0:05

Hello and welcome to Ultimate Health Podcast Episode 572.

0:07

I'm Jesse Trappist and I'm here to

0:11

take your health to the next level. Each

0:13

week I'll bring you long form conversations with

0:15

health and wellness leaders from around the world.

0:18

Today you're getting a deep dive with Cynthia

0:20

Thurlow. Cynthia is a nurse

0:22

practitioner, author of the bestselling book

0:24

Intermittent Fasting Transformation, a two-time

0:27

TEDx speaker with her second talk having more

0:29

than 14 million views and

0:32

the host of Everyday Wellness Podcast. On

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today's episode you're going to learn

0:37

about the biggest intermittent fasting mistakes,

0:39

the fasting benefits of spermidine and

0:41

berberine, how Cynthia breaks a

0:43

fast, what is insulin sensitivity plus

0:45

why it matters, what

0:47

is autophagy, how to approach

0:50

fasting as a woman going through perimenopause,

0:53

fasting and menopause, building muscle

0:55

is critical for metabolic health, the

0:57

difference between intermittent fasting for men and

1:00

women and so much more. As

1:02

always if you'd prefer to watch versus

1:04

listen this full episode is available over

1:07

on YouTube. You can get there by

1:09

going to ultimatehealthpodcast.com/YouTube. Be sure and subscribe

1:11

while you're there. You don't want to

1:13

miss anything. If as you're listening

1:15

to this episode you can think of somebody in

1:17

your life that could benefit from this information, give

1:20

the episode a share to them, help them along

1:22

their health journey and I thank you so much.

1:25

Here we go with Cynthia Thurlow. Insulin

1:27

sensitivity, this is something that you keep bringing up.

1:30

Talk about what that is and why it matters.

1:33

So insulin is this wonderful hormone

1:35

that has largely gotten a really

1:37

bad rap because

1:39

of this metabolic health base and you

1:41

know seeing all these escalating rates of

1:43

insulin resistance and type 2 diabetes and

1:46

PCOS and all these other metabolic diseases.

1:49

But insulin sensitivity really comes down to

1:52

when you eat a meal depending

1:54

on what macronutrients you've consumed, protein,

1:56

fat or carbohydrates. Understanding that fat

1:58

has the most negligible impact

2:00

on blood sugar and subsequently

2:03

insulin, then protein, then carbohydrate.

2:05

So if you eat a bowl of ice cream,

2:07

oh that's not a good, so you sit down and eat a bowl

2:09

of chips, you're gonna get a much

2:11

more exaggerated blood sugar response and insulin response than

2:13

if you eat, I don't

2:16

know, you eat a stick of butter. I don't know anyone that

2:18

would do that but let's just use that as an example. And

2:21

then understanding that if we are in a

2:24

state where we're eating like a

2:26

standard American diet where we're eating every two

2:28

to three hours, we're having snacks, we're having

2:30

mini meals, we're eating six to ten times

2:33

a day, that's six to ten times a day that

2:35

your blood sugar goes up in response to the

2:37

meal or the snack. Your insulin levels go up

2:39

in response to what you've eaten and

2:42

you're not really giving your body time to bring

2:45

that blood sugar and insulin back down. And

2:47

when your insulin levels remain high, you

2:50

are not able to tap into fat stores for

2:52

energy. And over time, if

2:55

insulin is, you get kind of

2:57

this buffering effect, you know, insulin's

2:59

a hormone and it's designed

3:01

to shuttle blood sugar into

3:03

cells. But if over time, it's

3:06

over overwhelmed, overworked, your

3:08

cells will actually get

3:10

resistant to the lock

3:12

and key mechanism that goes on with

3:14

this hormone. So instead of shuttling insulin,

3:17

sorry, instead of insulin doing its job to

3:19

take blood sugar and put it in the

3:21

cell, it just continues to circulate. So

3:23

then you're dealing with these correspondingly,

3:26

usually symptoms, you know, these are individuals and

3:28

they have things like a storage

3:30

problem with blood sugar in their liver called

3:33

Nafl-D, non-alcoholic fatty liver disease.

3:35

They can have skin tags, they may be

3:38

urinating frequently, they may have changes in their

3:40

vision, they may have kidney issues, they

3:42

may become, they will become weight loss resistant over

3:45

time. They may develop

3:47

high blood pressure, they may have high triglycerides and

3:49

low HDL. And there's a lot of different metrics

3:51

that we can kind of look at to turn the

3:53

lever to kind of look at, you know, is there

3:55

some degree of insulin resistance? But insulin

3:57

resistance all comes down to this

3:59

communication. problem of getting your blood sugar,

4:02

taking that glucose molecule and moving

4:04

it into into the cells intracellularly.

4:07

And if you're eating all that, if you're eating

4:09

frequently, then you're making it harder for your body to

4:11

be able to properly regulate

4:13

these hormones. Now if

4:15

you're eating two times a day,

4:17

three times a day, not snacking in between, your

4:20

body can work much more effectively. It goes,

4:22

you know, you eat a meal, you have

4:24

this bolus of protein and carbohydrates, blood

4:26

sugar goes up to accommodate, insulin goes

4:29

up, comes back down, you have a

4:31

load insulin, a lowered insulin state throughout

4:33

the day in between meals. You very

4:36

likely are not falling asleep, you're very

4:38

likely not having energy crashes, you have

4:40

sustained energy, you've got very

4:42

clear cohesive thoughts, you're

4:45

not weight loss resistant, generally speaking. And

4:48

so it's really under, it's really helpful to understand

4:50

that there are many lifestyle meeting things that

4:52

we do that impact how sensitive

4:54

our insulin is in terms of

4:57

communication with our cells. Things like meal

4:59

frequency, stress, for

5:01

quality sleep, exposure to

5:03

toxins, over exercising or you

5:05

know not properly fueling your body doing you

5:08

know chronic cardio, which I'm sure I'll probably

5:10

get hate mail over. But

5:12

it's important for people to understand there's a lot that we have under

5:15

our control, but it really

5:17

starts with understanding that insulin is our

5:19

friend, it is not a bad hormone,

5:22

sending with blood sugar. Glucose is not

5:25

an enemy either, but it's

5:27

our modern day lifestyles and the ways that we

5:30

eat that are negatively impacting these

5:32

hormone pathways and our ability for

5:35

our bodies to be able to

5:37

effectively lower our blood sugar,

5:39

move the blood sugar into the cells,

5:42

properly regulate these these key hormones.

5:44

I mean there's a lot more that

5:46

goes on, but I would say that's kind of like

5:48

the basic thing. So when I talk about metabolic flexibility,

5:50

it's our body's ability to effectively

5:52

free up both stored sugar and

5:55

stored fat as a fuel source and that's

5:57

what happens when our insulin levels are low.

6:00

As we are becoming more metabolically flexible, our

6:02

body can decide, do I need, am I

6:04

being chased by a rabid animal and I

6:06

need to flee? I need quick energy. I'll

6:09

use those carbohydrates. Nope. I need

6:11

to run a marathon. I'm going to actually,

6:13

or I need to, you know, be very

6:15

focused on intense intellectual work.

6:17

I'm taking an exam. Okay,

6:19

then, you know, what's going to happen is your body is

6:21

going to go in and free up these fatty acids or

6:25

even another fuel substrate or ketones,

6:27

which actually diffuse across the blood-brain

6:29

barrier and our brains really like fat.

6:31

So a lot of what

6:33

goes on in terms of, you know, doing

6:35

this switch of talking about metabolic flexibility

6:37

is understanding that we have a lot under

6:39

our control, but so much

6:41

about insulin sensitivity is a byproduct of

6:44

our lifestyle. So there's a lot that we can do. I

6:46

want to make sure I make that message very clear. There's

6:49

a lot we can do to improve this. It's not a,

6:51

you know, once you are no longer insulin

6:53

sensitive, that that's a, you know, do or

6:55

die. It's really, that is reversible. Metabolic

6:58

diseases, most chronic diseases are

7:01

completely reversible, but you have

7:03

to do the work. And this ties back

7:05

to what we talked about before, where insulin

7:08

is more sensitive at night versus

7:10

earlier in the day as a general statement, overlying

7:13

what you just said. Yeah, so

7:15

we're much more insulin sensitive earlier in the day.

7:17

That's much more aligned with this kind of chronobiologic

7:20

rhythm in our bodies. So

7:22

if you're going to have those carbohydrates, I always say, you

7:24

know, have them in the morning or early afternoon. Don't

7:26

sit down and have, my teenagers do

7:29

this, but like adults shouldn't do this, like

7:31

this massive bowl of pasta with a teeny

7:33

tiny piece of like protein. Don't

7:35

have that right before, because that's

7:38

going to make it harder for your body to actually

7:40

process this massive bowl of carbohydrates,

7:43

process carbohydrates very different than having

7:45

a sweet potato or, you know,

7:47

an orange or, you know, a bowl

7:49

of berries. Very, very different. I may

7:51

have said that backwards. You're more insulin

7:53

sensitive in the morning, less at night.

7:56

Yes, I knew what you meant. Let's

7:58

talk about somebody who... in general

8:00

has lost that sensitivity. This

8:03

ties back to the fasting and some of the

8:05

other things we've been talking about. But

8:08

let's give them a handful

8:10

of things they can do to start off in

8:12

a really general sense to work their

8:14

way back in the beginning. Yeah, I

8:16

think this is important for people to know

8:19

that there's definitely a path back. So number

8:21

one, prioritize protein. It will keep you satiated.

8:24

Number two, if you know that you

8:26

are, if you've lost a degree of insulin

8:29

sensitivity, be mindful of your carbohydrate

8:31

intake. And by that I mean, maybe you

8:33

need to measure your carbohydrate. Maybe you have a

8:36

quarter cup of berries. I know this will make

8:38

people mad. Maybe you have half a cup of sweet potato.

8:40

I mean, you really do have to be mindful. I

8:43

would say intermittent fast. You're starting with

8:45

ripping off the band-aid and stop

8:47

snacking, don't eat after dinner.

8:51

Maybe you start with 12 or 13 hours of

8:53

fasting. We know even that confers benefits. I would

8:55

say 12 hours should be the norm for everyone,

8:57

irrespective of what life stage they're in. So

9:00

some degree of intermittent fasting, making

9:02

sure you're sleeping. Like we know if you get

9:04

less than six hours and they have sleep, you

9:07

reduce your ability to control your blood sugar and

9:09

mitigate your blood sugar by up to 60%. It

9:11

also impacts your leptin and ghrelin,

9:14

appetite and satiety hormones, which is really

9:17

important. I would say

9:19

hydrate, move your body. Like

9:21

even 10 to 15 minutes of walking after

9:23

a meal will help mitigate your

9:25

blood sugar response. Like that should be a bare

9:27

minimum. I used to

9:29

make fun of these couples in my neighborhood that would

9:31

walk in the evening. Now we become

9:34

those couples, but it's really because we know there's

9:36

so many benefits. I mean, literally all you need

9:38

are shoes to be able to

9:40

walk after a meal. Like get outside, walk

9:42

for 10 or 15 minutes. I don't care how cold it

9:44

is. Put a hat on and gloves and

9:46

a jacket. Or

9:49

if you wanna really evoke some hormesis, maybe you

9:51

can be like my husband, he wears like sweatshirts.

9:53

I'm like, have you turned into a teenager? Like

9:55

my teenagers are impervious to coats. And so

9:57

is my husband as of late. So walking after a meal.

10:00

I think the other thing is

10:03

to get hormone levels checked. I think

10:05

this is very important,

10:08

not just sex hormones, but get a fasting

10:10

insulin checked. Everyone listening should have

10:12

a fasting insulin drawn a couple times a year.

10:14

It gives you a real sense of where you

10:16

need to be and we know a fasting insulin

10:19

will dysregulate way before your

10:21

blood sugar, way before that A1c

10:23

that everyone likes to perseverate over.

10:26

Look at inflammatory markers. A

10:29

fasting insulin is cheap. If you have someone

10:32

that's not willing to draw it,

10:34

it's anywhere from $15 to $20 based on

10:37

what I've seen online. It's

10:39

not a functional medicine test. It's not an expensive

10:41

test, but I think it can be very helpful

10:43

and I always say knowledge is power. Then the

10:46

last thing is understanding that stress

10:50

also impacts blood sugar, also

10:52

impacts cortisol, also impacts insulin

10:55

and trying to manage your stress. I'm not saying like a

10:58

little bit of stress is good. Stress

11:00

is normal, right? But if

11:02

you have chronic unrelenting uncontrollable

11:04

stress and it starts in the moment

11:07

you get up in the morning to the moment you go to

11:09

bed, you got to change something. I don't care if

11:11

it's you take five minutes at the end of your

11:13

day to read a book locked in your

11:15

bathroom because you've got little kids. I

11:17

remember those days. Maybe it's you

11:20

get you higher a sitter so that you have an

11:22

hour to yourself once or twice a week if

11:24

you're a single parent or you don't have

11:26

a lot of family support. But

11:29

finding the time to be able to prioritize doing something

11:31

that brings you to a way is

11:33

going to be very, very important. I

11:36

think those are the things I'd probably start with because I

11:38

know we started the conversation saying it's

11:40

overwhelming when you think about all the things,

11:43

but it really does start with food. What

11:46

we eat and when we eat really matters. Those

11:49

two metrics alone can have

11:51

a profoundly impactful impact on

11:54

blood sugar variability as well as insulin

11:56

sensitivity. I want to highlight something

11:58

you brought up there that's really important. the fact

12:00

that getting an insulin

12:02

test done fasted, the importance

12:05

of that, because what can

12:07

happen in the body, if you're

12:09

only measuring blood glucose and then

12:11

using that as your measurement of

12:13

your metabolic health, over

12:15

time as you're becoming more insulin resistant,

12:17

the body's just going to make more

12:19

insulin to keep that blood glucose at

12:21

bay. And if all you're measuring is

12:23

the glucose, you're going to think you're fine. But

12:26

in the background, for years and years, you

12:28

can be insulin resistant and

12:31

all kinds of health complications can be happening in

12:33

the background. Yeah, I think,

12:35

you know, when I finished my nurse practitioner

12:37

program, back in the 2000, 2001

12:40

timeframe, we used to say that

12:42

patients with the blood sugar under 140 were good. Now

12:45

it's under 100. So at least we're heading in

12:47

the right direction. That

12:50

gray area of how many women I

12:52

see that are really

12:55

squishing towards being insulin resistant, it's not yet

12:57

showing up on their A1C, which is a

12:59

90 day snapshot of blood sugar control.

13:02

Their blood sugar is a little higher than I want

13:04

it to be. And even checking at home, it's not where

13:06

it should be. And then we draw

13:08

fasting insulin and the light bulb goes off. It's like, oh,

13:10

your fasting insulin is 20. Well,

13:13

now I know why you're not losing weight. You know, talking

13:15

about fasting insulin is high. Guess what? You're

13:17

not going to be able to tap into fat stores. So helping

13:19

people understand that fasting

13:22

insulin can be a huge,

13:25

hugely insightful lab value

13:27

to be looking at that is inexpensive,

13:29

very valuable. I track my own. Like I

13:32

know what my fasting insulins have been over

13:34

the last four or five years, because

13:36

it kind of gives me a sense of, you know,

13:38

what direction my thyroid is going into. But

13:41

I think it's helpful for people to know you can

13:43

ask for these tests. This is a

13:45

test that's covered by insurance. This may

13:47

be helpful for helping you uncover what's

13:50

really going on below the

13:52

surface. And so I think

13:54

that that should be standard of care. Unfortunately, it's not.

13:56

There's still a lot of providers that just do

13:58

A1Cs. And I'm like, well, that's great. That doesn't

14:00

tell me a lot. Oh, that looks good. Okay.

14:03

Before we part ways, we'll end on this. And

14:05

this ties back to something you talked about before.

14:08

We're putting on muscle is

14:10

actually gonna help us regulate glucose

14:12

as well. So just coming full

14:14

circle and tying that into this part of the conversation

14:16

of ways to manage

14:19

blood glucose. So think

14:21

about your muscles as like a glucose

14:23

reservoir. You know, every time you're building

14:25

muscle, you are building opportunities for your

14:27

body to be able to dispose of

14:29

glucose. And so for all those

14:31

people out there who are fearful, they don't want

14:34

to look too muscular. Well,

14:36

as an example, women just don't have enough circulating

14:38

testosterone to ever look like

14:40

a man. Like that's physiologically

14:43

impossible unless you're taking exogenous

14:45

steroids. And that's a whole

14:47

separate conversation. But it's

14:49

helpful for people to understand that the more muscle mass

14:51

you have, the more muscle we

14:53

have on our body, skeletal muscle, the

14:55

more likely you are to be insulin sensitive.

14:58

And that is incredibly impactful and important

15:01

as we are getting older. If you

15:03

take nothing else away from our conversation, muscle

15:06

really is critically important for metabolic

15:08

health. Think of it as

15:10

a sponge for blood sugar. Think of

15:12

it as sponge for your glucose. And

15:15

that the more muscle we have, the

15:17

less we have to worry about your,

15:20

your insulin levels not being optimized.

15:23

So something to really think about. And the other thing

15:25

to kind of tie into that is, as

15:28

we are getting older and as we're having

15:30

all these sex hormone fluctuations that do occur

15:33

with normal functions of aging, don't

15:36

be fearful if you've done

15:38

all the other work to consider hormone

15:40

replacement therapy. Have a conversation

15:42

with your GYN or your internist. Understand

15:45

that the women's health initiative

15:48

that came out around 2002, which

15:50

I was largely insulated with being in cardiology,

15:52

but now understand a whole lot better, we

15:55

have a whole generation of clinicians that are

15:58

fearful to talk about prescribing and prescribing. hormones

16:01

when for many individuals, whether it's male

16:03

or female, one of the things that they

16:05

can benefit from in terms of insulin sensitivity, if they've

16:07

done all the other work like all

16:09

of it and they still need a little bit

16:11

support that having a bit of

16:14

estradiol and progesterone and possibly testosterone

16:16

and borac can make a big

16:18

difference. Big difference in all

16:20

these lifestyle pieces that we've talked about today.

16:22

And I believe Cynthia, last time we talked,

16:24

you mentioned you were using a cream, a

16:27

progesterone cream, is that still part of

16:30

your healthy routine? Well, I

16:33

use oral progesterone six nights

16:35

a week and I

16:37

was taking a break from the HRT

16:39

I was on because I

16:42

was on too much and so it was like kind of having

16:44

this wash down. So now I have an

16:47

estrogen patch and I have a cream

16:49

testosterone and so I'm on all three, about

16:52

75% of women don't

16:54

make enough testosterone in menopause

16:56

to be able to kind of get by without

16:58

it. 25% of

17:01

women do and so I always say testosterone,

17:03

you might be one of those people, is

17:05

magical unicorns that don't need that. But that

17:07

for me has been very helpful for continuing

17:09

to build muscle and I know we can

17:11

have a whole tangential conversation but very value

17:13

individual, work with a practitioner that knows what

17:15

they're doing so that you can ensure you're getting the

17:17

support that you deserve to have. I

17:20

really want to go deep into intermittent

17:22

fasting and specifically from a women's perspective.

17:25

I've covered it so many times on the

17:27

show, this practice which is very

17:29

simple when we get to the root of it but

17:32

you're an expert when it comes to how

17:34

to do this properly as a woman. So excited

17:36

to go deep and go granular with you

17:38

on that. Yeah, and I've been

17:41

looking forward to actually, I watch your

17:43

podcast so it's really nice to connect. It's

17:45

always nice as a podcaster to connect

17:48

with other kind of like-minded

17:50

podcast owners as well. We

17:52

have a lot to get into, we're going to have a

17:54

lot of fun and I want to start off by talking

17:56

about a myth that you actually dispel in your book and

17:59

this is a very very broad overarching myths that I

18:01

think is a good jumping off place, talking

18:04

about how intermittent fasting is unsafe

18:06

for women. Let's

18:08

debunk that. Yeah, it's a

18:11

source of endless frustration for me because

18:13

I have to believe

18:15

that the healthcare professionals or the

18:17

fit pros that are propagating this

18:20

myth have good intention. But

18:22

I remind people way before we

18:24

had grocery stores and refrigeration and

18:26

pasteurization, the processed food industry, we

18:29

were able to both genders were

18:31

able to mitigate food scarcity. And

18:34

so when someone says that

18:36

fasting is dangerous for women, I think

18:38

it really sends a very strong message,

18:40

a very negative message that loses out

18:42

on the fact that from an ancestral

18:44

health perspective, we have been fasting as

18:46

a species for 1000s of years, it's, you

18:50

know, interwoven into most if not all

18:52

of the major religions. And I'd

18:54

like to remind people that before we

18:56

had the conveniences that we do today, we

18:59

really did go through periods of time when we

19:01

were not able to have access to food or

19:03

we were eating twigs and berries, and maybe

19:06

occasionally able to have a kill and maybe

19:08

get some meat. So when someone suggests that

19:10

it's not, it's

19:13

not a viable option, or it's not the

19:16

antithesis of our kind

19:18

of standard American diet is really

19:20

doing us a tremendous disservice. Because

19:23

the concept of eating frequently, too

19:26

frequently, in fact, and eating hyper

19:28

palatable processed foods is

19:30

doing far more detriment than the

19:33

concept of eating less office often

19:35

within a prescribed feeding window or

19:37

timeframe. Let's continue

19:39

on that trend you started open up there

19:41

and talk about what intermittent fasting is, if

19:44

somebody is totally new to this practice. What

19:46

does it mean? It really means eating

19:48

less often. And I always suggest that sometimes

19:51

we make it far more complicated than it

19:53

needs to be. And for a lot of

19:55

people, the stepping off point is going from

19:57

dinner the night before until breakfast the following

19:59

day. And that means not

20:01

eating snacks or food after dinner

20:04

time. And then sleeping

20:06

in a fasted state and waking up and

20:08

maybe not eating within the first hour of waking. And

20:10

you've already done 13 or 14 hours fasted. And

20:14

I think the new continuum needs to be,

20:16

the new recommendation needs to be at a

20:18

minimum, all adults should eat,

20:21

you know, should give themselves 12 hours of digestive

20:23

rest, meaning that there's at least 12 hours a

20:25

day. Maybe it's from 6 p.m. to 6 a.m.

20:27

or 7 p.m. to 7 a.m. But

20:31

to allow our bodies to really get optimized

20:33

because the meal frequency piece, what we've been

20:35

taught about, you know, breakfast is the most

20:38

important meal of the day, that we need

20:40

to stoke our metabolism and air quotes, that

20:42

we need to have snacks and mini meals throughout

20:45

the day is really at the root for a

20:47

great deal of health and metabolic health issues that

20:49

we're seeing right now. For

20:52

somebody brand new to this, the thought of

20:54

skipping breakfast can be quite terrifying. Talk

20:56

about how over time the body evolves and

20:59

how to go about making the process more

21:01

gentle and set the person up for success.

21:05

Absolutely. And I'm all about being very

21:07

transparent that a lot of this is

21:09

very bio-individual. So if someone

21:11

is frightened or fearful, I don't

21:13

want them to be. It really

21:15

starts with the basics. When we're first

21:17

working together, the first thing I recommend

21:20

is to stop snacking because the

21:22

snacking piece will force you to

21:26

refortify what you are eating at

21:28

your meal. So really focused on

21:30

protein, non-starchy vegetables, healthy fats, the

21:32

right types of fats, the right

21:34

types of carbohydrates to keep you

21:36

satiated between breakfast and lunch

21:38

and lunch and dinner and dinner and

21:40

breakfast. And that is the antithesis of

21:43

the kind of Americanized, standard American diet,

21:45

where we're taught that we want to

21:47

eat every two to three hours. We want to

21:49

eat with greater meal frequency because ultimately

21:51

we want to train our body

21:53

to do is to effectively utilize

21:55

both fats, ketones and

21:58

carbohydrates or glucose. as

22:01

fuel sources. So you want to be

22:03

able to use both. Most people are

22:05

stuck in this carbohydrate burning mode, which

22:07

is highly inefficient. And you

22:09

can generally tell the people that are,

22:11

you know, stuck in this carbohydrate driven,

22:13

glucose driven paradigm, because they struggle to

22:15

lose weight, they get hangry if they're

22:18

not able to get food when they

22:20

get hungry, they have energy slumps, they

22:22

aren't able to get through their day,

22:24

they may in fact get very sleepy

22:26

after meals, that is not normal. But

22:28

that is the norm for most Americans.

22:30

And what I want people to work

22:32

towards is that as we are

22:35

eating less frequently, and ultimately, as we

22:37

burn through our sugar and get into

22:40

the fat stores, for energy, you're going to

22:42

have improvements of clarity, you're going to have

22:44

lowered insulin levels, you're going to become much

22:46

more metabolically efficient. And metabolic

22:49

efficiency or metabolic flexibility

22:51

is what all of us should aspire

22:53

to be. You know, when I worked

22:55

in cardiology as a nurse practitioner, and

22:57

I would see certain certain combinations

22:59

of labs that were abnormal, like high

23:01

triglycerides, low HDL, which is the heart

23:03

healthy to cholesterol, high blood pressure,

23:06

we would see, you know, abnormal lipid

23:09

levels, and you know, abnormal fasting glucose,

23:11

and certainly fasting insulin, you know, a

23:13

large waist circumference, those are signs that

23:15

your body is becoming less metabolically efficient.

23:18

But as I stated earlier, the other

23:20

signs that you can look forward to talk about

23:23

metabolic flexibility is do you fall asleep after eating

23:25

a meal? I'm not just talking about Thanksgiving, I'm

23:27

saying in general, do you get tired? Are

23:29

you not do you not have enough energy an

23:31

hour or two after eating? Or do you get

23:34

hungry in between meals? Because that can also be

23:36

a sign that you're either not as metabolically flexible

23:38

as you need to be. Or you're

23:40

just putting your meals together in a really non

23:43

advantageous way. So, from my perspective, a

23:45

lot of the training that I do

23:47

when someone is quote unquote dipping their

23:49

toe in the pond is fasting is

23:52

removing the snacking, moving on to

23:54

teaching people not to eat after

23:56

dinner, then kind of moving on

23:58

to restructuring your meals. And this

24:00

is critically important. Everything starts with what

24:03

we put in our mouths. So, you

24:05

know, you can't you're not going to maximize your

24:07

gains with fasting if you're still eating McDonald's

24:10

three times a day. So I always

24:13

encourage people to be moving towards a

24:15

more nutrient dense less processed diet. And

24:18

that's a lot of the training that I do that

24:20

you know, when you start eating more nutrient

24:22

dense foods, you're going to be full, you're

24:24

going to hit those to tidy cues, you're

24:26

not going to be looking for ice cream

24:29

and cookies and more servings of process carbs,

24:31

you're going to feel satiated, push the plate

24:33

away and feel comfortable and confident that your

24:35

next meal will be, you know, several hours

24:38

later, four to five hours later, or perhaps

24:40

the following day. And so we there's several

24:42

steps, we kind of move slowly through this

24:44

process. I don't recommend that anyone go

24:46

from being a couch potato eating

24:49

a standard American diet, and then immediately

24:51

shift into trying to fast or 16

24:54

hours because you will ultimately, unless you

24:56

are a unicorn, you will ultimately kind

24:58

of set yourself up for feeling pretty

25:01

darn uncomfortable through that process. So we kind

25:03

of do it slowly so that women

25:05

will gain the confidence that they can

25:08

ultimately continue to fast along this continuum

25:11

and do it successfully. So

25:13

what I'm hearing you saying is that

25:15

people should be afraid of skipping breakfast

25:18

initially, if they've been eating, you know,

25:20

very standard type foods, and eating in

25:22

a standard type way with snacking, you

25:25

have a very slow approach to help people get

25:27

to the point where they can skip breakfast and

25:29

not sweat about it. Yeah, so I

25:31

think there's a couple things that are important for

25:34

people to understand. Starving, excuse me,

25:36

fasting is not starving. So

25:38

that's an important distinction because people assume like,

25:40

oh my gosh, if I'm not eating, I'm

25:42

starving, no, they're very different. But

25:44

understanding what you can consume in a fasted

25:46

state, and that's plain coffee, bitter

25:49

cheese, black tea, green tea, bitter

25:51

is better. And there's actually components

25:53

or polyphenols, which are plant based

25:55

compounds which are in both plain

25:57

coffee, bitter cheese that can upregulate.

26:00

fat oxidation, which means we can burn more

26:02

fat. We definitely want to keep ourselves well

26:04

hydrated. I don't believe in dry fasting. That's

26:06

not something that I teach. And I'm a

26:08

huge proponent of electrolytes and electrolytes are things

26:10

that you're probably familiar with, like,

26:12

high quality salt, magnesium,

26:15

potassium, chloride, etc. And in

26:17

my 16 years working in

26:19

cardiology, I'm ridiculously savvy with

26:21

electrolytes. So first understanding what

26:23

you can consume in a fasted state, I

26:25

think is very important. Secondly, it's

26:27

understanding that when you break your fast, the way

26:29

that you want to structure your meals, and it

26:31

may be that you go from dinner to breakfast

26:34

at 8am. So maybe you've gone 14 hours

26:36

and you feel pretty good that when you

26:38

break your fast, you want to break your

26:41

fastest and protein protein is the most satiating

26:43

macronutrient. The other two macronutrients are fat and

26:46

carbohydrates. I'm not anti carb, I

26:48

want to be very clear about that. But I

26:50

think it's important to eat high quality carbohydrates. I

26:52

lean into a lot of vegetables, not

26:54

starchy vegetables is one example. I like

26:57

healthy fat. So if you're sitting down to have a

27:00

piece of salmon or a ribeye, you have plenty

27:02

of healthy fats already incorporated in that protein, you

27:04

don't need to then add a cup of nuts

27:06

and five packs of butter on your vegetables. So

27:09

I think that's an important distinction. If you're having

27:11

a lean protein, you know, like a piece of

27:13

chicken breast or turkey or

27:15

maybe having a piece of cod, you can

27:18

absolutely add some healthy fats into your

27:20

diet. So it's always protein and fats.

27:22

When you eat, or protein and carbohydrates,

27:24

you never ever ever have carbs by

27:27

themselves, you get the most, most

27:30

impact on your blood sugar and insulin

27:32

levels when you have carbs by themselves.

27:34

And so protein and fats will help

27:36

buffer some of that, that impact. So

27:38

I think it's critically important just

27:40

to understand that restructuring, restructuring

27:43

your meals is going to be very, very

27:45

important to help with satiety. And that's something

27:47

that we've been conditioned as a

27:49

society to eat heart healthy grains, and lots

27:52

of carbs. And I'll be the first person

27:54

to say that it's the processed carbs more

27:56

often than not. And the inflammatory seed oils

27:58

is another example. that have really gotten

28:00

us into trouble. And so if you kind

28:03

of use that formulation of going from dinner

28:05

to breakfast without eating, breaking your fast,

28:07

which you can break your fast at

28:09

any point, but breaking your fast in the morning with

28:12

protein and fat or protein and carbs, and we don't have

28:14

to make it complicated. It could be bacon

28:16

and eggs. It could be an avocado with

28:18

some leftovers from the night before.

28:20

You really don't have to make it complicated, but

28:23

because we've been conditioned to have

28:25

essentially a dessert for breakfast, those

28:28

muffins, the cereals, the Pop-Tarts, sugar

28:31

sweetened yogurt, things like that, that becomes

28:33

problematic because those habits can be challenging

28:35

to break. But I can assure you

28:37

that once you get to a point

28:40

when your body's much more metabolically efficient,

28:43

eating in this manner is going to guarantee

28:45

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28:47

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your book, you talk about for you, and again, we're

30:15

all different, we're gonna have different

30:17

stages in life when we, fasting

30:20

might look different for us, and I don't want

30:22

everybody just to run out and do what you're

30:24

doing, but in your book, you talk about waiting

30:26

till about noon to eat typically, and

30:28

you gave examples there of different foods and

30:30

talking about some of the beverages we can

30:32

have when we're in that fasted state. So

30:35

I think at this point, it'd be helpful,

30:37

Cynthia, if you could share with us what

30:39

a typical morning looks like for you. Which

30:42

of these beverages are you consuming, and

30:44

then go through what you'd eat in a day. You

30:47

know, obviously it's gonna be different day to day, but what

30:49

could that look like? It's a great

30:52

question, it's one I'm asked frequently. So when I get

30:54

up in the morning, I have about 12 ounces of

30:56

filtered water, and I have the first

30:58

set of electrolytes that I'll add into my

31:00

water, and that's just a given. I'm

31:03

not a coffee drinker, but I do have bitter tea.

31:05

This morning I had black tea, tomorrow I may have

31:07

green tea. If you don't love the taste

31:09

of bitter teas, I encourage you to drink it with a

31:11

straw. That's how I learned, actually learned

31:13

how to drink them and enjoy them,

31:16

because there's so many benefits that you get

31:18

from these beverages that it's worth it to

31:20

find a way around it. If you

31:22

don't like bitter coffee, like plain coffee, if

31:24

you've been putting cream and sugar, there's

31:27

two things that you can do that will not break a

31:29

fast, that can impact the flavor

31:31

profile of coffee. Number

31:34

one is sea salt. You can add sea

31:36

salt, or you can add cinnamon, and cinnamon

31:38

will actually increase insulin sensitivity, so that's another

31:40

benefit. I haven't actually added them

31:42

to the bitter teas, but I'm sure you could do

31:44

the same as well. I just prefer to have them straight

31:47

up. So for me, I've been

31:49

actually, during the past two years, I've been

31:51

breaking my fast a little earlier, depending on

31:54

how physically active I am. So

31:56

yesterday was a light day. I broke my fast at 10 a.m.

31:58

I closed my window at six. So at

32:01

10am yesterday, I actually had a protein

32:03

shake, which I don't normally do, but

32:05

it was one of those very busy

32:07

media days. And so I had a

32:09

protein shake with about 40 grams of

32:11

protein. And I had that

32:13

with probably, I would say probably half

32:15

a cup of blueberries, because it was a light

32:17

day, I can have a little bit more discretionary

32:19

carbs. And then my next meal, I sat down

32:21

and actually had

32:23

chicken breasts, I had broccoli, I

32:26

had a little, even though I tend

32:28

to be dairy intolerant, I do tolerate

32:30

grass fed butter. And so that

32:33

was, you know, the second meal. So I'm

32:35

always aiming for anywhere from 40 to 50

32:37

grams of protein with each meal, which means

32:39

my protein portions are quite large. And

32:41

then later in the afternoon, I actually had some

32:43

bison ragu, which was delicious. I had that some

32:46

over some cauliflower rice. And then I

32:48

closed my window. And sometimes in my home,

32:50

because I have teenagers and they're not

32:52

back from sports until in the evening

32:54

time, oftentimes I'm sitting with them

32:56

and I've already closed my window, but they

32:58

understand that I eat within a compressed feeding

33:00

window. And that works for me. And

33:03

there's a lot of research to demonstrate

33:05

that aligning your

33:07

feeding windows with chronobiology. So when it's

33:09

light outside, we eat, when it's dark

33:12

outside, we don't not eating, you know,

33:14

within three to four hours of bedtime,

33:17

I trend all my data on my or

33:19

ring. I'm not affiliated with or I just

33:21

love tracking data. I'm a little bit of

33:23

a nerd. And so I'll can

33:25

look at like when I have meals and

33:28

later in the evening and how it disrupts

33:30

my sleep. And that's what works for me.

33:32

So every person that's listening may need to

33:34

augment based on, you know, their, their needs

33:36

to personally, professionally, and otherwise, they may need

33:38

to adjust their feeding and fasting windows a

33:40

little bit differently. Certainly if I was still

33:43

in the hospital seeing patients and in clinic, I

33:45

wouldn't have the degree of flexibility that I have.

33:47

And I acknowledge that. But I

33:49

do have plenty of clinicians and people that

33:51

have very demanding jobs that do intermittent fast

33:53

around their work schedule. They just have to

33:55

be a little more regimented because they may

33:57

not get as many opportunities to eat. But

34:00

on a given day, I aim for 100 grams

34:02

of protein easily. I

34:04

don't count my carbs, but I do carb cycle. So

34:06

I always have one or two

34:08

days out of the week where I tend to be higher

34:10

carbohydrate. And by high, it's not nearly what

34:12

the average American is doing. The average American is anywhere

34:15

from 200 to 300 grams of

34:17

carbs a day. I'm probably on a higher day, probably 75

34:19

or 100. I'm

34:21

not ketogenic, but I generally stay. My

34:23

happy place is about 50 total carbs

34:25

a day. And that's, you know, I've

34:27

got your point. I've been doing this for so

34:30

long that I can eyeball my portions. But when

34:32

I was doing this, you know, new several

34:34

years ago, it was a little bit more

34:36

measuring and kind of tinkering to find where

34:38

the sweet spot was for me. Let's

34:41

come back to the bitter drinks in the

34:43

morning, the tea, the coffee. What

34:45

if somebody, you mentioned their cinnamon and

34:47

sea salt. Not things I've tried to

34:50

implement with my coffee, but interesting. What

34:52

about somebody who's made the switch already

34:54

from, say, like a standard white sugar

34:57

to like monk fruit, xylitol, stevia? I

35:00

know xylitol, I believe xylitol might spike

35:02

the glycemic index, but I don't believe

35:04

stevia or monk fruit does. Just

35:07

curious on your thoughts if somebody goes

35:09

that route to sweeten those beverages in

35:11

the morning. Does that break the fast?

35:14

Well, I don't think it's a clean fast.

35:16

And so I like people to, and

35:18

there are people who want to argue to the death on this.

35:21

Yes, maybe in a lab animal, it

35:24

did not evoke an insulin response. But

35:26

there's something called a cephalophase insulin response.

35:28

And you put something sweet

35:30

on your tongue, your body is getting ready

35:32

for food. And whether or not it is,

35:34

whether or not you

35:37

are doing a clean fast or dirty fast, and I

35:39

can differentiate between what they are, I

35:41

like people to learn best practices. So

35:44

if you are going from table

35:46

sugar to stevia in an effort

35:48

to reacclimate your palate with the

35:50

intention of going to black coffee,

35:52

that's fine. But if you're using

35:54

that as like you're going to

35:56

put monk fruit or stevia or

35:59

a thyrothalm. or any of the other cleaner

36:03

sugars that are out there, the intent

36:05

should always be like you're moving towards a

36:07

clean fast. That's always, I like people to

36:09

have best practices. I cannot tell you how

36:11

many people dirty fast and then

36:13

they don't get the results they're looking for. And

36:15

when I start kind of examining what they're doing,

36:18

I remind them that it doesn't mean

36:20

it's calorie lists. You know, there's

36:23

still, you know, there's still some properties

36:25

that you're adding to these drinks and

36:27

certainly for women, unfortunately, as

36:29

we get older, you have to be

36:31

more conscientious about discretionary food. And

36:34

so I think it's fine if you understand why

36:36

you're doing it, just like for the same reason,

36:38

if someone's on a standard American

36:40

diet and has couch potato and they have

36:42

to use a fatty coffee to get from

36:45

dinner to breakfast without feeling

36:47

awful as their body's

36:49

kind of detoxing and processing, getting rid

36:51

of all this, you know, highly

36:53

inflammatory food that they've been eating, I

36:56

think it's always with the intention and it's something

36:58

that certainly Dave Asprey has taught me that,

37:00

you know, meeting people where they are and acknowledging

37:03

that not everyone's ready to go directly to a

37:05

clean fast, they may have to have, you know,

37:07

a little, put the training wheels on the bike

37:10

and they're doing this as an intention to kind

37:12

of move to clean fasting. And I

37:14

think that's an important differentiator. What are your goals? What

37:16

are you working towards? Because if you have a problem

37:19

with sugar and a lot of people do, you know,

37:22

using stevia, using a Cyrothal, using

37:24

Monkford as an alternative is fine,

37:26

but you still may be masking

37:28

the fact that you actually have

37:30

a problem with sugar. And

37:32

the example is those bitter teas are bitter.

37:34

They are not meant to be sweet. And

37:37

so I remind myself when I'm drinking a

37:39

bitter tea, that there's

37:41

a purpose there, like bitter teas,

37:43

bitter foods, bitter greens are designed

37:45

specifically, the polyphenol content gives our

37:48

body important information and whether or

37:50

not it's helping with digestion or,

37:52

you know, making our bio less viscous, there's a

37:55

lot of different properties to bitter greens and things

37:57

like that. There is a purpose, there is information

37:59

in that. tea or that coffee that my

38:01

body would benefit from. And that's

38:03

always the reframe, like understanding you can build

38:05

up a tolerance to something that's bitter doesn't

38:08

mean you have to eat copious amounts. But

38:10

most if not all of us have an unhealthy

38:12

relationship with sugar. And so

38:15

those healthier sugar alternatives are

38:17

still sugars, they're still, they

38:20

may be cleaner, they may evoke less of an

38:22

insulin response. But to me, it's still kind of

38:24

masking a problem. That's why I'm not a huge

38:26

proponent of a lot of like

38:28

paleo and keto junk food, because it's just,

38:31

it's still junk food, as long as people understand

38:33

what it is, no judgment. But if

38:36

you've got a problem with a lot of processed

38:38

food, and you just keep replacing it with healthier

38:40

variations, there might still be an issue that you

38:42

have to address. Let's stick

38:44

on the clean fasting here for a bit,

38:46

because there are supplements that you talk about

38:49

in the book, things that we can include

38:51

Jernafast, that not only don't break the fast,

38:53

they enhance it. And there's one in

38:55

there we'll start with that is something I've never

38:57

heard of spermidine. So talk about

38:59

what this is and how somebody could use that

39:02

to take their fast to the next

39:04

level. Yeah, spermidine is

39:06

an interesting and despite the name,

39:09

most spermidine now is derived

39:11

from a wheat alternative, although I'm

39:13

assured that it's safe for celiacs. I've been

39:15

down a rabbit hole about spermidine for a

39:17

while, but it upregulates one of the key

39:20

benefits of fasting, which is autophagy. So

39:22

this waste and recycling process in the

39:25

body. And so spermidine is one of

39:27

these, you know, fasting mimetics.

39:29

So they're designed to kind

39:31

of upregulate and magnify

39:33

the benefits. And so spermidine,

39:35

I find fascinating. Burberry is

39:39

another one that's really fascinating to use. You

39:41

know, there's a lot of medicinal mushrooms that

39:44

can be beneficial always in the context of what else

39:46

are they in. But I

39:48

think it's interesting when people are looking to take fasting

39:50

to another level, obviously, you wait until you've got

39:52

the basics down before you start adding in these

39:54

things. But I think there are

39:57

always hackers. There are always people that are

39:59

looking to take or

40:01

to magnify the benefits that they're getting in a

40:03

really kind of benign way. And

40:06

I do find that spermidine is of interest. I'm

40:08

sensitive to gluten, so I've been a little reticent.

40:10

I do actually have a bottle. I got

40:13

a bottle through Dave Asprey, and so I

40:16

find it really interesting. I've had a lot of

40:18

questions, but I do kind of pause,

40:20

and I'm trying to connect

40:23

with an autophagy expert

40:25

to try to bring her on my podcast,

40:27

actually ask her all the questions that I

40:29

have about spermidine in

40:31

general, but originally it was derived from exactly what

40:33

it sounds like. The berberine is probably the one

40:35

that I think is much more accessible for a

40:38

lot of people, although all the research

40:40

that I've read on berberine, you don't want to use

40:42

them on a day that you've lifted because it can

40:44

actually inhibit muscle protein

40:46

synthesis. For anyone that's the same that's not

40:49

familiar with berberine, it is considered

40:51

to be nature's metformin or nature's glucophage.

40:53

And so I saw a lot

40:55

of glucophage and metformin prescriptions over the

40:57

years. But it's interesting that we

40:59

have this medicinal plant that

41:02

can help within some sensitivity as well. I

41:04

do occasionally take that, especially if I've had

41:06

a day with higher carbs and maybe not

41:09

my healthy carbs. Maybe I've enjoyed like

41:11

a piece of cake or it's been

41:13

a celebration of some kind, but

41:15

there are definitely things that you can

41:17

add to your fast that are fasting

41:19

mimetics. So they magnify the impact of

41:21

some of the fasting benefits. You've

41:24

brought up tophagy a couple times there. Can you

41:27

talk more on a granular level what that is,

41:29

why it's beneficial and at what

41:31

point you're in a fast, does that kick in? Well,

41:35

that is always the question, right?

41:37

When does the tophagy really get

41:40

magnified? So a tophagy is this

41:42

waste and recycling process that goes in when

41:45

we're in a non-fed state. And in opposition

41:47

to that is something called mTOR. But I

41:49

like for people to understand that just like

41:52

we put trash out every week and the trash

41:54

man comes and picks up the garbage. This

41:57

is actually what's going on the body, our body will

41:59

will restore. disease organelles,

42:01

mitochondria, etc. that could potentially go

42:04

on to be disease-provoking or it could

42:06

be precancerous, but it's a really way

42:08

of fine-tuning efficiency in the body. We

42:10

know that by the age of 40,

42:12

most, if not all of us, have

42:14

significant mitochondrial dysfunction. So let

42:17

me back up and talk about the mitochondria,

42:19

which are the powerhouses of our cells. And

42:21

so this is another way that we can continue

42:24

to replenish. Autophagy

42:26

is the recycling of disease,

42:28

disorder of mitochondria. Autophagy

42:31

is referring to different types of cells.

42:33

But it's with the understanding that these benefits

42:35

occur when we're in an unfed state and

42:37

why it's so, so important to have a portion of

42:40

the day when we're not eating. Now,

42:42

if you look at the research, about 16

42:44

hours, obviously, the longer you fast, the more

42:46

autophagy. 16, 18,

42:48

24 hours, that's when you've really seen up regulation.

42:51

But it's not to suggest that if you fast

42:53

15 hours, you don't get benefits. And to me,

42:55

it's not as if autophagy gets turned on and

42:58

turned off. I think there's a continuum

43:00

for autophagy, much like mTOR, that

43:02

you'll get to a point where you're

43:04

still deriving benefits. But obviously, if

43:06

you do a 24-hour fast, you're going

43:08

to take out more garbage than you

43:11

do with a 16-hour fast. But it

43:13

doesn't negate the importance of having periods

43:15

of the day when you're not eating. And

43:17

I think the longer that I fast, because I've now been

43:19

doing this for over six years, the

43:22

more I realize that this

43:24

is really the way that we can fine-tune

43:26

our bodies to work much more efficiently. In

43:29

fact, I would be the first person to say that

43:32

even though this has gained popularity in

43:34

the last five, 10 years, this

43:37

dates back, as I stated earlier, to ancestral

43:39

times. And so it's really aligning our bodies

43:41

with, I think,

43:43

a more simplistic way of living our lives. We

43:46

don't have to be governed by packing snacks and

43:48

mini meals. I mean, I recall a time when

43:50

I used to be the person drinking a protein

43:52

shake going to the gym and then drinking a

43:54

protein shake coming home from the gym because I

43:56

was told you should have 40 grams

43:58

of protein within a store. certain amount of time and

44:01

then I'd have all these snacks, not snacks, but

44:03

meals prepared throughout the day at work, which

44:05

made me laugh because more often than not, I

44:07

didn't have time to eat them. But I think

44:10

it's helpful for people to understand that autophagy is

44:12

taking out the garbage in our bodies, really efficient

44:14

thing to do gets up regulated when we're in

44:16

an unfed state. The longer

44:18

you fast, the more autophagy but that does not

44:21

in any way mean that you're not

44:23

still deriving benefits if you're fasting for less than 16

44:25

to 18 hours. That's always

44:27

a common question. And I would love to

44:29

be able to say definitive. It's exactly at

44:31

16 hours and 20 minutes that autophagy

44:33

really kicks in. And a lot of

44:36

a lot of researchers are making assumptions

44:38

that we believe this is the timeframe

44:40

in which that process really

44:42

up regulates in a beneficial way. And

44:45

I'll add to when it comes to autophagy,

44:48

there's simple ways that you can up regulate

44:50

that, even having coffee in the morning, having

44:52

ginger, having green tea, having cinnamon, so you

44:54

can mix cinnamon and coffee like we talked

44:56

about earlier, and that's going to ramp that

44:59

up. So there's really simple things

45:01

that people probably have at home that they can

45:03

do to ramp that up

45:05

starting tomorrow. Yes, exactly. We're

45:07

even doing things like high intensity

45:10

interval training, anything that's a hormetic

45:12

stress, or beneficial stress in the right

45:14

amount at the right time can up

45:16

regulate autophagy. And so I think it's important

45:18

that passing is not the only way

45:20

that you can do that because there are some people

45:22

that are like, Oh, I have to fast every day

45:25

and I just remind them, no, actually, you don't. There's

45:27

other ways you can do that because what we're trying

45:29

to do is improve mitochondrial health and

45:31

improve that metabolic flexibility and so things

45:33

that stress the body in beneficial ways,

45:36

like fasting or high intensity interval

45:38

training or cryotherapy or infrared sauna,

45:40

etc, or foods that we've talked

45:42

about can be hugely impactful. And

45:45

what do you think about stacking a number of

45:47

those on top of each other while you're fasting

45:49

so doing, you know, hit training or I think

45:52

you mentioned sauna there are a number of different things.

45:55

What are your thoughts on layering those on top

45:57

of each other and getting do we get more

45:59

benefit? it that way? Well, I

46:01

think it depends on the individual. So remember

46:03

what I said, it's that so hermetic stressors

46:05

are a beneficial stress in the right amount

46:07

at the right time. So if you're sleeping

46:10

well, you're managing your stress, you

46:12

have plenty of energy. Yes, I do think

46:14

and I do enjoy personally, I enjoy stacking

46:16

benefits like my husband and I have this

46:18

kind of ritual that we do together, we'll

46:21

do cryo and then infrared sauna

46:23

in a fasted state, sometimes we'll do hit

46:25

before we do that. Obviously, you

46:27

know, to me that works well for us,

46:30

but for other people that may not feel

46:32

right. And so I would experiment a little

46:34

bit days that I do hit, I definitely

46:36

will fast a little longer. And that's

46:39

just personal preference. So I think

46:42

that everyone should experiment to feel to

46:44

determine what feels right for them. Because

46:46

women that are still mentoring still getting

46:48

a menstrual cycle, they will feel the

46:50

first two weeks of their menstrual cycle.

46:52

So the follicular phase and estrogen predominates

46:54

from the day of their bleeding till

46:56

right before ovulation. It

46:59

makes you a rock star, you can push

47:01

your workouts, you can push your fasting windows,

47:03

you can, you know, go more ketogenic, low

47:05

carb, your body can withstand more

47:08

strenuous exercise. And so

47:10

I think the experimentation piece and understanding for

47:12

women where they are in your menstrual cycle

47:15

can allow them to like really lean in

47:17

those first two weeks. And

47:19

then as progesterone predominates in the luteal phase, you have

47:21

to get a little bit, even

47:23

though it's ironic insulin, you're more

47:25

insulin sensitive with estrogen predominates a

47:27

little more estrogen, excuse me,

47:29

a little more insulin resistant

47:32

in when progesterone predominates. And so I remind

47:35

people that as you get closer to menstruation,

47:37

the five to seven days, you want to back

47:39

off on the accelerator fasting, you don't want to

47:41

do as intense exercise, your body

47:43

might actually need a little bit more high

47:45

quality carbohydrate, you know, like 100 calories, which

47:48

isn't a whole lot. But understanding that there

47:50

are phases in a woman's menstrual cycle when

47:52

they can get away with a little bit

47:54

more hormesis or hermetic stress. And so definitely

47:56

women pushing more in the beginning of their

47:59

menstrual cycle. You know maybe

48:01

doing yoga, maybe doing walks in nature, but

48:04

not doing longer fasts right around the menstrual cycle.

48:07

I'm glad you covered that. I definitely want to

48:09

get into the menstrual cycle. Also want to get

48:11

into perimenopause and menopause, but we're gonna pause on

48:13

that no pun intended. I want to stick on

48:15

some of these adjuncts that people can add in

48:18

when they're fasting and another one

48:20

you mentioned in the book is the C8

48:22

MCT oil. So again, this is

48:24

something that you could put into your coffee in

48:26

the morning. You could take a spoonful of it

48:28

if you just want to shoot it back. Talk

48:31

about what the benefits are there and

48:33

how somebody, if you have any

48:35

other ideas, how somebody could incorporate that. Yeah,

48:38

and it's a great question. So C8 is

48:40

like the purest form of medium

48:42

chain triglycerides, caprylic acid, and

48:45

so quality is going to be important.

48:48

Always the caution with MCT oil is,

48:51

MCT oil in the right amount can give

48:53

you loose stools. So I always mention you

48:55

want to start out like a teaspoon, see how

48:57

you respond. I have friends that can do two

49:00

or three tablespoons a day. I can stick with

49:02

one teaspoon and it's a fat,

49:04

a beneficial fat that's processed very differently in

49:06

the body, goes directly to the liver and

49:08

gets processed. And so it can

49:10

be helpful for boosting ketones. It can be

49:12

helpful with energy production based

49:15

on the research that I've looked at. One

49:17

teaspoon in some coffee is not going to

49:19

break your fast. So when people

49:21

are doing an extended fast, I think

49:23

it's completely fine. Or you're someone that's

49:25

moving from a more processed diet, more

49:28

sedentary. That can be a training

49:30

wheel apparatus that you can add

49:32

to your regimen so that you are not

49:34

struggling as much. Like I always say, most

49:37

of us don't experience hunger as efficiently

49:39

as we should. And so that can

49:41

be uncomfortable for some people. They haven't experienced

49:44

that because they've been eating so regimentedly. So,

49:46

you know, the three meals a day plus snacks

49:48

in between. When we're talking about MCT

49:50

oil, I think it's a really cool

49:54

food that you can incorporate into your diet. Sometimes

49:56

people will do it during their feeding window. They

49:58

can use it in... They

50:00

can use it with salad dressings,

50:02

they can put it into beverages.

50:04

It tends to be pretty benign

50:06

without a lot of, sorry dogs,

50:10

without a lot of side

50:12

effects. Generally, we'll blend pretty easily into

50:14

smoothies and things like that. But I

50:16

do think you want to look for

50:18

C8, which is the most

50:21

purest form of MCT oil caprylic acid, and

50:23

then slowly see how you respond to it.

50:26

But I would suggest going low and slow

50:28

so that if you have any digestive issues,

50:30

you're not caught off guard. Alright

50:33

last adjunct I want to get into

50:35

is the detox binder. So using things

50:37

like charcoal while you're fasting to

50:40

help eliminate some of the junk that's

50:42

coming up during a fast. So talk

50:45

about some of the different options there and how that

50:47

works. Yeah, and so one thing

50:49

that's important about binders in general, you

50:51

don't want to take them with

50:53

other supplements or medication because it'll

50:55

literally bind everything it's exposed to.

50:58

So in a fasted state when you're

51:00

not eating, you're not taking supplements, you're

51:02

not taking any medication. I

51:06

think that activated charcoal, apple

51:08

pectin, certain types of

51:10

dichotomous clay can be very beneficial. There's a brand,

51:12

I'm not affiliated with them, there's a brand that

51:14

I like called GI Detox that

51:17

has a lot of nice properties, very gentle,

51:19

and that can help bind to some of

51:21

the crude crap that your body is actually

51:24

packaging up and getting ready to get rid

51:26

of. I

51:29

probably don't use a binder every day, I

51:31

probably use it a couple times a week.

51:34

Obviously if I'm doing a longer fast, I might

51:36

actually use it once or twice a day. This

51:39

is just another layer. Like if

51:41

you're interested, it's not necessary. The

51:43

binders can be hugely impactful. In

51:46

my ER nurse days, we used to use activated

51:48

charcoal when people came in with an overdose.

51:50

And so it literally acts like a sponge

51:52

in the body. So if you get, for

51:55

an example, if you get food poisoning, sometimes

51:57

it's beneficial to take activated charcoal so it

51:59

can bind to whatever you've been exposed

52:01

to. Now with this being said, again,

52:04

you do not want to take binders around

52:06

medication. So when I take my thyroid medicine,

52:08

I don't take a binder. I make

52:12

sure I'm way far away from

52:14

medication. Or if I've had

52:16

a supplement that I need to be on and make

52:18

sure that the binder is taken way, way away from

52:20

that. Typically the rule of thumb is you can take

52:22

a binder 30 to 60 minutes before a meal. So

52:24

if you're at the tail end of your fast

52:27

or two hours after a meal. So if you're

52:30

failing on doing a longer fast, and

52:32

you want to get that on board, you can take a

52:34

two hours after eating meal. So if you're two hours into

52:36

a fast, that's actually a good

52:39

time to take it without any cause of concern

52:41

that you're going to soak up

52:43

something that you don't want to like your

52:45

medication, I would say my thyroid medication is a good

52:47

example, I want to make sure my body can break that

52:49

down and use it. Since

52:52

I think at this point, a good framework for

52:54

the next part of our conversation is to talk

52:56

about you mentioned people being interested

52:58

in what you're eating. And this is

53:02

something I'm sure that changes and pivots

53:04

over time. But let's talk about

53:06

where you're at now with when you break your

53:08

fast, what you're eating. And then we

53:10

can use again that as a platform

53:13

to dive into different areas and talk

53:15

about different aspects of fasting and diet.

53:18

Yeah, I mean, right now I am

53:20

I use the term carnivore ish. And it's

53:22

really because I eat a lot of animal

53:24

based protein, that's what works really well for

53:27

my body. Whether

53:29

it bison or steak or pork or

53:31

chicken or fish. I mean, I

53:33

like to kind of mix things up. I

53:35

really genuinely like vegetables, which is why I could

53:38

never be full carnivore again. And

53:40

the tail end to that is I was

53:42

full carnivore after being hospitalized, because nothing else

53:44

worked for my digestive system. But I

53:47

really like vegetables and I like I

53:49

actually like fruit. And I

53:51

tolerate both really well, I do better

53:53

on a leaner diet. So leaner cuts of meat,

53:56

leaner cuts of fish, I

53:58

don't do as well with a lot of healthy fasting. So

54:00

when I do have healthy fats, it's smaller portions

54:02

and that's just what makes me unique And

54:05

that's been a lot of trial and error over the

54:07

last several years So when I break a

54:09

fast, I'm going to sit down with today. I had

54:13

Grilled bison and I had some hard-boiled eggs. I'm going

54:15

through an egg phase. I intermittently kind of go through

54:17

an egg phase I think I need I must mean

54:19

if need more choline in my diet So

54:22

I sat down and had a bison

54:24

burger. I had three deviled eggs I

54:26

had some leftover broccolini and that was

54:28

my lunch or when I broke my

54:30

fast and that to me is perfect and I'll Eat

54:33

another bolus of food later this

54:35

afternoon after you know playing my mom role

54:38

But that's kind of what I've been

54:40

working best with right now is a good

54:43

amount of protein I would say a hundred to a hundred

54:45

and ten grams of protein a day for me just based

54:48

on my ideal body weight and Then

54:50

you know as much non-starchy vegetables as

54:52

I want and I've been experimenting more with

54:54

fruit I had not been eating a lot of

54:57

fruit for a while But right now I'm in

54:59

a berry phase lots of raspberries and blueberries are

55:01

what I really enjoy Even

55:04

just green bananas like I think bananas have

55:06

been largely vilified But I love

55:08

a just green banana and it probably makes me

55:10

sound like a total weirdo But that's when it's

55:12

a lot less starchy There's just

55:14

something about it like it's literally when it's

55:16

just gone from green ish to a little

55:18

bit yellow That's perfect for me And those

55:21

are the things that that work really well for

55:23

me, and I always encourage people to Experiment

55:26

see you know if is yours or your

55:29

satiety cues kind of met with the

55:31

amount of protein that you're eating for me I am

55:33

so full when I'm done eating There's

55:36

no way I could eat more food It's

55:38

interesting when I travel though. I will say with

55:40

full disclosure. I've started ordering a second

55:43

thing of protein Like I was in a

55:45

restaurant last month, and I had

55:48

a naked burger on my plate

55:50

And I looked at the waitress. I said can I get a side of

55:52

shrimp? We're some chicken because this burger

55:54

was so small I felt like not I'm not

55:56

hitting that 40 50 60 grams of protein in that

55:59

meal So there's been a

56:01

great deal of experimentation, but that's what works best

56:04

for me right now. And definitely breaking

56:06

my fast is with a protein dense

56:08

meal, usually with some

56:10

carbohydrates, but usually in the form of vegetables.

56:13

So you've really hit home the importance of protein

56:15

when you break your fast. Let's

56:17

talk about why that is. I think it was 40, 50, 60 grams.

56:21

Why do you aim for so high? What is that doing for you? Yeah.

56:25

So for me, I'm very protective of my

56:28

muscle. And the one

56:30

thing that I have learned from being friends

56:32

with Dr. Gabrielle Line over the last

56:34

several years is that protein is

56:36

so incredibly important. Our protein needs actually increase with

56:38

age. You know, it's not that they go away.

56:41

My protein needs probably as a

56:43

51 year old female are

56:45

much more than they were even 10 years ago.

56:48

So protein is important for me because I'm

56:50

aiming for 110 grams a day. And

56:54

I kind of teach people that you want

56:56

more protein than you probably realize. So I

56:58

want to make sure that each meal has

57:00

50 to 60 grams of protein. That's ideally

57:02

what I'm shooting for. Number

57:05

one for supportive muscle protein synthesis.

57:08

Number two for satiety because the

57:10

one thing that people may or may

57:12

not realize is that as you are

57:14

losing estrogen in perimenopause towards the tail

57:17

end and into menopause, and

57:19

as this hormone called follicular simulating hormone

57:21

is going up, it

57:23

will drive the need for protein needs

57:25

will continue to increase. If

57:28

you don't get your protein, Matt, guess what?

57:30

You're going to crave fat and carbohydrates.

57:33

And it's important to understand that those

57:36

things tend to be hyper palatable. Meaning

57:38

if I sit down and have a bunch

57:40

of chips and guacamole, although delicious, that

57:43

is not going to give my body the macros

57:45

that it needs to be able to continue to

57:48

build muscle. What's important to

57:50

understand about muscle is that muscle helps

57:52

with insulin sensitivity. So as we are

57:54

losing muscle north of 40, you know,

57:56

this process of sarcopenia, our

57:58

bodies are effectively replacing. lean muscle

58:00

tissue with adipose tissue. Although

58:04

if you're looking at a fillet, neon,

58:06

which is lean muscle, a ribeye,

58:09

all of them delicious, that's not what we want

58:11

our muscles to turn into because we

58:13

start to lose muscle. Insulin

58:16

sensitivity will become more insulin resistant.

58:18

There are all these hormonal changes that are

58:21

occurring, especially for women, as they are transitioning

58:23

from perimenopause to menopause. And

58:25

so for me, it's helping individuals understand

58:27

whether you're a man or a woman,

58:29

you know, andropause is

58:31

a real thing. Menopause is a real

58:33

thing. And the way to get ahead of that

58:35

is to make sure you're eating enough protein,

58:37

you're getting high quality sleep, and you're lifting

58:40

heavy things. And that always seems

58:42

to be a triggering kind of trio because people say,

58:44

I don't want to lift weights. And I'm

58:46

like, I don't care if you do body weight exercise.

58:49

I've got my, you know, 76 year

58:51

old mom doing body weight exercise.

58:53

And she's slowly kind of

58:55

improving upon her sarcopenic

58:58

muscle. But it's

59:00

helpful to understand this is where

59:02

me as an intermittent fasting expert, I

59:04

will differentiate from the longevity experts. Because

59:08

to me, it is far more important to

59:11

be hitting those protein metrics than

59:13

it is to be having just one meal a day

59:15

than it is to be losing

59:17

continuing to lose muscle mass as I get older. I

59:20

think that on a lot of different levels, these

59:23

frank conversations are important so that people

59:25

understand those hormones that I'm

59:28

referring to estrogen, testosterone, progesterone,

59:31

whether it's cortisol, melatonin, as

59:33

these things are changing throughout our lifetime, they

59:36

can positively or negatively impact

59:38

how we are aging, whether that's

59:41

accelerated, you know, if you're losing

59:43

muscle and you're losing insulin sensitivity, you're increasing

59:45

inflammation, you're increasing oxidative stress.

59:48

We have a whole generation of providers

59:51

and also women who are fearful to

59:53

talk about hormones, let

59:55

alone talk about replacing hormones. And

59:57

so helping people understand very

59:59

transparent. because I tell I'm very comfortable

1:00:01

talking about what I've done that's worked and

1:00:03

what I've done that has not worked. I

1:00:06

think it's helpful for people just to start the conversation

1:00:08

with if you want to maintain insulin sensitivity

1:00:11

and you want to maintain lean muscle, you

1:00:14

have to change your relationship with

1:00:16

protein and you have to change your

1:00:18

relationship with the types of exercise that you're doing and

1:00:21

also really focusing on sleep and those three things

1:00:23

can be very, very helpful to

1:00:26

ensure that you remain metabolically healthy and I think

1:00:28

that's something that you and I really share is

1:00:30

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1:00:32

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1:00:34

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1:01:39

N T. Pick up

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some Element electrolytes today and

1:01:43

stay salty. Well I definitely

1:01:45

want to take some time later on in

1:01:48

our conversation to talk about metabolic health and

1:01:50

you mentioned insulin sensitivity insulin resistance I really

1:01:52

want to get into those as well but

1:01:55

before we do I want to make sure we

1:01:57

really get into some of the nuances of what

1:01:59

you're eating. and when you're eating. So

1:02:01

we kind of have an idea now of the food piece,

1:02:04

but let's go back to, let's just go right through

1:02:06

your day. I think that'd be helpful and

1:02:09

talk about what you're having

1:02:11

before you break your fast, when you break your

1:02:13

fast. You mentioned exercise, that being

1:02:15

a big piece of all this. When are

1:02:17

you exercising? I really want us before

1:02:19

we get into the next piece to have a good feeling

1:02:21

for what a day looks like. Okay, so

1:02:23

this is the, this is a typical day in

1:02:25

my life. Obviously, it's

1:02:28

a great question. I'm happy to answer it. But

1:02:31

remember, this is what works for me at this

1:02:33

stage of my life. So this may not work

1:02:35

for someone else. So I'm typically up between five

1:02:37

and six a.m. Usually,

1:02:39

the first thing I do is I get

1:02:41

my dogs out for a walk. And

1:02:43

it's important that I get out

1:02:46

like as the sun is kind of rising. So

1:02:48

my dogs get anywhere from one

1:02:50

and a half to two mile walk. And

1:02:52

then I'm getting sunlight exposure on my retinas. I'm

1:02:55

not wearing sunglasses, depending on how cold it is.

1:02:57

That's how long the walk is. I

1:02:59

come home, I feed them. I have

1:03:02

teenagers, they feed themselves and go off to school.

1:03:05

And then usually, whatever exercise I'm doing that

1:03:07

day, whether it's a day where

1:03:09

I'm doing more recovery work, or if it's the

1:03:11

day I'm lifting, I try to aim to lift

1:03:13

two to three days a week minimum. I

1:03:16

also really like doing Pilates. I probably

1:03:18

should be doing that twice a week because

1:03:20

I actually mentally that's good for me because

1:03:22

it's challenging, but in different ways. I

1:03:25

get quite a bit of walking in. So for me,

1:03:27

I'm aiming to have seven to

1:03:30

eight thousand steps done in the morning because that

1:03:32

kind of allows me to kind of gauge how

1:03:34

much more physical activity I need during the day.

1:03:37

After I've gotten my workout done, I really love

1:03:39

laying on a PMF mat. And

1:03:42

if anyone's wondering what that is, it's

1:03:44

a mat that has ions that are

1:03:47

actually helping to support the mitochondria. It's

1:03:49

incredibly relaxing. And for me, it

1:03:51

kind of reminds my body, depending

1:03:53

on the settings, okay, this is kind of

1:03:55

a little bit of recovery before I take

1:03:57

a shower. So usually in the shower

1:03:59

by nine. 9 o'clock in the morning, shower,

1:04:02

get myself ready for the day, whatever it is

1:04:04

I'm doing, household stuff, if it's laundry or other

1:04:06

things. I am

1:04:08

always, as soon as I get up in the morning,

1:04:10

I'm drinking water. I have a little bit of

1:04:12

mild dysautonomia. I

1:04:15

don't have POTS, so I don't have Postural

1:04:17

Orthotatic Hypotension that a lot of

1:04:19

individuals do. But I've always

1:04:21

craved electrolytes and I never knew why. And so

1:04:23

I've been working with a new functional medicine doctor and

1:04:25

the first thing he said, you know, he just mentioned

1:04:28

a couple things about my history and he's like, I

1:04:30

think you actually have mild dysautonomia

1:04:32

and some degree of hypermobility and I've

1:04:34

got some gut stuff. And so he said,

1:04:36

you kind of created this triad that he

1:04:38

sees. And so for me, electrolytes

1:04:40

are an important part of my day. I drink them

1:04:43

throughout the day, obviously in a fasted state,

1:04:45

it's the unflavored variety. But I

1:04:47

had a lot of like, when I tell you a lot

1:04:49

of electrolytes, a lot. And so

1:04:51

I'm drinking that all the way throughout the day. I

1:04:54

usually now break my fast a little earlier

1:04:56

than I used to. Usually

1:04:58

930, 1030, 11 is usually my sweet

1:05:00

spot depending on what's on my calendar. That's

1:05:04

when I'll sit down and have

1:05:06

50, 60 grams of protein. I'll

1:05:08

have those non-starchy vegetables. My

1:05:10

one vice in life is dark chocolate. And so I

1:05:12

allow myself to have a little bit of dark chocolate

1:05:14

every day. And I have zero shame about that. There's

1:05:16

a lot of things I don't eat, but

1:05:19

I love dark chocolate and that's something that makes me

1:05:21

happy. Little bit of a dopamine hit and then I

1:05:23

can kind of tackle my day. And

1:05:25

most of my day is working in my business.

1:05:27

If it's a Monday through Friday, I usually

1:05:30

start to kind of gear down around 330 because I

1:05:33

have a titto that has to be picked up from school.

1:05:36

And I may or may not, you know,

1:05:38

eat before I pick them up or eat

1:05:40

after. It just really depends on how the

1:05:42

day is structured. On the weekends, we're very

1:05:44

diligent about family meals during the week. It's

1:05:46

because we have so many different schedules, sports

1:05:48

events, things. It's just, it's kind of a

1:05:50

grab and go culture, which

1:05:52

used to not be the case. But now that

1:05:54

I have teenagers, we've had to kind of make

1:05:57

some accommodations. So that last meal could be at

1:05:59

four o'clock. be at five o'clock, it could be

1:06:01

at six o'clock. And again, I'll have

1:06:03

the same kind of plug and play, you

1:06:05

know, 50 to 60 grams of protein, more

1:06:08

non-sarchy vegetables, lots of water.

1:06:11

During my feeding window, I will have electrolytes

1:06:13

with some stevia in them and I'm

1:06:16

okay with that. I love

1:06:18

fresh sweet lemon in my water.

1:06:20

I'm happy to talk about all

1:06:22

the electrolytes I take because I try to

1:06:25

differ a couple different ways

1:06:27

to get them all in. I can tell by

1:06:29

my HRV, my heart rate variability,

1:06:31

how much hydration I've gotten. And

1:06:34

so that's a typical day. And then usually

1:06:36

I'm gearing down for bed. I like to

1:06:38

be upstairs, maybe not in bed, maybe not

1:06:41

per se, in bed, nine-ish. I

1:06:43

like to be in bed lights out by 9.30

1:06:45

or 10. This week

1:06:47

was unusual that I had my

1:06:49

mom was in town, my mom doesn't go to bed early

1:06:51

and then we had my older son had a lacrosse game.

1:06:54

And so I think I was in bed at like quarter

1:06:56

of 11 and I definitely feel differently

1:06:58

when I get up, when I go to bed later.

1:07:00

So that's a typical day.

1:07:04

Two usually large boluses of food.

1:07:07

Yes, I'm very cognizant of to

1:07:09

ensure I'm getting plenty of food in.

1:07:12

And some days I would

1:07:14

say the average day I get two large boluses

1:07:17

of food, which sounds terrible, two large

1:07:19

meals. And then at least

1:07:21

one day a week, I refer to

1:07:23

it as a refeeding day. And refeeding

1:07:26

makes me sound like I'm an animal in the zoo,

1:07:28

but it's really a day I will have a bit

1:07:30

more protein. I will account

1:07:32

for another meal and it

1:07:34

could be maybe that's a day I have a protein

1:07:37

shake and then two large meals. Or maybe

1:07:39

it's a day I just sit down and have, I'm

1:07:41

kind of going through this egg phase as I mentioned.

1:07:43

Maybe I have four eggs or

1:07:46

maybe I have an omelet, maybe I have five eggs, just

1:07:48

depends on how hungry I am. But

1:07:50

it's definitely with the understanding

1:07:52

that I'm very aware of how my

1:07:55

body feels, how's my recovery from

1:07:57

workouts, how's my sleep quality. But

1:08:00

the hydration and protein are two very

1:08:02

consistent things that I really actively work

1:08:04

towards. I have a

1:08:07

60-ounce glass pitcher that sits on my

1:08:09

counter and that's how I'm able to

1:08:11

kind of get a sense for how much water I'm consuming

1:08:13

throughout the day. So the expectation is by the time I

1:08:15

go to bed, I have finished that. So I'm drinking

1:08:17

it throughout the day, which I think

1:08:19

is really just very important for me. As

1:08:22

an example, I was out in Denver. I

1:08:25

live on the East Coast, but I was out in Denver last

1:08:27

month. When my mom grew up

1:08:29

in Denver, I'd gone to Denver hundreds

1:08:31

of – I mean a hundred times – many

1:08:33

times throughout my lifetime because I have family there.

1:08:36

I had an altitude headache. I

1:08:39

struggled. My HRV was in the toilet. My

1:08:41

sleep quality was off. And it was because I could not

1:08:43

– like I could not catch back up for the

1:08:46

hydration piece. And so for three

1:08:48

days, I had the headache, the hydration, electrolytes.

1:08:50

I was doubling up on electrolytes. And

1:08:52

it was interesting to see that

1:08:55

at altitude, I was really struggling because I

1:08:57

travel quite a bit. I don't

1:08:59

normally have that much trouble. But it was really

1:09:01

interesting to see the net impact on how

1:09:03

I felt because I just couldn't get

1:09:05

ahead of the curve. But generally speaking, that's

1:09:08

kind of how my days are structured. Now, if

1:09:10

I'm traveling, obviously different. Weekends

1:09:12

are different because it's so important for us to sit

1:09:14

down with our children and eat. And

1:09:17

it's just – it's a slower pace. Like during the week,

1:09:19

it's very purposeful. It's like, okay, I have 30 minutes.

1:09:21

I'm going to sit down and eat my

1:09:23

meal. And I think it's very important that

1:09:26

I don't rush through eating. I don't like to eat in my

1:09:28

car. I don't like to eat at my desk. I

1:09:30

think it's important to just unplug. Maybe I read a

1:09:33

book. Just very, very important

1:09:35

to make sure my body is relaxed when

1:09:37

I'm consuming food so that it can properly

1:09:39

kind of assimilate and break down when I'm

1:09:41

eating. This is great. I love all

1:09:43

the detail here. I think we went over some

1:09:45

of this last time we talked. But this obviously

1:09:47

is always changing like I mentioned before. And

1:09:50

we're getting into all kinds of detail we haven't covered. A

1:09:53

couple areas I really want to make sure we

1:09:55

dive deeper into. One being the electrolyte piece. They

1:09:57

kept coming up. And I don't remember specifically –

1:10:00

them coming up last time. So I'm curious,

1:10:02

is this a newer addition for you or

1:10:04

just something you're making more of a priority

1:10:06

in the last bit? And then it

1:10:09

sounds like you're having them throughout the day.

1:10:11

Are you drinking plain water too or is

1:10:13

it electrolytes all the time? It

1:10:16

is electrolytes all the time. I've always, it's

1:10:18

interesting. I even before intermittent

1:10:21

fasting, I because of cardiology, because

1:10:23

of my background and knowing what I

1:10:26

knew about my patients, I was like, you

1:10:28

know, I would recommend salting their food, which

1:10:30

was completely contrary to what we're typically telling

1:10:32

our patients, you know, high quality salt, but

1:10:35

I crave salt and it's my adrenals are

1:10:37

healthy. That's not the issue. I think I've

1:10:40

always, I've always needed them. And I

1:10:42

intuitively understood that. Because

1:10:44

this new physician that I'm working with, he laughed

1:10:46

when we asked me what I ate in a

1:10:49

day and he said, I think it's really

1:10:51

interesting that you are this attuned to

1:10:53

your body, you understand how much better

1:10:55

you feel when you're consuming

1:10:57

electrolyte, as opposed to not.

1:10:59

So when I look at

1:11:01

my day, I literally have, I don't know

1:11:03

if you've ever heard of Quentin ampoules, so

1:11:06

you can get hypotonic, hypertonic isotonic

1:11:08

water. They're little ampoules

1:11:10

that you break them off. I add that to

1:11:12

my water, you know, in an unfed

1:11:14

state, because there's nothing that's flavoring them.

1:11:17

It's pretty benign. I

1:11:19

add element to

1:11:21

my water in an unfed in a fed

1:11:24

state. Obviously, the unsweetened element is

1:11:26

pretty salty. So that has to be diluted

1:11:28

in a lot of water. But yeah,

1:11:31

all day long, I'm drinking electrolyte, I even have

1:11:33

other trace minerals that I'll

1:11:35

add. And what I found

1:11:37

is interesting is that I

1:11:40

sleep better, my HRV is better.

1:11:43

I'm a lot more alert

1:11:46

when I'm hydrating like this all during the day.

1:11:48

But I understand now that

1:11:50

there's something unique about my physiology that

1:11:52

I actually need more than the

1:11:54

average person. And someone had once

1:11:56

said, well, is it because you're low carb, because you've got

1:11:59

these renal losses of sodium and

1:12:01

I said, well, now I'm, I wouldn't

1:12:03

say I'm consistently low carbohydrate. For

1:12:05

listeners, if they're familiar, when you

1:12:07

go lower carbohydrate, you're actually breaking

1:12:10

down into pleating glycogen stores and

1:12:12

with glycogen being broken

1:12:14

down, you'll get renal losses of sodium

1:12:16

and other electrolytes. And I said, I

1:12:19

can tell if I'm, if I'm really low carb,

1:12:21

I can tell my body, I'll just start urinating

1:12:23

more often. I said, that's

1:12:25

not what this is about. I think this is

1:12:27

just what's unique to me and my lifestyle. But

1:12:30

I find that fasting in general, if

1:12:32

someone's fasting and not using electrolytes, it can

1:12:34

be a big game changer. People just feel

1:12:36

better. And we're mentally clear, they have

1:12:39

less cramping. And so the

1:12:41

longer I've done this, the more I just realized is

1:12:43

that that this might be my magical

1:12:46

unicorn properties is that I

1:12:48

consume a lot of electrolytes throughout the day,

1:12:50

but not in a way that's raised

1:12:52

my blood pressure or not in

1:12:55

a way that inhibits my ability to go to bed at night.

1:12:57

I don't wake up to urinate. So I know

1:12:59

I'm hitting the right threshold for me. But

1:13:01

I acknowledge if someone were to

1:13:04

see, because my mother was asking a lot of questions,

1:13:06

if someone were to see what I do in a given day,

1:13:08

they would probably be surprised. You mentioned Element

1:13:10

there, they're a longtime sponsor of the show.

1:13:12

I'm actually drinking Element right now. Big

1:13:15

fan. How many packs would you

1:13:17

go through a day? At

1:13:20

least three, sometimes four. And that's on top

1:13:22

of Quinton Ambules. That's on

1:13:24

top of Trace Minerals. I've

1:13:27

even got my, my

1:13:30

physician even has me on some vitamin C. So

1:13:32

I've got like a lot of mineral

1:13:35

support just in general. And to

1:13:37

his credit, actually, since he added

1:13:39

a couple new mineral supplements,

1:13:41

I actually feel really good. So I'm like,

1:13:43

okay, this is actually working towards that. But,

1:13:45

you know, when I was in Denver, I was consuming

1:13:48

probably eight a day because I was

1:13:50

doubling up because I knew what was happening. I

1:13:52

was like, my body's dehydrated. And it's

1:13:55

not acclimating to altitude as readily as I thought

1:13:57

it would. I was like, okay, I will never

1:13:59

be probably not going to

1:14:01

Machu Picchu anytime soon, which is even

1:14:04

a higher elevation. But you

1:14:06

know, as to your point,

1:14:08

I think that for each one of us, it's finding

1:14:10

that sweet spot. I have some people that will just

1:14:12

consume one element a day. And that's

1:14:15

as much as they tell, right? And so I think it's

1:14:17

the power of the end of one and

1:14:19

just understanding that, you know,

1:14:21

we each one of us has kind of

1:14:24

like unique needs that if

1:14:26

we're tuning into what our body is trying

1:14:28

to communicate can really make a big difference.

1:14:30

And for me, electrolytes are total game changers.

1:14:33

So when I travel, especially when I

1:14:35

travel overseas, or I'm doing longer

1:14:37

trips, that's how I can kind of gauge

1:14:39

how much water I'm consuming. So I always bring

1:14:42

that glass container, which you know, to my teenagers

1:14:44

is so embarrassing. They're like, Oh, there

1:14:46

goes mom with her electrolytes. I'm like, that's right.

1:14:49

So just to make sure I'm clear, this big container

1:14:52

has the Quentin ampoules, which is something I'm going to

1:14:54

look into. I haven't heard of them before. The

1:14:56

element and then trace minerals. What

1:15:00

kind of trace minerals? So it's

1:15:02

just a product that has, you know,

1:15:05

bioavailable potassium, sodium, magnesium

1:15:07

and chloride. And

1:15:10

the trace minerals are things like

1:15:12

manganese and lithium.

1:15:15

I take a separate vitamin C supplement,

1:15:18

you may or may not know, vitamin C is

1:15:20

one of these supplements

1:15:22

that if you take too much, it can actually

1:15:24

give you diarrhea. So it's very, it's like this,

1:15:27

I take a capsule because the powders I'm like,

1:15:29

no, I don't want to do that. It's a

1:15:31

little too, it's a little less specific. So, you

1:15:34

know, for me, it's finding what's

1:15:37

the right combination for me. But I

1:15:39

acknowledge when I say to other people,

1:15:41

this is what I do. It's like,

1:15:43

wow, that's, that's a lot of different

1:15:45

steps. However, because I feel good. That's

1:15:48

why it just reinforces like this

1:15:50

is physician sanctioned. So objectively, my

1:15:52

physician has signed off on this

1:15:55

with the acknowledgement that he's like, you've

1:15:57

figured out for yourself what you need, like your

1:16:00

little like cocktail of electrolytes

1:16:02

that you consume during the day that work

1:16:04

best for you. Oh, and

1:16:06

I love lemon. So I have a lot of lemon

1:16:08

squeezed into my water. For some reason, that's like perfect.

1:16:12

And what do you use for a base

1:16:14

of the water? Is it like a Berkey

1:16:16

water filter system or reverse osmosis? Just

1:16:18

since we've gotten into the nuances here, let's get the

1:16:20

full picture. So it's interesting that you

1:16:23

asked that question. So it's always filtered water,

1:16:25

but I had our water

1:16:27

tested and my new functional medicine doctor wanted

1:16:29

an even more involved.

1:16:32

There was like eight different vials of water

1:16:34

that had to be tested. And so I'm

1:16:36

still waiting to get that report because he

1:16:39

wanted that report to then determine what we

1:16:41

were going to get. I just wanted to

1:16:43

get a whole house, Aquasana system. My

1:16:45

husband didn't want anything on our counter. So our

1:16:47

Berkey did not make its way from our last

1:16:49

house. And so we're kind of in

1:16:52

this gray area right now waiting to figure that

1:16:54

out. The first test that

1:16:56

we did, which he felt like didn't

1:16:58

test enough things, showed us some cadmium.

1:17:01

So cadmium is a heavy metal. And

1:17:03

he felt like there was probably the

1:17:05

area of Virginia that I live in

1:17:07

has some, there's probably a

1:17:09

strong likelihood there's more heavy metals than

1:17:11

what we realized. So to this

1:17:14

date, I don't yet have that report. I'm told

1:17:16

it should be back next week. It's like a

1:17:18

three, takes like three weeks to test

1:17:20

all these things. But literally, there's this massive box

1:17:22

that shows up. They even have to

1:17:24

put all these eight vials of things, you know,

1:17:26

out of the kitchen sink, out of this other sink.

1:17:29

We have a brand new house. I don't anticipate we're going

1:17:31

to have any contaminants

1:17:33

that related to copper pipes or things

1:17:35

like that. So it's been a

1:17:38

very interesting journey. And I just say

1:17:40

this really humbly, like as a clinician, going

1:17:42

through this process has been very interesting. Let's

1:17:45

talk about the stevia piece. You mentioned

1:17:47

when you're in your fasting window, you're

1:17:49

having the unflavored electrolytes, which

1:17:52

opens up the bigger question, stevia,

1:17:55

how do you feel about it in general?

1:17:57

And then because I'm somebody I mentioned the

1:18:00

and big fan, I have the flavored ones.

1:18:02

I actually don't consume the unflavored ones, only

1:18:04

because I like all the different flavors, even

1:18:07

when I'm fasting. So this might be, this

1:18:09

is probably going to be a new piece

1:18:11

for me to implement when I'm fasting to

1:18:13

get the unflavored ones. Why

1:18:16

does that matter? Well, I

1:18:18

think this is, there's definitely

1:18:20

debate, certainly on social

1:18:22

media, some people say, well, it doesn't evoke a

1:18:25

blood sugar response. So it's irrelevant. But

1:18:27

I think more about a systolic phase

1:18:29

insulin response. So this physiologic

1:18:32

response to things that are sweet on our tongue.

1:18:35

And when I talk about a clean fast, a clean

1:18:37

fast incorporates things that I'm

1:18:39

pretty certain are not going to evoke an insulin

1:18:42

response in the body. And so I

1:18:45

think this is very nuanced. Obviously,

1:18:47

if you are metabolically healthy, insulin sensitive,

1:18:49

I don't think you really

1:18:51

have to worry about the nuances of having a

1:18:53

little bit of stevia in a feeding, excuse me,

1:18:55

a fasting window. But

1:18:58

most of my people that follow me and

1:19:00

are in programs are not metabolically healthy, or

1:19:02

they're kind of teetering on that edge. And I

1:19:04

do think it can be a differentiator between,

1:19:07

you know, clean fasting versus

1:19:10

maybe it's a little nuanced type of fasting.

1:19:12

So I think for an individual, if you're

1:19:14

insulin sensitive, probably not a big deal to

1:19:17

have a packet of CVS

1:19:19

sweetened element, I want to be really clear about

1:19:21

that. I don't beat myself up. If I want

1:19:23

orange salt, I'm going to have it and I'm

1:19:25

not going to feel guilty or badly about it.

1:19:28

I think that it's important to just

1:19:30

understand the context when

1:19:33

we're talking about non-nutritive sweetener. So there

1:19:35

was a study that was done in

1:19:37

cell last fall kind

1:19:39

of looking at non-nutritive sweeteners. And

1:19:41

it was in a mouse study and it was looking at saccharin,

1:19:43

which made me laugh because I was like, was it like 1980s,

1:19:46

like tab soda? That's like what my

1:19:48

grandmother used to consume. Like who's using

1:19:50

saccharin? They were

1:19:53

comparing that with aspartame

1:19:56

and ciphrulose. And

1:19:58

so to me, aspartame and sucralose or

1:20:00

these artificial sweeteners, those

1:20:03

I think I would definitely not recommend people

1:20:05

consume. They're in a lot of beverages, they're

1:20:08

in a lot of shakes, they're in a

1:20:10

lot of bars that are out

1:20:12

there that seem to be kind of benign. And I

1:20:15

say seem to be benign and I'll put that in air quotes.

1:20:18

And then there was also stevia that was used in

1:20:20

the study. And the kind

1:20:22

of first thing that it was looking at in a

1:20:24

mouse model was how did

1:20:27

these sweeteners impacts oroglucose tolerance?

1:20:30

And within 28 days, there was a negative

1:20:32

net impact on oroglucose tolerance and there was

1:20:35

a negative net impact on the gut microbiome.

1:20:38

Now this is a mouse or

1:20:40

mice. This is not a human,

1:20:42

but when we're looking at animal models, we could likely

1:20:45

kind of extrapolate that there could

1:20:48

be the potentiality of negative

1:20:51

interactions on the gut microbiome and our

1:20:53

insulin sensitivity or glucose tolerance for that

1:20:55

matter. But

1:20:57

I don't kind of put stevia

1:21:00

in the same bucket as saccharin,

1:21:02

sucralose, aspartame. I want to

1:21:04

be really clear about that. And

1:21:06

I think if you're having three or four

1:21:08

elements a day, that's very different than someone that's

1:21:10

having a lot of highly processed type of palatable

1:21:13

foods with a lot of artificial sweeteners in them.

1:21:16

And I think it's also, are you someone that's very

1:21:18

susceptible to artificial sweeteners? Some people it just drives

1:21:20

the desire for more and more and more

1:21:22

and more and more. And

1:21:25

I think for individuals that are

1:21:27

susceptible, they have to really abstain

1:21:29

or really limit their consumption

1:21:31

of non-nutritous sweeteners along

1:21:34

with traditional sweeteners. And so

1:21:36

it really begs the question of you have to know

1:21:38

yourself. I always like Mini Tortorich

1:21:40

because he has the no sugar, no grains.

1:21:42

That's kind of his mindset. And I was

1:21:45

at a talk that he gave last

1:21:47

year. We spoke at an event and

1:21:49

someone said, what's your favorite artificial

1:21:51

sweetener? And he said, none.

1:21:54

He said, because all you're doing is chasing

1:21:56

a problem with another problem. Meaning if you've

1:21:58

got a sugar, then you're going to have to know yourself. problem,

1:22:01

you're better off limiting or

1:22:03

eliminating the sugar than

1:22:05

trying to find the latest and

1:22:07

greatest, whether it's monk fruit, a

1:22:09

thirotol, stevia, etc. And

1:22:12

so I think we really just have to know ourselves. So

1:22:14

again, just kind of getting back to the original intent of

1:22:17

answering the question was if you're not

1:22:19

insulin sensitive, if you're dealing with, you

1:22:21

know, hyperinsulinemia or you've

1:22:23

got a high blood sugar, then

1:22:26

it probably matters what you're consuming

1:22:28

in a fasted state, significantly so. If

1:22:31

you're metabolically healthy, you're insulin sensitive,

1:22:34

I wouldn't worry about a package of elements. And

1:22:37

I'm just using element as the example. Obviously, there's other things

1:22:39

that we could use. I think that's

1:22:41

really how it gets really nuanced. And

1:22:44

do I on occasion have orange element in

1:22:46

a fasted state and feel fine? Absolutely. But

1:22:49

I think it's always in the context. But for

1:22:51

me personally, I'm having a combination of unflavored

1:22:54

and flavored orange

1:22:56

salt. That's my favorite throughout

1:22:59

my day. And so I think that

1:23:01

it's really big picture. Like I think

1:23:03

sometimes people can get so fixated

1:23:05

on minutia that they miss the big picture. And

1:23:07

the big picture is are you insulin sensitive? The

1:23:10

answer is yes, then worry a whole lot

1:23:12

less. If you're not, then you got to work on

1:23:14

those things because it can make a big difference in

1:23:16

the success that you have. As

1:23:18

you're going through what you eat, when you eat,

1:23:20

and you gave us kind of a typical week

1:23:22

saying things are a bit different on the weekend,

1:23:25

one of the things that jumped out at me

1:23:27

was the fact that you have this one day

1:23:29

throughout the week where you actually up the protein.

1:23:31

And for a lot of us, it already I'm sure

1:23:34

sounded like you're having quite a bit of protein on

1:23:36

a typical day. One

1:23:38

thing you didn't get into though is why you

1:23:40

do that. So what's the reason for that once

1:23:42

a week? Well I think

1:23:44

because I've been fasting for so

1:23:46

many years now, it's kind of,

1:23:48

you know, you can make the

1:23:51

argument I could have more carbohydrates that day or I

1:23:53

can have more protein, but it's designed to

1:23:55

kind of stimulate a little

1:23:57

bit more muscle protein synthesis, but also remind my

1:23:59

body. I'm not trying to starve it. Oftentimes,

1:24:03

women come to me, and I'll use a

1:24:05

woman as an example. Her example

1:24:07

is a middle-aged woman. She's

1:24:09

weight loss resistant. If a little bit of fasting

1:24:11

is good, more is better. They've been doing OMAD

1:24:13

for years. They're mad at me because I'm telling

1:24:15

them they're not eating enough food. They're going to break

1:24:17

their metabolism effectively. And we

1:24:20

have to kind of reverse diet, go

1:24:22

back to eating more food

1:24:24

because they've gotten to a point where

1:24:26

they're not eating, they're completely plateaued, but

1:24:29

they've not been eating enough food for years and years

1:24:31

and years. And what ends up happening is their

1:24:34

body's like, well, heck, I'm not going to get much

1:24:36

food today, so I'm not going to burn

1:24:38

any extra calories. There's no point in doing

1:24:40

that. And so I think

1:24:42

it really begs the conversation about

1:24:45

making sure you're eating enough food. So for me,

1:24:47

it's really kind of giving myself a little, maybe

1:24:49

it's 100 calories more. It's not a ton more

1:24:51

protein, but kind of pushing that metric

1:24:53

up and working with women that

1:24:55

have effectively gone to a point where

1:24:58

they're eating 800 calories a day, maybe 500

1:25:01

calories a day after eating one meal, they've just

1:25:03

gotten to a point where they've whidgeted down so

1:25:05

much. That can be destructive.

1:25:07

And this is when there's this

1:25:10

nuance of some degree

1:25:12

of disordered eating, that can

1:25:14

play a role. I don't

1:25:16

know if you're seeing that in some of the talking

1:25:19

to some of the guests that they're seeing

1:25:21

similar situations with patients. I have some people

1:25:23

who are pathologically fearful to eat more than

1:25:25

one meal a day. And I always say one meal

1:25:28

a day is fine around holiday,

1:25:30

vacation, you ate too much, you

1:25:32

don't feel good, you're bloated. One

1:25:35

meal a day is not a sustainable strategy

1:25:37

to be able to hit those protein macros,

1:25:39

to not end up losing muscle mass at

1:25:41

the expense of insulin sensitivity. And so for

1:25:44

me, a lot of why I do that is to

1:25:46

kind of push that threshold up.

1:25:48

Now, have I ever gotten to a

1:25:50

point where I had to kind of adjust my macros

1:25:53

and make sure I was pushing the envelope? That's why

1:25:55

that protein beast is so important. I

1:25:57

don't want my body to think that I'm trying

1:25:59

to be an ex- neglectful or

1:26:01

I don't track macros. I

1:26:03

don't track calories. But I

1:26:05

have it. I generally have a very good sense

1:26:08

of how much I'm eating. I'll

1:26:10

give you a good example. Two days ago, super

1:26:13

busy day, didn't stop and have lunch, totally

1:26:15

unusual for me. My son had

1:26:17

a lacrosse game, didn't eat enough for dinner.

1:26:20

And by the next day, I was like, I'm grumpy.

1:26:22

I know I'm grumpy because I didn't eat enough food.

1:26:24

I can't, I can't, I definitely can't exist like that.

1:26:26

So my, your body will definitely let you know. But

1:26:29

I think from the perspective of, um,

1:26:32

if you think you probably aren't eating enough food,

1:26:34

you probably are. So I think that's

1:26:36

an important, an important distinction to

1:26:38

me and how many individuals will share with

1:26:41

me across social media. They've been

1:26:43

doing OMAID for years, males and females. And

1:26:45

I'm like, you're probably in

1:26:47

a significant caloric deficit and that

1:26:49

could be detrimental. And so really

1:26:51

having those honest conversations, even if

1:26:54

the potentiality exists, that it's going to be

1:26:57

provocative or make someone uncomfortable. Or, um,

1:27:00

you know, I used to be the

1:27:02

co-host of another podcast and we would sometimes get those

1:27:04

questions and I would just say, well, if you don't

1:27:06

think you're eating enough, you probably are. And so

1:27:09

I think more often that we've already answered the

1:27:11

questions for ourselves without having to ask it. It's

1:27:13

like we already know we just need the validation.

1:27:17

Seeing the dogs coming through there as a

1:27:19

segue into you finding your way into the

1:27:21

health and wellness space. I think Cynthia, for

1:27:23

you, you were interested in starting to study

1:27:26

law and then you got

1:27:28

a dog and this, this was something

1:27:30

that helped your trajectory course cracked

1:27:33

into becoming a nurse practitioner. So I'd love for

1:27:35

you to talk about that, getting into the health

1:27:37

and wellness space and, and how your dog was

1:27:39

involved with that. Yeah. So

1:27:41

I was pre-law all through undergrad, got into

1:27:43

law school. And then when I started looking

1:27:45

at the ROI, I was like,

1:27:47

okay, I'm going to spend this much money on a private

1:27:49

law school and I'm going to get out and maybe make

1:27:52

this much money. And it didn't seem like a good, it

1:27:54

didn't seem like it was a good investment. And

1:27:56

at the time I always wanted a dog. I

1:27:58

had divorced parents who very responsible. said, there's

1:28:00

no way we can handle a dog. And so I got

1:28:02

out of college. And the first thing I did was get

1:28:04

a dog, I got a rescue. And she

1:28:07

changed everything for me, you know, I realized

1:28:09

I was really interested in medicine. Initially, veterinary

1:28:11

medicine, until I realized I'm allergic to cats

1:28:13

in a horrible way, there was no way

1:28:15

that would have been feasible. And

1:28:18

I went back to school and took premed classes. And

1:28:20

in one of my classes, my professor, because I was

1:28:22

probably two years older than most of the undergrad, he

1:28:25

was like, what are you doing in here? And so I expand, I'm going

1:28:27

to go to med school, he's like, you don't want to go to med

1:28:29

school, you want to go, he's like, you want to have

1:28:31

a quality of life. And I was like, Yeah, you're right. And

1:28:33

he said, my sister's a nurse practitioner, I want you to

1:28:35

meet her. The irony is, a

1:28:37

lot of people in my family are nurses

1:28:40

and doctors. And I think I automatically rejected

1:28:42

that as an option, because I

1:28:44

didn't want to do what everyone else did. And

1:28:46

so that's the complete irony. But one of the

1:28:48

best things that could have ever happened to me,

1:28:50

because when I started applying to, they're called bridge

1:28:52

programs. So in order to be a nurse, you

1:28:55

have to have a nursing degree, which I didn't

1:28:57

have. And so I got both a bachelor's and

1:28:59

a master's and a master's was the terminal degree

1:29:01

for nurse practitioners 20 years ago.

1:29:03

And so I was accepted

1:29:05

into a dual program. At that time, I was really

1:29:07

interested in HIV and AIDS research. And so I went

1:29:10

to the number one med school, medical

1:29:12

school campus for that. And I

1:29:15

will tell everyone and anyone, best decision I ever

1:29:17

made was not going to law school. Because once

1:29:19

I got into my medical training,

1:29:22

I was so happy, so intellectually

1:29:24

stimulated, I loved being of service

1:29:26

to others. And so that's,

1:29:28

that's the direction I went down. I was an ER

1:29:30

nurse, I'm a bit of an adrenaline junkie. And then

1:29:32

I went into cardiology as an MP. And probably everyone

1:29:34

that's listening saying, how in the heck did you get

1:29:36

from there to where you are now. And

1:29:39

I think a lot of it had to do one

1:29:41

of my children had life threatening food allergies. And I

1:29:43

read a book by Robin O'Brien called the unhealthy truth.

1:29:45

And I had the opportunity to connect with

1:29:47

her last year, which was like, so

1:29:50

just a very emotional experience. Because she

1:29:52

really did encourage me to change the

1:29:54

trajectory of everything I was doing, I

1:29:57

started getting much more interested in the role of

1:30:00

food is medicine. I started a doctoral program

1:30:02

and hated it. I did a wellness coaching

1:30:04

program, which didn't really excite me. And

1:30:06

then ultimately, I did a function nutrition program.

1:30:09

And that lit me up and really encouraged

1:30:11

me to leave clinical medicine six years ago,

1:30:13

as of April 1.

1:30:15

And to start my own business and for

1:30:17

anyone that's listening and wondering, like, how did

1:30:19

you get from again from there to where

1:30:21

you are? I had no business plan. I

1:30:23

just told my husband I knew I'd be

1:30:26

successful. So I'm not sure if that was

1:30:28

ignorance or just supreme confidence. But almost instantaneously,

1:30:30

I started attracting women

1:30:32

just like myself, who were feeling like late 30s,

1:30:34

early 40s that our needs were not being met

1:30:37

in the medical system, we were being sidelined, we

1:30:39

were given options to control

1:30:41

our hormones with synthetic hormones and IUD

1:30:43

and ablation or a hysterectomy, which are

1:30:45

none of which were of interest to

1:30:48

me at all. And so

1:30:50

life imitates art, I started attracting all

1:30:52

these women, I ultimately decided to do

1:30:55

a TED Talk in 2018, did

1:30:57

one talk and I was offered a second. And

1:31:00

the second one, ironically enough, is the one that

1:31:02

I'm known for. And there was

1:31:04

no strategy behind the topics I chose to

1:31:06

speak on, but I was asked to speak

1:31:09

on fasting and women because

1:31:11

this particular venue felt like

1:31:13

they weren't serving women's needs enough. And so

1:31:15

the rest is history. That's kind of how

1:31:17

I've gotten from there to here never realizing

1:31:19

that what I would really be known for

1:31:22

is intermittent fasting in women, but very grateful

1:31:24

to be able to speak on women's behalf

1:31:26

and advocate for them and empower

1:31:30

women to have better information so that they

1:31:32

don't feel so lost in middle age, perimenopause

1:31:35

and beyond, as I usually say. I

1:31:38

think it was about the time

1:31:40

that you transitioned from practice to

1:31:42

doing things solo, that you

1:31:44

found intermittent fasting. Because I think earlier you

1:31:46

mentioned around six years ago, or just over

1:31:49

six years, you found intermittent

1:31:51

fasting. And this changed your life. So

1:31:53

go to the part of the story where you find

1:31:55

that, what you're going through

1:31:57

with your health challenge at the time.

1:32:00

and how that changed everything. Yeah,

1:32:02

I mean, I was always very fortunate. I've

1:32:04

always been thin even after having kids, I

1:32:06

never had problems losing weight. And

1:32:08

all of a sudden, I was doing all the wrong things. But

1:32:10

I thought we're all the right things. I was not

1:32:13

sleeping enough. It has been who did a lot

1:32:15

of international travel, I had two young kids, I

1:32:17

had a very stressful job, you know, cardiology, as

1:32:19

anyone could imagine, you're dealing with the sickest, most

1:32:22

acutely ill patient population. And I

1:32:24

was doing really intense exercise,

1:32:27

like conditioning classes at 530 in the morning.

1:32:30

And probably not feeling my body the

1:32:32

way that I needed to. And

1:32:34

perimenopause is like a leveling playing ground. Like

1:32:37

you think you're doing all the right things,

1:32:39

but all of a sudden, you start gaining

1:32:41

weight, you can't sleep, you're anxious. And

1:32:43

it's all because of these fluctuations in hormones,

1:32:46

your ovaries are producing less progesterone, which

1:32:48

impacts your sleep and anxiety and depression.

1:32:51

And all of a sudden, your estrogen

1:32:53

dominant, so you're feeling puffy and bloated

1:32:55

and your guts a mess. And

1:32:57

so, you know, I came to fasting out of

1:33:00

the desire to feel better. And I

1:33:02

felt better so quickly, that it started

1:33:04

working into all of the teachings and

1:33:07

education that I was doing with my

1:33:09

patients. And then, you know,

1:33:11

pivoted into me starting programs that incorporated

1:33:13

intermittent fasting as well. So I look

1:33:16

at it as a blessing, I really came to

1:33:18

it out of a desire to feel better. And

1:33:20

then I came to realize that, you know, I

1:33:22

feel this good, I'm sure every other woman or

1:33:24

man for that matter deserves to feel this good.

1:33:26

And so it became an easy strategy

1:33:29

to incorporate, excuse

1:33:31

me, largely because on so

1:33:33

many levels, a lot of

1:33:35

what I had been taught even as a clinician

1:33:37

was just so blatantly wrong, like the

1:33:39

concept of heart healthy grains and,

1:33:41

you know, the, you know, food guide

1:33:43

pyramid or the my plate paradigm that

1:33:46

really is focused on

1:33:48

like 55% carbohydrates. And I'm like,

1:33:51

when a woman starts entering perimenopause,

1:33:54

you become insulin less insulin sensitive, even if

1:33:56

you're at a healthy weight, you

1:33:58

started replacing some of your muscle

1:34:01

tissue, so muscle loss of aging with

1:34:03

your sarcopenia, you start replacing some muscle

1:34:06

with adipose tissue, you become much

1:34:08

more metabolically inflexible. And this

1:34:10

is the kind of the, I

1:34:14

would say it's the start of this

1:34:16

metabolic inflexibility piece. And so on

1:34:18

a lot of levels, all the information we're

1:34:20

getting women is no longer working for them.

1:34:23

Like there is no concept of heart healthy grains

1:34:25

and we don't eat enough protein. We eat the

1:34:27

wrong types of fats. We eat too many other

1:34:30

wrong types of carbohydrates. And so a

1:34:32

lot of the training about perimenopause and

1:34:34

menopause is retraining us understand prioritizing

1:34:37

sleep, doing the right types

1:34:40

of exercise, which includes strength

1:34:42

training, absolutely critically important, anti-inflammatory

1:34:45

nutrition, working on stress management, which

1:34:47

does not involve two minutes of meditation once a

1:34:49

day. Like you really do have to work at

1:34:51

it. And so as I've kind

1:34:53

of navigated these years

1:34:55

on my own, it's validated or

1:34:57

invalidated things that I had known

1:35:00

before. And so the

1:35:02

beautiful thing is I feel like now I've

1:35:04

gotten to a point where I can really

1:35:06

advise like bio individuality rules for everyone, either

1:35:08

gender, but really empowering women to understand like,

1:35:11

let's lean in, like where are

1:35:13

you in your menstrual cycle? And should you be

1:35:15

fasting? Or if you're menopausal, you know,

1:35:17

how are you feeling if your sleep is

1:35:19

terrible and you're over exercising, please don't add

1:35:22

in intermittent fasting for anyone. If you don't sleep

1:35:24

well, I would say intermittent fasting is not going to

1:35:26

save you if you can't sleep properly

1:35:28

through the night and we could unpack like all

1:35:30

the changes that occur in the body when you

1:35:32

don't have sufficient REM or deep

1:35:34

sleep and the impact on

1:35:36

leptin and ghrelin and glucose and

1:35:39

insulin response and how critically and

1:35:42

foundationally important sleep is. So

1:35:45

on a lot of levels, I'm truly grateful because

1:35:47

intermittent fasting gave me back my life. Like I

1:35:50

say all the time, I feel more energetic than

1:35:52

I did 15 years ago and I was always

1:35:54

healthy on the outside, but I

1:35:57

really think it's the way that our bodies

1:35:59

are designed. to thrive. We are

1:36:01

not designed to be eating all day

1:36:03

long. We really aren't and this is

1:36:05

such a huge problem here in the

1:36:07

States and other westernized countries. Well

1:36:10

stay on perimenopause and really unpack this. I think

1:36:12

this is an area that you can really provide

1:36:14

a ton of value for us and

1:36:17

as somebody you know who's been through

1:36:19

it and been trying all these different

1:36:21

strategies. First of all,

1:36:23

what age does perimenopause start or what

1:36:25

timeframe can people expect to enter that?

1:36:28

Well I think to be honest with

1:36:30

you, we say five to ten years preceding

1:36:32

menopause and so the average woman in the

1:36:34

United States goes through menopause at 51. So

1:36:37

a lot of women are in perimenopause in their

1:36:39

late 40s, sorry late 30s. So

1:36:41

37, 38, early 40s, you're there. There's no question. I have

1:36:43

women that argue

1:36:47

all the time, no no no I'm not in

1:36:49

perimenopause. I was like okay. Statistically

1:36:51

I can tell you that you are. However,

1:36:54

what starts to happen initially is our ovaries

1:36:56

are as old as we are. Unlike men,

1:36:58

we don't replenish sperm every three days. So

1:37:01

if you're 40, your ovaries are 40 years

1:37:03

old, you're probably no longer ovulating every month

1:37:05

even if you're getting a cycle. Your

1:37:08

progesterone is starting to fluctuate and

1:37:10