Episode 18: HIIT, Body Comp and other Cool Science with Katie Hirsch, PhD, EP-C, CISSN

High-intensity interval training (HIIT), body composition, and good old exercise were discussed in Episode 18 of the Fire Rescue Wellness Podcast. Come along and meet my dear friend Katie Hirsch, a bright new star in the scientific community.

Dr. Katie Hirsch is an Assistant Professor in the Department of Exercise Science at the University of South Carolina, Arnold School of Public Health. Her research focuses on the effects of exercise and nutrition on body composition, muscle and protein metabolism, cardiometabolic health, and performance, frequently studying the utility of high-intensity interval training for promoting metabolic and muscular health. Dr. Hirsch completed postdoctoral training in protein metabolism at the Center for Translational Research in Aging & Longevity at the University of Arkansas for Medical Sciences. She completed her Ph.D. in Human Movement Science, MA in Exercise Physiology at the University of North Carolina at Chapel Hill, and BS in Exercise Science at Truman State University. Dr. Hirsch is also a Certified Exercise Physiologist with the American College of Sports Medicine and a Certified Sports Nutritionist with the International Society of Sports Nutrition.

So what? Now what?

As firefighters, time is at a premium.  Use Dr. Hirsch's suggestions to optimize VO2Max, body composition, and your health!

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Transcript

Annette Zapp: 0:02

Thank you for joining me on the Fire Rescue Wellness podcast. I'm your host AZ. I find the research and resources and then provide the fire service with the so what? now what? to ensure the health and well being of every member of our profession. Together. Let's thrive. Welcome back again to another episode of the Fire Rescue Wellness podcast. This is episode 18. And we are two days past Christmas if you're listening on the release date. So Merry Christmas to everyone. I am here with my friend Katie Hirsch, Dr. Katie Hirsch to be exact. Katie, say hello to my people.

Katie Hirsch: 0:41

Hello, people.

Annette Zapp: 0:43

Oh my gosh, Katie is so much fun. And I tell everyone in each episode, how I met the person that I'm interviewing, because I'm proud to say everyone that I've interviewed is personal friend. So I met Katie, I think it was in 2016. At the International Society of Sports Nutrition conference when it was held in Phoenix. Katie, do you concur?

Katie Hirsch: 1:10

That seems right. Yes. I think it was definitely at ISSN.

Annette Zapp: 1:16

And I'm pretty proud of myself. Because up to that point, I had been going to conferences for a few years before that. And I would just go to a session, then I'd go hide in my room. And then I go to a session and hide in my room. And so I arrived in Arizona early, and I went out to lunch and I walked back to the venue. And I went to registration and I saw... I had never met Dr. Antonio before. But I saw Dr. Antonio at registration. And I saw this young, bubbly, curly haired girl and I thought I'm just gonna go up and introduce myself. And it was of course Katie Hirsch and we've been friends ever since. So there you have it. So COVID sucke so bad, but there was one thing, a bright shining moment for me in COVID, which was I got to watch you defend your your thesis in 2020. Katie had to defend her thesis virtually. And so I probably never would have gone unless it was virtual. So I got to watch her grow up and become a docto; so awesome. So Katie, let's get started with the really hard questions. Who is Katie Hirsch?

Unknown: 2:31

Oh, man. Well, first, I have to say both of those memories are extremely special to me. I remember meeting you at that conference. And my side of the story was I was just trying to meet people. And so, so excited to just talk to somebody that also wanted to talk to me as a Master's student. So we've maintained friendship for years and then yes, defending was quite the experience, but a total silver lining that I couldn't do it in person, but that everybody could come and see it. And just like you who normally wouldn't be able to see that so that was super special. So who am I I am an exercise physiologist and sport nutritionist. I just started as an assistant professor at the University of South Carolina. I do research that focuses on Exercise and Nutritional strategies to support body composition changes, healthy metabolism, peak performance, whatever look that looks like for you at your age, stage, career, and then overall health. So anything kind of in those realms. And then outside of that I love all things, exercise nutrition myself, and spending time with my kitten. So that's me.

Annette Zapp: 3:58

Katie, I cannot believe I forgot to say this. But in Episode 17, which is releasing or has already been released, it would be December 20. I spoke with Dr. Kelly Kennedy, also with the ISSN. And we shared a funny story. Kelly and I met because of that green ISSN bag. And so I always talk about how the green ISSN bag, and listeners Katie actually gave me this summer at a conference a brand new, like out of the box green ISSN bag. I had a hard time not crying. It was very emotional. So all right. Now we know who Katie Hirsch is what sets your soul on fire.

Katie Hirsch: 4:45

Oh gosh, things that set my soul on fire. I really am super passionate about my research. And I think what I love about it is what I do is very practical and applied I and so I love that I get to ask really deep scientific questions and answer them, but I can explain them to you. And they're things that the average person can understand the average person can care about. We all need exercise nutrition in some capacity. So I love that I can get nerdy and scientific about things myself and dig into those questions, but I can share it with everybody very easily. And so I just love helping people live their best lives, and doing science with other people getting to talk about it super fun for me. So that's what gets me excited.

Annette Zapp: 5:41

And since my tagline on podcast is that I bring in the research and resources and then help the fire service with the so what now what, you are a perfect person to talk to. Very excited. All right, very excited. last big question, Katie, how are you changing the world?

Katie Hirsch: 6:03

Well, that's a very large question. For me, I have big crazy ideas of how I want to do that. But honestly, I just started my career, which is extremely exciting. I've been a student and a postdoc, and training up until this point. And so I'm really excited for the opportunity to to grow into who I am as a researcher, and what that ends up looking like, for what I do and helping other people. So my hope is that I can keep growing in that. And I'm just excited to see where that takes me. I really do feel like there's big things in store. I just don't know what they are yet. So this is just one step in that journey. And we'll see where it goes.

Annette Zapp: 6:50

Katie, I feel like you are one of the...there are scientists out there that are just the bright, shiny stars. And I feel like you're one of those so people keep your eye on Katie Hirsch. Alright, this is the part I've been really excited about Katie, I want to get into the nerd stuff. And I'm gonna have you talk about your research in general. But first, can we get kind of specific Is that okay?

Katie Hirsch: 7:16

Absolutely.

Annette Zapp: 7:17

Okay. One of the things that we know as firefighters from the research is that if we don't have a VO2max of at least 42 to the physiological cost, quote, unquote, of firefighting is really high for us. So first off, can you explain in in terms that would make sense to the typical firefighter? What does VO2max mean in the first place? What does that even mean?

Unknown: 7:49

Good question. So VO2max is kind of our gold standard, our best way to measure your fitness level. And it involves measuring your oxygen consumption. And so the better you are at consuming and using that oxygen to support exercise, the higher your VO2max is. And so there's a lot of physiology and metabolism and things that go into that. But in basic terms, it's just how well can you consume and use oxygen? And so it is our best way to measure your fitness level. Highly associated with disease risk, physical performance, all those kinds of things.

Annette Zapp: 8:31

And what kind of diseases would we be looking at Katie?

Katie Hirsch: 8:35

Oh, gosh, it correlates with any of them. So big ones are going to be cardiovascular, cardiometabolic diseases, diabetes, heart diseases. But even that we see you know, like, with cancer, your chances of making it through treatment, making it through treatment, well are better if we can go into those situations with a higher VO2max or a higher fitness level.

Annette Zapp: 9:03

I don't think I knew that. Katie, that's amazing. So what are some of the factors that can impact our VO2max. So let's just say I went I got it clinically measured. It's inadequate for structural firefighting. What are some of those things that I can focus on that will help me move that needle in the right direction?

Katie Hirsch: 9:28

Yes, so without getting super nerdy, practical things you can do to adjust that score are just gonna be incorporating some consistent exercise. So let's say you're someone that currently isn't doing any form of regular consistent movement. Just getting started with let's go for regular walk. That's going to help start building a good baseline, help improving all of those mechanisms that are going to help our VO2max. And then our body has to be stressed, we need to do different factors to help it grow it like homeostasis or staying right where it's at. So we need to push the body out of its comfort zone a little bit. And so once we've developed a good routine, now you can start adding in different things to challenge the body. So maybe that means we're going to power walk, maybe that means we're going to add in some jogging, maybe that means we're going to add in some cycling, maybe some weight, different things to then start challenging different aspects of the body, a big thing is building up to something a little bit higher intensity, is really going to help push those factors that drive vo to and make us more efficient in that sense.

Annette Zapp: 10:45

That is a really great answer. And so if you're listening, what I want you to take home is that you can just get started, it doesn't have to be something big and elaborate, you can just start with walking. The scientist said so. So Katie, I know that because I know you and I've gone to all of your poster presentations at every conference I've ever been to. And Katie's always so kind, she explains all of her researchin words that Annette can understand. It's, it's amazing. But one of the things that Katie studies is something called HIIT training. And this word HIIT gets thrown around, it gets bastardized a little bit on the social media and in the news. But Katie, can you tell us what actually is HIIT? And then how might it relate to firefighter fitness?

Katie Hirsch: 11:35

Yeah, so I'm a big fan of HIIT training. And it's basic terms, it's any form of exercise that involves periods, short periods of really high intensity, being on a scale of one to 10, about a nine or a 10. Intensity wise interspersed with periods of really low intensity or complete rest. So in the lab, for my research, a lot of times that looks like working hard for one minute, getting your heart rate up, you're breathing heavy, you're working hard. And then one minute of complete rest. And we'll repeat that 10 times. And so this is a really time efficient way to exercise. It's really, if you think about it, only 10 minutes of actual high intensity work. And if we add in a warm up and cool down, we're looking at a 20 minute workout tops. And so let's see with that it's time efficient, we can modify it lots of different ways. And what we see in the research, it's a really, really good way to drive your VO2max to improve your fitness levels in that short amount of exercise

Annette Zapp: 12:53

So especially with a firefighter who might be on time. duty, and there isn't a lot of time. And so one of the excuses we might tell ourselves is we don't have time to train. This is really time efficient. And so is there a particular? So we started talking about about HIIT without defining it. That's my fault, high intensity interval training. Is there a heart rate? Or is there a metric that we're aiming for Katie to get to be able to classify it as high intensity interval training,

Katie Hirsch: 13:32

There's a few ways we can do it. In the lab, I would measure your VO2max and we would try to get you to a level at a certain percentage of that. That's not realistic for the average person to go do. We're not measuring that just in day to day. So you can do a heart rate. The tricky part about heart rate as we get even when we're starting exercise, but as we get more fit, it's going to take a little while for our heart rate to catch up. And so those first few sets, you might feel like you're working really hard, but your heart rate maybe won't get up as high as you think it needs to get to. So we could calculate and say you need to reach 90% of your age predicted heart rate max. But the way I like to do it myself, that's a little bit better, in my opinion, is what I tell people on a scale of one to 10. Your first few hard sets should maybe feel like a seven. Now what happens is because we have those really short periods of rest, you're not going to fully recover in between each part that so the first three, maybe I'm shooting for a seven. The next three should maybe feel more like an eight. The next three should feel like a nine and then my last one should feel like a 10 like I'm going as hard as possible and couldn't go any longer stuff. I kind of follow that scale that helps me manage and stay the right intensity through the whole thing. Now, with time, you do adapt really fast to HIIT, you only need to do it to three days a week, but the body adjusts really quick. The reason for that we're really putting a shock on the system. We're driving adaptation, we're driving metabolism, and the body says, oh, shoot, if we're going to do that, again, I gotta adapt. So the body adapts really quickly. And so one thing we started doing is how do we then adjust this, so it's always a true high intensity. So something you can do on your very last set, give yourself a challenge and say, Okay, how long can I hold this high intensity. So whether you're power walking, jogging, swimming, biking, whatever it is, that last set, go as long as you can, if you can go for longer than about 75 seconds, it's probably in time to increase your intensity a little bit. If you don't go longer than 75 seconds, you can still only do about a minute, you're probably at a good spot, you're able to hold a high intensity through that whole protocol. So again, start at sevens, work to eight, Nines then tens then max it out. Throughout the whole thing, though, it should feel pretty hard, you should be breathing heavy, you shouldn't really be able to hold a conversation. You should be sweating, heart rate should be up all of those types of things.

Annette Zapp: 16:42

I really liked what you said, Katie about you're using the one to 10 scale and having the first sets be a seven, and then an eight and then a nine and then a 10. I've never, I've never actually heard it explained that way before. And that's really smart. I like it, I'm going to integrate it. So I just want to make sure that I'm...I don't want to put words in your mouth. But here's what I think I heard: if we are a firefighter, and we find out that our VO2max is inadequate, we can start pretty simple. If if we're maybe not in great shape, we can start pretty simple. With some walking, we can progress to something a little bit more challenging, whether that be jogging or doing the stairs or something like that. And then we can really drive improvements, in our VO2max, when we're ready with that HIIT. Is that a good summary?

Katie Hirsch: 17:36

That is correct. Absolutely. And, you know, just to add some science with that, the amount of change and VO2max that we see with two and three days a week of HIIT training is the same change in VO2max that we see with traditional aerobic training. So what I tell people with that, that means you can do either modality of exercise. So if you really dislike it, go do the steady training. If you really dislike steady training, go do some HIIT, you're gonna get the same end result. It's just what can we be consistent with? It's also just a little more time efficient. And so a lot of us are battling time and can't always go run for 30-45 minutes every single day. So if I can do HIIT two days a week, and still improve my VO2max that seems like when working smarter, not necessarily harder.

Annette Zapp: 18:37

I love it. Yes. Okay, so I for sure wanted to talk to you about HIIT training. So now we can check that off the list. Let's talk about some other nerdy stuff, some of your research that that you've done in the recent past that may be applicable to firefighters or just interesting and things for us to say. I might want to think about that. What do you got Katie?

Katie Hirsch: 19:03

Oh, gosh, things to think about. Um, so I've done some a lot of work lately on nutrition when you'reHIIT training. Um, so we know HIIT's great, we get all these great adaptations. But we also know we can do things nutritionally, to help drive that adaptation a little bit more even. And so some research that I published in the last couple years, we saw that, with two days a week of HIIT training on a bike, we can drive some muscular adaptation, especially if we include some protein consumption before and after the workout. The amount of muscle we usually think of muscle gain coming from just resistance training, and that's our best modality to gain muscle. But with HIIT training, we were able to increase our muscle in the legs, which as we know is super important for preventing slips, trips falls, for being able to power up stairs carry lots of equipment, and then just overall functionality as we age that we increase muscle mass in the legs, basically the same amount to offset age related loss of muscle. And so if we think about, Okay, again, if we're just trying to get the best bang for our buck, by doing this two to three days a week, adding in good protein right around the workout, if I can improve my VO2max and my leg strength, that's a huge factor for just maintaining good health, especially as we age. And that was in overweight, obese individuals who hadn't been exercising prior to that at all, but were otherwise generally healthy. And so it was really cool. We did this only for eight weeks. So pretty quick increases. Over that time. So many people reported to me even outside the study, you know, they felt like they could get up and down stairs a whole lot better. They could now go on hikes, and they weren't the first ones to tire out. They felt like they could keep going. They felt like they had better energy to play with their children, different things like that. So it all carries over. So back to the real question, getting some protein around, it can definitely help drive some of that muscular adaptation. And you can get even more bang for your buck.

Annette Zapp: 21:42

And Katie, your study was in overweight and obese individuals? Do you know would it be the same results in normal weight individuals or research to be determined?

Katie Hirsch: 21:57

To be determined a little bit? I think these people were relatively healthy. So I think we would tell based on increases, obviously, the more fit you already are probably aren't going to see the same adaptation. The other thing to think about is probably modality of the HIIT training. My guess is because on a bike, there's a lot more resistance, specifically on your legs, we were able to drive that. So something I'm curious to ask down the road is what does that look like with other exercise modalities? What if we know there's good data on HIIT on the stairs? That can drive do too, but does that also promote the same musculature changes that we've seen with the bike? What does that look like? Considering all those kinds of things?

Annette Zapp: 22:46

That sounds like a great study to do on

firefighters: 22:48

HIITon the stairs. Hmm. And also, maybe we could add some creatine? Hmm.

Katie Hirsch: 22:58

All good choices.

Annette Zapp: 23:00

Okay. So Katie, you did your PhD with one of the superstars of the scientific world, Dr. Abbie Smith-Ryan. And if you have looked at my social media, my listeners if you looked at my social media, or read some of my emails, I talk about Abbie Smith-Ryan, or we call her ASR all the time. And so Katie, I know for me, she's just a huge positive influence in my life, a great mentor, and I know she was for you, too. But if there are any young men or women out there listening, what would you tell them about your experience getting your masters then your PhD with Abbie?? Going on to the postdoc? Can you kind of elaborate on that career path a little bit?

Katie Hirsch: 23:52

Yeah, um, gosh, it's been a heck of a journey. And I think back on it all the time. My time at North Carolina was super formative. I'm super lucky to get to work with Abbie. At UNC, I honestly didn't know what I was, like, fully getting myself into, and then quickly realized I had gotten into something really special. So my time there was Abbie, I think, really opened my eyes to body composition. This is a really funny story. I don't always get to share. But I remember as a little undergrad, I knew I liked exercise. I knew I liked nutrition. I wasn't quite sure what a career looked like getting to do both of those. And I was trying to figure that out. And I Yeah, so I didn't know what career but I remember out loud, saying, I don't know what I want to do, but I don't want to do body composition. Um, see. Never say never. Because that's now all at the core of what I do is body composition assessment. But it took going to Chapel Hill to like open my eyes to how we can use body composition, how we can use exercise and nutrition to change it for the better. I'm anybody interested in doing a master's, I talk to students a lot now in my job about that pathway. A master's can open up a lot of doors, I think it's important to find a program that gives you the exposure to what you're interested in. And even if you're not quite sure what that is, finding a mentor doing things you are super interested in, what they're doing their work is going to, that's what you're going to be helping with. So if you can hop in on stuff you're already excited about, that's a win for everybody. Also finding a mentor, who you feel like you can work with, and you have good complementary working styles, and you feel like you can communicate with that communication is so important. And then I, you know, had the amazing opportunity to stay for my PhD. And just continue with what we had been doing. Growing in my research knowledge. I think at that point, I knew research was a good fit for me. And so again, same things I would say for a Master's, but a PhD at that point, you're kind of committing and saying, I want to do research. There's other pathways, you can go with a PhD, but that's what you're going to be trained to be able to do. And so again, finding someone who can help you grow into that give you the exposure, the opportunities, and Abbie pushed me to levels, I didn't totally know where possible. And I grew a lot as a person as a researcher through all of that. And I still, you know, talk to her quite frequently. She's still a big, big mentor and friend in my life. And so then yeah, I went on and did a postdoc and did two more years of some training and a different lab learning other techniques to measure muscle and muscle metabolism and got even more exposure of how do you write grant? How do you manage a lab? What does that look like in different settings? That was at a medical center versus a university setting? And then now here, I am kind of merging all those experience as a professor. So honestly, yeah, wild ride!

Annette Zapp: 27:34

And I was it has been I was I was there with you for just a little bit of it. But that's a wild ride.

Katie Hirsch: 27:40

You were there for most of it.

Annette Zapp: 27:42

With my green bag and very early on!

Katie Hirsch: 27:45

Yes.

Annette Zapp: 27:46

Well, Katie, as you were talking about your research into body comp brought up one more question, which is..Well, first, I'll start with a statement. There's a lot-the vast majority of the fire service is currently overweight or obese. And so body composition? Well, let me back up a little bit. One of the biggest predictors of injury in the fire service is overweight and obesity, as well as a previous injury. So we would be really well served to mind our body composition. And so I know at my department, we have what's called an Inbody. And it's a very expensive piece of equipment that probably not every department has the luxury of having. And there are various other ways to measure body composition. So Katie, can you just riff a little bit on what does body composition even mean? How do you measure it? And then what methods are actually accurate or worth using?

Katie Hirsch: 28:46

Yeah, this is like my favorite thing to talk about after HIIT training. So body composition in really simple terms, it's just what is your body made up of? Most people jump straight to BMI or body fat. BMI is one way to get kind of an idea of your body composition, but maybe not our best way. The BMI says relative to your height what's your weight. What we would expect is that higher than what we would expect or lower than what we can expect. Now we know a lot of times BMI can be wrong, especially in individuals with high muscle mass that start to misclassify. But honestly, by the time we start getting into obese categories, for the average human being, it's probably fairly accurate, as far as like where you fall in category wise. Now, beyond body fat is body composition. There are other components of our bodies. So that's muscle mass, like I mentioned, it's also body water is a really large component of our body and that's important. And so are our bones. And so in the lab, I specialize in a really fancy measure where I account for all those pieces of your body composition. Because that varies by your age, by your sex, by your race, all those different things can influence bone, muscle, water, body fat, all those pieces. Now, that's really only something we can do in the lab, it's really expensive acquires a lot of equipment. So something like an InBody is actually a really great choice. While I was at North Carolina, we did a lot of validation on the InBody device compared to our best way of measuring. And it really does a very good job. Now there's the potential for high variability. So it might tell you, you have, let's say, 25% body fat, that could be plus or minus three to 5%, especially if you're maybe not well hydrated. But if you do the measure hydrated, rested. First thing in the morning, before you eat and exercise really done anything else, it is going to give you a fairly accurate measure. And most importantly, it's gonna be really good for tracking, it is pretty reliable. And so even if it's not exactly spot on, if you're trying to reduce body fat, or change your body composition, it is going to be good for tracking. So just doing it first thing in the morning before any other influencers, it's going to do a good job. The reason I love body comp, and the InBody is good for this too, is I think it's important to not just focus on the body fat aspect, but also the muscle. I know, as a former college runner, I was very wrapped up in what was my weight? What was my body fat, and that's all I really thought about and nobody ever explained to me. I knew muscle was important, but it just never nobody told me like, do I have good muscle mass? Is it higher? Or is it lower? And unfortunately, you don't have awesome ways to classify musculature. However, when you're tracking your body comp, you can kind of tease that out. And so you can see, okay, is my weight changing? If it's not, that might be a good time to look at the components of your body comp, have I gained muscle and lost some body fat, and that's why my weight hasn't changed? Or am I losing musculature and gaining body fat? Where are those two pieces going? A big thing that happens with weight loss, people just focus on the body fat. And so they do things like heavy calorie restriction, and cut out a whole bunch of carbohydrates. And unfortunately, protein gets cut a lot. If all we focus on is restricting and eating less, we do lose body fat, but we also lose muscle and muscle is, not what we want to lose, we want to stay strong muscle drives our metabolism, it's what drives our caloric expenditure. It's what burns body fat, you want to keep that muscle. And so that's where exercise becomes so important during that time. That's where getting good protein becomes so important during that time. So as you're trying to reduce those numbers, you want to make sure that musculature number stays consistent, or increases, most likely, it's going to stay the same, maybe decrease a little bit. But we want to make sure we're not losing large amounts of muscle mass. You know, just I've seen during my time in the lab, you see people that are like, Oh, I've lost a lot of weight. And we get them on the scale. And it's true they have but it come from fat and muscle. And so then when we see their percent body fat, it didn't change because they've lost both. And unfortunately, you can be a quote unquote normal weight individual and still have a high percent body fat, which still puts you at risk for disease. So we need to change that ratio between the two. And that's where I think that body comp tracking helps you see those pieces and just saying, Am I moving those numbers in the direction? I actually think I am.

Annette Zapp: 34:24

I have two thoughts. Katie. The first one is I just gave a talk this morning. And I have a slide in that talk that says Build Muscle like your life depends on it because it does.

Katie Hirsch: 34:33

Yeah.

Annette Zapp: 34:34

It's a little dramatic, but it's also true. I feel validated now. Thank you, Katie. Yes. And then my second piece of it is, you know, it's very difficult. skinfold calipers are difficult for even a skilled operator to get a decent number. So to give the typical firefighter a pair of skinfold calipers and say go measure your colleague's body fat, it doesn't make sense. One of the things that I've incorporated as part of my yearly fitness testing, just as a measure to track is waist to hip ratio. Just because it's simple, it's easy to find the landmarks. And I always track that. But can you give us any insight into why we even started tracking waist to hip ratio? What does it mean?

Katie Hirsch: 35:26

Yeah, so waist to hip ratio starts to get at body fat distribution. And so not only is body fat in and of itself, kind of a risk factor. But maybe even more importantly, is where are you storing that body fat. And so higher amounts of body fat within your abdominal region, called Android patterning, or think Apple shaped, puts you at higher risk for metabolic diseases, cardiovascular diseases, diabetes, all those things we want to avoid. Why? Because that fats not being stored below the skin, like we normally think of body fat, it's being stored within the abdominal cavity, right up next to all of our vital organs. And so it starts to create a lot of pressure and inflammation right there next year organs. And so that form of body fat, much more associated with disease risk than if we're storing it more around our hip region. Some of that's influenced by hormones. So men tend to store more body fat within the stomach region, that's where testosterone tends to direct body fat. Women tend to store more fat around the hip region, that's their estrogen directed body fat. With women now it gets tricky as we age and go through menopause on estrogen decreases. Now we take on a more Android or stomach patterning of body fat. So that's where disease risk and women starts to increase as we get older. That's part of it. So that waist to hip ratio can help you start to see where am I storing that body fat? What might my risk be?

Annette Zapp: 37:09

And you can get one of the great tape measures that make it really easy to to get a great accurate measurement on Amazon for like $4.99. So yes, you can track that metric no matter what budget you have. Outstanding. Well, Katie, I, I have reached the end of my questions for you today. But was there anything that I should have asked you that I just, I missed the boat. And I should have brought up in conversation, anything that you can think of?

Katie Hirsch: 37:40

Well, one thing I was just thinking I should have said at some point, um, with talk of body comp and exercise, I think a lot of people can get wrapped up in body comp numbers. So those are good goals. But recognize that that takes time to change, it's not going to happen. Even in a month, you're gonna see slow, steady progress, and that's gonna stay off longer. But by doing consistent exercise, whether that's your daily walking, incorporating HIIT training, eating healthy, having good healthy muscle, through exercise, and diet helps offset excess body fat. And so if we can keep our muscles healthy, while we're trying to adjust that body fat that helped with disease risk substantially. So our muscle quality is just as important as muscle quantity. That that would be my take on point.

Annette Zapp: 38:41

That was very profound. Muscle quality is just as important as muscle quantity. I like it. Okay.... Well Katie, if any of the listeners want to catch up with you on social media, or if you want to provide an email, are you open to communication from my listeners?

Katie Hirsch: 39:01

Absolutely. send them my way.

Annette Zapp: 39:03

All right, social media, Instagram, is that the one you'd like to use?

Katie Hirsch: 39:07

You can find me on Instagram. You can find me on Twitter. Or you can always shoot me an email.

Annette Zapp: 39:13

All right, I'm gonna put all Katie's contact information in the show notes. And Katie, thank you so much. I've been looking forward to this conversation for a month. And with that, this is AZ. And I'm with Katie and we are officially out.

Katie Hirsch: 39:28

Bye