11:50
  Speaker 3: have a fourteen month old and I went in for
• 11:53
  Speaker 3: my six week postpartum check and I was seeing a
• 11:57
  Speaker 3: pelvic floor pet at the time, and she was so
• 11:58
  Speaker 3: amazing doing rigorous we're going through the process. But not
• 12:01
  Speaker 3: many people have access to that, whereas at my six
• 12:03
  Speaker 3: week check it was just kind of like, hey, hi,
• 12:05
  Speaker 3: I think you're good. And it really wasn't like gathering
• 12:09
  Speaker 3: the information or the data or even doing a heavy
• 12:11
  Speaker 3: internal exam to know how things were in terms of
• 12:14
  Speaker 3: my pelvic floor and so I feel like we just
• 12:16
  Speaker 3: need to collect more robust data for women postpartum to
• 12:20
  Speaker 3: guide these recommendations. But for right now, I feel like
• 12:23
  Speaker 3: it's almost similar to pregnancy recommendations, where it's like it
• 12:26
  Speaker 3: becomes just a very nuanced conversation based off of an
• 12:29
  Speaker 3: athlete's goals and how things are feeling. But I just
• 12:32
  Speaker 3: wish like individuals and athletes had more access to pelvic
• 12:36
  Speaker 3: floor pets where you can have more regular meetings in
• 12:40
  Speaker 3: more regular check ins, or even if we could establish
• 12:42
  Speaker 3: that within the classic like gynecology check ins would be
• 12:45
  Speaker 3: gun check ins, that would be amazing.
• 12:47
  Speaker 1: Yeah.
• 12:48
  Speaker 2: My like one of my soapboxes I have, like doulas
• 12:51
  Speaker 2: that's a soapbox, and then I have pelvic floor pets
• 12:54
  Speaker 2: because I think that this is something everyone even if
• 12:58
  Speaker 2: you are never going to run ever before you're not
• 13:00
  Speaker 2: running it, like you're never doing any sports, you should
• 13:02
  Speaker 2: still see a pelvic floor PD because it's not normal
• 13:06
  Speaker 2: to pa on yourself, and a lot of people do,
• 13:08
  Speaker 2: and this is just this should be part of like
• 13:10
  Speaker 2: the standard of care for everybody or.
• 13:13
  Speaker 5: You don't even know.
• 13:14
  Speaker 3: Actually for me, I mean, I've been an athlete my
• 13:16
  Speaker 3: whole life and I feel like I've gone through rigorous
• 13:18
  Speaker 3: training and I've gone through and you know, done a
• 13:20
  Speaker 3: bunch of mileage now as an endurance athlete. And when
• 13:22
  Speaker 3: I went to the pelvic floor PT, I actually couldn't
• 13:25
  Speaker 3: activate my pelvic floor muscles. And to me, it was
• 13:28
  Speaker 3: so eye opening that you know, this is not just
• 13:30
  Speaker 3: about like postpartum health, but also think about things like
• 13:33
  Speaker 3: back injuries and hip injuries and things like that. And
• 13:36
  Speaker 3: I was like, oh, I wonder if there's some connection
• 13:38
  Speaker 3: here because I literally have no ability to actitivate my
• 13:41
  Speaker 3: public floor muscles. And it was a very eye opening
• 13:44
  Speaker 3: experience for me. And I don't think I quite realized
• 13:47
  Speaker 3: the importance of public floor PT until really even having
• 13:50
  Speaker 3: gone through it.
• 13:51
  Speaker 1: Yeah, so all right, everybody, get a pelvic floor. Get
• 13:54
  Speaker 1: a pelvic floor PT.
• 13:56
  Speaker 3: Oh it's amazing. Yeah. And if you can't think, you know,
• 13:59
  Speaker 3: advocate for yourself at the would be guine. And what
• 14:02
  Speaker 3: I tell athletes to do is I think sometimes athletes
• 14:05
  Speaker 3: are afraid to speak up about what they're passionate about.
• 14:07
  Speaker 3: And if you're passionate about exercise and passionate about returning
• 14:12
  Speaker 3: back to sport, like advocate for yourself like treat yourself
• 14:15
  Speaker 3: like an elite athlete because you are, because you're exercising,
• 14:18
  Speaker 3: because you're putting yourself out there. And I think doctors
• 14:22
  Speaker 3: will hopefully give you more compassion and more time and
• 14:25
  Speaker 3: understanding if you advocate for yourself in that way.
• 14:27
  Speaker 1: Yeah, I actually would.
• 14:29
  Speaker 2: I think this is a place where I would draw
• 14:31
  Speaker 2: such a strong connection between what I think people should
• 14:34
  Speaker 2: do if they are thinking about sports and what.
• 14:36
  Speaker 1: They're doing in general.
• 14:37
  Speaker 2: That basically, when we have a baby, it is so
• 14:42
  Speaker 2: easy to just put everything that is you down at
• 14:47
  Speaker 2: the bottom, like the and you should in some ways,
• 14:49
  Speaker 2: like of course when you have a little infant and
• 14:51
  Speaker 2: you have kids, like your kids and the most important thing, etc.
• 14:54
  Speaker 2: But when we forget that there are also things that
• 14:57
  Speaker 2: we cared about before that we would like to get back,
• 15:00
  Speaker 2: then we aren't maybe serving even our kids as well
• 15:03
  Speaker 2: as we could because we've sort of forgotten that piece
• 15:05
  Speaker 2: of ourselves And a lot of times we're not talking
• 15:09
  Speaker 2: about those things and we're not saying that they're important,
• 15:11
  Speaker 2: and so then other people can't help us achieve them
• 15:14
  Speaker 2: and that it could be your partner, right, I mean,
• 15:17
  Speaker 2: I like people ask me all the time about you know,
• 15:19
  Speaker 2: how do I get back to exercising with my kids
• 15:22
  Speaker 2: are a little and like the first thing I always say,
• 15:24
  Speaker 2: they're like, oh, you know you run so much. I'm like,
• 15:25
  Speaker 2: and my kids are like twelve and eight, like I
• 15:28
  Speaker 2: just leave, you know, I leave, and it's fine, like
• 15:31
  Speaker 2: they watch television. But but there's another piece, which is,
• 15:35
  Speaker 2: you know, if this is something that's important to you,
• 15:38
  Speaker 2: it's something you should build in and you should say, like,
• 15:40
  Speaker 2: this is something I need to prioritize because it's something
• 15:43
  Speaker 2: I want to do, and like that's okay, it's okay
• 15:46
  Speaker 2: to say this thing is important to you.
• 15:48
  Speaker 1: Yeah, I love that.
• 15:49
  Speaker 3: And it's hard because I mean, I went through this
• 15:52
  Speaker 3: and running and endurance focus is my job, it's my career,
• 15:56
  Speaker 3: it's my life. And I got so much pushback from
• 15:59
  Speaker 3: family and friends, and I think there's almost the societal
• 16:02
  Speaker 3: pressure of you know, what are you doing? And I
• 16:04
  Speaker 3: even actually had as I was leaving the hospital, lactation
• 16:07
  Speaker 3: consultant tell me that I should be in bed for
• 16:09
  Speaker 3: three weeks after giving birth, which to me was seemed
• 16:12
  Speaker 3: to very counter to general recommendations and guidelines. I like
• 16:15
  Speaker 3: athletes to get up and get moving within reason, and
• 16:18
  Speaker 3: I just feel like there's almost these societal pressures and
• 16:21
  Speaker 3: each comment like that it's hard. It's hard to endure
• 16:23
  Speaker 3: when you care about something. And I think I've gotten
• 16:25
  Speaker 3: better and it was hard to go through this, But
• 16:27
  Speaker 3: as I've coached athletes, I'm like, no, this is important.
• 16:30
  Speaker 3: Is I need to emphasize the importance to me and
• 16:32
  Speaker 3: that it matters and it makes me a better mother
• 16:34
  Speaker 3: and parent by getting out there and doing this. And
• 16:37
  Speaker 3: I think it's really helpful for me for me to
• 16:39
  Speaker 3: have gone through this process and had to speak up
• 16:41
  Speaker 3: for myself on it.
• 16:42
  Speaker 1: Yeah.
• 16:43
  Speaker 2: So in my first pregnancy, I had an ob who
• 16:45
  Speaker 2: I had a complicated relationship with. But then my second pregnancy,
• 16:49
  Speaker 2: so why I write a whole book about anyway. And
• 16:51
  Speaker 2: then in my second pregnancy, I had midwife and one
• 16:54
  Speaker 2: of the things that was sort of much better about
• 16:55
  Speaker 2: that experience is she was like she just listened much
• 16:59
  Speaker 2: more to the things that were to me. So actually
• 17:00
  Speaker 2: I was running like the entire time, and she's the
• 17:02
  Speaker 2: one who was like, hey, you know, maybe you need
• 17:04
  Speaker 2: like a support belt and then you won't have to
• 17:06
  Speaker 2: pee like quite as frequently. So it was just like
• 17:08
  Speaker 2: a little bit of someone I remember that so vividly
• 17:10
  Speaker 2: as like okay, like I told a person this was
• 17:12
  Speaker 2: important to me, and then they are like helping me
• 17:14
  Speaker 2: achieve that rather than telling me, you know, well, like
• 17:19
  Speaker 2: stop running because it's dumb.
• 17:22
  Speaker 3: And it's amazing too. I love what you say about
• 17:23
  Speaker 3: the belt is because I feel like there's also some
• 17:25
  Speaker 3: little suggestions that go so far. And I think that
• 17:29
  Speaker 3: the more that we have education on like postpartum exercise
• 17:33
  Speaker 3: and even exercise during pregnancy, those little suggestions might be
• 17:36
  Speaker 3: the difference for someone to get out the door versus
• 17:38
  Speaker 3: not to get out the door. And I think the
• 17:40
  Speaker 3: more that we can arm practitioners and armed coaches and
• 17:43
  Speaker 3: even just like like societal messaging, likely you just such
• 17:46
  Speaker 3: a great job of this. I've learned so much more
• 17:49
  Speaker 3: from pregnancy about pregnancy and postpartum care from you than
• 17:53
  Speaker 3: I have from any provider that I've ever seen. And
• 17:55
  Speaker 3: I think the more that we can have these like
• 17:57
  Speaker 3: different avenues of spreading information, the easier it will be
• 18:01
  Speaker 3: and we can raise the numbers. I mean, like forty
• 18:03
  Speaker 3: percent of women I've seen is the number is very
• 18:05
  Speaker 3: based off where you see them, but like forty percent
• 18:07
  Speaker 3: of pregnant women are active and I think it's these
• 18:09
  Speaker 3: little small suggestions and people doing the good work to
• 18:12
  Speaker 3: make it easier to get out the door that's really
• 18:14
  Speaker 3: going to be helpful.
• 18:15
  Speaker 2: Yeah, And I think it's it's you know, and also
• 18:17
  Speaker 2: emphasizing to people that get out that you know, getting
• 18:19
  Speaker 2: out the door to take a brisk walk like there
• 18:21
  Speaker 2: are when we talk about starting exercise, which I think
• 18:24
  Speaker 2: is kind of can be like it can be an
• 18:27
  Speaker 2: enormous challenge. It's the enormous in pregnancy is normal challenge
• 18:29
  Speaker 2: after to just give people sort of little pieces of
• 18:32
  Speaker 2: things that help them, that make it possible to do
• 18:35
  Speaker 2: this and is worth It's worth a lot.
• 18:37
  Speaker 3: Yeah, I think for me, so I gradually generally what
• 18:39
  Speaker 3: I do for athletes is I have them return to
• 18:42
  Speaker 3: a crash training usually like two to three weeks postpartum,
• 18:45
  Speaker 3: sometimes earlier, depending on the athlete. And then six weeks
• 18:48
  Speaker 3: is that gentle run walk and for every athlete it's
• 18:51
  Speaker 3: run walk and it's really helpful, I think, just to
• 18:54
  Speaker 3: ease back in so gradually, and then sometimes it varies too,
• 18:57
  Speaker 3: you know, it's like six weeks is the earliest I
• 18:59
  Speaker 3: bring back leads back to run walk. Sometimes it's twelve weeks,
• 19:01
  Speaker 3: sometimes it's eighteen weeks. And I feel like the more
• 19:04
  Speaker 3: that people and athletes can have these individualized conversations about
• 19:08
  Speaker 3: what is this return to look like and it's okay,
• 19:10
  Speaker 3: Like if if your twelve weeks and your friend is
• 19:12
  Speaker 3: six weeks, that's totally okay too, because palvis is heal
• 19:16
  Speaker 3: at different rates and different modes of delivery, so many
• 19:19
  Speaker 3: different complications, and I think the more that these open
• 19:22
  Speaker 3: conversations happen the better.
• 19:23
  Speaker 2: Yeah, yeah, it's boy. I mean the other thing is
• 19:26
  Speaker 2: like it's very humbling when.
• 19:27
  Speaker 3: You oh, it's so humbling. I have never felt worse exercising.
• 19:32
  Speaker 3: I was like simultaneously so excited to be back and
• 19:36
  Speaker 3: also like this is heinous at the same time. And
• 19:39
  Speaker 3: I think there also needs this to be this space too,
• 19:43
  Speaker 3: because sometimes I feel like there's this sensationalism when we
• 19:46
  Speaker 3: talk about athletes that are returning to sport postpartum, and
• 19:49
  Speaker 3: then it's also there's like doomsday conversations, and I feel
• 19:52
  Speaker 3: like there's not always this like middle of the road
• 19:54
  Speaker 3: conversation about yes, this is hard, this is daunting, this
• 19:57
  Speaker 3: is challenging, this will be probably unlike anything that you've
• 20:00
  Speaker 3: ever experienced. Before, but it's also doable and amazing at
• 20:03
  Speaker 3: the same time. And I think the more that we
• 20:05
  Speaker 3: have those middle the road conversations, the more fruitful it's
• 20:07
  Speaker 3: going to be.
• 20:08
  Speaker 2: Totally all right, So I want to actually back up
• 20:11
  Speaker 2: or sort of move into other parts of the lifestyle
• 20:14
  Speaker 2: life not lifestyle, in the life cycle a little bit,
• 20:17
  Speaker 2: because you have worked a lot on these issues of
• 20:21
  Speaker 2: red to the Athlete Female Athlete triad, and I think
• 20:24
  Speaker 2: I would love to have you just talk a little
• 20:26
  Speaker 2: bit about the history of sort of how we think
• 20:28
  Speaker 2: about fueling for women and it's impact on health, in
• 20:32
  Speaker 2: part because I think it matters for people who listen
• 20:34
  Speaker 2: to this, but in part because I think something I
• 20:35
  Speaker 2: think about a lot is a parent of a daughter
• 20:38
  Speaker 2: and a daughter who engages in sport. And the landscape
• 20:43
  Speaker 2: of this has changed quite a lot in the last
• 20:45
  Speaker 2: of our understanding of this has changed quite a lot
• 20:47
  Speaker 2: in the last several decades.
• 20:49
  Speaker 3: I think, Yeah, I would say we're in right now
• 20:51
  Speaker 3: what we call fueling revolution, the idea that fueling our
• 20:55
  Speaker 3: bodies is one of the most important things to unlock performance,
• 20:58
  Speaker 3: to unlock mental health, to unlock sony different of different
• 21:01
  Speaker 3: like benefits that we're going to get from athletic activity.
• 21:04
  Speaker 3: And it's exciting to be in research in this time
• 21:07
  Speaker 3: because I feel like we're seeing so much data and
• 21:10
  Speaker 3: so many new papers coming out about different ways to
• 21:12
  Speaker 3: feel bodies. But I think first to bring it back
• 21:14
  Speaker 3: actually to pregnancy and postpartum. Something that's not talked about
• 21:17
  Speaker 3: enough is the idea that relative energy defficiency in sport
• 21:20
  Speaker 3: or REDS. So when an athlete or an individual is
• 21:23
  Speaker 3: in a state of low energy availability, so essentially their
• 21:26
  Speaker 3: energy expenditure is mismatched with their energy balance and they're
• 21:30
  Speaker 3: not getting in enough caloric intake. This is very common
• 21:33
  Speaker 3: postpartum because athletes are breastfeeding, which is high demand on
• 21:37
  Speaker 3: the body. There's often weight loss that happens postpartum two
• 21:40
  Speaker 3: and sometimes that weight loss trajectory just keeps going and
• 21:44
  Speaker 3: potentially unhealthy ways. And so I think there also needs
• 21:47
  Speaker 3: to be more conversation about REDS and low energy availability
• 21:50
  Speaker 3: in that postpartum period for women, especially when too it's
• 21:53
  Speaker 3: hard to fuel. You know, you're busy, you have your
• 21:56
  Speaker 3: adjusting to breastfeeding demands, and you know, for me, I
• 22:00
  Speaker 3: remember just trying to like cram food in my face
• 22:02
  Speaker 3: as I'm breastfeeding and from a run.
• 22:05
  Speaker 1: Yes, I would tell.
• 22:06
  Speaker 2: My husband like, when I am breastfeeding, you need to
• 22:08
  Speaker 2: like bring me like cottage, like made me like cottage
• 22:11
  Speaker 2: chese is like pineapple next to my breastfeeding chair.
• 22:16
  Speaker 3: Yeah, oh it's wild. I'm like just please, like, can
• 22:18
  Speaker 3: you just like give an ivy drip of pizza into
• 22:20
  Speaker 3: me as we as I sit here and breastfeed. And
• 22:24
  Speaker 3: even like energy demands, I mean I would have to
• 22:26
  Speaker 3: fuel my exercise almost like one point five times the
• 22:29
  Speaker 3: amount that I was doing before in order to sustain
• 22:32
  Speaker 3: like breastfeeding and lift demands as well. So I think
• 22:34
  Speaker 3: REDS is also a really interesting conversation in the postparting period,
• 22:38
  Speaker 3: but in general, so REDS is also very common in
• 22:41
  Speaker 3: athletes across the life cycle.
• 22:43
  Speaker 1: Can you say, let's let's for the for the the
• 22:46
  Speaker 1: casual listener, Yes, give us the red like the rundown
• 22:50
  Speaker 1: of the reds sort of what is this?
• 22:52
  Speaker 3: Yes, so REDS is common. There's also the female athlete
• 22:55
  Speaker 3: triad which has been started first and then REDS came
• 22:58
  Speaker 3: as an evolution of the female aff triad. And so
• 23:01
  Speaker 3: it's the idea that there is this mismatch in energy
• 23:04
  Speaker 3: balance and so athletes or individuals are not meeting their
• 23:08
  Speaker 3: energy demands and they're meth they're left with an energy
• 23:11
  Speaker 3: deficit at the end of the day that can have
• 23:13
  Speaker 3: long term impacts on many different bodily functions, from things
• 23:17
  Speaker 3: like like the menstrual cycle to fertility, to even cardiovascular
• 23:23
  Speaker 3: health and bone health. And then the Female Athlete triad
• 23:26
  Speaker 3: specifically talks about this low energy availability component and how
• 23:30
  Speaker 3: that intersects with menstrual cycle dysfunction and then low low
• 23:34
  Speaker 3: bone health or low low bone density, and so this
• 23:38
  Speaker 3: can be a big concern for endurance athletes, athletes competing
• 23:41
  Speaker 3: in aesthetic sports, and then honestly athletes all throughout the
• 23:45
  Speaker 3: life cycle, both genders, male and female. And it's been
• 23:50
  Speaker 3: a passion of mine in terms of my research and work.
• 23:53
  Speaker 2: Yeah, and so you know, my sense of this is
• 23:55
  Speaker 2: that there's kind of really been this evolution of understanding
• 23:59
  Speaker 2: that for women, for girls, that this when we see
• 24:06
  Speaker 2: this sort of loss of vnstluation, this energy deficiency, we
• 24:09
  Speaker 2: see it lead to injury, and then we see it
• 24:11
  Speaker 2: lead to basically a lack of ability to continue in
• 24:15
  Speaker 2: sports over time, and that the change here is the
• 24:20
  Speaker 2: idea that you actually do need to fuel, You need
• 24:22
  Speaker 2: to eat.
• 24:23
  Speaker 1: Basically, you need to eat more. That's the thing, you guys,
• 24:25
  Speaker 1: that's the thing.
• 24:26
  Speaker 3: And there's actually been some fascinating research coming out that
• 24:29
  Speaker 3: carbohydrates are often so we basically need lots and lots
• 24:32
  Speaker 3: of the food revolutionist let's get all the macronutrients, let's
• 24:34
  Speaker 3: get protein, let's get fat, let's get carbohydrates. But there's
• 24:37
  Speaker 3: been some really interesting new studies looking at low carbohydrate
• 24:41
  Speaker 3: intake as a predictor of relative energy divisioncy in sport,
• 24:45
  Speaker 3: and the fact that carbs are super important for young athletes,
• 24:48
  Speaker 3: for developing athletes, for all athletes training their body well,
• 24:51
  Speaker 3: and especially female athletes, and so carbohydrates have been a
• 24:55
  Speaker 3: big focus in recent research. But I think the other
• 24:57
  Speaker 3: thing that's interesting is sometimes athletes can be in a
• 25:00
  Speaker 3: state of low energy availability and everything can seem fine
• 25:04
  Speaker 3: for a period of time, and some of the effects
• 25:07
  Speaker 3: in terms of risk of stress fractures and risk of
• 25:09
  Speaker 3: injuries and risk of negative performance take longer to happen.
• 25:13
  Speaker 3: And so these conversations, these really open conversations, are important
• 25:16
  Speaker 3: because we really need to identify athletes at a younger
• 25:18
  Speaker 3: age and start having these conversations for prevention at a
• 25:22
  Speaker 3: really young age.
• 25:23
  Speaker 2: Yeah, we basically don't want don't want our girls to
• 25:26
  Speaker 2: be like eating so little that they perform great in
• 25:29
  Speaker 2: high school and then never again and then.
• 25:32
  Speaker 3: Exactly or not go through puberty. I mean, I think
• 25:35
  Speaker 3: a big challenge is if you have low energy availability
• 25:37
  Speaker 3: or reads around the time of puberty, you can either
• 25:40
  Speaker 3: delay puberty or not experience the same magnitude or impact
• 25:43
  Speaker 3: of puberty. And I think the more that we talk
• 25:45
  Speaker 3: about the fact that puberty is a great thing, Like
• 25:48
  Speaker 3: it might be hard to perform during the time of puberty,
• 25:52
  Speaker 3: but if you go through puberty and sustain and fuel
• 25:56
  Speaker 3: your body, well you are going to be in these
• 25:58
  Speaker 3: other words of Lauren Fleshman is an amazing and durance athlete,
• 26:01
  Speaker 3: You're going to be a grown ass woman and that
• 26:03
  Speaker 3: grown ass woman is going to do performances and compete
• 26:06
  Speaker 3: stronger than you ever could. And so it's like fuel
• 26:10
  Speaker 3: is really the catalyst to get there. And I just
• 26:13
  Speaker 3: I think it's I'm so passionate about having these conversations.
• 26:16
  Speaker 2: So this is like slightly off topic, but I think
• 26:19
  Speaker 2: it is a topic I find very interesting, which is
• 26:23
  Speaker 2: the question of carbohydrates versus like you know, the keto diet,
• 26:29
  Speaker 2: and so I was listening to Andrew Hubertman or whatever.
• 26:32
  Speaker 2: There's a whole space of the world that's kind of
• 26:35
  Speaker 2: like carbohydrates are bad. And then there's a space that
• 26:37
  Speaker 2: I think is much more the one you and I
• 26:39
  Speaker 2: live in, which is like carbohydrates as performance fuel is
• 26:41
  Speaker 2: like incredibly important. Like do you have a sense of
• 26:44
  Speaker 2: how we bring these like how we bring those together?
• 26:48
  Speaker 3: Actually, yeah, I don't think we bring them together.
• 26:50
  Speaker 1: I think we keep them opposite.
• 26:51
  Speaker 3: It's probably the way I would approach it is. I
• 26:54
  Speaker 3: think in the longevity space, there are some discussions surrounding
• 26:56
  Speaker 3: the keto diet, and I think for certain individuals it
• 27:00
  Speaker 3: makes it might make sense from a longevity perspective, but
• 27:03
  Speaker 3: I would argue that athletes are in a totally different
• 27:06
  Speaker 3: cohort of the population. That we are fueling our bodies
• 27:10
  Speaker 3: and stressing our bodies in ways that if we add
• 27:12
  Speaker 3: the key, if we add ketosis into that, it's going
• 27:15
  Speaker 3: to send our bodies into a state of haywire and
• 27:18
  Speaker 3: excessive stress, an excessive courtsult to the point where the
• 27:21
  Speaker 3: longevity benefits that you would get from it are probably
• 27:23
  Speaker 3: negligible anyways, Plus the performance benefits are terrible. And yes,
• 27:28
  Speaker 3: I think like a focus on low carbohydrate diets may
• 27:32
  Speaker 3: work for a very small percentage of male athletes, but
• 27:35
  Speaker 3: I think that's really scratching at the margins. Whereas I
• 27:37
  Speaker 3: would never recommend a female athlete to go on a
• 27:40
  Speaker 3: low carbohydrate diet. It's not worth the risk, it's not
• 27:43
  Speaker 3: worth the challenges associated with it. And part of the
• 27:46
  Speaker 3: fuel and revolution that I was talking about is the
• 27:48
  Speaker 3: fact that we have seen bonkers performances recently in marathons
• 27:52
  Speaker 3: and ultra marathons, and one big reason is a lot
• 27:55
  Speaker 3: of athletes are consuming more than ninety grams of carbs
• 27:57
  Speaker 3: per hour and it's providing those performance schemes that we
• 28:00
  Speaker 3: need to develop and to really progress as athletes.
• 28:04
  Speaker 2: I've thought a lot about the question of how, like
• 28:07
  Speaker 2: how we think about food and how we think about
• 28:09
  Speaker 2: the idea of a healthy diet, and I actually think
• 28:11
  Speaker 2: so much that question is asked, like what is a
• 28:13
  Speaker 2: healthy diet, as if there's like a singular answer to that,
• 28:16
  Speaker 2: and I think the answer is, like if you are
• 28:17
  Speaker 2: trying to run, you know, an ultra marathon, like that
• 28:21
  Speaker 2: answer is going to be completely different than if you're
• 28:24
  Speaker 2: you know, sort of sedentary and trying to you know,
• 28:27
  Speaker 2: lose weight or trying to prevent diabetes or whatever that is.
• 28:31
  Speaker 1: These just like totally different questions.
• 28:33
  Speaker 3: I love. I love that point, and it's almost it
• 28:35
  Speaker 3: gets back for it's almost a very similar conversation to
• 28:37
  Speaker 3: the pregnancy discussion. Is the recommendations have to be so
• 28:40
  Speaker 3: nuanced to really like capture the best health of pregnant
• 28:45
  Speaker 3: women and athletes that we were looking for. And I think,
• 28:48
  Speaker 3: like we really just have to have these nuanced conversations
• 28:51
  Speaker 3: surrounding food and fuel. And I think we're approaching. I
• 28:54
  Speaker 3: think we're getting better in that space, but there's still
• 28:56
  Speaker 3: a lot of work left to do.
• 28:57
  Speaker 1: Yeah, totally.
• 28:58
  Speaker 2: I had a conversation with my brother over the holidays,
• 29:01
  Speaker 2: who's like quite a good runner, and he explained to
• 29:03
  Speaker 2: me that he does.
• 29:04
  Speaker 1: Not fuel before his runs. Oh no, no, it got
• 29:07
  Speaker 1: so much worse.
• 29:08
  Speaker 2: And then when he goes out for like twenty miles,
• 29:10
  Speaker 2: he doesn't fuel before, he doesn't fuel during, and he
• 29:14
  Speaker 2: only brings water if it's the summer.
• 29:16
  Speaker 3: Oh my gosh, he's gonna he's so fast.
• 29:20
  Speaker 1: The thing is, it's like twice like I was like,
• 29:21
  Speaker 1: think about how fast you could be pain myself.
• 29:25
  Speaker 3: Okay, But it's exciting though, because when I work with
• 29:28
  Speaker 3: an athlete, like that's when I coach an athlete like this,
• 29:30
  Speaker 3: I'm like, just think about the performance games, except you're
• 29:33
  Speaker 3: gonna have ahead. It's like I Actually, my husband and
• 29:36
  Speaker 3: I on our podcasts, we use the term food doping
• 29:39
  Speaker 3: because honestly, the performance impacts from adequately fueling your body
• 29:43
  Speaker 3: are so strong that they could actually be categorized. Like
• 29:47
  Speaker 3: if you think about like the magnitude and the sheer
• 29:49
  Speaker 3: percentage of it, it's so much that it's like it's
• 29:52
  Speaker 3: you actually compare it to like doping efforts, which obviously
• 29:55
  Speaker 3: we don't want to do. Well, that's not great for athletes.
• 29:56
  Speaker 1: Yeah, compared to the shoes, like you're spending four hundred
• 29:59
  Speaker 1: all on the Alpha fly V three like gets grand crackers.
• 30:04
  Speaker 3: Yeah, and if those are five percent, fueling your body
• 30:06
  Speaker 3: might even be a fifteen percent, and it's like, let's
• 30:08
  Speaker 3: get those fifteen percent.
• 30:10
  Speaker 1: Yeah. Okay.
• 30:11
  Speaker 2: My last topic is the paucity of data on women's health.
• 30:15
  Speaker 2: And I think this is this is like everywhere in women,
• 30:20
  Speaker 2: and it comes up in this very extreme way in exercise.
• 30:24
  Speaker 2: So like, for example, people still the site this idea
• 30:27
  Speaker 2: that every extra pound of weight costs you two seconds
• 30:29
  Speaker 2: a mile, and that's myself.
• 30:31
  Speaker 1: It's like from some study in the nineteen seventies.
• 30:33
  Speaker 2: There are a lot of problems with that study, but
• 30:34
  Speaker 2: it's also just men, and it's always just men. Every
• 30:37
  Speaker 2: one of these things is just men. And why why
• 30:42
  Speaker 2: are we only studying men?
• 30:44
  Speaker 3: It's so hard for a long time, and it makes
• 30:47
  Speaker 3: a little bit of reasonable sense when you think about it,
• 30:49
  Speaker 3: but this should not be the reason that challenges research
• 30:52
  Speaker 3: fromen athletes. Is the idea that women athletes obviously have
• 30:55
  Speaker 3: the mentual cycle, and the mental cycle can cause a
• 30:58
  Speaker 3: host of confounding variables, things like temperature and metabolism and
• 31:02
  Speaker 3: cardiovascular changes that if you included a group of female athletes,
• 31:06
  Speaker 3: you would have to control for the mentro cycle to
• 31:08
  Speaker 3: get good data, and sometimes it's just hard to do that.
• 31:11
  Speaker 3: And so that makes a little bit of a sense,
• 31:13
  Speaker 3: but it can't be the reason that we exclude female athletes,
• 31:16
  Speaker 3: and I think we need to. If a researcher chooses
• 31:20
  Speaker 3: not to study female athletes, I think they need to
• 31:22
  Speaker 3: clearly state that in the abstract and clearly state that
• 31:24
  Speaker 3: in the methodology and explain why they didn't do that,
• 31:27
  Speaker 3: because it's shocking the amount of research right now where
• 31:30
  Speaker 3: we're extrapolating from male athletes to female athletes, and it's
• 31:34
  Speaker 3: like so many of these principles just don't hold. It's
• 31:38
  Speaker 3: it's really challenging, and it puts women athletes at a
• 31:41
  Speaker 3: great disadvantage in terms of like how they're supported from
• 31:43
  Speaker 3: a scientific standpoint.
• 31:44
  Speaker 2: Yeah, and I think it is in some ways the
• 31:46
  Speaker 2: same reason, the same sort of class of reasons that
• 31:48
  Speaker 2: we don't include women in or pregnant with, like we
• 31:50
  Speaker 2: don't include women in a lot of other studies, which
• 31:52
  Speaker 2: is like, well they might get pregnant, what if they're
• 31:54
  Speaker 2: breastfeeding like their menstro cycle is weird, you know, like
• 31:57
  Speaker 2: there's like they're just not simple like men. It's like
• 31:59
  Speaker 2: always the same, just the same, same, same, all the time.
• 32:02
  Speaker 2: And women are interested and complicated and that's you know,
• 32:06
  Speaker 2: that's and that's hard to include. And actually there's been
• 32:08
  Speaker 2: a fair amount of change in this over time, but
• 32:11
  Speaker 2: it's still true when we ask about things like drug
• 32:14
  Speaker 2: trials or vaccine trials, they almost always exclude women who
• 32:17
  Speaker 2: are pregnant or breastfeeding and then and I think the
• 32:20
  Speaker 2: place we saw this in the most extreme way was
• 32:23
  Speaker 2: in COVID, where they basically excluded pregnant women from the
• 32:25
  Speaker 2: vaccine trials for some ethical reasons, but then it turned
• 32:28
  Speaker 2: out like that was probably the population that would benefit
• 32:31
  Speaker 2: among the most from the vaccine, and then people were
• 32:35
  Speaker 2: afraid to do it because they weren't included in the trial.
• 32:37
  Speaker 2: So there was like a real, like a real human
• 32:39
  Speaker 2: cost to that exclusion that I wish we had thought
• 32:43
  Speaker 2: about more in advance.
• 32:45
  Speaker 3: It's such a good point. And actually I think a
• 32:47
  Speaker 3: parallel to that is actually just the conversation that we
• 32:49
  Speaker 3: were having about, you know, low carbohydrate diets. So much
• 32:53
  Speaker 3: of that research that was coming out that people were like,
• 32:55
  Speaker 3: oh my gosh, this is the next fad that we
• 32:57
  Speaker 3: have to golm onto. We're done in males or done
• 32:59
  Speaker 3: in male athletes, and the dangers for female athletes are
• 33:04
  Speaker 3: so much higher, and it's like it's one area where
• 33:06
  Speaker 3: it literally can it does not like the hypotheses and
• 33:10
  Speaker 3: the conclusions that we draw from the research on male
• 33:13
  Speaker 3: athletes just do not translate to female athletes, and in
• 33:15
  Speaker 3: fact that can be negative in terms of the consequences
• 33:18
  Speaker 3: that it has on female athletes, and I can think
• 33:20
  Speaker 3: of so many examples that also parallel that, and it's challenging,
• 33:24
  Speaker 3: and I think we are though. I think we're in
• 33:26
  Speaker 3: this area right now. There's programs like Stanford Faster Boston
• 33:29
  Speaker 3: Children's has an amazing female athlete program, and there's so
• 33:32
  Speaker 3: much like I think companies and media are clamoring for
• 33:36
  Speaker 3: our female athlete research that there's almost been this explosion,
• 33:38
  Speaker 3: which is amazing. We just have to make sure that
• 33:40
  Speaker 3: that explosion of research and the explosion of how we
• 33:43
  Speaker 3: talk about it it's evidence based and rigorous. That way,
• 33:46
  Speaker 3: we're not like doing things for female athletes that might
• 33:49
  Speaker 3: not actually be back or supported by research.
• 33:51
  Speaker 2: I mean, the idea of always having good evidence based
• 33:54
  Speaker 2: causal researches. You're not going to hear me argue with that.
• 33:57
  Speaker 1: Yeah.
• 33:57
  Speaker 3: I think one place that we see this often is
• 34:00
  Speaker 3: I think there's been almost a push to almost change
• 34:03
  Speaker 3: the entire training philosophy based on the menstrual cycle. And
• 34:07
  Speaker 3: for me, like I researched the mental cycle, it's so important,
• 34:09
  Speaker 3: it's so important to its study, but it's also one
• 34:12
  Speaker 3: variable and a host of so many variables that feed
• 34:15
  Speaker 3: into performance, and I think it's one area where when
• 34:17
  Speaker 3: we think about the explosion of female athlete focus, like,
• 34:21
  Speaker 3: I think that's an area we're having a nuanced conversation.
• 34:23
  Speaker 3: Makes sense. It's like, let's look at individual data points,
• 34:26
  Speaker 3: individual responses to the menstrual cycle. But I don't think
• 34:29
  Speaker 3: we have to treat the menstrual cycle as this population
• 34:32
  Speaker 3: level variable and ad just training on, you know, just
• 34:36
  Speaker 3: based off of that, when there's so many other variables
• 34:38
  Speaker 3: that matter.
• 34:38
  Speaker 1: I love it. Okay, I have some rapid fire questions
• 34:40
  Speaker 1: for you the end, but I love it where we
• 34:42
  Speaker 1: get before we get to that, what doesn't tell me
• 34:46
  Speaker 1: what's next for you sports was what's your next race?
• 34:49
  Speaker 1: Just because I want to know?
• 34:50
  Speaker 3: Yeah, question, I love it. I love doing ultra marathons.
• 34:54
  Speaker 3: I've actually so I have an autoimmune disease that causes
• 34:58
  Speaker 3: myocarditis and pericarditis in my heart, so I've to be
• 35:00
  Speaker 3: very careful with ultra running. And it was actually interesting
• 35:04
  Speaker 3: and like navigating a high risk pregnancy being pregnant with that.
• 35:08
  Speaker 3: But I'm back in a space where I'm hopefully going
• 35:10
  Speaker 3: to be able to compete ahead and there's a race
• 35:12
  Speaker 3: called the Lake Sonoma fifty miler, which is in Sonoma, California,
• 35:16
  Speaker 3: and it's on trails and it's beautiful, and I'm really
• 35:20
  Speaker 3: excited to hopefully be able to return back to the
• 35:22
  Speaker 3: ultra distance.
• 35:23
  Speaker 1: That's amazing. Okay, rapid fire.
• 35:26
  Speaker 2: Someone says they want to return to relatively serious endurance
• 35:31
  Speaker 2: exercise postpartum.
• 35:32
  Speaker 1: What is the first thing you tell them to think about?
• 35:34
  Speaker 3: Oh, pelvic floor pet. I think it's so important to
• 35:37
  Speaker 3: loop in with a pelvic floor pet. I also think
• 35:40
  Speaker 3: to just listen to your body. I think listening to
• 35:43
  Speaker 3: your body a very underrated. You will know, Like for me,
• 35:46
  Speaker 3: I could feel my hips just weren't ready, and so
• 35:49
  Speaker 3: I think, just take a good systems check on how
• 35:51
  Speaker 3: things are feeling, and ideally work with professionals too.
• 35:55
  Speaker 1: I want to do better run fueling. What's the best
• 35:56
  Speaker 1: pre run snack?
• 35:58
  Speaker 3: Ooh, there's so many snacks to choose. I'm like, how
• 36:01
  Speaker 3: do I choose just one? I want them all?
• 36:04
  Speaker 1: Okay?
• 36:05
  Speaker 3: I think for me, this is a Boulder, Colorado shout out.
• 36:07
  Speaker 3: There's a bar called Bobo's Bars, and they're amazing. They're
• 36:10
  Speaker 3: pretty hard, high carbohydrate bars, and the banana chocolate chip
• 36:14
  Speaker 3: is amazing it's so good. So their small companies support them.
• 36:18
  Speaker 1: They're delicious ideas for gentle ways to stay active in
• 36:22
  Speaker 1: the throes of the first trimester fatigue, nausea, or later
• 36:27
  Speaker 1: as the center of gravity changes.
• 36:28
  Speaker 2: How do I like not give up exercising when I'm pregnant?
• 36:33
  Speaker 3: Oh, yes, this is a great question. Walking. I like walking.
• 36:36
  Speaker 3: For me, I personally love running. I embraced walking so
• 36:39
  Speaker 3: much during pregnancy, and I slowed down and saw things
• 36:43
  Speaker 3: that I never saw before. I'd be on a tron
• 36:45
  Speaker 3: and be like, I didn't know there was a house here.
• 36:47
  Speaker 3: This is really cool, and I think like to me,
• 36:50
  Speaker 3: I experienced the wonders of walking through pregnancy. Great for
• 36:53
  Speaker 3: aerobic activity, great thing for lower impact activity. And then
• 36:57
  Speaker 3: also pool exercises they're great for reducing It just feels
• 37:02
  Speaker 3: great to get in there and you're like, my body
• 37:04
  Speaker 3: feels like kind of normal again, especially for me in
• 37:06
  Speaker 3: the third trimester. So pool running, pool aquatics, pool exercises
• 37:11
  Speaker 3: and walking are fantastic.
• 37:13
  Speaker 1: A running stroller is worth the price.
• 37:16
  Speaker 3: Oh this is this is a hot take. I don't
• 37:20
  Speaker 3: know if they are. So we have a running stroller
• 37:24
  Speaker 3: and we love it. But to be perfectly honest with you,
• 37:26
  Speaker 3: it's pretty heavy and clunky, and we don't use it
• 37:29
  Speaker 3: a ton. We have run more with like our Mesa stroller,
• 37:33
  Speaker 3: which is not in anywhere sense like a jogging stroller,
• 37:36
  Speaker 3: and my husband will be doing like we'll be doing
• 37:39
  Speaker 3: loops of the neighborhood with this, just like regular conventional stroller.
• 37:43
  Speaker 3: And so you know what, I'm gonna go with the
• 37:44
  Speaker 3: no on that.
• 37:45
  Speaker 1: Yeah, I mean I agree with that. We used ours
• 37:47
  Speaker 1: like nine times. Yeah.
• 37:49
  Speaker 3: Actually, I had thought about it the other day. I'm like,
• 37:51
  Speaker 3: we bought this like four hundred dollars stroller and at
• 37:53
  Speaker 3: this point each mile in it is like forty dollars.
• 37:57
  Speaker 1: I'm like, what if we do it's unfortunate. It's okay,
• 38:01
  Speaker 1: last time.
• 38:02
  Speaker 2: Give moms one unronic affirmation they can tell themselves in
• 38:06
  Speaker 2: the morning when they're putting on their maternity or postpartum
• 38:09
  Speaker 2: stretchy pants and their sneakers to get at the door.
• 38:11
  Speaker 1: What's the affirmation?
• 38:12
  Speaker 3: Oh, you know, I'm gonna go with I love me
• 38:16
  Speaker 3: some me because I think when I was pregnant, I
• 38:20
  Speaker 3: that like self love peace. I like loved my beauty
• 38:23
  Speaker 3: growing inside me so much, and I was like this
• 38:25
  Speaker 3: little creature is amazing, but I feel like that love
• 38:28
  Speaker 3: for me and like a changing body and changing hormones,
• 38:31
  Speaker 3: and like I just didn't feel like my same athletic
• 38:34
  Speaker 3: self even though I felt amazing to get out an
• 38:35
  Speaker 3: exercise and I could have used I could have just
• 38:38
  Speaker 3: like looked in the mirror myself and then like, oh,
• 38:40
  Speaker 3: love me some of me. It would have helped a lot,
• 38:42
  Speaker 3: and I think would have helped me, like you know,
• 38:44
  Speaker 3: just also enjoy the process too, and to be there
• 38:47
  Speaker 3: for all loves and.
• 38:48
  Speaker 6: Downs of it.
• 38:49
  Speaker 1: I thank you, Thank you, Megan, thank you so much.
• 38:58
  Speaker 7: For me here.
• 38:59
  Speaker 3: Emily, thank you. This was such a blast. I really
• 39:01
  Speaker 3: appreciate it.
• 39:18
  Speaker 2: More parent data, including your own tips to each other
• 39:21
  Speaker 2: about getting active after having a baby.
• 39:23
  Speaker 1: After the break during pregnancy, I was kind of grieving
• 39:49
  Speaker 1: the loss of like knowing my body and also like
• 39:52
  Speaker 1: how I've known me to be through movement. I am
• 39:56
  Speaker 1: one year, eleven months, fourteen months, or months postpartu.
• 40:00
  Speaker 6: I was part of them.
• 40:00
  Speaker 4: With my second baby.
• 40:02
  Speaker 8: I absolutely thought I was going to be that super
• 40:05
  Speaker 8: fit mom that was active.
• 40:07
  Speaker 7: I worked out until the day before my c section.
• 40:10
  Speaker 3: I had the great fortune of being able to be
• 40:13
  Speaker 3: active throughout the entirety.
• 40:15
  Speaker 7: Of my pregnancy, however, but recovering from pregnancy, it really
• 40:21
  Speaker 7: felt like I was hit by a truck.
• 40:23
  Speaker 1: In some ways.
• 40:24
  Speaker 3: It made me a little dismayed just to see how
• 40:28
  Speaker 3: much society praised me for that. I canceled my gym
• 40:33
  Speaker 3: membership a couple months ago.
• 40:35
  Speaker 1: I cannot get there, and that's okay.
• 40:37
  Speaker 8: Honestly, when I wasn't working out, I didn't miss it
• 40:40
  Speaker 8: because it just didn't fit in this season, in this time.
• 40:47
  Speaker 5: I just really felt like almost a form of guilt
• 40:51
  Speaker 5: of like, I really want to focus on getting back
• 40:54
  Speaker 5: to feeling like.
• 40:55
  Speaker 1: Myself, feel like myself again.
• 40:58
  Speaker 5: And my friends are like kind of telling me that
• 41:01
  Speaker 5: silly or not important.
• 41:02
  Speaker 8: It's what I have to do to feel normal, to
• 41:04
  Speaker 8: feel same.
• 41:06
  Speaker 6: I can't tap into that part of my brain without
• 41:08
  Speaker 6: playing volleyball.
• 41:09
  Speaker 3: You know.
• 41:09
  Speaker 5: It was so hard for me to wait and to
• 41:12
  Speaker 5: be patient and to not just do too much too soon.
• 41:15
  Speaker 7: You know, it's not necessarily pretty. Putting on those workout
• 41:20
  Speaker 7: pants for the first time running was hard.
• 41:25
  Speaker 2: I began with a tenth of a mile out of.
• 41:28
  Speaker 6: Ten, and one day one of my friends convinced me
• 41:31
  Speaker 6: to go for a run with her and in the
• 41:34
  Speaker 6: middle of the run, she looked over at me and
• 41:37
  Speaker 6: she just said, Wow, it must be so hard to
• 41:43
  Speaker 6: run with those huge breastfeeding boobs.
• 41:46
  Speaker 4: I got on my cute little leggings and headed out
• 41:50
  Speaker 4: the door to trampoline class. I bounced three times, I
• 41:56
  Speaker 4: peed three times, and I just walked off and was
• 42:00
  Speaker 4: home like fifteen minutes later.
• 42:02
  Speaker 8: Went out for a run and learned the hard way
• 42:06
  Speaker 8: that doing some core and pelvic floorwork to ease into
• 42:09
  Speaker 8: it was definitely the right goal.
• 42:14
  Speaker 7: My advice for anyone who's like trying to get back
• 42:17
  Speaker 7: into working out would be if you can have a
• 42:20
  Speaker 7: friend or to join you for a group exercise class,
• 42:24
  Speaker 7: and then you can hopefully have that connection and community afterwards.
• 42:28
  Speaker 5: There's a lot of different apps and programs out there,
• 42:30
  Speaker 5: but I have to just say that I use this
• 42:32
  Speaker 5: one called Expecting an Empowered This Society.
• 42:35
  Speaker 4: Couch to five k.
• 42:36
  Speaker 7: Walks, I would aim for five ten twenty minute walks.
• 42:42
  Speaker 8: The best thing I think you can do to support
• 42:44
  Speaker 8: a partner is get them a subscription to Audible.
• 42:47
  Speaker 4: It's amazing.
• 42:51
  Speaker 8: After the birth of my daughter, I actually have a
• 42:54
  Speaker 8: newfound respect for my body.
• 42:56
  Speaker 5: I think the whole thing has given me a deeper
• 42:57
  Speaker 5: appreciation for my body can do it literally grew a baby,
• 43:01
  Speaker 5: but then it also healed from that.
• 43:03
  Speaker 2: Most importantly, I gave myself a lot of grace and
• 43:06
  Speaker 2: repeated to myself that anything was better than nothing.
• 43:10
  Speaker 8: Be nice to yourself and be proud of where you are.
• 43:13
  Speaker 7: It takes the time.
• 43:29
  Speaker 1: Parent Data is produced by Tamar Avishai with support from
• 43:32
  Speaker 1: the parent Data team and pix. Also special thanks to
• 43:36
  Speaker 1: our house violinist, my daughter Penelope.
• 43:38
  Speaker 7: No problem mom.
• 43:40
  Speaker 2: If you have thoughts on this episode, please join the
• 43:42
  Speaker 2: conversation on my Instagram at Prof Emily Ostar, and if
• 43:46
  Speaker 2: you want to support the show, become a subscriber to
• 43:49
  Speaker 2: the parent Data newsletter at parentdata dot org, where I
• 43:53
  Speaker 2: write weekly posts on everything to do with parents and
• 43:55
  Speaker 2: data to help you make better, more informed parenting decisions.
• 44:00
  Speaker 2: For example, in twenty twenty two, I wrote a post
• 44:02
  Speaker 2: about how much aerobic exercise is safe during pregnancy that
• 44:05
  Speaker 2: looked at fetal heart rates, relaxing and more. If you
• 44:09
  Speaker 2: like what you hear, please leave the show or a
• 44:10
  Speaker 2: positive review on Apple Podcasts. It really helps people find
• 44:13
  Speaker 2: out about us. Rite Penelope right, mam. We'll see you
• 44:18
  Speaker 2: next time.