Ep. 456 Why Muscle Matters: Metabolism, Myths & More with Dr. Shannon Ritchey

I am delighted to have the amazing Dr. Shannon Ritchey joining me today. She is a doctor of physical therapy, a fitness trainer, and the founder of Evlo Fitness.

In this insightful conversation, we explore the complex landscape of social media and its influence on our perceptions of health and fitness, unpacking myths, stigmas, and societal conditioning. We dive into body recomposition, looking at the compare and despair trap of social media, the effects of fitness challenges, and the science behind muscle soreness and eccentric exercises. Dr. Ritchey explains how to measure body composition requirements accurately, how muscle supports metabolic health, and the results of different types of muscle fiber stimulation, and she also shares her thoughts on Zone 2 cardio, Pilates, high-intensity interval training (HIIT), nutrition, and more.

This discussion with Dr. Ritchey offers a wealth of information, and I look forward to welcoming her back for another conversation later this year.

IN THIS EPISODE YOU WILL LEARN:

Navigating the noise around fitness on social media
Benefits of GLP-1s and some common misconceptions around GLP-1 use
Why we need to find credible sources when looking for health advice
Why it is crucial to start building muscle early to prevent future health issues
Over-exercising affects your overall health
Role of nutrition in body composition
How social media can lead to unrealistic expectations around body image
Is protein essential for muscle-building?
How creatine supports muscle growth and cognitive health
Some common micronutrient deficiencies, including magnesium, vitamin D, and omega-3
Why testing to determine specific needs for micronutrient deficiencies is important

Bio: Shannon Ritchey

Dr. Shannon Ritchey is a former physical therapist, a fitness trainer with over 15 years of experience, and the founder of Evlo Fitness. She educates on the science of exercise, specifically teaching women how to build muscle with less wear and tear on their bodies. Residing in Austin, Texas, but originally from Kansas, Shannon is a wife and mom to a daughter (and pregnant with a second!).

“My goal is to educate women on how and why to build muscle in a way that doesn't tear their body up.”

-Dr. Shannon Ritchey

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Connect with Dr. Shannon Ritchey

Transcript:

Cynthia Thurlow: [00:00:01] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:29] Today, I was joined by the amazing, Dr. Shannon Ritchey. She's a doctor of physical therapy, fitness trainer, and founder of Evlo Fitness. Today, we spoke at length about navigating social media with regard to myths and stigmas, the impact of body recomposition, the role of societal conditioning and social media impact of scale, as Shannon refers to it, compare and despair, the impact of fitness challenges, the science between muscle soreness and eccentric exercises, the best way to accurately measure body composition needs, why muscle leads to better metabolic health? And the impact of different types of muscle fiber stimulation her thoughts on Zone 2 cardio, Pilates, high-intensity interval training, nutrition, and more. This is truly an invaluable conversation with Dr. Ritchey. I look forward to having her back later in the year.

[00:01:27] Well, welcome, Shannon. I've been looking forward to this conversation. So good to see you bright and early on a Thursday morning.

Dr. Shannon Ritchey: [00:01:33] Great to see you. And, you know, it's been years since I've seen you last because you were on my podcast like two or three years ago, so--

Cynthia Thurlow: [00:01:39] I know. My book came out, which is, like-

Dr. Shannon Ritchey: [00:01:41] That’s right.

Cynthia Thurlow: [00:01:42] -hard to believe. The book baby. I've got another book baby coming in 2026.

Dr. Shannon Ritchey: [00:01:47] Oh, my gosh. Wait. Congratulations. Are you insane? You're doing another one? Wow.

Cynthia Thurlow: [00:01:53] It's kind of like childbirth. You forget what it's like, and then when you're in the midst of it, you're like, this is really hard. And then it goes-- And then you receive the baby and it's done and you forget about the pain. And so--

Dr. Shannon Ritchey: [00:02:04] Right.

Cynthia Thurlow: [00:02:05] I literally can say that this was a harder baby to birth, if you will, than a real baby. [Dr. Ritchey laughs] Yes. But I think this time around, it's going to be a book that's even more impactful. And you're expecting your second baby, when is your baby?

Dr. Shannon Ritchey: [00:02:19] Yes, my baby is due in August. It's funny because I'm also considering writing a book, so I'm considering a book baby and a baby baby. [laughter] And at the same time, maybe not, now that I'm hearing you talk about it. Yeah, I'm due in August. I'm so about six months now.

Cynthia Thurlow: [00:02:33] Oh, congratulations. I have an August baby and an October baby. And the August baby was easier than the October baby. Because it was harder to be pregnant all of August, all of September into October.

Dr. Shannon Ritchey: [00:02:46] Yeah.

Cynthia Thurlow: [00:02:48] And so August you'll get some alleviation of-- I know it will be warm where you live. It's certainly hot and humid here in the southeast. And so, I just recall thinking when I had Liam, I was like, oh my God, it was so much more hot because I was pregnant all of August, all of September, and then had him October 5th.

Dr. Shannon Ritchey: [00:03:04] Right. You were in your third trimester in like the hottest part of the year, which would be rough. At least in August-- It's horrible here in August in Austin, but at least I'll kind of be pinned up with the baby inside anyways.

Cynthia Thurlow: [00:03:15] Yes, lots of air conditioning will be in your future.

Dr. Shannon Ritchey: [00:03:19] Definitely. Definitely.

Cynthia Thurlow: [00:03:20] I know before we started recording, we were having a conversation about a lot of noise on social media and how it can be challenging to navigate information ,influencers. And as you astutely stated, a lot of individuals that have viral videos, viral content are not necessarily people that we should be taking advice from. How do we navigate who to listen to about fitness and about weight training on social media and beyond?

Dr. Shannon Ritchey: [00:03:49] Well, I think not to say that someone that doesn't have a higher degree doesn't know what they're talking about, but at this point there are so many individuals with PhDs, doctorates, higher education, who have gone through, they know how to read research studies, they have clinical experience, they have had in depth education about the entire body, all of the systems of our body, and so they have a deeper understanding of it than someone who is just kind of learning it on more of a surface level. So, I think at this point there's really no reason for us to not have really good information from people who have those higher degrees.

[00:04:32] So not that I'm going to sit here and be a degree police and say that if you don't have a high degree, you don't know what you're talking about because that's just not true either. But if you're trying to filter and get the best information, I really do tend to, for myself, for sure look for those people who have the PhDs, they have the doctorates, they have the education, because that's just a great first filter. You can pretty much trust for the most part. I mean, you know, 90% of what they're saying versus someone who doesn't have the clinical experience, who doesn't have the education. They may be posting things that are outdated, irrelevant, not based on clinical experience, based on more of their personal anecdote so that's kind of the filter that I like to put on things, first and foremost.

[00:05:17] And then second, I think there's some things that-- There's so many myths, and we can talk about all of those myths. And as soon as I see a myth like that, I immediately know, “Okay, that person is not credible. And they're just trying to get views and clicks and likes.” So, I think, you know, there's-- And again, we can go through all of them. But like if someone's saying like, “Spot treat this area or do these exercises to tone.” If someone's using the word toning, I tend to think like, okay, these are clickbaiting things that they know that women are looking for, like a fast-track situation. And so those are things that I tend to like, okay, let's tune that out. That's not based in science. And it's not going to leave you the results that you're after. The results that you're after tend to take more time. They're not something you can't spot treat fat. Toning is just another word for building muscle. So, let's call it what it is, let's build the muscle, and we all need to be doing it. So those are some kind of things that come to mind.

Cynthia Thurlow: [00:06:14] Well, and I think it's so important because we are a culture that has been brought up, certainly my generation, that smaller is better, skinny is better. And so, when you hear those buzzwords as you're mentioning, I think about how many patients I worked with over my traditional kind of allopathic medicine career that would get upset if they weren't losing five or ten pounds a week. And I would tell them, “You need to understand that is not sustainable. If anyone is telling you that you should be losing five to ten pounds a week, then that is not sustainable. That is crash dieting. That is yo-yo dieting. That is going to ultimately damage your metabolism.” We know there's a lot of solid research on the dangers of yo-yo dieting.

[00:07:02] And so, finding that reframe of helping people understand what is sustainable weight loss, as an example. Building muscle, we understand this is now, like, foundational to our health, how critically important it is and how for many of us, we've been so conditioned to be thin and small and skinny, and that has not led us to develop healthy metabolic health. It hasn't allowed us to develop the musculature that's going to allow us to not only remain insulin sensitive, but also ensure that we are not falling when we get older.

[00:07:34] So as a physical therapist, that's your background. You understand what the sequelae of the loss of muscle and how that leads to frailty and falls. And maybe that's the next thing to kind of touch on before we come back to dieting and scale stigma, which is a huge issue for many, many women. And I say this in a loving way, we have to redevelop a relationship with ourselves and with those numbers on the scale just being one metric of many to determine our overall health.

Dr. Shannon Ritchey: [00:08:04] Yes, absolutely. I mean, I had a body recomposition, which means losing fat and gaining muscle at the same time. And I weighed more than I did prior to starting that journey, even though my pant size was smaller. And you could-- I felt more-- I hate this word, but “toned,” because that's the aesthetic that so many people are going for, but I weighed more on the scale, so it does-- Because I had more muscle mass. So, I think the scale can be so deceiving. It is a tool, but I think it can be so deceiving.

[00:08:36] And I think to your point about losing five to ten pounds a week and doing the crash diets, a lot of times when you're doing that, you're severely limiting calories and/or doing a lot of exercise and cardio. And we see that when that happens, you're not only losing fat, but you're also losing muscle. Well, if we're pairing that and cycles of that throughout your life with the natural aging process, where you're losing muscle just as you age, unless you're trying to maintain or build it, all of a sudden, these women that have been dieting like this on and off for 10, 20, 30 years now find themselves hitting perimenopause, accelerating in muscle loss. Their body composition feels so different than it did. And they're like, “What is happening? I'm not changing anything.” It's like, well, we've spent 10, 20, 30 years slowly losing muscle mass from these lifestyle changes and from these diets and from the fitness industry, really deceiving us into what actually works. We need to prioritize our muscle to your point. Not only now it is beneficial for you in the short term. But in the long term, when we're thinking about, we want to be avoiding falls. And if you do fall-- which is inevitable, everybody falls. Even I fall sometimes. If you do fall, you want your bones to be strong and resilient. You want to have the muscle mass to be able to pick yourself up off the floor. So that's not something that you need to wait or that you should wait until you're 80 to start worrying about. You start worrying about it now and start building muscle mass now so that you're developing the skeletal resilience as you get into your older age.

Cynthia Thurlow: [00:10:19] I think that's really key. We don't think about frailty until we see it like I have-- My father passed away last year, but my mom is 79. And I remember during the pandemic we didn't see my mom for a period of time, like most of us probably didn't see our extended family members. And the first time I saw my mom, during the pandemic, I remember thinking, oh my gosh, she looks so frail. And we've talked about this, so I'm not saying anything publicly that I have not discussed with my mom.

Dr. Shannon Ritchey: [00:10:48] Sure.

Cynthia Thurlow: [00:10:50] But I was shocked by the amount of muscle mass she had lost during the pandemic. And it was probably not being able to go to the gym, not being as active as she normally is. And what's insidious about it is by the time we become more sarcopenic, we've lost more muscle mass. And I always use the example of we all want to be a filet, so we want most of our muscle to just be muscle as opposed to fatty infiltration like you would see with a ribeye. By the time we have that ribeye musculature, we've gone like really far off into an area where we are more likely to be sedentary. We are more likely to struggle to have activities of daily living like getting off a toilet.

[00:11:32] And let me be clear, I had 50-year-olds in the hospital that we would put a bedside commode next to their bed or the nursing staff would, and they would struggle to get out of bed, get to the bedside commode, get off the bedside commode and get back in bed unassisted, 50-year-olds. So, you can imagine how much more magnification happens if we're the slip sliding loss of muscle, it is not just about esthetics. And I think for a lot of people, they think, “Oh, you just want to look good in a bikini or you want to look good but you want to be able to wear short sleeve shirt and feel confident.” No, no. We are talking about body mechanics, fall prevention.

[00:12:10] I actually tripped-- And this is worth sharing, I tripped last November. I was at an event and my sandal actually got caught in a tree root as I was leaving this event, and I fell forward. And I was in between two physician friends who watched me like they-- Not that they were watching me fall, but watched this whole thing transpire. And had I not, but actually, it happened so quickly, I didn't have time to put my wrist down, so I hit my elbow and I hit my chin. I didn't break any bones, but I had a really significant sprain. And I remember thinking, “Oh, my gosh, if I wasn't doing all the things I've been doing, I could have very easily broken my jaw, I could have broken my elbow,” which is what I fell on. And so, it just reaffirmed for me why it's so important because trips and falls happen, but we don't want to have a catastrophic injury. Like when I was in physical therapy for six weeks, you would appreciate this-- I was at a hand and wrist physical therapist. Every person in that room was easily over the age of 75. They all had broken their radius right at the wrist. And so, every single one of them was in physical therapy post surgery. And all I could think of was, “This is our future if we are not actively working against it.”

Dr. Shannon Ritchey: [00:13:19] Right. And you think about, “Oh, an injury. I can rehab. The modern medicine is excellent. I'll be fine.” And yeah, totally, you can always rehab, you can always get better. There's always room for improvement. But the problem is, if we are banking on that when we get to that point and we have a severe injury, a lot of times those severe injuries can really sideline you for a long time. And you were lucky enough to be at a healthy point that you probably healed relatively quickly, but if you weren't, that process could have taken you six months longer. And in those six months, you probably wouldn't have been able to exercise the same. You wouldn't have been able to load your muscles the same. And so, you would have been deconditioning your body even further. And so, it can--

[00:14:04] That's what ends up ultimately killing so many elderly people that fall. They fall, and it's not the fall itself that kills them, it's the months of being immobile, development of pneumonia, things like that ultimate, so the fall is the catalyst, and that starts really in your 20s, 30s, 40s, 50s, 60s of how you're exercising and how you're loading your body.

[00:14:33] So even though it's that one event that happens when you're, you know, 80-years-old, 90-years-old, it's a lifetime of accumulation of load or deloading that ultimately adds up to that final event, which I know it sounds morbid to talk about, but it's important for us to know and be educated about.

Cynthia Thurlow: [00:14:51] Right. Absolutely. I have a family member who three years ago fell and broke her hip, and she has severe osteoporosis as a byproduct of being a kidney transplant. So, she's on drugs that are ensuring-- She's 35 years out of a kidney transplant, which is, for listeners, is an incredible feat.

Dr. Shannon Ritchey: [00:15:09] Awesome.

Cynthia Thurlow: [00:15:10] In fact, every time I interact with a nephrologist or kidney doctor, I always share this story about this family member. And they're like, “That's amazing.” Well, last year, in the midst of all the other stuff that went on in 2024, she fell and broke her femur. So that's the long bone. So now she's like tinker toys trying to put tinker toys back together. She has not been mobile without assisted devices, like a wheelchair, a walker, since May of last year, because trying to put all these bones back together, and she is sharp as a tack, but her body is slowly but surely kind of breaking down. And so, we've had a lot of conversations, like, trying to make sure, doing everything we can to get her as mobile as possible. Because you're right, it just becomes this vicious cycle.

[00:15:54] Now, one thing that I think is really important and we touched on this at the beginning. There's a lot of stigma around weight. There's a lot of stigma around the scale. Where do you think that originates from? What is driving that? Is it our toxic diet culture? Is it unrealistic expectations? Nowadays, there's just tons of filters, so there's even an account on Instagram. I think it's Goob. He's funny. He actually will call out people that use tons of filters. And, like, I don't use a body filter, so I don't understand how that works, but it'll kind of point it out. Yeah, so I'm like, I wouldn't have even looked at that photo and thought that. But the point of this is I think there's just a lot of stigma around numbers and scales. And I'm curious what your thoughts are and what drives that preoccupation.

Dr. Shannon Ritchey: [00:16:42] It's a really good question. I mean, years of social conditioning, I think drives it. And social media surely doesn't help. And I'm the first one to say, I've met so many of these influencers, fitness influencers, who post content and they know their angles. And you can make yourself look a certain way on a video and maybe that's not like a representation of what you actually look like. So, it can be very discouraging for someone who's just scrolling and seeing these images. And also, you're likely seeing the people that have the best genetics and spend so much of their life focused on fitness. And they never drink alcohol. They're very, very, very healthy. So, you're seeing like the top of the top.

[00:17:29] But that's who we're comparing ourselves to on social media. And I think that there's a little bit of aspiration which can beneficial, but then there's a lot of like compare and despair. And then it's like, oh, I'm scrolling and. And like now I'm stressed and so I'm going to go eat some cookies because, like, I'm stress eating. And so, I think that there's a lot of that. I think lot of fitness content that is pushing unrealistic routines and pushing things that women don't want to do.

[00:17:59] So, for example, we think about the 75 hard or all of these fitness challenges that are encouraging you to exercise more than once a day. Well, if you're not even exercising once a day or even a few times a week, trying to exercise twice a day is just a lot. And also, with the expectation that your workouts need to grind you into the ground, they need to be super intense. If you're not sweaty, if you didn't burn a million calories, if you're not super sore the next day, then, did I even have an effective workout? Is that even worth my time? And so, understanding where to place your time and energy which is precious. Your time and energy is precious. Where to place your time and energy towards the things that are actually going to move you forward.

[00:18:42] And to me, those things are loading your muscles. Loading your muscles and strength training doesn't have to look like grunting, lifting bros at the gym. And I think so many women are afraid of lifting because that's the stigma that we have about it. It doesn't need to look like that. It can be gentle. It can be lifting weights in the comfort of your home. You don't even have to leave the house. So, it doesn't need to be an hour long. Our workouts are 35 minutes. I almost never break a sweat. I probably almost barely burn any calories, but I'm loading my muscles and I've slowly built muscle both before, during, and after pregnancy, which is really awesome. You can do it at any stage of life as well. But I think there's all of these stigmas that make people not act so it drives inaction instead of driving action because we think that it needs to be so extreme.

Cynthia Thurlow: [00:19:29] Yeah. And it's interesting because I think what I did even ten years ago is very different than the way I exercise now. And I think for a lot of individuals and I'm going to use two examples that I think everyone is familiarized with, whether it's CrossFit or Orangetheory Fitness. I'm not saying that there's anything wrong per se with that degree of intensity of workout, but I find for many women north of 35, north of 40, 45, 50, they don't recover the way that they used to recover. And so, I will have women in programs that will tell me they're exercising like Orangetheory Fitness five days a week and they're wondering why their adrenals are trashed and they're exhausted and their hair is falling out and they can't lose the weight and that becomes a source of--

[00:20:13] They think if a little bit of exercise is good, more is better. And so, helping them come to the realization that exercise is a hormetic stressor, beneficial stress in the right amount at the right time and we just become a little less stress resilient as we're getting older, which is not to suggest we're telling anyone not to exercise. It's just be smart about how you exercise. I can tell you that if I have overexercised, which I don't do anymore, but my tell was I was tired, like tired not just after the exercise, but I wouldn't sleep as well. I would be really-- I would have more painful muscles. Like the kind of muscles where you feel like you can't go up and down the stairs. Like you're not supposed to be so sore that you then go to a point where you don't want to move, you don't want to recover.

[00:20:58] I'll never forget that was probably 15 years ago and I probably had two-- The boys were probably, gosh, probably two and four. And this very well-meaning trainer in the gym who was generally training younger clients, she put me through a workout that I literally for three days, like going up and down the stairs was so painful. And I'm not someone that like complains about sore muscles, but it was so exquisitely painful. That is a sign that you are working out too intensely.

Dr. Shannon Ritchey: [00:21:25] Yes.

Cynthia Thurlow: [00:21:26] And I think that that is important for us to understand, like we don't have to punish our bodies. This is not about, as you said, compare and despair. But sometimes what you're seeing on social media or TV or a movie is someone that is their whole job is to make their body ready to look a certain way, to be photographed or to be in a show or to be on TV. That is not what they probably look like day to day outside the context of that training regimen.

Dr. Shannon Ritchey: [00:21:51] No.

Cynthia Thurlow: [00:21:52] And so, I think that for a lot of people, they are comparing someone's like most fit looking day ever and thinking that's what that individual, that's the standard with which they're trying to attain. And for most of us that's not realistic.

Dr. Shannon Ritchey: [00:22:05] Right. It's not. And many of those individuals are potentially on anabolic steroids. So, we have to remember that as well. And I think where this really, because I can come from a background of over exercise, like many women, lots of cardio, lightweight, high rep, “Toning,” type of workouts that I thought were going tone my body and spot treat fat and all the things years ago and that resulted in all this chronic pain and not really a lot of great results to show for it.

[00:22:34] So, when you understand the science, this was ultimately the mindset switch for me was understanding what works and what doesn't and what's an important metric to follow and what's not. Soreness is not necessarily a good indicator that you had an effective workout. Soreness tends to happen when you do something new. So, if you do something that your body isn't experienced with or if you had a heavy eccentric component to your movements, so the lowering phase of a bicep curl, that's an eccentric component. So, if you had a workout that had a lot of eccentrics in it, you can be sore or if you did a new movement, then you can be sore.

[00:23:11] But the problem with soreness is I always say we want light to no muscle soreness after a workout. Soreness is inevitable if you're consistent. It happens to me still. But we want light to no muscle soreness because we want to be able to train again the next day and then the next day and then the next day. And like you said, when you were super sore for three days, you couldn't train those days. You had to rest. And so during that time period, it's not like you're building muscle that whole time. If you are not training, you're losing an opportunity to build muscle or maintain the muscle that you've built. So, we want to make sure that we can stay consistent.

[00:23:44] And if you're not recovering because you're tearing your body apart and you feel like you got hit by a truck after every workout, then you're either not working out because you're sore and depleted, or you're going to your workout anyways and its really low quality because you are so fatigued. Your body only has so much to give. So, if you can show up to a workout and be fresh, be recovered, and that's why I recommend not working the same muscle groups every day because we want to give those muscle groups breaks to actually recover and heal and build. But if you're showing up to every single workout more and more and more depleted, it makes total sense as to why you're not seeing results. You're not giving your body a very good stimulus. So, I do think that some of these things that we've been taught need to be switched. And then when you understand the science, it's way more easy to get on board.

Cynthia Thurlow: [00:24:32] Yeah. And I think it's important just to have those kinds of parameters because for many years we were taught if you're not sore after you've lifted weights, then you haven't had any benefit because you're not breaking down your muscle. And that's actually not the case. And what I found is, for me personally, like my-- I always say the things you don't want to do in the gym are the things you generally need to do. So, as an example, I don't like Bulgarian split squats, but they're very, very effective. And so, if I go a long period of time and I don't do them the first week after I've done them, I'm going to be a little bit more sore than usual, but once I have integrated kind of progressive overload, which I'm sure we'll probably touch on, then I'm like, okay, my body is just acclimating to a new stimulus. And I think that's the point of what you're stating is that helping us understand like we want to be conscientious about how we go about doing strength training, but we do not want to put ourselves in a position where we injure ourselves. I can't think of anyone, like, I jokingly say, this is why I no longer ski. I skied my entire teenage years and early adulthood and I stopped skiing regularly. And so now that I'm not skiing regularly, the statistical likelihood I'm going to have an issue is a little higher. And I said to my husband, I don't like being cold. And I know my boys and my husband all love snowboarding. I'm like, “I will be happy to send you on a trip and I will do my own thing.”

Dr. Shannon Ritchey: [00:25:55] Totally.

Cynthia Thurlow: [00:25:56] Because I am all about like being proactive. I'd rather invest the time in another activity that I actually like doing-

Dr. Shannon Ritchey: [00:26:01] Yeah.

Cynthia Thurlow: [00:26:02] -as opposed to putting myself in the potentiality of falling. And what's interesting, and this is just a dovetail, for those that ski, the snowboarders, there's so many snowboarders now, what I find is it's oftentimes not that you haven't skied in a while, it's that the snowboarder, probably like the left less competent snowboarders will ski over the back of your skis, and that is oftentimes how I see people getting into trouble. And so, I always say lovingly, my boys, my husband all snowboard. But I'm like, I will stay on the skis and I will happily like hang them up and not go back to that.

Dr. Shannon Ritchey: [00:26:34] Totally. It's not worth getting an injury at a certain point in your life. I'm the same way. It's so fun, but is it really worth it for me to like tear an ACL? Especially when fitness is my job. I'm like, I don't know. I don't think it's worth it. I'm not good enough to like take that risk.

Cynthia Thurlow: [00:26:53] Yeah, absolutely. And what are your thoughts on when women come to you and they want to have an accurate representation of body composition? So, we're talking about fat free mass to muscle mass. What are your like tried and two recommendations because probably not everyone has access to things like Bod pod, which for listeners is fascinating. It looks like an egg, you sit inside of it. It pulls all the air out and it can actually give you an accurate representation of those two metrics.

Dr. Shannon Ritchey: [00:27:21] DEXA scans are becoming more and more prevalent and accessible. There's a company, have you heard of BodySpec? They do--

Cynthia Thurlow: [00:27:28] I have.

Dr. Shannon Ritchey: [00:27:29] They're in a lot of major cities. I know they're in Austin, LA, I think maybe New York or San Francisco, but they're in a lot of the major markets and I think it's like $40 to get a body scan, and it'll tell you roughly your fat mass, muscle mass, bone density, things like that. You can also ask your doctor because sometimes they can give you a note and/or a referral and sometimes they're overly expensive or inaccessible. And if that's the case, then you-- There's not really super reliable ways to measure it beyond the Bod Pod or a DEXA scan unfortunately.

[00:28:06] There are those body composition scales and I got one because I wanted to test it out. What I did is I got a DEXA scan and then immediately after went home and did the body composition scale. And it was very inaccurate. Yeah, the DEXA scan tends to be decently accurate. And these scales, it was way off. It underestimated my fat mass and overestimated my muscle mass. However, what we're looking for when you are undergoing a training regimen and you're changing your nutrition and things like that, is the change over time. So maybe if you're just looking at the trends like, although the absolute values of those scales might not be super helpful, if you're just looking at the trends over time, you could use it. Again, it's an accessible tool that anyone can use. I think mine was like $50. It's called H-U-M-E Hume, I’m not sponsored or anything like that. But again, pretty inaccurate, but you could look at the trends over time.

[00:29:03] And then another way to do it is honestly just using your eyeballs. Looking at yourself in the mirror, are you seeing more muscle definition? Are your clothes fitting different? I don't recommend looking at the scale. As we said, if you're building muscle, the scale might be going up. Are you going up in your list? Are you able to lift heavier weights over time and/or do more reps with the same amount of weight? That's the same as going up in weights. Progressive overload is either doing more reps of the same weight or increasing the weight or both. So, is that happening if you're gaining muscle? If you're training close to failure, which is very, very important, most women are not training close to failure, then you probably-- And you're eating enough protein, you probably are building muscle, so it takes time.

[00:29:46] I like to set the goal of building five pounds of muscle over the span of a year, and I like that because it's very doable. You can definitely build five pounds of muscle over the span of a year, but you won't be in a rush. And that's important because we can't hurt ourselves. If you're building muscle, we don't want to get injured because that will sideline you and that will derail your progress. So gently trying to build muscle, staying consistent in the gym, trying not to tear apart your body when you do your workouts, because we have to think about the recovery for the next workout and setting a goal of building five pounds of muscle every year.

[00:30:21] Odds are you're not going to build five pounds of muscle every year. Odds are you're not going to get bulky. Most women, that's the biggest fear. And I think I get asked on every single podcast I go on, what do women get bulky? Is this a fear we should be afraid of? No, honestly, it takes a long time for us to build muscle. Some women have the genetics to build muscle very quickly, but I would say that's the minority of women. Most women, it takes them years. Most women are not training close to failure. Most women are not eating enough protein, and so it takes time. But if you slowly start to build muscle-- Again, even if you're only concerned with the aesthetic benefits, you will start to like how you look. And of course, we can talk about the metabolic benefits and the longevity benefits, and those are incredible too and that's what makes you stay, ultimately, is how good you feel, that's what makes you stick to it, but the aesthetic benefits are a nice bonus too.

Cynthia Thurlow: [00:31:15] Oh, absolutely. And I think for a lot of individuals, there's still this misconception as you astutely stated, women are worried about getting bulky. It is physiologically impossible for us to get “bulky” unless we're taking anabolic steroids or large amounts quite honestly, because I do see some people on social media that are women that clearly are taking probably super physiologic doses of testosterone because they just have a particular body habitus. It's very evident to me. Their face looks very drawn and there's no judgment. If that's what they choose to do and that's what they and their prescribing provider are doing, then that's their decision. But I think for the rest of us, it's understanding that testosterone is incredibly potent in our bodies. It is intricately involved in building muscle mass. It does take time, I think, for anyone.

[00:32:03] I'm one of those leaner individuals and I've never been someone that has like massive big muscles, but they're gentle small muscles, and that is just the way that my body responds to exercise. Having said that, I do have a couple girlfriends that are-- They jokingly talk about they breathe and they just build muscle. And you're right, that is definitely the minority. And these are the people that generally tend to gravitate towards, they might be involved in competitions, bikini competitions. And you look at them and you're like, “Oh my gosh, you look like you were sculpted out of clay.” It's unbelievable how that-- seems to effortlessly they build muscle.

[00:32:39] But as an example, that has been my focus for the past year is trying to put on five pounds of muscle. It is not easy. I mean, if I look at metrics, as you stated, are you going up in weight? Yes. Are you noticing body composition changes? Yes, but they're subtle and they're over time. And that is kind of the message that I want to make sure women really understand is that we want small, sustainable changes over time. We're not looking for losing 20 pounds in a month. That is not what we're looking for. Although, I do find in a lot of patients, just changing their nutrition can be huge. Like if you suddenly go from eating a lot of ultra-processed foods to eating a more nutrient-dense diet just by virtue of the fact, you're consuming less calories. And it's not just about the calories, it's just that we know ultra-processed foods trick our brains into eating more food. And if you look at the research, anywhere from 500 to 1000 additional calories a day unknowingly. And that I think is really a good argument for trying to eat a more nutrient-dense diet. Curious, when we talk about how important muscle building is, let's first look at metabolic health. What are the benefits of building muscle on metabolic health?

Dr. Shannon Ritchey: [00:33:52] Well, the listeners might have heard that muscle is your biggest glucose sink. And what does that mean? Muscle stores glycogen. So, when we eat food as you well know, and your audience I'm sure knows, the food that we eat is converted into glucose. Blood sugar rises, insulin rises and the glucose travels throughout our body to serve the cells, power the cells. And anything left over, anything in excess, is either stored in the liver, in the muscle, or as fat. And if you have more muscle mass, you have more available sites for that blood sugar to go.

[00:34:30] So, if we think about it, if we increase our muscle mass, insulin sensitivity improves, which improves every single process in our body. Insulin touches and affects every single cell in our body. So, if we can store more glucose, as in the form of glycogen in the muscles, we can improve our insulin sensitivity, improve the function and longevity of our entire body. So, it's really just as simple as thinking about that.

[00:34:56] Now what's important is not only that you're building more muscle to store more glucose, but also that you are emptying those glycogen stores in your muscle by training close to failure. So, a lot of people are understanding the importance of building muscle and strength training and picking up weights. And so, they go to the gym and they do three sets of ten or they feel their muscles burn a little bit and then they're like, “Okay, I'm done.” Where they follow a program and they say, “Okay, I'm going to do this exercise for 60 seconds or I'm going to do it for 10 reps.” And then they do it and then they're done. But they're not getting anywhere close to failure. So, they're not stimulating those higher motor unit muscle fibers, those type 2 muscle fibers, and tapping into their glycogen stores and emptying those glycogen stores so that the next time they eat, those glycogen stores can be replenished. So, training close to failure is something that is very, very important if you ultimately want the result of building strength and muscle.

[00:35:51] Now you don't have to train close to failure using really low reps. The studies show that you can use a wide variety of rep schemes anywhere from 6 to 30 reps taken close to failure will build the same amount of muscle. So, you can use relatively lighter weights. Now there's pros and cons to using relatively lighter weights, but especially if you're just starting out and you're like, “I don't want to lift super heavy.” You don't have to, to build the muscle and strength, you can lift relatively light as long as you're approaching failure in 30 reps or less. So, a lot of people go to-- Again, no shame on any fitness method, do whatever you're going to stay consistent with.

[00:36:28] But a lot of people will go to these like bar classes or even gym classes that are lifting weights and they're training one muscle group for minutes and minutes and minutes on and they're doing very high rep, upwards of 50, 100 reps for one single muscle group. And that's just simply not enough load to trigger and stimulate the type of muscle growth that we need as we age. Maybe you're triggering a little muscle growth in your type 1 more endurance fibers, but we tend to keep a good composition of our type 1 fibers as we age and we lose our type 2 muscle fibers as we age, which are only stimulated if you are lifting heavy enough close to failure. So, I cannot emphasize this enough.

[00:37:05] Lift close to failure. And if someone's like, what does that mean? What does that feel like? In your last rep, let's say you're doing bicep curls. In your last rep, the best way to know that you're close to failure is that your velocity decreases, so your rep speed decreases. You're trying to lift the weight quickly, but you physically cannot. That is an indication that you are now using your larger muscle fibers and therefore stimulating those larger muscle fibers for growth. Other indicators that you're close to failure are maybe you do that last rep, it's slow, you think you might be close to failure, pause. Take a three to five second break. If you could keep going easily, you weren't close to failure because odds are you were using your type 1 muscle fibers, which can recover within seconds. Whereas if you're recovering your type 2 muscle fibers, those take a minute or longer to recover again. So that's a really good indication that you weren't actually training close to failure. That was a lot. Did I answer your question?

Cynthia Thurlow: [00:38:00] No. That is actually the best explanation for training to failure that I've ever heard. And I say that quite honestly. And we have a lot of experts on here, but clarity and helping people visualize and understand what that means. Because if you hear train to failure, people are like, “What does that mean?” And so that is a very explicit understanding. So, for those that are doing, let's say you mentioned bar, let's talk about Pilates because I love Pilates for posterior chain work. I like it for flexibility for me personally. But women will ask me, “Is Pilates sufficient to build muscle?” I know the answer to this. I'm sure we share the same opinion. What are your thoughts on Pilates for let's say middle-aged women?

[00:38:41] Because a lot of women, let me just interject this. A lot of women get concerned. They're worried if they go to the gym and they're lifting heavy, they're going to hurt themselves. So, they're like, “Okay, I'm going to do Pilates. I don't have to work as hard. I'm on the reform or I'm working in a class. It's an upper-level class. Yes, I'm a totally competitive person and I only-- when I go to Pilates, I only want the toughest instructor, I only want the most intense class.” But having said that, help us understand what Pilates can be beneficial for and what it doesn't do for us.

Dr. Shannon Ritchey: [00:39:11] Sure. So, let's start with, does it build muscle? It certainly depends on the exercise that you're doing in the resistance of that exercise. If you can train close to failure using a Pilates exercise or a reformer exercise, absolutely that exercise can build muscle. Many times these reformer classes are doing far more than the 30 reps necessary, and it burns, it is hard, you will be super sore. You might be dripping in sweat, again, but all of those things aren't the necessary stimulus for building muscle. Training close to failure in 30 reps or less is a reliable stimulus for building muscle.

[00:39:47] And then many times too, in these Pilates classes is there's just a lot going on. So maybe you're holding a plank and you're bringing your knees in and out, so the shoulders are working, the legs are working, your abdominals are working. And when there's a lot working at once, your body is prioritizing stability and balance over motor recruitment or over muscle recruitment. Because there's so much going on, the load isn't very specific to one single muscle group. So therefore, you can't load any of those muscle groups with very much intensity and so it might not be a super effective stimulus for muscle growth.

[00:40:21] Now, that's not to say, again, that you couldn't pick a really specific exercise, stabilize certain parts of your body, and really target one muscle group and take that specific muscle group close to failure in under 30 reps, some methods, absolutely, but you just have to ask yourself those questions when you go to the specific class that you're going to. One thing that Pilates can do is build muscular endurance. Like we said, it might be less important for most women to focus on endurance because we tend to keep a good composition of our type 1 muscle fibers as we age. However, if it's something that you enjoy, you love the group aspect, I say go for it.

[00:40:59] But it's just a matter of where we are putting our precious time and energy. And when we are thinking about, “I only have this amount of time to allocate to exercise and fitness.” Not only time, but recovery, because if you're doing a really hard Pilates class, that might interfere with your recovery, which will affect your subsequent training workouts. So, we have to think about “What can I have time for and what can I recover from?” I personally think strength training should be the cornerstone of your routine. Plug those workouts into your routine first. From there, add 150 minutes of light-to-moderate intensity cardio.

[00:41:33] Cardio is important. Historically, it has been overdone, but it is important. No one can deny the benefits of working our heart and lungs right. It is important. From there, if you have the capacity to add one HIIT workout per week, that's a sprint workout, very, very short. Think 15 minutes or less, where you're going all-out effort for very short bursts, like 30 seconds, and then you're breaking in between. You only need to do one of those per week to see incredible benefits, maybe 2 max. Most people are doing way more because they think more is better when it comes to hit, and that's not true. From there, if you have the recoverability, the time, the access to take a Pilates class, I say go for it. But again, I just like to think that there are other more potent ways to spend our time.

Cynthia Thurlow: [00:42:20] Yeah, and I think you bring up so many good points. I think many people feel ashamed, like, oh, they see-- And I love Dr. Peter Attia's content, but sometimes they'll talk about the research around exercise. And I'm like, most people do not have two hours for Zone 2 training during the week, like, that is a luxury. And many of my patients are in the car early in the morning. They're at a hospital all day. They come home, they're tired, they're like, the thought of having to walk on my treadmill for 30 minutes is not realistic. So, I love that you emphasize focusing on the strength training. If you have time, add in these other elements.

[00:42:55] I know Zone 2 cardio is getting a lot of attention right now. And I think I love Zone 2 cardio. There is not a flat surface in my neighborhood just walking with my dogs is Zone 2 cardio because of the hills. Let's talk about Zone 2 cardio and how that fits into this conversation around exercise.

Dr. Shannon Ritchey: [00:43:13] I did a whole podcast about if strength training doubles as cardio. And it was really fascinating to dive into the research because strength training has so many benefits, but we just see that strength training does not cover all of your bases. It covers a lot of them. If you only have time for one thing, I say strength train because we're losing muscle. You are going to get some cardiovascular benefits. You can even get flexibility benefits, joint health. I mean, truly, it is incredible. If you have time for one thing, make it be strength training close to failure, but it does not have the same effect on your cardiovascular health as straight cardio does.

[00:43:55] So, when we think about cardio, there's many forms of cardio. You might have heard of all of the zones of cardio, Zone 1 through 5, and some of them have been demonized. I tend to think that any cardio and movement is beneficial. Anything that's benefiting your cardiovascular system or your body as a whole is beneficial. The problem is that people just take it to the extreme and do way too much and break their body down and they start to see negative benefits. So, all of it is great in moderation. I think Zone 2 is particularly interesting because it tends to improve your mitochondrial density. It's something that we again are losing as we age, which can improve our metabolic function from the inside out. And you're just not getting those exact same benefits from a strength training routine, so I am a big fan of integrating in Zone 2 cardio.

[00:44:44] I totally agree with you. I think the experts that are preaching it, absolutely, they know what they're talking about, but it might not be realistic for most people to go out and spend an hour on their run every day and then go do the strength training as well. It can be a lot for people. So, I'm the same way. I walk, I do my Evlo five times per week and that's it. And if I look, I just tested my VO2 Max recently and it's great, perfect range, it's in a high range, it's great. And I don't do a ton of cardio, so I don't think you need a lot of it, but I also don't think we need to fear it or avoid it, and I do think that we need to prioritize it.

Cynthia Thurlow: [00:45:25] Yeah, I think that for so many people, they're just so confused about what to focus in on. I think for many of us, certainly for my generation, like I remember in college we were doing step aerobics and there was all this emphasis on running and sprinting and all these things. And I admittedly I ran track in high school, but I've never loved running. So, for me I was so happy and affirmed to know that just the actual movement of day to day living, we call it “NEIT,” so non-exercise induced thermogenesis, parking, when you go to the grocery store, you go to the mall, like park a little farther out, just all those ways that we can increase our step count and just being physically active, I think are really important. And I recall when my kids were younger, you certainly are in the process of having your second child, but those years are precious. And there just wasn't-- I wasn't the type of parent, although I did occasionally. We would go to the gym, and my husband and I would work out together, and the kids would be in like this great kids center we had this amazing gym.

Dr. Shannon Ritchey: [00:46:24] That's awesome.

Cynthia Thurlow: [00:46:26] Years later, my kids were like, “We hated going to that kid center.” And I was like, “Oh, it was so nice. You guys can't even complain about that.”

Dr. Shannon Ritchey: [00:46:33] Right.

Cynthia Thurlow: [00:46:34] I think for many of us, we feel a sense of guilt when we leave our kids with a babysitter or do these other types of things. So, I think being really efficient with our time and our exercise is something that we should certainly emphasize.

[00:46:47] Now, I know we haven't touched on nutrition, but there's a lot of misinformation about this. There are the gym bros that want to focus on just calories, and I'm not suggesting calories aren't important, but it is not the full picture. Let's talk about nutrition. When you are speaking to clients or even in your app or on your podcast, what role does nutrition play in body composition changes? Because I think for a lot of people, we've still been conditioned to believe that we can continue eating like we were at 18 and that it's not going to impact us. I can tell you without question, when I hit probably early 40s, all of a sudden, those days were over. The days of being able to eat whatever I wanted are completely gone. And I had to make some big decisions. No gluten, no dairy, that's what works for me personally. Everyone has to decide for themselves. But I think for a lot of individuals, they don't put enough emphasis on nutrition. And I really think nutrition is foundational to everything.

Dr. Shannon Ritchey: [00:47:42] It absolutely is. And I think we've been taught and misled that exercise can erase a meal or exercise is what you need to get fit and lean and thin. And it's so funny, when I tell anyone what I do and that I'm the founder of a fitness platform, they're like, “Oh, can you help me with this?” And they like point to their belly like, [laughter] “How do I lose this?” Or they’re like pull on their arms and they're like, “How do I get rid of this?” And I'm like, “That's nutrition. That is nutrition.” That strength training and exercise is great for your metabolic health. It is necessary. It is going to improve your muscle mass, your cardiovascular health. But we just see from the studies that exercise alone is not a very potent stimulus for fat loss.

[00:48:27] You might lose a little bit of fat by exercising or introducing a little bit more exercise than what you're used to, but it’s very small amount compared to the amount of fat that you can lose if you dial your nutrition, if you eat high protein, eat a nutritious diet. And I'm not a nutrition expert, so I don't like to give advice there. I like to leave that to you all. But I also like to educate on exercise is not your golden ticket to fat loss, it's just not. And a lot of people over exercise with that expectation and then they end up being super frustrated, injured, feel horrible, feel exhausted. They end up hungrier because they're exercising so much, so they eat more, or they yo-yo and so it really is understanding and separating exercise and fat loss.

[00:49:18] And I think when you do that, you'll end up seeing so much better results. You'll end up exercising in ways that are actually beneficial. You'll end up loading your muscles in ways that are actually going to lead to muscle development. And again, I think that when you understand the science of these things and you start to put them into practice, it feels so much more sustainable. You're not doing these crash diets. You're not over exercising. You have a lot of mental freedom around exercise because you know recovery is important. Okay, I take two recovery days every week and I have zero guilt on those recovery days, whereas 15 years ago I would have been, “Oh it's Sunday and I haven't worked out. I feel so guilty.” So, there's so much mental freedom around it when you understand all of these things, it's just so much more of a sustainable process.

Cynthia Thurlow: [00:50:07] And I think that's really what is key, is that we want these changes to be sustainable long term. And I think anytime you-- And I'm saying you pejoratively like or the community at large, if you are doing something that you cannot do long term-

Dr. Shannon Ritchey: [00:50:21] Yeah.

Cynthia Thurlow: [00:50:22] -then that's not the right decision for you. Like I'll provide an example. I went gluten free at 40 and I put into remission every autoimmune condition that I had.

Dr. Shannon Ritchey: [00:50:31] Wow.

Cynthia Thurlow: [00:50:32] And that to me is huge. In fact, my dermatologist just was shocked. She just kept saying, “This is just from taking gluten out of your diet,” yes.

Dr. Shannon Ritchey: [00:50:38] Wow.

Cynthia Thurlow: [00:50:39] And for me it's a non-negotiable because I think it's really important for me not to-- We’re far more likely as women to develop autoimmune conditions. And as our immune system starts to change, as we are navigating perimenopause and menopause, we are just more likely to add on to those autoimmune conditions. With that being said, I love dark chocolate. If someone said to me, “Cynthia, for the rest of your life you cannot have dark chocolate,” which is my one last bite, I'd be like, “That is not sustainable.” So, I think for each one of us it's determining what is feasible, what is reasonable and then making adjustments. Like if someone says, “I really struggle with not having gluten,” it's like, okay, then we need to find some gluten-free alternatives. We need to find a clean tortilla. We need to find occasional piece of bread. Things that you can have when you feel like you want to have those items but not put yourself in a position where you are impacting your health in a negative way.

[00:51:31] I'd love to know your thoughts around supplements. Are there supplements that you feel like are beneficial for women, things that you take. I know obviously in pregnancy you're limited in what you can take, but in your non-pregnant state, are there particular supplements that you really like and you recommend with some frequency?

Dr. Shannon Ritchey: [00:51:49] I am not formally trained in this area, but I will say what I do and what I've seen incredible benefits from and what I have personally studied. So, creatine, I know it's so interesting, it's so popular, but I've been taking creatine for years and it's not new and it's just interesting that it's like trendy and popular right now, but creatine is great. Creatine, again, not a magic pill. If you're not training properly and you're not eating enough protein, creatine is not going to be that band-aid that allows you to build muscle and tone up or whatever it might be. So, it's just a supplement. And supplement is a supplement for a reason. It's supplementary to all of the other things that you're doing. So it can-- It has been shown to beneficial for muscle growth and strength and cognitive health and things like that, so I do take creatine. I've passed it by my doctor and I continue to take it during pregnancy, but again, if someone's pregnant, pass it by your doctor.

[00:52:48] And then aside from that, I keep it so minimal. I take a prenatal vitamin right now, and that's about it. I do a lot of protein powder because I find it convenient. And I'm in the stage of my life where I'm running a business. I'm a mom. I don't always have time to eat a chicken breast, like, sometimes it's Greek yogurt with protein powder and some berries and that's how I'm getting 40 grams of protein in that meal and call it a day, so it's a little bit of a convenience thing for me to get my protein. And I've found a clean brand that I really like. I don't know if you've heard sort of Just Ingredients and we can cut this out if you don't feel comfortable sharing, but I really like their protein and I also use their creatine, but other than that, I keep it so minimal.

Cynthia Thurlow: [00:53:30] Oh, and I love that. And I think for a lot of us, it's just figuring out what works, what resonates. I'm a huge proponent of creatine. I probably have been taking that for the past five years. My entire family takes it every day, especially the teenagers. And so oftentimes I'll get questions, “Is it safe for teenagers to take creatine?” Yes. I've asked the experts, the researchers, the people that are in the know. And I love, and as you astutely stated, if you are pregnant trying to conceive, talk to your OB about it, but I love that your OB/GYN is progressive enough that they understand the science behind creatine and it's not a big deal.

[00:54:08] I think that whey protein or protein powders for so many women, that's how they get their protein up to at least 100 g a day. There's no shame in that. I probably have maybe two protein shakes a week and it's usually on days where I'm like out of the house but want to break my fast and want to be conscientious about it. So, I think there's no shame. Just be conscientious about where you source from. I think you just need to read the ingredient list. Popular brands in my house are MariGold, which is sourced from like New Zealand way. Over time we've had Kion at the house. We've had another company called Clean Simple Eats. That's almost like dessert because they have a flavor profile that literally it just looks sinful. And my kids enjoy that.

Dr. Shannon Ritchey: [00:54:50] Yeah, love.

Cynthia Thurlow: [00:54:50] Yes. So, I think it's just finding what works best for you. Do you use or do you talk about essential aminos? Because I feel like sometimes these can fill in the gaps. Like when I travel, I will occasionally take those. Again, it's not something I take every day because I do aim to get my protein from real food sources.

Dr. Shannon Ritchey: [00:55:07] Yeah.

Cynthia Thurlow: [00:55:06] But we get a lot of questions about essential amino acids in particular. Not so much branch chain in which we know are not as helpful or beneficial.

Dr. Shannon Ritchey: [00:55:16] You know, I myself am a little confused about that because I've seen the science or I don't know, people talking about this, going back and forth about like, “Do you need them? Are they beneficial? Are they not beneficial?” So, I don't personally take them. Do you recommend?

Cynthia Thurlow: [00:55:31] In the sense that-- I think Dr. Don Layman, he’s kind of gestalt about essential aminos is if you're getting in at least 100 g of protein a day, you don't need them. So that's kind of where my mindset goes if I'm traveling and I know I'm going to-- Like if I go to the west coast because from my part of the United States I can't fly direct to the west coast, which stinks, and so it's a long day of travel out, a long day of travel back. I never can manage to get enough food in. That might be the day that I'll have some essential aminos. And if you think about it from the perspective, its protein breaks down into amino acids, it'll bolster by about 30 g of protein, and that's the time that I will use it.

[00:56:08] I get concerned and that's why I want to make this distinction. The goal should always be to aim for the food. If you can't get enough in with the food, then I would look at a complete source of protein, like a whey Protein shake is a great option. If you're traveling and you're struggling to get enough protein in, and by that I don't mean I don't do that my entire vacation, it's just usually the day of travel. I think they can beneficial. But a bottle of essential aminos will last me months. So, it shows you like I'm not taking them every day. I actually don't like to have to take an additional supplement unless I absolutely need to.

Dr. Shannon Ritchey: [00:56:39] Yeah, me too.

Cynthia Thurlow: [00:56:39] But there's always questions around EAAs. Beyond that, it's funny, we'll get questions about magnesium and yes, we know micronutrient deficiencies can be problematic. What I find is its generally magnesium, vitamin D and omega-3s.

Dr. Shannon Ritchey: [00:56:52] Yeah.

Cynthia Thurlow: [00:56:53] But obviously, again, if you're getting two fatty fish meals a week, you're probably getting enough Omega-3s, but sometimes you don't know, and that's why I think testing can beneficial. Micronutrient testing to see exactly what you need. It's interesting, in my house, we've done that with my younger son and my husband, and they both had bizarre micronutrient deficiencies.

Dr. Shannon Ritchey: [00:57:13] Really?

Cynthia Thurlow: [00:57:14] One was deficient in vitamin E and omega-3s, and then my husband was deficient in, like, coenzyme Q10 and some other molybdenum. So, it's like he needed trace minerals. So, having said that, probably more of an issue for those of us that have been around on the earth a little longer. But I think, when we come down to it, I think looking at vitamin D when you're going to your doctor's office or provider's office is completely reasonable. Looking at magnesium, and obviously red blood cell magnesium is going to be more accurate than a general serum magnesium and then Omega-3s, that's usually a little bit more sophisticated testing, but I think those things can beneficial.

Dr. Shannon Ritchey: [00:57:52] Yeah, well, I'm like, “Oh, a lot of those things are in my prenatal, so that's great.” Killing two birds with one stone.

Cynthia Thurlow: [00:58:01] Exactly, exactly. Well, please let listeners know how to connect with you outside of this podcast. As I mentioned, you have an amazing podcast. You have an app, you do a lot of social media content, and I love that you are featuring the baby bump this time around. I think that's what I read the other day. You're more conscientious about that. And to be honest, I think we're in like a blur with our first pregnancies. And then our seconds were like, “Okay, I'm a little bit more aware. I know what to expect this time around.” So, I love that you're embracing that.

Dr. Shannon Ritchey: [00:58:26] Totally. And I'm like, not as self-conscious this time. I'm like, “Yeah, I'm pregnant. Obviously, I'm just going to let the bump out. I'm just going to let it out.” And the bump is bigger this pregnancy than it was in the last pregnancy. And I think that's really common. So, yeah, I'm having fun dressing. Whereas the first pregnancy I was like, “Hide me,” which was so sad to look back on.

[00:58:45] But, yes, so I have a podcast it's called the Dr. Shannon Show. I do really short episodes educating on really specific topics around fitness. My goal is to educate women on how and why to build muscle in a way that doesn't tear their body up. Because as you said, so many women start to run into recovery issues as they get older. And even if you're not, you should be getting ahead of that. So, we have an app called Evlo Fitness, E-V-L-O fitness. And we've got a 14-day free trial if you want to give it a go. It's new fitness classes. All of our trainers are doctors of physical therapy. So, all the classes are 35 minutes. It's a very structured hypertrophy program or muscle building program. And then you can find me on Instagram, @dr.shannon.dpt. And I'm kind of on TikTok @dr.shannonritchey. And I think that's it. I think that's everything.

Cynthia Thurlow: [00:59:38] Well, thank you. It's been a great conversation. I'll have to have you back again.

Dr. Shannon Ritchey: [00:59:41] I would love to be back. Thank you so much for having me.

Cynthia Thurlow: [00:59:43] Of course.

[00:59:45] If you love this podcast episode, please leave a rating and review. Subscribe and tell a friend.

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