High Performance Health

Most of us assume that if we look healthy on the outside, our heart is fine on the inside, but today, preventive cardiology dietitian Michelle Routhenstein explains why that's exactly the assumption that gets women into trouble, especially through perimenopause and beyond.
We get into the two numbers your doctor probably isn't checking, ApoB and Lp(a), the first five diet changes Michelle makes with clients to bring down high cholesterol numbers, why stretching may be doing as much for your arteries as it does for your joints, and why blood pressure, not HRV, deserves far more of your attention as you move through this life stage.

WHAT YOU'LL LEARN

●      Why heart disease can silently progress in women who look and feel healthy

●      What ApoB and Lp(a) actually measure, and why they matter more than LDL and HDL alone

●      The first five diet changes to lower high ApoB or non HDL cholesterol

●      Why saturated fat, fiber, and gut health all influence your cholesterol numbers

●      Why blood pressure, not HRV, deserves more of your attention in perimenopause

●      How menopause hormone therapy really affects your cardiovascular risk

●      The minerals your heart needs to keep beating and pumping properly

TIMESTAMPS
00:00 Heart Disease Risk in Women: ApoB, Lp(a), and the Tests Your Doctor Isn't Running
10:18 The Hidden Inflammation Driving Your Heart Disease Risk (And How to Test for It)
19:29 The Truth About Saturated Fat and Cholesterol After 40
22:19 The First Five Diet Changes to Lower High ApoB or Non HDL Cholesterol
29:24 Bloating, Gut Health and Thyroid: The Hidden Heart Disease Risks in Perimenopause
39:41 Why Stretching Might Be Protecting Your Arteries, Not Just Your Joints
51:48 Does Menopause Hormone Therapy Actually Protect Your Heart?
VALUABLE RESOURCES
• Take the BioSyncing Quiz to help you understand what’s actually happening in your body — and how to fix it.

👉 https://biosyncing.scoreapp.com/

 

A BIG thank you to our sponsor who makes the show possible:

• MitoQ - Support your cells at the source with MitoQ NAD+ Dual Action, designed to boost NAD levels and help your cells actually use them for steady energy and sharper focus

👉 https://www.mitoq.com and use code ANGELA for 10% off your first order.

 

ABOUT THE GUEST

Michelle Routhenstein, MS, RD, CDCES, CDN, is a preventive cardiology dietitian and the founder of Entirely Nourished, a nutrition counseling practice specializing in the prevention and management of heart disease. She holds a master's degree in clinical nutrition from New York University and has spent over a decade helping clients improve markers like ApoB, Lp(a), blood pressure, and inflammation through personalized, science-based nutrition. She sits on the medical advisory board of the National Menopause Foundation and works with clients at every stage, from prevention to recovery after a cardiac event.

Website: https://entirelynourished.com/Instagram: https://www.instagram.com/heart.health.nutritionist/LinkedIn: https://www.linkedin.com/in/michellerouthenstein/

Vertical jump improved by over three centimetres in elite soccer players after just six weeks, simply by targeting one overlooked part of cellular biology: the mitochondria. Angela Foster talks with Dr Anurag Singh, Chief Medical Officer at Timeline, about the science of mitophagy, the process that clears out dysfunctional mitochondria, and how the clinically studied compound urolithin A supports it. They walk through real clinical trial data spanning soccer players, elite weightlifters and Olympic-level runners, with a particular focus on findings in women, exploring measurable gains in strength, power and recovery markers like reduced muscle damage and perceived effort. Listeners will learn why mitochondrial renewal takes weeks rather than days to show up, what it actually means when energy dips after stopping supplementation and rebounds on restarting, and why this matters especially for women navigating perimenopause, when recovery and inflammation can shift noticeably. Tune in to understand what's really happening at the cellular level behind your energy and recovery.

KEY TAKEAWAYS

Understand mitochondrial health as a three-stage cycle: biogenesis (creating new mitochondria), fission and fusion (making existing ones more efficient), and mitophagy (clearing out dysfunctional ones). Neglecting that final clearance step is, as Dr Singh puts it, like never taking the garbage out of a cluttered house.

Expect mitochondrial and performance benefits to build gradually rather than instantly. Clinical studies show improved mitochondrial health in muscle tissue after one month, with measurable strength and power gains showing up after two to four months, so don't judge a mitochondria-targeted intervention by how you feel after a week.

Pay attention to recovery markers, not just strength numbers, when evaluating training interventions. In a four-week study with elite runners, those taking mitopure showed lower rate of perceived exertion and lower creatine kinase, a muscle damage marker, suggesting easier recovery rather than just raw performance gains.

Try a deliberate break from a supplement or intervention to gauge whether it's actually working for you. Both Angela and Dr Singh independently noticed an energy dip after stopping urolithin A supplementation, which is a practical way to separate real effect from placebo.

Look for research that specifically includes women, since women are historically underrepresented in supplement and performance studies. Timeline's trials run roughly two-thirds female participants, which matters for understanding how recovery and inflammation patterns shift during phases like perimenopause.

STANDOUT QUOTES

"If we have a super cluttered house, there's only so much we can do to improve it. At one point, we've got to take out the garbage." — Dr Anurag Singh

"Rome wasn't built in a day." — Dr Anurag Singh

"It's the only thing we know outside of exercise and fasting that hits that mitochondria specific autophagy." — Dr Anurag Singh

"I feel like I can do everything and have fun with my kids." — Angela Foster

"That's the reason we're doing all this, right? It's our life. We want to live it healthily, fully." — Dr Anurag Singh

VALUABLE RESOURCES
•  Take the BioSyncing Quiz to help you understand what’s actually happening in your body and how to fix it.
👉 https://biosyncing.scoreapp.com/

Most women think poor sleep is inevitable as they get older. It isn't. It is your stress hormones, your cortisol cycle, and a specific stage of deep sleep called N4, and all three can be addressed. 

I sit down with Dr. Juliane Hellhammer, a psycho-neuro-endocrinologist specialising in stress and sleep, and what he shares will make you rethink everything you thought you knew about rest and recovery. If you have ever woken at 2am with your mind racing, struggled to feel recovered no matter how much sleep you get, or wondered whether your wearable is actually telling you the truth about your sleep quality, this episode gives you the science and the solutions. Because what if the sleep stage that matters most is the one no one is talking about?

WHAT YOU’LL LEARN

• Why perimenopausal women wake up at 2am and what is actually driving it

• What N4 deep sleep is and why it matters after 40

• What destroys deep sleep quality in perimenopausal women and how to fix it

• Can wearables accurately measure deep sleep stages

• What poor sleep does to brain fog and fatigue in perimenopause

• Why trying too hard to sleep is keeping you awake

• What genuinely high quality sleep looks like

TIMESTAMPS

00:00 Why Deep Sleep, Stress & Sleep Duration Matter in Perimenopause

07:48 Why Trying Too Hard to Sleep Is Destroying Your Deep Sleep

13:26 What High Quality Sleep Really Looks Like and The Ancient Ingredient That Improves It

23:20 Why You Wake Up at 2–4am in Perimenopause and How to Fix It

27:34 Top 3 Evidence-Based Upgrades for Sleep and Recovery

30:25 How to Use the Sleep Well Supplement for Best Results

VALUABLE RESOURCES
•  Take the BioSyncing Quiz to help you understand what’s actually happening in your body and how to fix it.
👉 https://biosyncing.scoreapp.com/

 

ABOUT THE GUEST
Dr. Juliane Hellhammer is a psychoneuroendocrinologist, PhD researcher, and Founder and CEO of daacro, a specialist clinical research organisation based in Trier, Germany, focused on stress, sleep, and psychobiology. With decades of experience running clinical trials on how chronic stress and cortisol impact health, she is one of Europe's leading experts on the physiological relationship between stress and sleep disorders.

Try Sleep Well Dissolvable Granules: https://www.avogel.co.uk/herbal-remedies/sleep-well/
Website: http://www.daacro.com

LinkedIn: https://www.linkedin.com/in/juliane-hellhammer-phd-38865232/

Why Wearing Sunscreen All Day May Be Doing More Harm Than Good for Women Over 40

In this thought-provoking episode, Angela Foster sits down with renowned beauty expert and author Liz Earle MBE to challenge conventional wisdom about sunscreen and sun exposure. Liz discusses why current public health messaging around universal, all-day SPF use might be too extreme, potentially robbing us of vital Vitamin D and other essential benefits of natural daylight.

KEY TAKEAWAYS

Many people assume they still get Vitamin D while wearing sunscreen. However, Liz points out that this only happens because most people apply it too thinly or miss spots. 

Applying high SPF when it is completely unnecessary, like on a dark winter morning during an underground commute, is a sign that public health messaging has become too broad. 

Our skin isn't just a physical barrier; it actively receives light and communicates with the body's immune system. 

Exposing your skin to gentle, early-morning sunlight (when the UV index is low) acclimatizes it. 

Medical professionals and researchers are beginning to speak out against extreme sun avoidance. 

BEST MOMENTS

"When people say, 'Yes, you get Vitamin D from the sun when you're using sunscreen,' yeah, because you're not using your sunscreen properly. You're actually allowing some of that UVB to come through the skin."

"The worst thing that we can do is stay indoors all year and then rush out for our two-week summer beach holiday and fry ourselves on the beach... That's because our skin has not got used to the sunlight."

"The skin is actually an organ of light reception. This is what we're just beginning to understand, that the skin has light receptors on it for reasons—they're signaling, it's not just blocking and keeping our insides intact."

"I don't know if you take collagen supplements, I do, but actually by going out in early morning light, I'm telling my body to make more collagen. So it's preparing the skin."

"He says that he thinks that we will look back at this time and our lack of sun exposure as being as damaging to our health as smoking."

VALUABLE RESOURCES

• Take the BioSyncing Quiz to help you understand what’s actually happening in your body — and how to fix it.

👉 https://biosyncing.scoreapp.com/

A BIG thank you to our sponsors who make the show possible:

• Timeline - Support your mitochondrial health: Timeline Mitopure delivers Urolithin A at the clinically studied dose to support cellular renewal and energy production, helping counter the natural decline in mitochondrial function that comes with age.

👉 Get 20% off Mitopure when you visit http://timeline.com/ANGELA and use code ANGELA.

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Most women in perimenopause are training hard, eating well, and still dealing with joint pain, stiffness, and injuries that never fully heal. Juliet Starrett, New York Times bestselling author and co-founder of The Ready State, joins me to reveal why the joint pain and stiffness so many women write off as ageing is actually a specific syndrome nobody warned you about. We get into what 30 minutes of floor sitting a day can do for your hips and low back, why most exercise routines are silently narrowing your range of motion, and the five weekly movement non-negotiables Juliet recommends for every woman over 40.

WHAT YOU'LL LEARN

• Why perimenopause triggers joint pain, frozen shoulder, and mobility loss

• How 30 minutes of floor sitting a day rewires your hips and reduces pain• Best movement habits for women over 40

• How strength training may be stealing your flexibility over time • How to train through injury without making it worse

• The HRV myth debunked and what to track instead

VALUABLE RESOURCES

• Take the BioSyncing Quiz to help you understand what's actually happening in your body and how to fix it.

👉 https://biosyncing.scoreapp.com/

A BIG thank you to our sponsors who make the show possible:

• Timeline - Support your mitochondrial health with Urolithin A at the clinically studied dose to support cellular renewal and energy production, helping counter the natural decline in mitochondrial function that comes with age.

👉 Get 20% off Mitopure when you visit http://timeline.com/ANGELA and use code ANGELA.

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

ABOUT THE GUEST

Juliet Starrett is a New York Times bestselling author and co-founder of The Ready State, where she and her husband Dr. Kelly Starrett have spent decades helping people move better, hurt less, and stay physically capable as they age. Their work focuses on making mobility and strength training practical and accessible for anyone dealing with pain, stiffness, or the feeling that their body is working against them.Website: https://thereadystate.com/Instagram: https://www.instagram.com/julietstarrett/YouTube: https://www.youtube.com/@TheReadyState