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Juliet and I are back from a long stretch of travel with a lot to get into. I was inducted into the Best Hour of Their Day Hall of Fame at Affiliate Con in Dallas, but the bigger honor is being in a class that includes our late friend Rob Orlando, who brought strongman training into the modern gym.

Juliet wants everyone to run, not walk, to the theater for the new Elizabeth Holmes documentary, You Can See Everything. She's not wrong.

This week's actual science: we met Rob Leon at The Assembly, whose father is a neurobiologist at UC Irvine, and they're building a product around the connection between smell and brain health. The research on smell loss as a dementia predictor is genuinely surprising.

We also break down the first real study out of California's later school start time law. The results are clear, and the math on what it means for how much sleep kids get is worth knowing.

Plus Weird Longevity Shit, BFR recovery shorts, and some book sequels I've been waiting for.

• Why smell loss may be one of the most undervalued brain health indicators
• What a new study found when they measured California's later school start time law
• The math on how much extra sleep teenagers gained (and why it adds up fast)
• The strongman training legacy of Rob Orlando
• Bryan Johnson's "GLP Brian" and what our crew thinks of it
• How BFR recovery shorts work as a travel-friendly recovery tool

(00:00) Intro + Kelly's Hall of Fame induction

(00:58) RIP Rob Orlando + strongman legacy

(01:55) Elizabeth Holmes documentary, You Can See Everything

(04:23) Caroline at Cal Water Polo + Eszter Varró story

(06:30) Book recommendations: Elder Race sequel + Thricebound Fool

(07:23) Weird Longevity Shit: Bryan Johnson's GLP Brian

(09:09) BFR recovery shorts (HYTRO)

(09:51) The Assembly + Aescape robot massage

(12:28) Memory Air: smell, brain health, and dementia research

(18:43) California later school start times study

(25:30) Upcoming: Eudemonia, Antarctica, Boner Protocol

#BrainHealth #DementiaRisk #TeenSleep #Longevity #RECESS #TheReadyState #SmellLoss

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Women have always trained hard. The science surrounding how they fuel, recover, build bone, and respond to training has had a lot of catching up to do.

In this episode of The Ready State Podcast, Kelly and Juliet sit down with Dr. Kate Ackerman, a triple-boarded physician, former elite lightweight rower, and co-founder and president of the Women’s Health, Sports & Performance Institute (WHSP), to explore what changes when female physiology becomes part of the research question from the beginning.

Kate traces her work back to her own experience making weight as an athlete, then unpacks the evolution from the Female Athlete Triad to Relative Energy Deficiency in Sport (RED-S), including how underfueling can affect hormones, bone, cardiovascular health, injury risk, and performance. She explains why bone health begins much earlier than most people realize, how iron status should be evaluated in athletes, and why RED-S deserves attention in postmenopausal women, too.

They also dig into menopause research, strength training, GLP-1s, and WHSP’s mission to answer the questions women themselves say matter to their health and performance.

• How low energy availability and RED-S can affect bone, hormones, cardiovascular health, injury risk, and athletic performance and why RED-S can occur in both men and women.
• Why adolescence represents such an important window for building bone density, with roughly 90% of peak bone mass accrued by age 18.
• What athletes, parents, and coaches should understand about iron and ferritin, including why one lab value rarely tells the whole story.
• Why RED-S can matter after menopause, even when menstrual-cycle changes can no longer serve as a warning sign.
• How WHSP is approaching unanswered questions around female athletes across the lifespan, from adolescent health and pregnancy to menopause, strength training, hormone therapy, and performance.

(00:00) Intro: Dr. Kate Ackerman & the Future of Female Athlete Health

(04:35) Kate’s journey from collegiate rowing to lightweight competition

(06:04) Making weight, underfueling & Crystal Light cereal

(09:30) Extreme weight-cutting tactics in lightweight rowing

(12:05) When losing your menstrual cycle was a “badge of honor”

(12:44) The Female Athlete Triad & Kate’s experience with menstrual loss

(15:43) Kate’s unconventional path into sports medicine

(16:33) Becoming triple-boarded in internal medicine, sports medicine & endocrinology

(20:50) Understanding the Female Athlete Triad & RED-S

(21:10) Why Kate calls osteoporosis a “childhood disease”

(23:01) How low energy availability affects health & performance

(24:49) RED-S warning signs for parents, coaches & athletes

(29:16) Why WHSP was created & the research gap in female athletes

(30:26) Building a one-stop medical model around the female athlete

(33:33) Moving from reactive healthcare toward prevention & performance

(39:06) Iron deficiency, ferritin & what athletes should know about their labs

(41:26) Why ferritin alone doesn’t tell the whole story

(43:53) WHSP’s research across the female lifespan

(44:51) Menopause, hormone therapy & the questions we still need to answer

(47:16) Strength training, bone health & better markers for RED-S recovery

(48:47) What the Boston Marathon study revealed about underfueling & performance

(53:06) What female athletes say they actually want researchers to study

(55:10) RED-S in postmenopausal women

(56:43) What RED-S can look like without a menstrual cycle as a marker

(58:26) GLP-1s, underfueling & muscle loss

(1:01:02) Strength training research for postmenopausal women

(1:02:16) Kate’s vision for the future of female athlete health

(1:05:34) Infinite Shelf: Ted Lasso & The Nightingale

Huge thanks to our sponsors, BEDGEAR, Momentous, and LMNT.

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Juliet and I just got back from Vancouver and 27 straight days of back-to-back conferences. The shift at the YPO Health Summit from two years ago was striking. The conversation has moved from mitochondrial supplements to something more basic: are you doing the fundamentals? We call this third wave fitness, and it finally feels like we are cresting into it.

Romania's football federation just introduced a Black Card for youth soccer, and it is unlike anything we have seen before. Referees can now permanently end games because of how parents and spectators are behaving. No rematch, no restart, just over. There are also silent game days where adults cannot cheer or coach at all. The whole platform is built around joy, respect, and optimism in youth sports. With Outplay finished and heading to shelves next fall, we are paying close attention.

EC Synkowski's A Good Nutrition Book dropped October 1st. We wrote the foreword to the book because her work and thinking around nutrition have been genuinely transformational for us.

And finally, the University of Liverpool just published the longest randomized trial ever run on diet drinks. The results are going to surprise you, or at least give you permission to enjoy your crispy Diet Coke in peace. We have opinions, a bedazzled can, and an unhinged passion that we can't totally explain.

• Why the YPO Health Summit felt fundamentally different this year and what the return to basics actually looks like in high-level wellness spaces
• What first, second, and third wave fitness means and why the shift matters now
• What's in EC Synkowski's A Good Nutrition Book and why the 800-gram challenge changed how Kelly and Juliet think about nutrition
• How Romania's Black Card system works for youth soccer sidelines and whether something like it could take hold in the US
• What the longest randomized trial on diet drinks found about weight loss and potential harm

(00:00) Intro

(00:24) Empty nesting and an overbooked fall

(01:43) YPO Health Summit Vancouver: the back-to-basics shift

(05:01) First, second, and third wave fitness

(06:32) Rope flow for 100 CEOs, forgotten anniversaries, and 16 years of Mobility WOD

(08:21) Outplay: manuscript submitted

(11:06) EC Synkowski's [A Good Nutrition Book](https://a.co/d/0519vMrI) and the [800-gram challenge](https://thereadystate.com/trs_podcast/ec-synkowski-sustainable-nutrition/)

(13:38) Romania's [Black Card](https://www.nytimes.com/athletic/7586821/2026/09/12/football-black-card-referee/) for youth sports sidelines

(19:15) The diet drink study and the Diet Coke debate

(25:21) Wrap

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What if the fitness metrics you’re obsessing over aren’t telling you what you think they are? HRV. VO2 max. Resting heart rate. Zone 2. Wearables have given us more data than ever… but do you know how to use it to inform your training?

In this episode of the Ready State Podcast, Kelly and Juliet Starrett sit down with renowned strength and conditioning coach Joel Jamieson to cut through the noise around cardiovascular fitness, recovery, and resilience. Drawing on more than 25 years of experience coaching UFC champions, Olympic athletes, special operators, and professional sports teams, Joel explains why a higher HRV isn’t always “better,” what Zone 2 training is really trying to accomplish, and why your aerobic engine matters even if endurance sports aren’t your thing.

They also explore how to balance low, moderate, and high-intensity training, practical ways to measure whether your conditioning is actually improving, and why stress outside the gym has to factor into how you train. The takeaway? Better fitness isn’t about chasing a perfect score – but about understanding what your body can handle, how well it recovers, and how to train accordingly.

• Why a higher HRV doesn’t always mean you’re better recovered
• What Zone 2 training is actually trying to accomplish
• Why cardiovascular fitness is important for improving resilience
• How to balance low, moderate, & high-intensity conditioning
• Why stress outside the gym should influence how you train

(00:00) Intro: Joel Jamieson on HRV & Conditioning

(03:33) The HRV Problem for Midlife Athletes

(05:13) What Is HRV?

(09:41) The Evolution of HRV Tracking

(13:32) What's a Good HRV?

(16:18) Morning vs Overnight HRV

(20:49) Why Higher HRV Isn't Always Better

(24:00) HRV, Resting Heart Rate, & Heart Rate Recovery

(26:50) Chest Strap vs Wrist-Based HRV

(29:33) How to Improve Your HRV

(34:10) How Fast Cardiovascular Fitness Declines

(37:53) Training Intensity Zones Explained

(43:30) Low, Moderate, & High Intensity Training

(45:59) Why Low-Intensity Training Builds VO2 Max

(48:33) Is VO2 Max Testing Worth It?

(51:04) The Cooper's Test

(55:09) How Fast Can Conditioning Improve?

(59:55) Team Athletes & Recovery

(1:01:46) Life Stress, HRV, & Training

(1:04:00) Lifestyle Sets Your Gym Limits

(1:05:21) Infinite Shelf

Huge thanks to our sponsors,Momentous, LMNT, and BEDGEAR.

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This one's a first: Juliet and I are recording from different states. I'm up in Evergreen, Colorado, fresh off the Farren Summit in Boulder, where Juliet and I ended up in the same room as Robb Wolf, John Welbourn, and Andy Stumpf. Felt like CrossFit 2.0.

The American Society of Hematology just raised the diagnostic floor for ferritin from 15 to 30 ng/mL, and if you've ever been told your iron levels are fine while running on empty, this is a massive deal. Juliet shares her 30-year story here, including what finally worked.

Two landmark CTE studies dropped the same week: one out of Australia showing 61% of examined rugby league brains had CTE, and one from the US putting it at 1 in 4 NFL players. We get into what that means for families and youth athletes thinking about contact sports.

Plus a real update on Outplay, our book on youth sports performance for parents, which we are nearly ready to turn in.

• Why the American Society of Hematology raised the ferritin diagnostic floor from 15 to 30 ng/mL, and what the thresholds are for different populations
• How to tell if iron deficiency may be affecting you, low ferritin symptoms, and which tests to ask your doctor about (ferritin, TIBC, CBC)
• Why standard iron treatments so often fail, and what finally worked for Juliet after three decades of trying
• How CTE differs from a concussion, and what two new studies on rugby league and NFL brains actually found
• How families and coaches should think about youth contact sports in light of the new CTE research
• What the Outplay book covers and where it stands in the writing process

(00:00) Intro: first time recording apart, Kelly in Colorado

(00:40) Farren Summit recap and the Boulder trip

(01:13) Kelly's CU Boulder days and the shared senior thesis story

(04:48) CrossFit reunion: Robb Wolf, John Welbourn, and Andy Stumpf

(06:59) Fall travel: YPO Vancouver and the Brett Bartholomew conference

(07:57) Eudemonia with Momentous and the Antarctica trip

(10:24) New ASH ferritin thresholds explained: from 15 to 30 ng/mL

(11:38) Low ferritin symptoms and why standard treatments kept failing: Juliet's 30-year story

(14:35) What finally worked: iron infusions and menopause

(17:26) Which tests to ask your doctor for

(18:24) Kelly's concussion history and CTE intro

(19:24) New CTE research: 61% of rugby brains and 1 in 4 NFL players

(20:02) CTE vs. concussion: what's the difference

(21:37) Youth contact sports and how families should think about risk

(24:27) Guardian caps and other interventions; Eric Freitag episode on concussions, (https://thereadystate.com/trs_podcast/eric-freitag-concussions/)

(26:27) Outplay book update and the Outplay Way card deck

(30:50) Skateboarding as free play, shoutout to Lisa's son Fox:(https://www.instagram.com/p/DdiCvqzp1HL/)

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What does it take to keep someone performing when their job leaves almost no room for downtime? In this episode of the Ready State Podcast, Kelly and Juliet Starrett sit down with longtime friend Dr. Drew Contreras, a retired Army physical therapist who went from supporting soldiers in combat to becoming the first full-time physical therapist embedded in the White House Medical Unit.

Drew shares what he learned caring for everyone from White House staff to Presidents Barack Obama and Joe Biden – and why the fundamentals of human performance matter even more when time is your most valuable resource. From encouraging naps during relentless work schedules to introducing walking meetings at the White House, Drew explains how small changes can help people stay functional under extraordinary pressure.

The conversation also explores the changing role of physical therapy, why PTs should be doing more than treating injuries one patient at a time, and how technology such as digital health and AI could reshape the profession.

• What working with two sitting U.S. presidents taught Drew about keeping people functional under extreme pressure
• Why naps, walking meetings, and other simple interventions can make a major difference during sustained periods of high-stress work
• How physical therapists became a “force multiplier” for keeping soldiers healthy and operational during deployment
• Why Drew believes physical therapists should play a bigger role in performance and musculoskeletal primary care
• Why embracing new technology such as digital health and AI will be essential for the future of physical therapy

(00:00) Intro to Dr. Drew Contreras

(02:55) How a Combat PT Got Handpicked for the White House

(07:00) The Birthday Basketball Game That Started It All

(12:05) Building a Wellness Culture in the White House

(19:15) What Actually Moved the Needle on Health

(22:05) Naps, Walking Meetings, & Reframing Work

(26:30) Deploying as One of the First Combat PTs

(31:00) PT as Human Performance, Not Just Rehab

(33:20) Treating Obama vs. Biden – Different Ages, Different Needs

(38:50) Leading the APTA & Scaling Physical Therapy

(43:45) The Money Problem in Physical Therapy

(53:30) PT as Musculoskeletal Primary Care

(1:00:30) AI, Digital Health, & the Future of PT

(1:04:21) What the Presidency Really Does to a Person

(1:11:30) Infinite Shelf: Legacy by James Kerr

Huge thanks to our sponsors, LMNT, BEDGEAR, and Momentous.

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Juliet and I have been saying yes to everything this fall. We're calling it the Fall Travel Junket, and it's stacked with events from Phoenix to Vail to Antarctica. Follow our Instagram or subscribe to The Ambush for details. And spoiler: you can join us in ANTARCTICA! For real!

We've been watching the new season of Ted Lasso, which is putting women's sports on mainstream television in a way that's hard to ignore. We get into what that means culturally, including who we'd want to see make a cameo.

Private equity is moving into youth sports with the "stay-to-play" model and it's terrible for players and parents. We dig into that, the "pay-to-play" model, what's happening at the policy level, and what parents can actually do.

We close with two Instagram trends that gave us pause: men in the longevity space calling facelifts "aesthetic wellness," and a dating site for people who didn't get the COVID vaccine.

New episodes of The Ready State Podcast drop every Thursday. Subscribe wherever you get your podcasts so you don't miss a thing!

• Why Ted Lasso's new season is putting women's sports inequities on mainstream display
• What the WNBA surge and Copa 71 reveal about the growing appetite for women's sports
• How private equity operates in youth sports through the stay-to-play model
• What New York Magazine and the Denver Post found when they investigated the pay-to-play childhood
• What parents can actually do right now, from supporting Senator Murphy's bill to keeping rec leagues alive
• Why calling facelifts "aesthetic wellness" is a branding problem worth naming
• What "Unjected" is, and what it says about the stranger corners of wellness culture

(0:00) Welcome back + Goings on in Starrett Land: our empty nest and the Fall Travel Junket

(02:10) PT Biz Mastermind and Brett Bartholomew's Non-Superficial Conference

(02:46) The Assembly in Vail, Eudaimonia, and the Antarctica expedition

(04:46) Ted Lasso's new season and the women's sports moment

(06:15) WNBA, Copa 71, and cultural momentum toward the 2027 Women's World Cup

(09:54) Ted Lasso cameo wishlist: Emma Hayes and Megan Rapinoe

(12:45) Private equity in youth sports: NYMag and Denver Post investigations

(13:56) The stay-to-play model and Senator Murphy's bill

(17:24) Free play, skate culture, and why it matters

(20:15) What parents can do: rec leagues, Positive Coaching Alliance, taking action

(22:30) "Aesthetic wellness": men calling cosmetic procedures a health practice

(27:48) Unjected: the dating site for the unvaccinated

(29:52) Outro

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What if the biggest breakthrough in women’s health isn’t a brand-new protocol… but learning how to better apply the fundamentals to the person in front of you?

Kelly and Juliet Starrett sit down with Dr. Abbie Smith-Ryan, professor of exercise physiology and nutrition at UNC Chapel Hill, to explore what the latest research can teach us about training, body composition, creatine, and women’s health across the lifespan. Drawing from more than 15 years in the lab – and her experience as a collegiate runner who suffered 9 stress fractures – Abbie explains how our understanding of female physiology has evolved.

They unpack how women can use body composition data without becoming ruled by the numbers, why creatine may become even more valuable as we age, whether women really need female-specific strength programs, and how to approach HIIT and recovery during perimenopause and menopause.

The takeaway? Human bodies aren’t black and white. And now that we have more tools than ever, the focus should be on finding the ones that work best for you.

• How Abbie’s experience with 9 stress fractures shaped her approach to training, fueling, and women’s health
• Why body composition data can be a valuable tool for tracking muscle, bone, fat, and long-term health
• What the research says about creatine for women, from muscle and hydration to potential cognitive benefits
• Why women don’t necessarily need “women-specific” strength training – and when female physiology should influence how you train
• How to use high-intensity interval training, recovery, and scaling to get results without turning every workout into an all-out effort

(00:00) Intro

(01:43) Meet Dr. Abbie Smith-Ryan

(04:00) Advocating for Women's Health Research

(06:37) Women's Health Research: What's Changed & What's Missing

(11:40) 9 Stress Fractures, Underfueling, & Low Energy Availability

(17:54) Body Composition & Injury Risk

(23:21) DEXA, Bod Pod, & Measuring Body Composition

(30:43) Body Composition for Midlife Women

(35:47) Juliet's Bone Density Loss During Menopause

(37:28) What the Research Says About Creatine for Women

(41:42) Creatine Hesitancy, Myths, & Safety

(45:41) Creatine Loading & the Menstrual Cycle

(48:23) Creatine Dosing: 5g vs 10g & Brain Benefits

(52:32) What's Changed in Athletic Performance

(54:43) Applying Elite Performance Science to Everyday Women

(55:27) Women-Specific Strength Training: Science vs Marketing

(1:00:32) Overcomplicating Exercise

(1:02:16) HIIT, Recovery, & the Menstrual Cycle

(1:04:50) HIIT vs Sprint Interval Training

(1:07:30) The 20-Minute HIIT Protocol: 1 Min On, 1 Min Off

(1:09:48) Abbie's Proof of Practice Podcast

(1:13:49) No Black & White Answers

(1:16:07) Have We Improved Sports Science?

(1:20:23) Infinite Shelf: '90s Rap Music

Huge thanks to our sponsors, BEDGEAR, Momentous, and LMNT.