女性健身需求辩论：Stacy Sims博士对Lauren Colenso-Semple博士

因为当女性投入时间锻炼时，她们希望看到成效。

Because when women are going and putting the time in to do exercise, they want to see an outcome.

她们希望看到瘦体组织增长。

They want to see lean mass development.

她们希望看到骨骼改善。

They want to see bone.

她们希望看到内脏脂肪减少。

They want to see reduction in visceral fat.

如果他们持续处于运动后的分解代谢状态，就无法摄入能更快促进合成代谢的营养物质。

And if they're holding that post exercise catabolic state, they are not putting in the nutrition that is going to cause the anabolic state in a more rapid responsive rate.

再次强调，关键不在于此。我知道证据不多，但通过斯图过去五、六年的研究，我们更多看到的是营养分配方面的影响。

So again, it's not about, I know there isn't a lot of evidence and we see that now over the course of the past five or six years, a lot with Stu's work, that there is more the distribution aspect.

但当我们开始关注如何终止分解代谢状态、减少对内分泌健康的影响时，女性运动后的营养补充时机就显得尤为重要。

But when we start looking at shutting down that catabolic state and reducing the impact on endocrine health, post exercise nutrition and timing for women becomes really important.

好的。

Okay.

那么劳伦，你对这个有什么看法？

So Lauren, do you have a response to that?

还是说，基于人类实验结果——比如更严格的人体临床试验数据——这才是你认为应该传达给大众的内容？

And again, kind of based upon human out like, you know, more absolute human outcome trials Or is that, along the lines of what you'd consider, telling people too?

对。

Yeah.

我认为，描述合成代谢与分解代谢状态，并把运动后营养视为启动这一代谢级联的关键——运动本身才是生长的刺激源。

I think, you know, describing, you know, anabolic or catabolic states and looking at the post workout nutrition as what's going to kind of turn on that cascade, the exercise is the stimulus for growth.

如果我进行负重训练，肌肉会变得敏感，此时补充营养就像是锦上添花。

So if I'm lifting weights, then I'm sensitizing the muscle and then bringing nutrition is going to be kind of the icing on the cake.

所以训练是刺激源，而我想用蛋白质来优化这个刺激效果。

So that's my stimulus and then I wanna optimize the stimulus with protein.

但营养补充的具体时间其实并不重要，因为运动后促进生长的窗口期相当长。

But the timing of that nutrition isn't really going to make a difference because that window of post exercise in order to further stimulate is a pretty long window.

我们发现无论是运动后立即进食还是等待一小时，重要的是总热量和总蛋白质摄入量。

And what we see is whether we're eating immediately post workout or we're waiting an hour, what's important is overall calories and overall protein.

我们测量了两种月经周期中蛋白质合成与分解的合成代谢和分解代谢反应，结果显示没有差异。

And we've measured the anabolic catabolic response in terms of protein synthesis and breakdown in both menstrual phases, there's no difference.

因此我认为引入月经周期和这种过度复杂化的考量，只会让那些可能连自己处于月经周期哪个阶段都不清楚的女性更加困惑。

So I think bringing in the menstrual cycle and that level of over complication makes it even more confusing for women who probably don't even know which menstrual cycle phase they're in.

所以我认为归根结底，证据表明训练才是促进肌肉增长最重要的刺激因素。

So I think bottom line is the evidence shows the training is the most important stimulus for growth.

无论你是健身后立即进食，还是一小时后、两小时后再吃，长期来看都不会影响肌肉增长。

If you eat right after the gym or you eat an hour later, you eat two hours later, long term muscle growth is not going to be affected.

我也想在这里插一句，对吧？

And I'll like to jump in on there too, right?

比如说我们看到女性——我只是举个案例——

So if we're seeing women, and this is, I'm just giving a case example, right?

因为我们讨论的是实际情况。

Because we're talking about real time.

我们看到有些女性会早早去健身房，进行大重量训练，执行周期化训练计划，却延迟营养摄入。

We see women who will go to the gym early, they'll do heavy lifting, they're doing their periodized program, They delay their intake.

她们会变得更强壮，但不会增加瘦体重。

They'll get stronger, but they won't put on lean mass.

如果她们在进食状态下训练，就能增加一些瘦体重。

If they go in and they are doing fed training, they'll put on some lean mass.

如果她们空腹训练，完成大重量训练后再进食，也能增加瘦体重。

If they go in fasted, they do their heavy lifting and they eat afterwards, they'll put on lean mass.

所以我们在这里看到的重点不是热量，也不完全是蛋白质的摄入时机，而是女性往往没有把握住所有必要的进食机会。

So what we're looking at here is not the calories, it's not necessarily the timing of the protein, it's the fact that women don't necessarily take every eating opportunity they need to.

当我们讨论运动后的饮食与营养时，我想从低能量状态的角度来分析当前情况。

So when we're talking about post exercise food and nutrition, I'm pulling from, let's look at what's happening from a low energy state.

因为我们发现，延迟运动后的食物摄入会导致这样的结果。

Because we see that this is what happens when we are delaying food intake post exercise.

我们被认为处于低能量状态。

We're perceived as being in a low energy state.

如果观察低能量可用性状态下的变化，四天后我们会发现甲状腺功能开始下降。

And if we're looking at what happens with a low energy availability state, we start to see after four days, this is a downturn in our thyroid function.

因此当我们对女性说：我们希望优化健康、优化瘦体重增长、优化骨骼健康时，运动后的营养补充就显得尤为重要。

So when we're talking to women and saying, Hey, we want to optimize health, we want to optimize lean mass development, we want to optimize our bone health, then that post exercise nutrition becomes really important.

因为我们知道这会抑制食欲，人们会说‘我要推迟进食’。

Because we know that there's a blunting of appetite and people are like, I'm a delay at my food intake.

接着我们就会开始看到低能量可用性带来的后果。

And then we start seeing the outcomes of low energy availability.

如果从实际角度讨论，这点非常重要。

And if we're talking from practical terms, that's really important.

确实非常重要。

It's really important.

好的。

All right.

我能稍微插句话吗？

Can I jump in a little bit on that?

我能先说一件事吗？

Can I just do one thing?

等一下。

Hold on.

拜托。

Come on.

因为我只是想确认一下，因为我们的观众群体多样，涵盖了各种类型的人。

Because I just want to make sure, because our audience is, there's a wide variability of different types of people.

再次强调，我们看到很多患有肥胖症、糖尿病和代谢功能障碍的人。

So again, we're seeing a lot of people with obesity, diabetes, metabolic dysfunction.

你某种程度上是在讨论能量可用性的问题。

You're kind of talking about an energy availability.

对，你们知道的，低体脂的精瘦运动员和我们的部分患者之间存在差异，尤其是当你提到甲状腺时，我们看到的那种类似病态甲状腺功能正常的情况。

Right, you guys are, you know, so there's a difference between low body fat lean athletes and some of our patients, especially when you start getting into, you mentioned the thyroid, that's kind of a sick euthyroid thing that we see.

这是一个正常过程，当人们体脂极低时，处于高压力、高运动量和低摄入的状态下。

It's a normal process when people have really low body fat under high levels of stress, high exercise, low intake.

这也是长期皮质醇升高的部分原因，这涉及到女性运动员三联征和下丘脑性闭经。

It's also part of what, you know, cortisol is up on a chronic basis that, you know, gets into the whole female athlete triad, the hypothalamic amenorrhea.

所以我只是想确保大家清楚，我们正在讨论的这些内容。

So I just wanna make sure people are clear as to, you know, kind of the things we're

谈论 是的。

talking Yeah.

那是我的专长领域。

That's my lane.

不在肥胖症的范畴内。

Not in the obesity world.

我不在普遍问题中。

I'm not in the general problem.

我在自己的轨道上。

I'm in my lane.

是的。

Yeah.

好的。

Alright.

好的。

Alright.

那么医生没问题。

So doctor okay.

所以Stolusky医生，你的意思是如果人们——我不想曲解你的话。

So doctor Stolusky, what you're saying is if people and I don't want to put words in your mouth.

那么你是说如果女性进行空腹训练，她们最终实际摄入的总量会减少，所以总体上你说她们不会获得足够的蛋白质和热量？但如果她们做到了，Lauren医生表示这并不重要。

So you're saying that if people do, women do fasted training, they will end up actually not eating as much in total, so in general you're saying they won't get as much protein, they won't get as many calories, And if they but if they did, yeah, doctor Lauren's saying, it wouldn't matter.

但你的意思是由于空腹训练抑制了她们的食欲，所以她们最终总体上会摄入更少的热量和蛋白质。

But you're saying because they go fasted, it blunts their appetite, so they end up eating fewer calories and protein overall anyway.

我不想曲解你的话。

And I I don't wanna put words in your mouth.

这就是我脑海中的想法。

So that's what's going through my mind.

是这样吗？

Is that right

或者说，是的。

or Yeah.

因为我所处的群体和研究的文献都聚焦于如何从骨骼健康、肌肉健康角度优化身体成分，以及如何消除低能量可用性等问题，对吧？

Because the group that I'm always in and the literature that I'm always in is all about how are we optimizing our body composition from a bone health, from a muscle health, and how are we eliminating things like low energy availability, right?

因为我不属于普通人群。

Because I am not in the general pop.

我研究的是活跃女性群体的文献，明白吗？

I'm in the literature here of active women, right?

因此当我们审视进食时机、食欲波动时，我们试图让人们更清楚'被喂养'的含义，理解食欲控制的意义，并希望减少低能量可用性的不良影响。

So when we're looking at eating opportunities, and we're looking at appetite perturbations, and we're trying to get people to have a better idea of what it means to be fed, what it means to have appetite control, and we want to reduce the ill effects of low energy availability.

我们将运动后营养视为关键节点，它能最大化肌肉生长，优化食欲激素波动。

We look at that post exercise nutrition as a very important point to be able to maximize muscle growth, maximize our appetite hormone perturbations.

我们将其视为重要的进食机会，这将有效增加他们的热量摄入。

We look at it as an opportunity to be able to have that eating opportunity that is going to increase the amount of calories that they're taking in.

所以当我们从分子层面观察蛋白质摄入的作用时，那个时机窗口确实非常理想。

So when we're looking at the absolute molecular level of what is happening with protein intake, yeah, the window's great.

但如果我们告诉女性'进食时间无关紧要'，她们就会错过这个对身体和激素级联反应有直接益处的绝佳进食时机。

But if we're telling a woman, look, you know what, it doesn't matter when you eat, then they miss this massive eating opportunity that is going to be a direct benefit to their body and their hormonal cascade.

好的，医生。

Okay, Doctor.

劳伦，你有什么要说的？

Lauren, what do you have to say?

是的，我完全同意低能量可用性是个严重问题。

Yeah, well, I fully agree that low energy availability is a problem.

长期处于低能量可用状态可能导致一系列健康问题。

There can be a host of health issues if you are in a chronic state of low energy availability.

但这与我所说的完全是两回事——不能因为你是女性，就要求训练后半小时内必须摄入30克蛋白质，否则就会陷入低能量状态。

But that to me is a very different conversation than to say, oh, because you are a woman, you need 30 grams of protein within a half hour of your training session, else you will be in a state of low energy availability.

这两者根本不能相提并论。

Those are just two different things.

空腹训练也是同样的道理，对吧？

And it's the same thing with the fasted training, right?

确实低能量可用性是个问题，但这些关于营养时机选择的细微差别对预防低能量状态并不重要。

So yes, low energy availability is a problem, but these nuances and nutrient timing aren't important for preventing a state of low energy availability.

不，但运动后大脑会因消耗了卡路里而认为你处于热量赤字状态，将你判定为低能量状态。

No, but post exercise, your brain is perceiving you as being in a calorie deficit because you have used the calories and it is perceiving you as being in a low energy state.

所以如果女性持续保持这种状态，即使热量摄入充足，我们仍会观察到相同的身体紊乱现象。

So if women keep holding that, then we see that it does create the same kind of perturbation, even if they do have optimal calorie intake.

如果她们把热量摄入集中在早晚，而白天长时间处于能量匮乏感知中，即便总热量达标，身体仍会如同处于低能量状态。

If they're booking their calories on either end of the day and they have a big hole in the day of a perception of low energy, it's still as if they are in a low energy state, even if they have the same amount of calories that they need.

因此这个问题确实很重要。

So it does become important.

那么是否存在长期临床试验数据，能证明这种如你所说的持续性'能量缺口'现象——尽管总热量和蛋白质摄入充足——会导致月经周期紊乱、肌肉流失等健康问题？

So are there long term clinical trials where there's this hole, as you described, chronically, however sufficient calories and protein are being consumed, and then we're seeing menstrual cycle dysfunction, muscle loss, other health issues?

我们注意到哥本哈根方面正在针对这个课题进行大量研究。

We're seeing a lot of work coming out of Copenhagen that's looking specifically at this.

当对比月经失调与月经正常女性时，我们发现前者虽然总热量摄入充足，但存在热量分配时段错位的问题——注意不是'倾向'，而是确实存在这种状况。

And we see that when they're comparing women who have menstrual cycle dysfunction versus women who have normal menstrual cycle, then those who have menstrual cycle dysfunction tend to fall in, or I shouldn't say tend, do fall into the state of having adequate calorie intake, but there's a misstep of when those calories are placed.

对于那些月经周期功能正常的女性来说，她们会在运动后进食，并且全天保持规律的饮食间隔。

For those women who have normal menstrual cycle function, they are eating after exercise and eating at regular intervals throughout the day.

因此，我再次很高兴能与您分享这些研究。

So I, again, am happy to share those studies with you.

好的。

All right.

那么让我看看，如果人们进行空腹运动，尤其是瘦型女性运动员，她们确实很可能需要在运动后补充蛋白质。

So let me see if So if people are doing fasted exercise, especially lean female athletes, they probably really do need to get in some post workout protein for sure.

我认同这一点，我认为这适用于所有人。

I'll buy, you know, I think that kind of goes across the board for everybody.

但你是说有研究表明，即使全天热量和蛋白质摄入充足，在非空腹运动状态下，人们的临床结果也存在差异？

But you're saying there are studies showing like, clinical outcome differences for people with, you know, equivalent, sufficient caloric protein intake throughout the whole day, even in a fed you know, even if they're in a fed exercise state.

假设他们吃了早餐后去锻炼，你是说他们仍然需要在运动后摄入30克蛋白质，以防止出现能量不足的情况？

Let's say they eat breakfast, they go work out, you're saying they still need, you know, 30 grams of protein, we'll call it, after the workout to prevent that sort of, insufficient energy situation.

这会导致我提到的下丘脑性闭经，比如月经周期不规律等问题吗？

And and and it's causing what I mentioned as hypothalamic amenorrhea, like irregular menstrual cycle things?

是的。

Yes.

简而言之就是这样。

That's the short answer.

好的。

Okay.

我正在查找研究作者的名字，以便告诉你具体是谁。

I'm trying to find the author of the study so I can give you a name.

是的，

Yeah,

无论如何，我们肯定会把这些引用放在节目注释里。

mean either way we will definitely put these citations in the in the show notes.

但在她查找资料时，劳伦，我是说，你对于这种基于证据的实践操作性的看法，根据你所了解的。

But while she's looking for that, Lauren, I mean, your your perspective on the on the practice the evidence based practicality of that, from what you know.

我是说，她正在查阅那项研究

I mean, she's looking up the the study to

对，是的。

to Yeah.

我是说，我担心我们某种程度上在做同样的事。

Mean, I'm I'm concerned that that we're sort of doing the same thing.

对吧？

Right?

我们盯着这些短期窗口或短期指标，然后就说‘好吧’

We're looking at these short term windows or short term measures and then saying, okay.

如果在这个单日研究中，或者理论上这种激素级联正在发生，或者我们测量这条单一通路后，就据此推断说——长期来看我们将经历这些有害的结果。

Well, if in this single day study or if theoretically this hormonal cascade is happening or if we're measuring this single pathway and then extrapolating upon that to say, we are going to experience these outcomes long term that are somehow deleterious.

这漏掉了关键的一步。

And that's missing a huge step.

基于机制、通路或啮齿动物数据来推测和假设是一回事。

It's one thing to speculate and hypothesize based on mechanisms or pathways or rodent data.

但将其转化为‘女性绝对不该空腹训练，必须在锻炼后30分钟内摄入蛋白质’又是另一回事。

It's another to translate that to, hey, if you are a woman, you should never train fasted and you must eat protein within thirty minutes of your workout.

例如，我们只需要

For example, just we need

我们需要确保看到假设的结果数据就是实际结果

we need to make sure we see the outcome data that is hypothesized is what

我们是正确的

we're Right.

但我们实际上想测量长期关注的结果

But we wanna actually measure that long term outcome of interest.

那会是百分比

That would be percent.

是的

Yeah.

因为这将是件大事，我在内分泌学培训和相关数据中从未见过，要知道，在同等条件下——卡路里、蛋白质、体脂训练，特别是在进食状态下（而非空腹状态，比如不是隔夜禁食），如果错过了我们过去所称的'合成代谢窗口期'的蛋白质摄入，可能会导致下丘脑-垂体-性腺轴功能紊乱

Because that that would be a big deal that that I have not seen, you know, endocrinology training and and data that, you know, all things being equal, calories, protein, body fat training, especially in, let's just say, in a fed state, so not a fasted, you know, not an overnight fast or something, that not getting, you know, protein within that anabolic window that we used to call it, would lead to sort of the hypothalamic pituitary gonadal axis dysfunction.

所以，我的意思是，如果真是这样，那将是个大问题

So that, I mean, because that's a big deal if that's the case.

是的

Yeah.

莫妮卡·托兹维特是许多研究的第一作者，这些研究关注日内能量不足与代谢紊乱的关系

So Monica Torzvit, she is the lead author on a lot of these studies that are looking at within day energy deficit and metabolic perturbations.

而且这些研究并非孤立案例

And it's not just a one offs.

他们对研究对象进行了长达数月的跟踪

They follow them for quite a few months.

他们也在男性中进行了研究。

And they have also done it in men.

因此，在代谢扰动方面，男性与女性的结果对比显示，男性睾酮水平有所下降，最大摄氧量降低；而女性则表现为甲状腺功能减退，以及

So the outcomes for metabolic perturbation in men versus women, we see some decrease in testosterone, decrease in maximal oxygen uptake, and for women we see a reduction in thyroid, we see a reduction in

月经周期状态。

menstrual cycle status.

重申一下，这不是长期能量不足，而是次优状态。

Again, that's not chronic energy, you know, sub optimization.

这纯粹是在讨论蛋白质摄入问题。

That's just purely, purely talking about protein intake.

这关乎

This is about

总热量及其在全天的分配方式。

total calories and the way that it's distributed throughout the day.

如果我们考虑用食物来框定一天的开始和结束，即使你获得了最佳宏量营养素和热量摄入，仍会出现代谢扰动，因为中间存在长时间的空腹期。

So if we're looking at bookending the day with food, and you're getting optimal macronutrient, optimal calorie intake, you're still gonna end up with a perturbation because we're seeing this big hole of no food.

当我们研究日内能量不足与进食时机的关联时，再叠加时间生物学提供的公共卫生数据，二者在代谢扰动与热量摄入分布的关系上呈现出高度一致性。

When we're looking at what they're talking about within day energy deficiency and timing, and then if you overlay that on the public health data coming from chronobiology, they mimic each other with regards to how we are seeing metabolic perturbation with calorie intake and where we are placing those calories.

具体是哪种代谢扰动？

And what specific perturbation?

比如我观察到皮质醇与睾酮比值上升，或者说睾酮与皮质醇比值变化——这又涉及到我的医学专业领域了。

So I'm seeing like cortisol to testosterone raise or testosterone to cortisol ratios, which again is my medicin.

但这是短期现象，无关紧要

But that's acutely and that doesn't matter

在右边。

in the Right.

只是临床上的。

Just just clinically.

我猜是

I guess the

对。

Right.

我的意思是，我们可以说，运动后睾酮水平上升，但这并不意味着长期来看我们会看到更多增长。

Mean, we can say, oh, testosterone increased post exercise, but that doesn't mean that we're going to see more growth long term.

这样的例子太多了，我们测量某个指标后，就陷入纠结：'哦，这个上升了，那是不是意味着会出现病理变化？'

There's so many examples of this where we measure something and then get really bogged down in, oh, you know, well, this increased, and therefore, are we going to see a development of a pathology?

还是会出现下调，导致脂肪减少、肌肉增长或肌肉流失？

Or are we going to see a down regulation that leads to fat loss or leads to muscle growth or muscle loss?

因为人们真正关心的是这些结果，当你告诉他们'不该做这个'或'必须做那个'时。

Because those are the outcomes that people are actually interested in and hear when you say you shouldn't do this or you must do this.

我从不说'不该'或'必须'。

I don't say shouldn't must.

我不说'不该'或'必须'。

I don't say shouldn't or must.

这是个误解，就像你们嚷嚷说我研究老鼠一样。

This is the misconception, the same as you guys shouting out that I study rats.

我不研究老鼠，也不引用啮齿类动物研究。

I don't study rats, I don't cite rodent studies.

我并不是说你应该或不应该。

And I don't say you should or shouldn't.

我提供证据，说明这是最优方案，而决定权在你。

I'm giving evidence, I'm saying this is what's optimal, and you make your decisions.

我没有硬性规定。

I don't have hard and fast rules.

如果你我在说看

If You I'm say looking

为了

for

具体来说，空腹训练对女性无效。

specifically fasted training doesn't work for women.

热量赤字对女性不起作用。

A calorie deficit doesn't work for women.

这怎么就不是一刀切的说法了？

How is that not a blanket statement?

因为我没有说你应该或不应该。

Because I'm not saying you should or shouldn't.

我是说证据表明，当我们观察人们进行空腹训练的结果时，发现它对女性效果不佳。

I'm saying this is what the evidence, and we're saying, look, fasted training doesn't work well for women when we're looking at the outcomes that people are doing for fasted training.

我们看到内分泌系统受到比健康范围更大的干扰。

We see more perturbation in our endocrine system than what's healthy.

如果我看这项关于热量赤字的研究，它指出这组训练有素的女性中，65%基础代谢率被抑制，尽管能量可用性和24小时能量平衡与其他正常代谢率受试者相似，但她们在一天中处于严重能量赤字状态的时间更长。

And if I'm looking right here at this study over here that is looking at within calorie deficit, says this group of well trained women, sixty five percent had suppressed RMR and despite similar energy availability and twenty four hour energy balance compared with subjects with normal RMR, they spent more time in severe energy deficit within the day.

在更大的单小时能量赤字情况下，这与更高的皮质醇水平相关。

At a larger single hour energy deficit, which was associated with higher cortisol levels.

在一个

In one

有趣的是，但我们还是想看看长期效果如何。

Interesting, day but again, we would want to see how that plays out in the longer term.

然后观察，好吧，让我们在一天内、二十四小时周期内测量这个。

And then see, Okay, well, let's measure this in the day, in that twenty four hour period.

这很有趣。

This is interesting.

它具有假设生成性。

It's hypothesis generating.

在我看来，它还没有准备好以这种一刀切的实用方式转化。

It's not ready to be translated in such a practical blanket way, in my opinion.

好的。

Okay.

是的。

Yeah.

这些都很合理。

And that's all fair.

我是说，从实用性角度再次考虑，关于皮质醇的那些事。

I mean, and again, kind of from practicality perspectives, again, with, you know, the cortisol stuff.

所以高强度运动，所有运动都会提升皮质醇水平。

So high intensity exercise, all exercise increases cortisol.

这是正常的生理反应。

That's a normal physiologic response.

我们希望皮质醇能产生这种反应。

We want that to happen with cortisol.

皮质醇本身并非有害物质，除非是因药物导致的垂体问题或肾上腺引发的皮质醇过量。

Cortisol in and of itself is not a bad thing unless you have medication induced pituitary or adrenal induced excess cortisol.

这些都是我需要处理的大问题。

Those are huge problems that I deal with.

所以，你知道的，早晨的皮质醇反应，运动时的正常皮质醇反应。

So, you know, cortisol response in the morning, normal cortisol response to exercise.

我们更希望避免因长期压力或慢性厌食症导致皮质醇过量，但这仍属于生理范畴。

We would prefer to not have chronic stressors and chronic anorexia causing excess cortisol, but that's more about, but that's still physiologic.

好了，我们继续往下讲。

So, all right, so we're going to move on.

我们会把这些内容放在节目备注里，让大家讨论。

We'll put those things in the show notes and, you know, let people discuss that.

我认为这

I think that's

会

going

是未来值得讨论的有趣数据——如果运动后立即摄入蛋白质是唯一变量，我想你说的对下丘脑垂体或哺乳动物脓肿很重要。

to be interesting data to discuss in the future if getting protein right after exercise with being the only variable, I think is what you're saying, is important for hypothalamic pituitary or mammal abscess.

我们应该请这位医生来。

We should get this Doctor.

莫妮卡在线。

Monica on.

我们会和她谈谈。

We'll talk to her.

有意思。

Interesting.

我没事。

My Alright.

去那是关于谁应该从哥本哈根开始谈的？

Go to the Is that the what who should just talk about from Copenhagen?

好的。

Okay.

明白了。

Alright.

是的。

Yeah.

好的。

Okay.

那么下一个。

So next one.

现在这个很有趣。

Now this is this is a fun one.

所以这是关于史黛西的，显然针对30岁以上的女性，这个数字来源于某处，可能来自你提到的内容。

So there was due to Stacy, do women over 30 obviously, this is this number is coming from something, maybe from what you said.

与低负荷、高次数、较长间歇休息期相比，30岁以上女性是否需要高负荷、低次数和较短间歇休息期来增强肌肉和力量？与男性相比，在肌肉生长和力量增益方面呢？

Do women over 30 need high load but low reps and shorter intercept rest periods for muscle and strength gains compared to obviously the opposite of, lower load, high reps, longer intercept rest periods, and compared to men, for muscle growth and strength gains?

这是一个问题。

That was one question.

不是30岁，而是围绝经期。

It's not 30, it's perimenopause.

所以我们看到围绝经期。

So we see that perimenopause.

所以

So

那我们就把这个阶段称为40到50岁吧。

we'll call it in your 40s and 50s then.

对，对。

Yeah, yeah.

因为围绝经期最早出现的现象之一，就是雌激素和孕激素比例变化导致的肌球蛋白功能障碍。

Because one of the very first things that happens with perimenopause and the change in our ratios of estrogen and progesterone is a dysfunction in, myosin.

所以我们观察到肌球蛋白磷酸化的变化。

So we see a change in the phosphorylation of myosin.

因此我们的肌肉收缩强度会减弱。

So we have less of a strong muscle contraction.

当你开始进行大重量低次数的训练时，最早观察到的变化之一就是尿激酶磷酸化的改变，因为这是中枢神经系统的反应，对吧？

One of the first things that we see when you start doing heavier or higher loads in lower volume is a change in uromycin phosphorylation because it is a central nervous system response, right?

所以当我们研究力量发展时发现，进入围绝经期后会出现力量和爆发力的急剧下降，大约一年后开始出现瘦体重的流失。

So when we're looking at strength development, when you start getting into perimenopause, we see this precipitous loss in strength and power, and then about a year or so later, you start losing lean mass.

当我们谈论大重量训练时，关键在于真正减少功能性力量和爆发力的流失。

So when we talk about lifting heavy, it's about really mitigating that loss in strength and power that's functional.

我们审视时发现，好吧，让我们变得强壮并保持强壮，这样我们就能保持本体感觉和力量。

When we're looking at, okay, let's get strong and stay strong so we keep our proprioception and we keep our power.

在此过程中，我们也在增加瘦体重。

Along the way, we're also building lean mass.

所以当我们设计一个常规周期化训练计划时，当然不会让所有人一直做5x5训练，因为这并不合适。

So when we're looking at a regular periodized program, of course, we're not going to have everyone go do 5x5s all the time because that's just not appropriate.

我会用这些例子来说明，因为它们能帮助人们理解肌肉功能的爆发力基础。

It's like I'll use those examples because that's trying to get people to understand the power base end of muscle function.

当我们考虑如何调整训练时，很多我这个年龄段、从小接触运动和力量训练的人，都深受90年代观念影响——用粉色哑铃做超高次数训练。

So when we're looking at how are we changing it up, a lot of people in my age group who have grown up with exercise and strength training really have the idea of the 90s where you have pink dumbbells and really high reps.

而我们发现这并不能抵消肌球蛋白磷酸化的变化。

And we see that that doesn't counter this change in our myosin phosphorylation.

你必须进行大负荷训练。

You have to do the heavy loads.

因此当我们希望人们真正专注于保持力量和瘦体重时，就要让他们在基于爆发力的训练中实施周期化计划。

So when we're trying to get people to really focus on maintaining strength and lean mass, we want them to periodize in that power based training.

尝试让女性理解并实践这一点非常有趣，我们也看到了其中的变化。

And trying to get women to understand that and to do that has been really interesting and we see the change in that.

从文献中我们看到——相关研究也越来越多——力量谱系中的爆发力训练对40岁直至70-80岁人群都特别有益。

For the outcomes, we see in the literature, and it's coming out more and more, that the power end of the strength spectrum is really beneficial from 40 all the way up to 70 or 80.

你同时也会累积增加瘦体重，但力量要素才是维持生命质量的关键所在。

And you will put on a cumulative amount of lean mass as well, but it's the strength component that's really important for maintaining life.

你能给我们一些具体数字吗？

Can you give us some specific numbers?

因为在我看来，你知道，大重量低次数训练，比如3到6次重复，相比而言，你知道，8到12甚至15次重复，更像是轻到中等重量训练。

Because I guess in my mind, think, you know, a heavy load, low repetition is kind of like, you know, like three to six repetitions compared to say, you know, eight to 12 to 15 repetitions of, you know, lighter to moderate weight.

实际上，失败后，你知道，从整体来看，现在所有研究似乎都表明，那些重量和重复次数范围对肌肉增长的效果都非常相似。

Post a Right, failure, by the and, you know, and in the grand scheme of things, it seems like all the studies are now showing that kind of all those, you know, weight and rep ranges are all kind of very similar for muscle hypertrophy.

当然，你知道，力量举和运动员耐力训练之间确实存在细微差别。

Obviously, there you know, subtle differences for, you know, power lifting compared to endurance training for athletes.

当然，在代谢健康领域，我认为我们总体上需要更大的训练量。

And then, of course, in the metabolic health world, I'd argue that we just need more volume kind of in general.

不过，你能先给我些数据吗？然后我们可以让劳伦来，你知道，提出不同意见。

But, so can you give me some numbers and then we'll let Lauren kind of, you know, potentially counter to anything.

是的。

Yeah.

而且我要说，确实有文献表明在瘦体重增长方面，也就是肌肉肥大方面，真的没有差异。

And is, and I will say, yes, there is literature coming out showing that there really is no difference in the lean mass gain, like the muscle hypertrophy.

这不是我担心的重点。

And that's not what I'm worried about.

我关心的是力量部分。

I'm worried about the strength component.

所以如果我们采用80%1RM做3到6次，这就是我们的方案。

So if we're looking at three to six at eighty percent one rep max, that's what we're doing.

这都是相对的。

And it's all relative.

我们并不是要立刻把某人扔进去。

And it's not that we're going to throw someone in right away.

我们必须像对待其他人一样逐步引入他们，对吧？

We have to phase them in just like anybody else, right?

我们不希望有人受伤。

We don't want injury.

我们不希望人们如此渴望

We don't want people to So want

Graham一开始就做300磅的后蹲吗？

Graham and doing 300 pound back squats yet, right off the bat?

好吧，公平。

All right, fair.

我们希望每个人都像Joan逃跑那样接受训练。

We want everyone to be trained like Joan run away.

不，这是逐步引入人们并学习如何移动，了解他们的活动能力，以及你在一个合理的周期性超负荷计划中做的所有事情。

No, it's phasing people in and learning how to move, what is their mobility, all the things that you do in a proper periodized overload program.

但与其让人们逐步进入三组或四组10到15次的增肌阶段，我们真的需要女性在进入围绝经期并看到这些变化、开始失去力量和爆发力时，开始进行更重的负荷训练。

But instead of phasing people into three sets or four sets of 10 to 15, which is our hypertrophy end, we really need women to start, as they start getting into perimenopause and seeing these changes and losing that strength and power, we want them to do the heavier loads.

然后你可以周期性地转向更多增肌类型的训练。

And then you can periodize into more hypertrophy type stuff.

好的，医生。

Okay, Doctor.

Lauren。

Lauren.

劳伦？

Lauren?

嗯，我们对力量耐力连续体的理解确实随着时间的推移而不断演变。

Well, our sort of understanding of this, you know, strength endurance continuum has really evolved over time.

曾几何时，所有私人教练认证都教导说，你需要用大重量、低次数来训练力量，用中等次数来训练肌肉肥大。

So there was a point in time where, all the personal trainers certifications taught that you need to do these high load, low reps for strength and more moderate reps for hypertrophy.

而超过12次就只是肌肉耐力训练，对这两者都没有实际用处。

And then anything above 12 and it's just muscular endurance and it's not actually useful for either of those things.

但我们的理解已经发展到认识到，只要你训练到接近力竭的程度，所有这些次数范围和负荷都能促进肌肉生长。

But our understanding has evolved to the point that we realize as long as you're training close enough to failure, all of those rep ranges and loads can induce muscle growth.

当我们考虑力量时，当然如果你是为了最大力量（如1RM）而训练，那么你需要以专项运动的方式进行训练。

When we think about strength, certainly if you're training for maximal strength as in one rep max, then you need to be training in a sports specific manner.

所以我们需要使用大重量和低次数，因为我们关注的结果是1次最大重量。

So we need to use those high loads and low reps because our outcome of interest is a one rep max.

但即使你在8到10次范围内训练，只要随着时间推移增加负荷，你仍然会变得更强壮。

But even if you're training in the eight to 10 rep range, you're still getting stronger if you increase load over time.

因此对于大多数人来说，从衰老和肌肉健康的角度来看，我认为关键信息应该是：让训练具有挑战性并保持渐进性。

So for the majority of people from a kind of aging and a muscle health perspective, I think the message should be make it challenging and make it progressive.

史黛西医生，

Doctor Stacy,

对此有什么回应吗？

any response to that?

听起来都挺合理的

Pretty all all sounds pretty reasonable to It

听起来，是的，相当合理且一致。

sounds, yeah, pretty reasonable and the same.

完全一样。

It's just the same.

就像是

It's like

好的。

Okay.

具体主张是什么？

What was the claim?

你知道，从社会文化的角度来看。

You know, from a sociocultural perspective.

对吧？

Right?

我今年52岁，明白吗？

So I'm 52, right?

我成长于凯特·摩丝时代和粉色哑铃盛行的年代。

And so I grew up with the Kate Moss era and the pink dumbbells.

如果我们想鼓励女性走进健身房挑战自我，就必须给她们具体的数据指标。

And so if we were trying to get women to get in the gym and challenge themselves, we have to give them numbers.

如果我们只说做8到10次，她们就不会真正突破自己。

If we say go in for eight to 10, they're not going to challenge themselves.

我理解劳伦的出发点，也看过相关文献，但同时我也看到大量新研究表明：当进行3到6次训练并真正挑战中枢神经系统时，能显著提升力量、爆发力和瘦体重，进而增强本体感觉，预防老年人跌倒——这些效果在老年群体实践中已得到验证。

And I understand where Lauren is coming from, and I've seen the literature, but I'm also seeing a lot of literature coming in and showing that when you're doing the three to six and you're really challenging central nervous system, you're gaining a significant amount of strength and power and lean mass, which goes forward to proprioception, preventing falls when we're seeing this being implemented in older individuals.

我们还发现它正在重建女性在围绝经期流失的整体力量。

And we're also seeing that it is building that total strength that women are losing in perimenopause.

但没错，这是一个完整的分期训练计划。

But yes, it is a total periodized program.

我们不会让某人年复一年地执行单一的力量训练计划而毫无变化。

It's not like we're going to put someone on a power based program year in, year out, and there's no change.

因为我们希望她们获得这种力量，同时也希望她们增加些精瘦肌肉。

Because we want them to have this strength and we also want them to put on some lean mass.

是的，希望收听这期播客的听众都认同：我们需要每个人都去健身房或在家进行力量训练，逐步增加负荷。确实，围绝经期女性需要做负重运动、力量训练、渐进式超负荷，变得更强壮，预防跌倒。

Yeah, hopefully nobody listening to this podcast disagrees that we need everyone to get into the gym or at home, do some strength training, progressively load it up, And yes, we need our perimenopausal females to do weight bearing exercise, strength training, progressively overload, be stronger, prevent falls.

这就是为什么我告诉患者，无论我们讨论什么骨质疏松药物，只要能确保她们未来四十年不跌倒，她们大概率就不会摔断髋骨。

That's why I tell my patients no matter what medicine we talk about for their osteoporosis, if we can find a way to make sure they don't fall over the next forty years, they're probably not going to break a hip.

所以这真的很重要。

So that's really good.

我开玩笑的。

I'm joking.

是啊。

Yeah.

然后你们就聊到负重背心之类的东西了对吧？

Then that you get into some of this weighted vest stuff, right?

我没有。

I don't.

不，你不谈这个吗？

No, you don't talk about that?

好的。

Okay.

那我们就留到下一期播客再讨论吧。

So we'll save that for another podcast.

我原本以为这是我们能

I thought maybe that was one of the things we

再讨论一下的话题

had another something about the that

还行。

was okay.

好吧。

Alright.

这是

That's the

最后一部分了。

last part.

我们还有时间再讨论一个观点，得确保我们准备充分。

We have time for one more claim that we wanna make sure we're Alright.

是

Is it

关于热量缺口那个吗？

the calorie deficit one?

我觉得我们已经讨论过热量缺口相关的内容了，不过关于月经周期训练的话题怎么样？

I think we kind of already got into that, into the calorie deficit stuff, but what about the training around menstrual cycle?

好处哦，

The benefit Oh,

那是个

that's a

好问题。

good one.

关于女性月经周期期间训练和营养调整的建议是否存在我们尚未掌握的细微差别？

There any truth nuances to recommending differences in training and nutrition around a female's menstrual cycle that we haven't been able

我想先听劳伦斯医生怎么说，然后再听奥尔莱特医生的意见。

to doctor I wanna see doctor Lawrence say it first, then I want doctor Alright.

听起来不错。

Sounds good.

老兄，我已经完全准备好了。

I'm just all geared up, man.

我知道。

I know.

这是

It's

我们只是投了个曲线球。

it's we're Just three a three a curveball.

好吧。

Alright.

是的。

Yeah.

我们很完美。

We're perfect.

因为我在想，过去五年间事情已经发生了变化。

Because I was like, things have changed in the past five years.

好的。

Okay.

我们就听听劳伦医生怎么说吧。

Let's let's just let's just hear what doctor Lauren said.

看，这就是她的研究资料。

Like, this is her research right here.

嗯，很多...对。

Like, lot of Yeah.

我们...对。

Us Yeah.

具体来说。

Specifically.

所以

So

是的。

Yeah.

我认为这是个很好的例子——机制上很有趣，但在实际应用中似乎并未见效。

I mean, I think this is a good example of something that is mechanistically interesting that doesn't really seem to be panning out in a practical way.

所以当我们通过摘除卵巢来观察雌激素缺乏对啮齿动物的影响时。

So when we look at the effect of estrogen deficiency in rodents through removing the ovaries.

然后我们发现，哦，可能对肌肉有影响。

And then we see, oh, maybe there's an effect on muscle.

这很有趣。

That's interesting.

但问题显然在于，这并不能解释月经周期内的短期波动。

But then the question is, obviously, that doesn't translate to short term fluctuations around the menstrual cycle.

所以我做的工作就是真正评估这个问题。

So the work that I did was to really evaluate that question.

高雌激素的卵泡期是否真的对肌肉有所谓的'合成代谢'作用？

Is the high estrogen follicular phase quote unquote anabolic for muscle?

而高孕激素的黄体期是否真的对肌肉有所谓的'分解代谢'作用？

And is the high progesterone luteal phase quote unquote catabolic for muscle?

在一个严格控制的主体内设计中，蛋白质合成或分解没有差异。

And in a very tightly controlled within subject design, there were no differences in protein synthesis or breakdown.

更重要的是，参与者的月经周期体验在激素波动的时间和幅度上存在很大差异。

More importantly, the experience of the menstrual cycle for the participants was so different in terms of the timing and magnitude of the hormone fluctuations.

因此，制定任何不考虑这些差异的千篇一律的计划都是非常非常短视的。

So prescribing any sort of cookie cutter program that doesn't account for those differences is really, really shortsighted.

我认为在运动适应方面，保持一致性是关键。

And I think consistency is key when it comes to adaptations to exercise.

所以任何阻碍一致性的做法都是有问题的。

So anything that discourages consistency is problematic.

是的，我的意思是，如果你五年前问我这个问题，我可能会说，从分子基础和我们在早期文献中看到的内容，特别是90年代的文献来看，基于周期的训练确实有道理。

Yeah, I mean, if you were to ask me this question five years ago, I would have said, well, from the molecular basis and what we're seeing in early literature, especially from the '90s, that yes, phase based training makes sense.

但随着我们深入研究并采用正确的方法论，我们也知道许多女性并不排卵，而且每位女性在月经周期中的体验都不同，这必须是个性化的事情，对吧？

But as we start really digging into it and looking at proper methodology, and we also know that a lot of women aren't ovulating, and every woman's experience over the menstrual cycle is different, it has to be an individualized thing, right?

所以你知道有些日子感觉很好，有些日子则不然。

So you know there are some days where you feel great and some days you don't feel great.

那么调整你的训练计划，在感觉良好的日子增加强度训练，在状态不佳的日子安排恢复性训练。

Well, change your training up so that you're doing harder stress on the days you feel great, and then maybe some recovery on the days that you don't.

我认为我应该为早期推广阶段训练负责，但后来我撤回了这种说法，因为科学已不再支持这种观点。

I think I'll take ownership of pushing out, you know, like phase based training in the early days, and I've retracted that saying, Hey, the science doesn't support that anymore.

这就是科学的魅力所在。

And that's the beauty of science.

你获得的证据越多，就越能提出并说明：等等，你知道吗？

The more evidence you get, the more that you can like put out there and say, Hey, wait, you know what?

这里存在太多细微差别了。

There's so many nuances here.

我们知道有些女性深受影响，因此她们需要追踪并了解自身受到的影响。

We know that some women are heavily affected by it, and so they need to track and understand how they're affected.

我们也看到有些女性完全不受影响。

We also see some women are completely unfazed.

早期当人们说'你必须完全休息两周'时，我感到非常沮丧。

I was getting very frustrated early days where people were like, You have to take completely two weeks off.

实际上并非如此，从分子结构角度看，或许应该降低强度，但不需要完全休息。

It's like, No, it's like, you know, from a molecular structure, maybe you want to bring down the intensity, but not take time off.

所以完全同意洛恩的观点，不能一刀切。

So totally with Lorne, you can't have a cookie cutter.

这种方法行不通，因为现在有很多女性不排卵，但她们自己却不知道。

It just doesn't work because there's so many women now who don't ovulate and they don't know it.

她们仍然会有出血现象，但那属于无排卵性出血。

They'll still have a bleed, but that's an inovulatory bleed.

所以如果她们试图进行分期训练并以为自己是在经期出血，实际上正如劳伦所说，她们缺乏连贯性，完全搞错了重点。

So if they're trying to phase based train and they think they're bleeding, actually, as Lauren's saying, they're missing consistency, they're missing the mark.

感谢分享。

Appreciate that.

连贯性重于复杂性。

Consistency over complexity.

我想说，我很感谢你更新了对这个问题的看法。

I may, I just, I want to say I appreciate you updating your perspective on that.

但我想强调的关键点是，你提到之前主要依赖分子层面的研究，而现在我们有了更多以人类为研究对象的数据，这些数据能实际测量我们关注的结果或改进方法论等。

But just a key that I wanted to touch on is you said, I was really relying heavily on kind of molecular work and maybe now we have more human subject data that's actually measuring those outcomes that we're interested in or improving methodology, etcetera.

所以我想知道，你现在是否持有某些观点，比如虽然主要依赖分子研究，但期待更多数据来提供信息，可能帮助你维持或根据需要调整现有观点？

So I'm wondering, are there any claims that you have now that you think, you know, I am relying pretty heavily on molecular work, but I look forward to more data that will inform us, that maybe will help me maintain that opinion or evolve it as required?

从分子层面来说，只有月经周期相关的内容。

From a molecular standpoint, only the menstrual cycle stuff.

我仍然对正在出现的一些研究很感兴趣，因为我们现在必须关注这些。

And I'm still really interested in some of the stuff that's coming out because we have to look right now.

此外，我也非常关注更年期研究的进展，不是从分子角度，而是从人群研究的角度。

Well, I'll also take it out as I'm also very interested in how the menopause research is playing out, not from a molecular standpoint, but from a population standpoint.

因为不幸的是，大多数女性健康研究对象的年龄段都集中在像我和劳伦这个年龄。

Because unfortunately, most of the women's health research lifespan is on people like me and Lauren.

我们是白人，属于上流社会。

We're white, upper class.

我们有条件参与各类研究项目。

We have the availability of going in and being participants in studies.

我们能享受医疗服务，但这在全球范围内只是极小部分。

We have access to healthcare, but that is a very small in in total global space.

所以我正与社会学家朋友合作，他们提出：太平洋岛民群体、非裔美国人群体或踢足球的非洲女性在月经周期会经历什么？

So I'm working with friends who are sociologists and they're like, well, what about what happens in menstrual cycle in Pacifica populations or African American populations or African women who are playing soccer?

这些都是截然不同的经历。

So those are all different experiences.

更年期的情况也是如此。

And the same with menopause.

每种文化对更年期都有不同的讨论方式。

Like every culture has a different conversation about menopause.

这些从文献中浮现的有趣讨论，将切实影响我们如何应用实践信息。

So those are the interesting conversations that are coming out in the literature that can actually play out of how we are approaching and applying practical information.

这个总结非常到位——我们确实需要研究各类人群：从体脂率低的年轻运动员，到体重困扰者、代谢疾病患者、围绝经期/绝经后女性、老年人，涵盖所有族裔群体。

That's a great way to conclude that because we definitely need to study all these different things across all different people from young athletes with low body fat to those who are struggling with weight, metabolic disease, perimenopausal, postmenopausal, elderly people, and in all different ethnicities.

而这正是我们当前的困境所在。

And that is where we struggle for sure.

我们在肥胖领域拥有大量数据。

We have a lot of data in our obesity realm.

这些研究中有许多女性受试者，因此积累了相当多的围绝经期相关数据。

A lot of patients in those studies are females, so we have a lot of sort of perimenopausal data on them.

讽刺的是，很多治疗二型糖尿病的相同药物，你知道的，主要使用者是白人男性等等。

And then ironically, a lot of the type two diabetes with some of those same medicines are, you know, predominantly, you know, white men, etcetera.

所以我认为这个观点很棒。

So I think that's a great point.

斯宾塞，你还有其他具体问题吗？

Any other specific questions, Spencer, you got

没有，我只是想说，我们大概还剩五分钟。

No, I was just going say, so we have like five minutes left.

所以根据我的观察，医生。

And so from my observation, Doctor.

劳伦和我们很像，我们都非常注重随机对照试验的结果。

Lauren, similar to us, where we're like, we're very RCT outcome based.

但同时也很务实，你知道的，临床相关的是实际心脏结局显示了什么？

But also pragmatic, you know, clinically relevant What the actual heart outcomes show?

因为在医学领域，我们有很多药物，我们觉得它们经过研究，机制看起来正确，结果却发现会致命。

Because in medicine, we have a lot of meds that we're like, oh, they were studied, they look right mechanistically, and then it turns out to kill.

结果发现会致命之类的。

Turned out or something.

不。

No.

这才是令人压力山大的地方，因为我有个兽医朋友说，动物用药剂量比人类更精准，药物效果也更好。

And this is the pressuring thing, because I have a friend who's a vet and she's like, Animals are dosed way better and have better outcomes on meds than humans do.

我说，是啊，确实如此。

I'm like, Yeah, that's true.

因为我和丈夫手术后带回家的止痛药处方完全一样。

Because my husband and I get sent home with the same prescription after surgery for a pain killer.

这就像在问，为什么？

It's like, why?

因为我们忽略了关键点。

Because we're missing the mark.

另外在医疗保健领域让我担忧的是AI驱动的诊疗结果，对吧？

And the other thing that worries me in healthcare is AI driven outcomes, right?

AI读取的数据本身已存在严重偏见，它忽略了那些恰好关乎女性健康的细微差异。

Where you're having AI that is reading the data that's already there, that's already heavily biased and it ignores the nuances and the nuances happen to be women's health.

所以这确实是个值得关注的领域。

So I mean it's an interesting landscape for sure.

那么我想就此结束讨论。

So yeah, I'd like to close it out.

我注意到Sims医生...

What I noticed is Doctor.

Sims医生注重实践，虽然会参考随机对照试验，但更关注那些可能带来长期效果的小型机制性研究。

Sims cares about the practical and does look at some of the RCT, but does get more into the mechanistic stuff that has some smaller outcomes that may lead to longer term.

我这样说有偏差吗？

Is it, am I off base there?

感觉Lauren医生就像是...

It just seems like Doctor.

Lauren医生的态度是'要么随机对照试验，要么免谈'。

Lauren's like RCT or GTFO.

那是我的，那是个玩笑。

That's my, that's a joke.

我不确定那是否就像女士，我说，

I don't know if that's just like Ma'am, I said,

不，但那是，那是个玩笑。

no, but that's, it's a joke.

这是个玩笑。

It's a joke.

但就像，但并非如此，因为我在网上会感到恼火，当有些人提出某种机制时，是的，但最终，这真的重要吗，比如空腹与进食状态这类事情。

But like, but not, because I get annoyed online when some people come up with some mechanism, yeah, but like in the end, does it really matter, for example, like the fasted versus fed and some of that stuff.

所以这有点，只是一种有趣的差异。

So it's kind of, it's just kind of an interesting difference.

但实际上，听起来你们很相似，我不确定。

But practically, sounds like you guys are similar, I don't know.

实际上，我们都希望人们运动，希望人们吃得好，希望人们睡得好，也希望人们关注自己的身体。

Practically, we all want people to move, we want people to eat well, we want people to sleep well, and we want people to be aware of their bodies.

是的。

Yeah.

因为有些是

Because some are

在我们的马洛中，我们需要一些基本的东西。

in our Marlowe, we want some of the basics.

当我们看到一些人提出主张时，一些患者就会感到困惑，比如等等。

When we see some people make claims, then some patients get confused like, wait.

我必须做这个吗？

Do I have to just do this?

然后就像，好吧，我们还得进行这场讨论。

And it's like, well, and then we have to have this discussion.

我觉得很多时候——我不想说是敌意，但有时确实是敌意。

I think that's where a lot of the the I don't wanna say animosity, but sometimes it's animosity.

比如，哦，为什么他们要那样说？

Like, oh, why they make why they say that?

我认为我的核心观点是——我确实对机制很感兴趣。

I think what my point really is I'm certainly interested in mechanism.

这就是我成为科学家的原因。

That's why I became a scientist.

我认为‘为什么’背后的‘是什么’非常迷人，我们了解得越多越好。

I think the why behind the what is fascinating and the more we learn the better.

但如果我们要以实际方式传播科学，告诉人们如何饮食和训练，就需要谨慎避免操之过急，要依赖随机对照试验。

But if we're going to communicate science in a practical way and tell people how to eat and how to train, then we need to be careful that we're not jumping the gun and that we are relying on the the RCTs.

所以我认为科学趣味性和实际可操作性之间存在区别。

So I just think there's a difference between scientifically interesting and practically actionable.

好的。

Okay.

嗯。

Yeah.

对。

Yeah.

公平

Fair

够了。

enough.

认为这很合理。

Think that's reasonable.

但总的来说，是的，这次真的很有趣。

But overall, yeah, this was this was really fun.

谢谢你们，斯泰西和劳伦。

Thank you, Stacy and Lauren.

做个好运动员。

Being a good sport.

人们会非常非常欣赏这次对话的，能够公开讨论这些事情，既有实际的观点，也有一些我们可以引用的有趣科学内容。

Think people will really, really appreciate this conversation, having, you know, just have an open conversation about this stuff, having some practical points that come out of it, but also some interesting scientific things that we can cite.

所以，请把这些发给我们，我们会放在节目笔记里，并尽量以某种连贯的方式整理，斯宾塞。

So, yeah, please, send us those, and we'll put them in the show notes, and, we'll try to we'll try to organize it in some sort of a cohesive coherent manner, Spencer.

按主题分类？

By topic?

我...我...

I'm I'm

我肯定会被困在这件事上。

I'm gonna be stuck doing that, I'm sure, of it.

但是

But

嗯，我很确定站在这里的摄像师会搞定这事。

Well, my I'm pretty sure my video guy who's standing here is gonna do it.

所以我打算直接开始——如果你有朋友、家人或任何人对女性健身、健康和训练感兴趣，请务必分享这期内容，并记得订阅。

So I'm just gonna take So you standing right if anybody has a friend or family or anybody that is interested in women's fitness, health, and training, make sure you share this with them, and make sure you subscribe.

还有去看看Doctor。

And check out Doctor.

Stacy Sims，她在网上很活跃。

Stacy Sims, she's all over the internet.

Doctor。

Doctor.

Lauren，我们多次邀请过她，你也可以关注她的Instagram。

Lauren, we've had on multiple times, you can check out her Instagram as well.

我们会把这些链接放在节目备注里。

We'll put those links in the show notes.

感谢大家的收听。

Thanks everybody for listening.

谢谢。

Thank you.

你。

You.

片尾。

Outro.

本播客仅用于娱乐、教育和信息传播目的。

This podcast is for entertainment and education and information purposes only.

请记住，本播客中的医生并非您的私人医生。

Remember, the physicians on this podcast are not your physician.

这些内容不应被视为专业或个性化的医疗建议。

It should not be considered professional or personalized medical advice.

不应将其用于替代与您的医生或医疗专业人士讨论您的具体健康问题。

It should not be used to replace speaking with your physician or medical professional to discuss your specific health concerns.

所讨论的主题不应仅用于诊断或治疗任何病症。

The topics discussed should not be used solely to diagnose or treat any condition.

因此，我们对任何不良医疗结果概不负责。

A result, we are not responsible for any unwanted medical outcomes.

所讨论的观点和意见仅代表主持人个人，不代表任何其他实体的立场。

The views and opinions discussed are of those of the host only and do not represent those of any other entities.