TODAY'S AJENDA #71

Recently, I had the pleasure of spending some time with Clare Farrell, Head of Nutrition for one of the most highly ranked sports teams in the world: Liverpool FC. 

Fresh off their Premier League Championship season, Liverpool’s Clare Farrell answered some of your questions about nutrition. Clare’s job is to fuel elite multi-million-dollar soccer (football if you’re British 😉) players, but today, her expertise benefits Ajenda subscribers!

Get ready to unleash your inner elite athlete: 

What’s your take on intermittent fasting for women over 40? Specifically, does training while fasted help or hurt weight loss and muscle building? 

I believe there is a time and a place and a specific population suited to intermittent fasting. 

With the athletic population I predominantly work with who have high recovery and performance demands, I do not recommend intermittent fasting as the athlete’s bodies are in constant fuel and recovery mode (with the exception of working with athletes during the Ramadan period). 

For active women who regularly train, wishing to maintain and/or support muscle mass growth and development, fasting can be tricky as it limits the ‘feeding’ window when total daily calories and total daily protein must be consumed in a short period of time (i.e., 6 hours). 

Without a structured and well-planned nutrition strategy, it is difficult to consume the correct amount and split of micro and macronutrients in this feeding window. Intermittent fasting may also not be suitable for women who like to have regular light meals, snacks, and generally feel hungry throughout the day. Fasting can heighten cravings, which may result in the overconsumption of calories. Therefore, it’s counterintuitive for those wishing to lose body weight or fat. 

If you’re a non-elite athlete, should you add electrolytes to water? Or is plain water enough for adequate hydration? 

Electrolytes (minerals like sodium, potassium, and magnesium) help regulate your body’s fluid balance. Both athletes and non-athletes need to replace electrolytes in three scenarios: 

1. Heavy Sweating: From doing high-intensity exercise, being in hot and humid environments, or fluid loss due to fever. 

2. Illness: In the unfortunate case of a gastrointestinal bug, we lose electrolytes through vomiting and diarrhea. 

3. Heat: If you’re traveling or in a hot climate, you’ll need electrolytes to regulate the amount of water in your body and prevent dehydration (as well as overhydration!). 

To replenish your body’s electrolytes, use an electrolyte product or consume salty snacks and/or meals such as salted crackers, chicken broth, or add salt (sodium) to meals. 

Recently, I’ve noticed that electrolytes are becoming a trendy habit. However, you can overdo it. This can lead to laxative effects, electrolyte imbalance, and high sodium levels, especially if you’re someone who has a heavy hand with salt at your meals! 

What’s your go-to, post-workout recovery meal? 

I typically train in the mornings, so I love an egg breakfast. The versatile egg has so many great protein-rich meal options: poached, scrambled, hard-boiled, French toast and omelettes, the latter being my favourite. I also add carbohydrates to refuel the muscles (such as toasted sourdough bread).  

• Pro Tip: As the intensity and duration of your training increase, so should the quantity of carbohydrates in your recovery meal. 

The last piece of the plate puzzle is adding color. Go with either fruit or vegetables. I opt for spinach and peppers in my omelette, served with sliced cherry tomatoes and drizzled with balsamic vinegar and a pinch of black pepper. 

What’s your opinion on protein sources: animal or plant-based? And do you follow the standard 1.6 grams per kg of body weight daily, or go higher? 

Animal protein (such as poultry, fish, meat, and dairy) contains all the essential amino acids your body needs. It gives you more bang for your buck when it comes to the quantity of protein per gram of food. 

On the other hand, you’ll find lower amounts of protein in plant sources, including pulses, legumes, nuts, and seeds (the best plant sources are tofu and tempeh). Therefore, pairing different plant options together is beneficial. 

• Here’s what I recommend: A diverse diet with as many different foods and colours as possible. Include both animal and plant sources if you can. If you’re solely relying on plant sources, you’ll need a plan to ensure you’re hitting your daily requirements. 

Like most answers in nutrition, no one (protein) size fits all. It depends on body weight, body composition, training load, and recovery demands. But typically, that number falls within the range of 1.6g-2g of protein per kg of body weight. 

What do you think is the biggest nutritional mistake non-elite athletes make?

When people whose goal is to reduce body fat skip meals and snacks to reduce the daily calories consumed. Some believe that replacing food (usually breakfast and lunch) with coffee will do the trick. 

This can work in the short term. However, your energy levels will crash, and your body will start conserving energy by moving less throughout the day. Therefore, you burn fewer non-exercise calories (NEAT or Non-Exercise Activity Thermogenesis). 

By evening, your cravings become heightened and your energy levels are depleted. This increases your risk of overeating/binging on energy-dense snacks. 

While a calorie deficit (consuming fewer calories than you burn) is needed to reduce your body fat, a more sustainable, longer-term approach is to find a solution that fits your routine and schedule. That’s how you can curb cravings and maintain energy levels that let you perform your best, whether that’s at work, at home, or in training. 

^{Clare Farrell, Head of Performance Nutrition, Liverpool FC - Clare Farrell is currently the Head of Performance Nutrition with the first team at Liverpool Football Club. Her role oversees nutrition strategies at the club to support the players' health, performance and recovery around training and matches. Additionally, Clare works with players on a one-on-one basis to individualise their training and game-day fueling, recovery and supplement routines according to their specific positional demands and/or goals.}

If you’ve been doing everything “right” (expensive moisturizers, serums, eye creams) but your skin is still dry, dehydrated, and just blah, I’ve been there. 

I used to be so focused on what I put on my skin that I totally missed what was happening underneath. But it’s what’s happening underneath that can make all the difference between dull and dewy skin. 

So today, I wanted to share the two products that I use and love that target your skin from the inside out: Pique’s BT Fountain Ceramide Powder* and ReFountain Triple Biomaxed Magnesium. 

ReFountain: Why Three Forms of Magnesium Matter

Before we even get into products, let me be clear that great skin is mostly genetic. And while we can’t control who wins the genetic lottery (I wish), we can control the second biggest factor for clear skin: sleep. 

• Science Says: Poor sleepers show more signs of skin aging, have weakened skin barriers, and take longer to recover from sun damage. 

As women, we face nearly double the risk of insomnia compared to men. And this ratio worsens as we age due to the unique biological and hormonal changes we experience (thank you, menopause…). 

That’s why we talk about an inside-out approach to radiant skin; it begins with sleep. Enter: Pique’s ReFountain Triple Biomaxed Magnesium. Magnesium is involved with over 300 (!) biochemical processes in your body, including sleep, stress, energy, and even building strong bones. 

• Science Says: A 2012 study of 46 older adults with insomnia took 500mg of magnesium for 8 weeks and fell asleep faster, slept more efficiently, and had lower cortisol (stress hormone). 

Pique’s ReFountain Triple Biomaxed Magnesium combines three types of magnesium to promote deep and restorative sleep: 

• Magnesium Glycinate is bound to glycine, an amino acid that supports relaxation and sleep. It’s the most calming form and is easy on the stomach.

• Magnesium Taurate combines magnesium with taurine, which has been shown to support heart rhythm and calm the nervous system.

• Magnesium Malate helps with energy production and muscle recovery, making it ideal if you’re dealing with fatigue and tension.

Each form of magnesium absorbs differently in the body and affects different systems. But instead of having to get three separate supplements, Pique’s ReFountain Triple Biomaxed Magnesium has them all in one convenient sachet. I drink it every night and it helps me stay relaxed and sleep deeply! 

BT Fountain: Hydration Starts on the Inside

Aside from sleep, staying hydrated is the next most important step for radiant skin. The skin is your body’s largest organ, and like every other organ, it needs water to function. 

But as we age, our hormones work against us. During perimenopause and menopause, estrogen drops, and our skin becomes dry, dull, and itchy (the worst). 

This is why even the most expensive moisturizer won’t cut it. That’s where Pique’s BT Fountain Ceramide Powder comes in. 

This beauty powder blends phytoceramides, hyaluronic acid, and electrolytes. Instead of topical serums that just sit on your skin, this blend works systemically. 

Here’s the science behind it: 

• Hyaluronic acid is a moisture magnet that can hold 1,000 times its weight in water. By drawing hydration into the skin, it visibly helps plump fine lines. 

• Electrolytes regulate the balance of fluids in your cells, making it easier for your skin to retain moisture. 

• In a randomized double blind placebo clinical trial (the gold standard of clinical trials), Pique’s blend of ceramides improved skin elasticity by 26% and hydration by 21% after 60 days. 

My Take?

Your skin doesn’t care what the latest trending product is. It only cares that you take care of the basics: sleep, hydration, and barrier function. 

Both BT Fountain and ReFountain Triple Biomaxed Magnesium were designed with those fundamentals in mind. They aren’t magic bullets, but they are smart, evidence-based tools. 

So if you're looking to glow more and stress less this summer, a glass of ceramides in the morning and magnesium before bed might just be the solution your skin (and mind) have been waiting for. You can find both in Pique’s Deep Hydration Protocol, and Pique is offering Ajenda subscribers 20% off for life, plus a free gift, when you subscribe. (Yes!!!)

Here’s to nourishing both the nervous system and skin barrier from the inside out! 

Why do some women develop heart disease despite having “perfect” cholesterol numbers? The answer may lie with a type of cholesterol that’s genetic, overlooked, and could change how you approach heart health. 

First: What’s Lipoprotein(a)? 

Introducing: Lipoprotein(a). Lp(a) is a type of “bad” LDL cholesterol that carries an extra protein called apolipoprotein(a). 

That added protein makes it stickier than LDL, which also makes it more dangerous. High levels of Lp(a) promote plaque buildup and blood clots, raising your risk of heart attack, strokes, and aortic valve disease. 

• Science Says: High Lp(a) (around 150mg/dL) is associated with up to a 2-3-fold increased risk of coronary artery disease. 

Lipoprotein(a) Isn’t In Your Standard Blood Test  

Here’s the thing: standard blood tests don’t measure Lp(a). They typically check your: 

• LDL

• HDL

• Triglycerides 

• Total cholesterol

These markers can all be improved with diet, exercise, and medication. But Lp(a) is different. It’s genetic and doesn’t respond to lifestyle changes (read: no amount of spinach or cardio will budge these numbers). 

That’s why some doctors skip testing as they assume there’s “not much they can do.” The problem with that logic is that it means you could walk out of your doctor's office with "excellent" cholesterol numbers while carrying a cardiovascular threat. 

And it’s not that uncommon, either! About 1 in 5 people have elevated Lp(a). 

Should You Get a Lipoprotein(a) Blood Test? 

The American Heart Association and American College of Cardiology now recommend that everyone get tested for Lp(a) at least once in their lifetime. But it’s especially if you check any of these boxes: 

• Elevated LDL despite aggressive treatment 

• A family history of premature heart disease or stroke (e.g., your parents had a heart attack in their 40s or above) 

• Personal history of cardiovascular disease without traditional risk factors

• You’re in that frustrating “borderline” zone where your doctor isn’t sure if you need medication (such as statins). 

At the end of the day, there’s no harm in getting an Lp(a) test. It’s relatively inexpensive (about $30 if you pay out of pocket), and many major labs (Quest, LabCorp) offer it. 

What To Do After Getting The Lp(a) Test

Let’s say you do have elevated levels of Lp(a). Now what? 

Unfortunately, there aren’t any FDA-approved medications specifically to lower Lp(a)...yet. Drugs like pelacarsen (an antisense oligonucleotide currently in phase 3 trials) are showing real promise in lowering Lp(a) by up to 80%. Many cardiologists feel this drug COULD be approved later this year. Stay tuned.

While we wait for new treatments, here’s how to control your risk:

• Do more frequent check-ups and monitoring 

• Consider advanced testing (like a CAC test!) 

• Get your LDL cholesterol as low as possible

• Quit smoking and maintain a healthy weight

And don’t forget to tell your family members (remember, Lp(a) is genetic!). While you can’t change your Lp(a), you can control other factors that make a real difference. 

So, should you get the test? If you haven’t yet, then yes. Knowledge is power when it comes to your heart. And for women in midlife who are often underserved in cardiology, the Lp(a) test lets you take control.

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ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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