05 Jan 2026

2h 11m

#378 ‒ Women's health and performance: how training, nutrition, and hormones interact across life stages | Abbie Smith-Ryan, Ph.D.

The Peter Attia Drive

The podcast explores exercise and nutrition strategies tailored to women's health across their lifespan. Abbie Smith-Ryan, an expert in exercise physiology, discusses topics ranging from bone health in young girls to managing training and nutrition through the menstrual cycle, perimenopause, and menopause. Early exercise habits and diverse sports activities shape bone density and fitness, while menstruation often marks a turning point in girls' sports participation. Smith-Ryan emphasizes resistance training for injury prevention and the importance of nutrition as fuel, highlighting the need for adequate calorie intake and nutrient timing. The conversation also covers the impact of hormone fluctuations on performance, recovery, and metabolic flexibility, along with practical advice on exercise programming, supplementation, and hormone therapy.

Outlines

Part 1: Introduction, Background, and Youth Athletics

Part 2: Navigating the Menstrual Cycle

Part 3: Perimenopause and Lifestyle Interventions

Part 4: Training Optimization and Body Composition

Part 5: Personal Experience and Life Stages

Part 6: Sarcopenia, Muscle Quality, and Metabolic Health

Part 7: Injury Prevention and Aging

Part 8: Mental Health and Clinical Considerations

Part 9: Conclusion and Final Takeaways

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Preview

How to Get Rich: Every EpisodeNaval

#378 ‒ Women's health and performance: how training, nutrition, and hormones interact across life stages | Abbie Smith-Ryan, Ph.D.

The Peter Attia Drive

Part 1: Introduction, Background, and Youth Athletics

00:09Podcast Introduction: Translating Longevity Science, Guest Introduction, and Episode Overview

Podcast Introduction: Translating Longevity Science, Guest Introduction, and Episode Overview

02:57Abbie Smith-Ryan's Background: Collegiate Running, Research, and Women's Health Advocacy

Abbie Smith-Ryan's Background: Collegiate Running, Research, and Women's Health Advocacy

07:23Exercise Recommendations for Young Girls: Injury Prevention and Bone Health

Exercise Recommendations for Young Girls: Injury Prevention and Bone Health

11:03Adaptability of Young Athletes: Nutrition as Fuel for Performance and Recovery

Adaptability of Young Athletes: Nutrition as Fuel for Performance and Recovery

13:55Strategies for Young Athletes to Meet Caloric Needs: High-Fat Foods and Planned Consumption

Strategies for Young Athletes to Meet Caloric Needs: High-Fat Foods and Planned Consumption

Part 2: Navigating the Menstrual Cycle

17:02Training Through the Menstrual Cycle: Prioritizing Recovery and Addressing Individual Needs

Training Through the Menstrual Cycle: Prioritizing Recovery and Addressing Individual Needs

21:32Optimizing Training and Nutrition During Ovulation and the Luteal Phase

Optimizing Training and Nutrition During Ovulation and the Luteal Phase

24:22Strategies for Managing the Luteal Phase: Omega-3s, Magnesium, Creatine, and Caffeine

Strategies for Managing the Luteal Phase: Omega-3s, Magnesium, Creatine, and Caffeine

28:40Protein Intake and Metabolic Rate During the Luteal Phase: Prioritizing Adequate Consumption

Protein Intake and Metabolic Rate During the Luteal Phase: Prioritizing Adequate Consumption

32:20Training Adjustments and Self-Compassion Throughout the Menstrual Cycle

Training Adjustments and Self-Compassion Throughout the Menstrual Cycle

Part 3: Perimenopause and Lifestyle Interventions

35:31Hormonal Contraception, Perimenopause, and Symptom-Driven Approaches

Hormonal Contraception, Perimenopause, and Symptom-Driven Approaches

37:53Monitoring Hormone Levels and the Importance of Lifestyle Changes During Perimenopause

Monitoring Hormone Levels and the Importance of Lifestyle Changes During Perimenopause

41:54Prioritizing Exercise During Perimenopause: Consistency, Intensity, and Addressing Mom Guilt

Prioritizing Exercise During Perimenopause: Consistency, Intensity, and Addressing Mom Guilt

Part 4: Training Optimization and Body Composition

44:31Volume vs. Intensity: Tailoring Exercise to Time Constraints and Individual Goals

Volume vs. Intensity: Tailoring Exercise to Time Constraints and Individual Goals

47:25Structuring a Three-Hour Weekly Exercise Routine: Resistance Training and High-Intensity Cardio

Structuring a Three-Hour Weekly Exercise Routine: Resistance Training and High-Intensity Cardio

50:04High-Intensity Interval Training: Structuring Workouts and Prioritizing Exercise

High-Intensity Interval Training: Structuring Workouts and Prioritizing Exercise

53:33Weight Loss vs. Body Composition: Setting Realistic Goals and Measuring Progress

Weight Loss vs. Body Composition: Setting Realistic Goals and Measuring Progress

57:17GLP-1 Agonists and Muscle Preservation: Resistance Training and Protein Intake

GLP-1 Agonists and Muscle Preservation: Resistance Training and Protein Intake

1:01:14Underfueling and Bone Density: Balancing Caloric Intake and Exercise

Underfueling and Bone Density: Balancing Caloric Intake and Exercise

1:04:55Structuring Resistance Training and Setting Sustainable Body Recomposition Goals

Structuring Resistance Training and Setting Sustainable Body Recomposition Goals

Part 5: Personal Experience and Life Stages

1:07:30Self-Quantification and Injury Prevention: Lessons from Personal Experience

Self-Quantification and Injury Prevention: Lessons from Personal Experience

1:12:33Supplementation and Body Composition Changes Post-Pregnancy

Supplementation and Body Composition Changes Post-Pregnancy

1:15:14Eating More to Be Leaner: Frequency, Nutrient Density, and Time-Restricted Feeding

Eating More to Be Leaner: Frequency, Nutrient Density, and Time-Restricted Feeding

1:17:28Training and Nutrition During Pregnancy and Postpartum: Prioritizing Health and Athleticism

Training and Nutrition During Pregnancy and Postpartum: Prioritizing Health and Athleticism

Part 6: Sarcopenia, Muscle Quality, and Metabolic Health

1:21:42Sarcopenia in Women: Resistance Training and Hormonal Changes

Sarcopenia in Women: Resistance Training and Hormonal Changes

1:23:08Muscle Quality Changes During Perimenopause: The Importance of Lifestyle

Muscle Quality Changes During Perimenopause: The Importance of Lifestyle

1:25:27Intracellular Fat Accumulation and Metabolic Flexibility: Research Insights

Intracellular Fat Accumulation and Metabolic Flexibility: Research Insights

1:27:59Metabolic Inflexibility and Aging: Hormonal vs. Lifestyle Factors

Metabolic Inflexibility and Aging: Hormonal vs. Lifestyle Factors

1:31:31Optimizing Training for Metabolic Flexibility: Protein Intake and Exercise

Optimizing Training for Metabolic Flexibility: Protein Intake and Exercise

1:34:45Future Research: GLP-1s, Exercise, and Menopause Hormone Therapy

Future Research: GLP-1s, Exercise, and Menopause Hormone Therapy

Part 7: Injury Prevention and Aging

1:37:40Achilles Tendon Tears and Training Specificity: Balancing Hormones and Lifestyle

Achilles Tendon Tears and Training Specificity: Balancing Hormones and Lifestyle

1:39:21Misconceptions About Women's Training: Individualization and Leveraging Existing Research

Misconceptions About Women's Training: Individualization and Leveraging Existing Research

1:41:46Muscle Fiber Types and Aging: Preserving Power and Explosiveness

Muscle Fiber Types and Aging: Preserving Power and Explosiveness

1:44:53Maintaining Power and Addressing Joint Pain: Individualized Approaches

Maintaining Power and Addressing Joint Pain: Individualized Approaches

1:47:00Starting an Exercise Routine at 70: Machine-Based Training and Glute Activation

Starting an Exercise Routine at 70: Machine-Based Training and Glute Activation

1:50:04Progression and Functional Strength: Carries and Grip Strength