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Feel Better, Live More with Dr Rangan Chatterjee
#285 Why Intermittent Fasting Works with Dr Jason Fung
#285 Why Intermittent Fasting Works with Dr Jason Fung

#285 Why Intermittent Fasting Works with Dr Jason Fung

Feel Better, Live More with Dr Rangan ChatterjeeGo to Podcast Page

Dr Rangan Chatterjee, Dr. Jason Fung
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Jun 21, 2022
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Episode Transcript
0:00
I used to think, you know, weight loss is just about calories and - calories out the energy. Balance equation is always true, but people always misinterpreted to mean that just eating fewer calories leads to body fat loss. It does not.
0:15
Hi my name is Ron. Good chance Jay, welcome to feel better live more before we get started. Just wanted to let you know that my
0:30
Latest book, happy Minds happy life. The new science have mental well-being, is now finally available in America and Canada. Of course. It is already been out in the UK for over two months. Now, many of you, I know have already got your own copy, but now if you live in the US or Canada or know, someone who does who you think may enjoy it, please do let them know. It's available as a paperback ebook and as an audiobook, which I am narrating.
1:00
If you enjoy my weekly podcast, I really think you're going to enjoy this book. Now, onto today's brand new episodes, when was the last time you had something to eat? What's the food consumed at a meal time? Or just because what, today's guest on my podcast, has a simple but powerful message that I believe could revolutionize your health dr. Jason Fung is one of the world's foremost experts on intermittent fasting. He practices in
1:30
It has a kidney specialist and in 2012, he co-founded America's first intermittent fasting clinic and he's published multiple International. Bestsellers, including the Obesity codes, the diabetes code, and the cancer codes, and he runs a global online coaching program called intensive dietary Management's. And he's someone who works tirelessly to communicate. Simple messages with the public on his YouTube channel and we begin our conversation by discussing how many
2:00
Any unscheduled opportunities to eat. There are in Modern Life. Why? These days, is it okay to eat at your desk. In meetings were walking down the streets on public transport or even on the sofa at home. Just a few decades ago such habits, what does seem very out of place? Jason explains that the idea that it's good to graze all day. It's unscientific and damaging our bodies can only drawn our fat stores for energy when we're not
2:30
The fat States, Jason says, all default should be not eating with two or three meals planned in short windows over 24 hours. Instead these days schools, workplaces and places of pleasure are designed around opportunities to snack. And for many of us, it's causing a host of problems. Adjacent explains, how many of us actually eats more and more often than we should not because we lack self-control, but because we feel hungry,
3:00
and we feel hungry because we're eating the wrong Foods. Jason also covers why in his opinion, calorie counting is not the answer when it comes to getting your weight and health in check and why some foods are more fattening than others, even if they're equal in calories. Now, Jason's approach is to encourage all of us to switch to what he calls the right Foods. Whole unprocessed foods low in sugar, and refined carbohydrates, which will not stimulate.
3:30
Amounts of a hormone called insulin as a results. Jason says, you'll be less hungry less inclined to eat constantly and return your hormones to the way they're designed to work. Jason is also a big fan of intermittent fasting for the right person and explains easy ways to practice it. The common mistakes and misconceptions and reveals. One of the rules are not as strict as you think. Whether you're already a fan of intermittent fasting, whether
4:00
you're in the dark or whether you are someone who is yet to be convinced either, G to give this conversation. A listen, Jason is a fantastic Communicator who's helped, countless people all around the world, improve their health and well-being. I really enjoyed my conversation with him. I hope you enjoy listening. Now before we get started, I think it is really important for me to say that this episode may not be suitable for everyone. In particular people who have recovered from or are currently
4:30
Suffering from eating disorders, may find themselves getting triggered by some of the content. In fact, Jason and I actually discussed this very topic towards the end of our conversation. Please also, note that if you are on medication for conditions, such as type 2 diabetes, it is advised. You speak to a healthcare professional before fasting for prolonged periods.
4:53
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6:52
Or and now my conversation with dr. Jason fun. You have been sharing health information with your patience with people all over the world's for coming up to a decade. Now you've helped so many people improve their lives improve their health with all that experience with all that knowledge. I wanted to start by asking you what are some of the daily things
7:23
That people can think about doing that's going to help them feel better improve their health reduce weight if they need to but also reduce the risk of getting sick in the
7:32
future.
7:34
Yeah, I think there's a few things. I mean one is sort of to stop a lot of this sort of snacking that goes on, you know, for a long time people sort of said, oh, you should eat sort of ten times a day sort of thing, right? I'll make sure you get your snacks and stuff and I think it really sort of drives Us in the wrong direction. Based on, you know, the people who need to lose weight because unfortunately, that's the more you know that
8:04
The majority of people these days and this idea that you should sort of eat all the time, and it being healthy is probably one of the most sort of damaging things that we've done to people. It's not natural. It's not what we used to do. It's not that's what we haven't like, we haven't done that for most of most of our history, it's only been in the last sort of 30 years. Have people thought why you should eat six to eight times.
8:34
As a day, most of the time, it was sort of two to three times a day maximum with stipulations, that you really shouldn't eat more than that. And then now all of a sudden people are like, oh yeah, you should eat. So you know, all the time to lose weight. I'm like, how does that even work, right? Like from a physiologic standpoint, when you eat, you're not losing weight, you cannot be it's impossible. So, you know this idea that oh you have to you have to do that. It's sort of a very, very
9:04
Modern idea that's been presented as scientific and all that sort of stuff. I think it's really damaging because then people don't get the right idea that hey, you can leave your body and you know we don't figure out where it's going to get its energy from without completely screwing up the system sort of thing. So I think that's one of the things I've sort of focused on mostly is trying to increase that sort of fasting period or if you're trying to lose weight using intermittent fasting that kind of thing. It's
9:34
it's one of the things that I think makes no sense to me whatsoever here. The next thing I think it's it's important to do is sort of put it on the schedule. That is even things like eating. It should be sort of scheduled, so all that unscheduled snacking and stuff that that really derails people. So you're walking by and you say hey there's a, you know, a coffee shop. I'm going to get a coffee then you see that going of coffee and then you smell the donuts, and then it
10:04
Before you know you've got the donuts, right? So the problem is that you've got all these periods of time where you've got unscheduled sort of opportunities to eat and they're never really good for you. You're walking and you're in the office, somebody has a bowl of candy out. So you go get some candy, you go to the, you know, it was never on the schedule, you have meeting all of a sudden somebody's ordered a plate of cookies. And before you know it you've eaten cookies, right? So there's all this sort of scheduled stuff like
10:34
Unscheduled stuff. And so, you really want to just put it, make sure, you know, when you're eating your you make sure your it's sort of like mindfulness, right? You're deliberately scheduling a time to eat and every other time don't eat, right? And it sort of goes hand-in-hand with this idea that we should eat all the time to lose weight. We think that there's no cost to it or, you know, maybe we're the ones ordering state of cookies for, for the afternoon meeting, right? And it's like, it's not necessary whenever
11:04
As necessary. It's not doing anybody any favors. So, you know, make sure that when you're eating, you know, it's sort of, it's sort of on the schedule. Like, if it's not on the schedule that you shouldn't be eating and it's the same idea as mindfulness Behavior.
11:21
I love the idea of scheduling when you're going to eat it. Almost feels like a revolutionary act in the 21st century because there's such, there's such food availability all the time. You know, we're always surrounded by food tempted by food and just a very simple idea that put, when you're going to eat on the schedule, I think for many people it may be the first time they've ever heard that before.
11:50
Yeah, it's sort of is what your default is, right? So most of the time up until say the 90s, the default was not eating. So therefore you scheduled when you ate breakfast, lunch and dinner. All of a sudden based on no science, really. We thought we should eat constantly for the minute, you get up to the mini, go to bed, you cared constant refrains. Well, you know, always eat breakfast. Never skip breakfast, start eating immediately, and then have
12:19
Bedtime snacks and have snacks, you think about? And I don't know in the UK. But in Canada, for example, if you send your kids to school, they get like warning snacks. They got after school snacks, they get snacks. When they go on the bus, you know, they then they play, you know, Sports and somebody wants to give them snacks in between, you know, to give them energy and it's like, you know, they have plenty of energy, whether you give them sugar or not. And so, the default all of a sudden became
12:49
Day. So you know, it was, it was strange because we went from a default of not eating. You have to decide when you're going to eat to eating all the time and dissent deciding when you're not going to eat, which is bizarre. Yeah. So you know and and not healthy because if your Baseline is to eat, then we wait, it's unfortunately, there's no way around it.
13:12
You are a big proponent of fasting intermittent fasting and you've done a lot to spread knowledge of that.
13:19
Throughout the world over the past few years, many people these days are trying to experiment with some form of fasting in your experience. And I know you've got, you know, years of practical experience doing this with real life patients with busy lives. You know, busy jobs, kids to look, after all those kind of things. What are some of the common mistakes that people often make when they try and do some form of intermittent
13:48
fasting?
13:50
Um probably the biggest one is sort of over eating when you fast like thinking that just because you didn't eat for a period of time, that gives you sort of card blaz to eat whatever you want afterwards. Sort of there's two important factors in weight loss has one is the foods that you eat and we talk about this all the time. That's your diet, right? What you eat when you decide you want to eat. So you know people are paleo and keto and vegan and whatever it's there.
14:20
Plenty of different diets and we argue about that all the time. But what a lot of people don't talk about is sort of the time you spend not eating, right? And that's your period of fasting. How long should it be? How often should you eat? Those are just as important questions, because it's more than half of your day, is, should be spent not eating. So, you know, if you, if you get that part, right? That is you spend a period of the day, not eating 16, hours or 24 hours or whatever you decide. It's
14:50
It still doesn't mean that you can just eat whatever you want. And there's been several studies using this exact sort of sort of overfeeding strategy. That is oh well, fast for 16 hours and then let people eat whatever they want. Well, it's a very unsuccessful strategy. You want to eat still healthy still, sort of good, nutritious Whole Foods and combine the fasting. It's not sort of like they're sort of like two levers, right? You want them both going in the right direction.
15:20
You don't want to go one up and one down, that's just going to make it infected. So, you know, and and that's one of the things that people don't understand because there are some rat studies, for example, that said, well rats, you let them do whatever they want. And as long as they fast for period of time, they stay under way. So, therefore that should apply to humans to. You can eat whatever you want. That is, if you fast 16 hours, you can eat junk food and fast food and McDonald's and all this sort of stuff. It's like, no, you can't -
15:50
when you're fasting, all you're trying to do is let your body use the calories. That you stored away as body fat, that's all it is. A body fat is nothing more or less than a storage form of calories. You take in food energy in the form of calories and your body stores, some of that away. That's when you eat when you don't eat or when you're fasting, then your body is going to use the store of calories that you've put away, right? That's why you don't die in your sleep every single night.
16:20
Because your body has the ability to store some of those calendars away. So that's all it is. So they're always boggles my mind that people experts are saying, oh, you know, in Turin, fat is bad for you. And it's like, not natural. It's like it's the most natural thing in the world. Yeah, you're supposed to be cycling. That's why you have this word, break, Fast breakfast. You're supposed to fast. Otherwise, you can't break your fast but you're supposed to feed and you're fast. And if you ask your grandmother, she knew she would
16:50
say something like, well, you know, you just got to give your time your body, some time to digest the food that you've eaten.
16:57
Yeah, it's funny. How culture has changed so much just in the last 30, 40, 50 years, where this idea of eating all the time has become just so prevalent and it's really interesting. What people actually do, you know, Professor Sachin Panda from the Salk Institute? I know when I last spoke to him.
17:20
He was sharing information with me from his app that people are tracking how often they are eating for and he said 50% off non shift workers in the US, are eating pretty much over a 15 hour period each day. Now technically was 14 hours, 45 minutes, but basically 50% are eating over 15 hours, he said under 10% of people, but they were tracking what he's saying in, under a 12-hour window.
17:50
Now, if we compare that to a hundred years ago, this is so abnormal, isn't it? This is, it's so not how we have lived for most of our Revolution. And I guess the question then is, you know, why is this problematic? And when we say fasting, or when you use the term fasting, what do you mean by
18:09
it?
18:11
Yeah, and it's really, just fasting is just any period of time that you're not eating. And if you think about the 14 hours, 45 minutes, if you, if you wake up at 8 a.m. and you start eating immediately, you're eating until 10:45 p.m., right? That's that's basically your entire waking day, right? - brushing your teeth sort of thing, right? It's a ridiculous amount of time to be eating, and that's the average.
18:41
So, you know, when you talk about this, how did you know how did this happen and why is it so bad? Well, I think I have my theories about why it happened, but the reason it's so bad. Is that your body really exists and one of two states? That's either in the FED state, which is you eating insulin is high, which is telling your body. Please store some of these calories that are coming into your body because you're going to need them for when you're not eating or it's in the fasted state, which is
19:11
Insulin is low. You're not eating your body says, hey, I need calories. Please take them from my storage, right? So it's no different than a refrigerator. For example, you go to the grocery store, you have too much food, you put it in the fridge, right? So now think about it this way, if you now go to the store five or six times a day and all the time, you're putting food in your fridge, putting feet pretty soon. Your fridge is going to be full. Then somebody says, well in order to empty your fridge, you
19:41
Need to go to the store more often. It's like, does that make any sense? When you're eating, you're telling your body, like, you're literally telling your body, please store some of these excess calories into storage, put it into storage because that's what the insulin does is neither good nor bad. It's just its job. So, because you're stimulating it all the time, you're telling your body all the time to do it, for 14 hours, and 45 minutes of every day. You're telling your body to do that. And it's actually more because of course,
20:11
Stomach actually holds some of the food and slowly sort of pushes it out. So it's not 1445. That's your body is in the FED State, actually hours longer than that. So the point is simply this, like me to try and complicate things so much all the time, but it's very simple. When you're eating, you're storing calories, when you're not eating, you're using calories. That's all it is. And that's natural, and it's normal and you can handle it. Like, people think it's so, you know, you need to eat to die.
20:41
Thousand calories in a day. You shouldn't cut your calories. For example. Like what, you know, if you're fast the entire day? Well, if you're worried about those 2,000 calories, well, what about the hundred or 200, or 300 thousand calories that you have stored currently on your body? Like why would you worry about the 2000 just like the refrigerator if you don't go to the store one day, are you going to be really badly off? Well, your fridge is overfill.
21:11
You have way too much stuff in the fridge is, eat something from the fridge. That's the same thing. If you don't eat your body has a, you know, 300 thousand calories of body fat, your body is going to use it or you're diabetic. You have blood sugar sort of this spilling out from everywhere. Your body's going to use some of that Sugar because it's a source of energy. So what's wrong with that? How is that bad? In any sense of the word, You're simply letting your body use it for what it was designed.
21:41
Signed for, and that's the whole point of fasting was, which is why it always boggles my mind that you see expert saying, oh, you know, I intermittent fasting so bad for you, but you have and, and they're certain circumstances of course if you're malnourished if you're underweight, you know. Sure, absolutely. But if you're overweight, if you're a type 2 diabetic, that's actually exactly what you want your body to do.
22:03
Yeah, let's expand this Beyond weight loss because
22:10
One of the things that pulls all of your work together, for me at least is that we have overly focused on calories.
22:19
And not focused enough on hormones and it's easy to talk about fasting and burning body fat in the context of someone who might have type 2 diabetes. Or someone who is carrying excess fat and considers themselves to be overweight. But this goes beyond weight, doesn't it? This is actually a very helpful practice for people who want to be an Optimal Health, have more energy. Yes. Have a good body weight but also reduce the risk of getting sick in the
22:49
Chair. Yeah, absolutely. Because if you think about it, like, it's a balance, right? ET store calories, you don't eat you, use those calories, right? And you want to keep those imbalance. So, 12 hours, 12 hours is perfect. If you think about a typical sort of 1960s 1970s because and I, you know, I choose that time because it's before the Obesity epidemic and people aren't really watching their diet, particularly people are eating white bread and jam and you know, stuff like that, right?
23:20
But if you think about it, you know, a breakfast, maybe 8:00 before school and then you had dinner. Maybe around 6:00. That's a 10-hour eating window and 14 hours of fasting. And literally everybody did that every single day without even thinking about it. So, was it hard? No, because that was true to your Baseline. And the, the point is that it's not, it's not neither difficult, it's just about your habits, and then you
23:49
Then all of a sudden, and people switched and change, but before that, you would hear things like, you know, if you wanted an after-school, snack your mom would say. No, you're going to ruin your dinner. If you want a bedtime snack, she'd say no, you should have eight more at dinner, right? So there was no, not this tolerance of snacking, it was sort of a sketch. A general thing that you did once in a while, but rarely it's an Indulgence, right? And then it became every day. So, you know,
24:19
my kids, when they went to school on a trip, for example, a bus trip, right? They go on the bus and you get this nose from the school. Which would say, please send to snacks with your child and I'd be playing. Why are they not eating lunch? Or am I not feeding them dinner? Is that what I think it is? And and then we teach them that it's you have to snack on time and then we blame them for gaining all this weight and then tell them that. Hey, it's your diet, it's your lack of will.
24:49
Our and it's like, well, you know, we focus on the wrong things, and you might say, it was all very inadvertent. I think it wasn't that anybody deliberately meant to do that. It all came back to sort of the dietary guidelines, which was in the 70s. People said, you know, you should eat, Ultra, Ultra, ultra low fat. And in order to do that the government, the United States government, encouraged people to eat processed food because you could process the fat out
25:19
out of it and put other things mostly carbs because fat and protein tend to go together. And so instead of eating say typical breakfast of eggs and bacon which I keep you full until lunch, they'd eat two, slices of white bread and jam and some sugary cereal. The problem with that and we know this of course, is that insulin spikes up very high. Glucose spikes are very high because they're all very highly refined carbohydrates, then it crashes. So by 10:30, you're just starting
25:49
Thing. So then you go get yourself a low fat muffin and then the same thing happens, right? Your instant go spikes, a very higher insulin spikes up very high and then and then it's gone. So people started eating more frequently because they're basically just eating a whole bunch of refined carbohydrates. Then they said, well, I'm eating six times a day. When I used to eat three times a day but since I'm eating super low fat, this must be a good thing there. Never was a good thing. Of course, it was just a boy.
26:19
By-product. Now, of course, we we know we shouldn't be eating a whole pile of refined carbs like right away but back then, two slices of white bread and strawberry jam was perfectly acceptable, very low-fat. Almost, 05 of fact, all sugar, all refined carbs. So I think that's sort of how it came about because of this sort of insistence that we eat low fat, low fat low fat which unfortunately wasn't like more beans it was with find highly, refined carbs is what replace the fat.
26:49
Our diet but then the inadvertent thing was that even as we moved away from those refined carbohydrates. So we start acknowledging, hey there's healthy fats. Hey, you should eat nuts, how you should eat whole grains. Even as we moved away from those refined carbs, you never moved away from the fact that we're just eating constant, and of course, our institutions have changed to allow all that, right? So, our habits of change, you have your it's acceptable to eat at your desk, as a
27:19
Acceptable to eat in the movie theaters. It's acceptable to eat in front of the TV is acceptable to eat. While you're walking. Like all of those things would have been super frowned upon if you went to the office and you are eating at your desk in the 70, people would be like, what the heck are you doing? Like there's a place to eat and it's not at your desk, go eat somewhere else, but because everybody was hungry all the time, you know, you got this 237. I mean you've been to, you've been to meetings.
27:49
Medical meetings, right? Like my God it's like okay so you have a full bracket then at 10:30 they were all out the you know, the granola bars and stuff and that's at 10:30 a.m. you just ate a huge breakfast at like 8:00 a.m. and then you have lunch and then you know at 2:30 there's a nutrition break. Right? Or they roll out muffins and cookies and stuff, right? And then you go eat dinner. Looks like these are for doctors like you and me and this is at every
28:19
Every single meeting you go to American Heart Association Diabetes, Association like you'll go to The Diabetes Association and then rolling out. Yeah, snacks and snacks. And fact, it's like, okay, well, what's the message here?
28:35
Eat all the time. It always is.
28:37
I think that just speaks to culturally
28:42
How much this has changed as you say, it's just acceptable now to do this. In fact, if you were hosting a meeting, it would probably be considered rudes. If you didn't provide cookies and biscuits and those sort of things, do you know what I mean? It's very few of us are able to resist societal environmental pressures, which is why what happens at schools saddens me so much because it literally is conditioning kids from a young age too.
29:12
I think, oh, I need to stack them. Not he's of a two hours. I need to eat something where as you know the truth is we know we don't need to do that and culturally there's country. So I think France, it's still there in France where snacking is just not that common are acceptable type thing to do. You eat when it's mealtimes? And you don't sort of eat in between. And when I spoke to Professor, Tim specs on the podcast, he was saying very similar to you the impacts of constant snacking what it does for the gut microbiome. All kinds of things that
29:42
we just don't need to be eating all the time. Now Jason one of the central ideas and your work is that chronically elevated. Insulin is problematic for a variety of different reasons. When was the first time you started to become aware off this as a doctor and then maybe you could go from there and explain what causes insulin to go up. And what happens to us? Why should someone listening to this right now who doesn't have time?
30:12
Diabetes things are in pretty good health. Maybe they've got a little bit of extra fat that they don't want, but they can live with it. Why should they care about chronically, elevated insulin? Just taking a quick break to give a shout out to bond charge. Now, you may be wondering who on earth a bond charge. While many of you will have heard me talk about the Brand's blue blocks for quite a while.
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32:35
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33:05
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34:32
It actually impacts a huge number of medical conditions. It actually. So, if you look at insulin resistance which is really the same as chronically elevated insulin, the sort of like, two sides of the same coin, right? So it's called hyperinsulinemia, which is basically a word, hyper means, High insulin and then emia means in the blood. So hyperinsulinemia case just means high blood levels but insulin resistance people have heard of is the same really as hyperinsulinemia, think they do.
35:01
Same thing, and it really impacts a huge number of conditions such as heart disease, type 2 diabetes, which can cause then kidney disease nerve problems. Amputations cancer is related to insulin levels. So, there's just all of these chronic conditions that are really the main focus of today's medicine that are made worse by chronically elevated, insulin levels. And the point is that you're really not supposed to be in that state.
35:31
Eight. So when you look at hormones and this applies to almost all of our money, you're really supposed to have a spike of hormone and then go to low level, so whether it's thyroid hormone or growth hormone or cortisol, or parathyroid hormone all of these hormones, they Spike, and then they go down. So growth hormone, for example, spike in the morning and then I'll go down to very low levels. And that's why you have to measure these hormones at certain times of the day and not other times. They didn't he in court?
36:01
All in the blood work, for example. Well, insulins really supposed to be the same, you're supposed to have sort of high levels when you eat, then it's supposed to go down and then it's high levels and goes down. So you're always supposed to have this sort of balance between the two. What's really bad is, when you have high levels all the time and that's true for cortisol as well, cortisol again, it's not bad for you. It's just a natural hormone but you're supposed to have it's like up and then go down when you have a chronically high. It's actually super. Super
36:31
Bad for you. This idea that eating all that you should eat all the time. Of course, leads to insulin levels being up all the time. And the other problem is that, as you move away, from fatty foods and stuff, then you're choosing foods that typically Spike insulin much higher. So, if you're choosing white bread over eggs in the morning, eggs of have very little insulin effect, and white bread has very high in some effects. Your, you know, it's a sort of a double whammy you're choosing foods that are very high insulin.
37:01
And if you think about it, so insulin, it's job is to tell you, it's a nutrient sensor. So it tells you food is coming into the sword away. So you choose white bread. So even if it's the same number of calories, that you choose a white bread versus an egg. When you eat that white bread, glucose spikes up insulin spikes up. When instance bikes up and says put all those calories into storage because that's that's its job. That's what telling you you. So we eat that bread. It contains two things, it contains the energy which is
37:31
The calories but it also contains instructions as to what to do with those colors. So you eat the white bread and it's that goes up all of that energy goes immediately into your storage. Well. Now at 10:30, you have no energy left, your blood sugars are starting to go very low. So what happens? Your body says I need to get more food. Why? Because you've put it all away, just like you go to the grocery store and you take the food instead of eating some of it, you put all of it into the freezer or the fridge. Well, you have
38:01
I think to eat. So then you go out and buy more food, right? It makes no sense. Where's the egg is not going to go up as high. That energy is now available for you to use all day and you're not hungry at 10:30 because you still have energy to do your activities of daily living, right? But it was the hormones really that made the difference. And this is the thing, I think is really important. When you have two Foods you know, like bread and eggs.
38:30
Which are the same number of calories.
38:33
The body's response to those calories are completely and utterly different, okay? So one of them spikes insulin, one of them doesn't. So in order to say that they are equal and hear this all the time, a calorie is a calorie, just count your calories, right, that's how you get stupid ideas. Like, oh, you can eat ice cream for dinner, just don't eat your broccoli because your there's 100 calories of broccoli, you didn't eat. So you can eat 100 calories of ice cream. Well, that's stupid is really, really bad advice.
39:02
That a lot of experts gave out because they're like it's the same number of calories, but the hormonal effect is so different and it's the hormones that tell your body. What to do you take 100 calories in, you can either store it away or you can use it as energy, right? One of them makes you fat and one of them make you full gives you energy which one do you want to do? Where you have to choose 200 calories that don't go straight to Fat which is you know the ice cream.
39:33
The white bread and so on, right? And that's the point that everybody misses when they're still focused on calories and there's so many people out there that are like Tyler, you're saying calories aren't important, like, I'm saying that there's way more important things than the calories because it's what you do with that energy not just the total amount of energy.
39:54
Yeah. A couple of things that for me one of the problems with saying whether you're eating ice cream or eggs or
40:02
salmon or whatever it might be, it's the same as long as the same amount of calories problem. Number one with that for me, is that food is so much more than calories. Food is information food has an impact on inflammation? Has an impact on genetic expression. It does so much. It's its signal so many things in the body, which we really undervalue when we just say how many calories is in that firstly? Secondly, I think this idea of calories is
40:32
Just exploring in a little bit more depth because as you say, a lot of people talk about calories in versus calories out. Simple. If you want to lose weight or maintain a healthy weight, you just need to get in a deficit with calories. You know. We have to be burning off more than we're taking in technically scientifically. Do you have any insight on
40:51
that? Yeah, so the energy balance equation is basically, they say body fat equals calories in - calories out. That's sort of the
41:02
What we all think about. So therefore people say oh you must be in a caloric deficit. You actually can never be in a caloric deficit because it's a balanced equation. There's three variables body fat calories in calories out and they must balance. So the point is that if you change one of those variables and everybody forget I always think there's only two variables calories in calories out know, there's three variables body fat calories in calories out. If you change one of those variables calories in it
41:32
Not need, there's two other variables, it does not mean that your body fat will decrease. Because if you decrease calories in, you could also decrease your calories out. That is your metabolic rate will go down and your body fat will be unchanged, right? So the energy balance equation is always true. But people always misinterpreted to mean that just eating fewer calories leads to body fat loss. It does not. In fact, almost every study we've done over
42:02
Over the last sort of 5060 years, says that when you simply reduce calories and don't change the sort of composition of your calories, then what happens is that body fat goes down a little bit but what happens is your metabolic rate goes down more. So if you go from 2000 calories, for example, you're burning 2000 meeting 2000. You're you're, you're, you know, in balance
42:28
You want to lose weight now. So you go down to 1,500 calories. That's what everybody says, right. 500 calories less per day. So you cut out the salmon, then you cut out the eggs, but you love bread and ice cream. So you keep your bread and ice cream. You go down to 1,500 calories. There's two possible things. That happen one is that you lose body fat, but to the other possibility, is your body, simply Burns, 1500 calories, and your body fat stays relatively unchanged. That does not break the energy.
42:57
A balanced equation. Neither does a break. The laws of thermodynamics. In fact, when you look at studies every study, we've done practically over the last 50 years shows that is precisely what happens you eat 1500? Calories your body, then actually goes down and burns, 1400 calories. And you start to gain weight back. And then when you start to gain weight back because you did the diet all wrong by focusing on calories. People say, oh, you know, you weren't trying very hard, you didn't have willpower and all this kind of stuff, right?
43:27
And that's the whole problem with weight loss is that when you focus on calories, you're you're losing the start of thread of the energy balance equation. You think that eating fewer calories guarantees you body fat loss. It does not. You can just as easily balance that equation by reducing your energy expenditure. Just like if you are working and you get fired, you lower your expenses.
43:57
Yeah, that's just what you do. So that you protect your bank account, right? You don't want to take money out of your bank so you lower your expenses. So you reduce your income, your juicer expenditures. So same thing with calories, you reduce your income. How much you eat calories in your body? Reduces calories out. You don't control that. Yeah, you can't decide to burn more calories, but your body does. Yeah. Now, all of a sudden, you're in a situation where you're still overweight,
44:24
But you're eating 1500 calories, and your body's burning 1,500. So you're cold, you're tired, you're hungry, you feel terrible, but you're not losing anybody with that is actually precisely what has happened and everybody who's done a diet knows this every single person, the failure rate of sort of counting calories for weight loss. The failure rate is somewhere around 95 to 99%. And yet, we think that this is the scientifically proven way to
44:54
Do you think it's actually proven to fail? It's guaranteed, this is practically guaranteed to fail. If you don't adjust the foods that you're eating, because as you say, we think it's all about willpower. But really it's all about eating the right Foods because the hormonal response to those foods which is telling her body to either gain weight or not gain weight, right? That's that's what tells our body.
45:18
It's just Monster blee different like you eat bread. You eat an egg, we can measure some difference in the hormones that you've stimulated, right? It's not just airy-fairy, we know it hundred percent for sure that there is a difference and yet we have to pretend that those hormonal differences make. No, doesn't matter. Yeah. Right. Which is
45:41
ridiculous. Yeah, it really isn't.
45:44
You know, the other thing I think people miss when they're focusing too much on that equation. Is that when we talk about calories outs everyone assumes, it's just one thing you know. It's like how much did I exercise? For example, that day, they forget that actually calories out could well be for different things. That basal metabolic rate is, you mentioned. So, you know, how much energy does it take to keep the lights on and your body lungs kidneys, whatever it might be. There's also the thermogenic effects of foods
46:14
The whole context of things, it's relatively small, but still that's part of that calories out part of the equation, there's purposeful movements and exercise which has can burn some calories. Although potentially not as much as people think. And then there's also neat, you know, non-exercise activity, thermogenesis, a kind of non purposeful movement, all these kind of subtleties people are not thinking about when they're thinking about that equation. So I think for many reasons whilst scientifically that equation may be
46:44
Be true in terms of practical application for most people that has very little value. And I think I think this is a wider Point Joseph for me which is there's a lot of technical scientific debate around. These kind of topics insulin calories in and calories out. You know, for me like you as a practicing clinician, it's like, well, you know what? Yeah, we can debate these little nuances and there's science or we can simplify things and just help people do.
47:14
What we know and we see repeatedly work, do you know what I mean? And I feel that's one of the reasons I wrote much like your approach. You have seen tens of thousands of patients. You've helped probably millions of people through the internet now and through your books across the world. A lot of people are gaining huge value from this. And I think we sometimes miss that, when we're trying to dot all the I's and cross the t's with the science it's important but it's not
47:40
everything.
47:41
Yeah, absolutely. And this whole idea that, you know, a certain number of calories, 100 calories of bread versus 100 calories of Peg are going to have different effects on the body. They have different hormonal effects, it boils down practically to a simple idea. That is some foods are more fattening than other foods, which is of course, an idea that your grandmother would have thought blindingly obvious, right? Like he gets fat,
48:11
Being broccoli, like, zero people in the whole world who gets fat eating cookies, many many, many people write and she didn't understand the difference between, you know, the hormonal responses of broccoli versus cookies but she understood that you eat these Foods. You know, and this goes back hundreds of years because the first low carb diet was sort of like what Banting in the 1800's, right? So you're talking about at least 150 years, people have said, hey certain things
48:41
Is really make people gain weight and even if you go back to ancel keys, for example, so he did a very interesting study in the 40s, the Minnesota starvation study, interesting. The it wasn't the sort of starvation study at all, is a 1,500 calorie a day diet 1570 calories, which is actually not far off of what people advised for weight loss. Very high, starch foods because that was what his was available in post-war Europe at the time. So, when he measured
49:11
Birds metabolic rate, it drop by like 40 percent. When you drop calories by, about 40% metabolic rate, drop by about 40% and what happened, he actually measured other things. So, heart volume, shrank stroke volume like the amount of blood that you pump out went down. People were cold for, they're generating less body heat because they're burning. 40% less calories here. Sort of these sort of metabolic housekeeping things. Like how much blood do you, not pumping blood? You're more tired, you get
49:41
Get, you know, you you're not generating body heat your cold, right? So the whole point is that, yeah, all of these things are important. This calories out is not just exercise. The majority of it is
49:56
You know, basal metabolic rate and you don't control that through your mind, right? You control that through your hormones, it's your hormones. That control everything. That's just the way it works. In the human body, everything is controlled by hormones. You don't control how strong your bones are, that's controlled by growth hormone and other hormones parathyroid hormones, right? You don't control how active your thyroid is. So this idea that it's all about willpower, you know, because people look at this thing, they go body fat.
50:25
Equals calories and - calories out. So therefore calories and is what you eat. Calories out is exercise. It's all willpower. It's like that's nonsense. It actually doesn't work for anybody because you have to actually it's an extremely simplistic way of man that things when you go one level deeper and say, okay, so okay calories and - calories out. It's what you eat and what you exercise? Let's go one level deeper. Why is it that you're eating more or eating the wrong Foods? Well, it's because
50:55
Hungry. So that comes back to your hormones and then you look at calories out, what's exercise? Let's go. One level deeper, actually mostly basal metabolic rate so you can control what you eat. But you can't control how hungry you are. We can't decide to be less hungry. You can't decide that you're going to burn more calories. So it's all down to your hormones. It wasn't due to willpower at all so you can take a drug such as the magnetite which is a weight-loss drug. Now when you completely whack that appetite you know and
51:25
Half people lose weight and never was will power. It was that you controlled the hunger as opposed to the calorie, right? It all comes down to hormones. The human body is run by hormones. That is that is the chemical Messengers, that tell our body what to do. And in this idea that it's, it comes down to something so simplistic, like calories calories, and such a terrible notion. Because not terrible. It's just misused because it's a unit from
51:55
Six not physiology, right? So it's the amount of heat energy that is contained in a certain amount of food. It doesn't tell anything about how our bodies going to use it. A block of wood may have 100 calories. If you eat that block of wood you will get none of it, right? So it's like well, you know, that's it, right. I mean, there's, there's there's lots of calories and a block of wood, but you won't absorb any of it. It's just a unit of physics. Physiology is what
52:25
happens in the human body, right? Where the calorie receptors do we have calorie counters within our body. There's a huge of this many calories there. For this, right? And you look at the failure of that sort of academic notion that we can be, so precise that we are now physicist, not Physicians, right? Like we're Physicians that sort of stuff from physics doesn't work because it doesn't jive with how the human body works. We don't have calorie counter did
52:55
Have calories scepters. Like there is nothing in our body that senses, how many calories you
53:00
eat? And it doesn't account for the realities of Modern Life where people are sleep deprived right? And therefore their hunger in society, hormones are completely off, whack. It doesn't account for chronic stress, which raises that hormone you mentioned earlier cortisol, which again has a huge effect on our hunger and all kinds things and where we might store that body fats, you know, the human body is just much more complex and I think
53:25
I think a lot of people have a certain bias, right? So, if you're a personal trainer, I guess your bias is probably the subset of people. You've seen people who are coming to see you, who believe that. Actually, working out regularly exercising, hard is really, really important to lose weight, and, of course, it can form, part of the overall strategy of things, but they're for your viewers are personal training is going to be hugely impacted by what you see, of course, my view is hugely impacted, but what I've seen over, 20 years,
53:55
Tens of thousands of patients. But as a general practitioner I guess one thing I would say is that you see everything, you literally see everything, you see, people who've got all kinds of issues and therefore I feel that gives you insight into a whole variety of different people, different Lifestyles, people who are shift workers. You know and you you know you're a practicing clinician as well I guess as a nephrologist you will also see a huge amount of different people, right?
54:22
Yeah, exactly. And that's one of the things that you see, a lot of, in this sort of Fitness World, and there's just sort of Bro Science. Because, you know, you're so invested in this idea that it's all about effort. Right? You know that that that all of Weight Loss is just due to effort and willpower, right? As opposed to, you know, eating the right foods and all these other things that are so important. We know like sleep and stress and so on
54:53
I used to, you know, and I think we all did, of course, we all used to believe that right now, I always thought in medical school and above, I see, think, you know, weight loss is just about willpower. It's about controlling, what you eat right now. I thought it strange that there are a lot of medical conditions that cause weight gain weight loss, but weight gain in particular, and I always thought it was strange because how can a medical condition cause weight gain. It's all about willpower hundred percent about willpower.
55:22
Our it's about calories in calories out I used. And I thought, how is that possible? That you have a medical condition that has nothing to do with willpower, right? So, if you're, if you have prader-willi or any of these other conditions, that cause obesity, you know, Allison's, sorry. Cushing's Disease, half of that cause weight gain because we know that it's caused by sort of.
55:50
Effort. Right? So it's very strange, but as you go on, then you realize, no, it's all about. It's all about the hormones. Like, you give somebody insulin and I don't really care how much willpower you have you gained weight, why? Because you're literally telling your body to gain that weight. So, therefore, if that's the important thing, then how are you going to minimize those instructions to gain weight while you eat Natural Foods is Natural Foods even carbohydrate-containing?
56:19
Any foods natural ones have far less incentive fact then others. Yeah and intermittent fasting when you don't eat, you know your body is going through. Insulin levels are going to go low, your body's going to start using calories instead of storing calories, right? So it's all about those those those hormonal effects that we have to understand that we said, were unimportant because we sort of elevated calories to be the
56:49
And only thing, and I think a lot of Fitness people and a lot of scientists, in fact, love the sort of, Simplicity of that idea, but unfortunately, it wasn't really true and you see it all the time. Like there's so many people like doctors, for example, there's a lot of doctors who are overweight, and I know a lot of doctors, most of my friends are doctors, right? And what I say that they have no willpower, absolutely not.
57:19
Not, I've seen these people work sort of 36 hours at a time, right? When they put their mind to something, they will absolutely go out and do it. Nothing will stop them. You know, these people are overweight, some of them are obese. Some of them are my friends.
57:39
I don't think they have no willpower. I don't think they have a lack of willpower. As the reason that they are overweight, I think they're eating the wrong Foods because they or the getting the wrong advice to eat constantly and so on and so many doctors have come back to me. So when I started talking about intermittent fasting, probably about eight years ago, I go honestly, people thought I was insane like it was you know, common knowledge that you had to eat all the time.
58:08
I'm even to lose weight, right? And when I came out and said, well, you can find sameen and and most of the doctors, that that I spoke to, you know, the because they knew me and they would listen to me. They said this actually makes a lot of sense and they're all like, you know, I remember when I was in residency and training, I'd go like 24 hours without eating nothing, bad ever happened. I was so busy and emergency. I so busy in the operating room at. So many patients, I just didn't need
58:38
Nothing really happened. Other than as hungry for a little while but I was too busy, I ignored it. And I'm thinking yeah because when you don't eat your body is just going to take whatever calories it needs from your body fat and that's it. And everybody's like, yeah, I was like 30 pounds lighter at that time, right? When I didn't eat constantly. So a lot of the log Physicians, would always come back. And say, you know what, this makes a lot of sense from a physiologic standpoint, this idea that you should eat all the time is wrong. So one
59:08
You know, fasting is a way to eat fewer calories because you're here taking it from your stores and you're feeling full because you've taken it from your stores. All right just like you take food from the fridge. It doesn't mean your last fall. You're just as full as if we went to the store. Just we took it. You took those calories from a different place. You took it from Storage. Same thing with body fat, you took those calories from Storage as opposed to from food? Yeah, no difference in terms of physiology. So yeah, it's interesting because a lot of doctors themselves.
59:38
These sort of Highly Highly Educated people with and and that's, that's one of the things that, you know, I think has started to sort of resonate through. There was an interesting study where they looked at. They did a, they did a Facebook poll of Physicians and how they lose weight. And what was interesting was that 75% of people used intermittent fasting in this hole for weight loss Physicians
1:00:08
And yet the only Council that for about thirty percent. So, the huge gap was that the doctors wanted to lose weight and wanted to do something effective, which was in fasting. But with their patients, they had to give sort of. Yeah, sanctioned advice didn't include the fast.
1:00:27
I want to get into some practical information for people. I think one of the really beautiful things you said so far is that it's not a lack of willpower. And and unfortunately, this over focus on the Cal has led to a lot of people feel really bad. So that they, they think, you know, I'm really trying like I'm restricting my calorie intake and I'm not eating that much, but I can't lose weight and they feel like failures. I feel guilt. They feel ashamed of themselves which is really, really,
1:00:57
Like to try and make long-term Behavior change when you feel like that. So I want to go into some really practical things before we do, just to finish off the calories in, calories out model for a moment. My Approach has always been with patients and and when I like you, when I write books, I say look if you fly that counting calories works for you and you can fit into your life and your lifestyle and your getting the health outcome you desire. I'm not trying to change your mind. I'm not
1:01:27
saying stop doing it. If that works for you, go for your life. I'm just saying in my experience. I haven't found it. Sweet that helpful, certainly for most people that come to see me. What would you say to someone who is watching? This says Jason. Listen. I actually have no problem, counting calories. I like counting them three times a day and I can maintain my weight. Can maintain my hell doing this. What would you say to that person?
1:01:53
I agree with you. I mean, if something is working for you,
1:01:57
And go ahead and do it. Like, there's no reason to stop and you know, it really goes for any anything. It's if you're eating 10 times a day and you're doing well with it, then go ahead be my guest and we know every everybody reacts differently so I'm okay with that. But if you want to make a change then you know you could probably got a that's where to start. Right here is a good place to start and then you decide what to do with it. And I think the other thing, you know, I think
1:02:27
You said that was very good, was that this idea of sort of people who aren't losing weight, what happens of course is that when you focus on calories and say it's all about willpower, what you're saying to these people is that they don't have the willpower which I think is absolutely not true. Because it's one of these embedded assumptions in the calories in, calories out model, that is that nobody acknowledges, which is that calories.
1:02:57
Is out handle down about basal metabolic rate can go down when you diet. So therefore if you are not losing weight,
1:03:08
Even as you lose as you eat fewer calories, you can still not lose weight because your metabolic rate is going down along with it. So why are you blaming these people? And that's, that's where you get a lot of, you know, a lot of people sort of just have made that assumption that calories out is going to stay stable at 2,000 calories a day, right? This is the whole thing, when you read these people who are like, oh, just just cut, 500 calories a day, you'll lose a pound.
1:03:38
Take that actually never happens because that assumes that your calories out, your metabolic rate stays at 2000 calories every physiologic study. We've ever done says it goes down and you know, it must go down. So for example, if you take somebody who's 200 pounds you say, cut 500 calories, a, you know, a day, you lose a pound a week. Does that mean in 200 days weeks? They'll lose the way zero pounds like, no, absolutely not. That will never happen.
1:04:08
And even if you stick to 1500 calories, so therefore your metabolic rate must go down at some point turns out it goes down almost immediately and persist. So, therefore, this idea that it was all because they skipped on their diets, right? That that's not true. It might have just been a very curly constructed diet that is not taking into account, just the foods, but also the sort of eating duration, the fasting, the hormones, what hormones are stimulating with the foods that
1:04:38
You're eating what information? You're giving your body. What instructions are giving by there's so much of that other other things that are important. Yeah yeah. And I think it's time to take that sort of guilt and shame away from those people. We're all sort of working
1:04:55
together. Yeah, it's a great Point. Let's get to the sort of practicalities you've mentioned in your books, you mentioned this conversation that chronically elevated insulin
1:05:08
Is problematic for a whole variety of different reasons. Yes, for the developments of type 2 diabetes are putting on weights. Also, you know, a lot of people aren't aware that it increases blood. Pressure increases fluid retention increases a type of cholesterol called vldl very low density lipoprotein, which can be problematic. And so for a variety of reasons we want to lower that. So there's two Broadway's. I'm getting that we can do that. One is through a diet that does not
1:05:38
Constantly, push up insulin and the other way, is with a form of intermittent fasting, or, you know, bringing in some type. So, if we start off with food and diet you mentioned, low-carb earlier on, in this conversation, of course, we know how divisive the diet landscape currently is in your experience. If we're thinking about a diet food choices that don't Spike insulin,
1:06:08
Too much. What are the kind of principles you like your patients to
1:06:12
follow? Yeah, and I think this is where, you know, there's always a lot of difference in opinion, they are slow car versus high carb and I actually think that there's a huge difference even with in carbohydrates. So the the problem is not generally the carbohydrates, but the processing that makes the biggest difference. So if you look at
1:06:38
Glycemic index which is, you know, which looks like carbohydrate containing food sees how much insulin tends to go up and glucose tends to go up. They tend to go together of certain foods. What you see is that unprocessed carbohydrates tend to cause a lot lower spike in insulin and then processed foods. So you take cereals like Cheerios and stuff. They're really, really high. You take a very refined product, like white bread, just very, very high.
1:07:08
Then you look at something like boiled potatoes and it's just extremely low. They're both carbohydrate containing foods. So there's a big difference even with in carbohydrates. Beans, beans are carbohydrates. They have a different type of amylopectin they have amylopectin C versus amylopectin, a, their digestion is completely different. There's still cars. So trying to simplify it to just carbs is difficult because you could eat a lot of beans and who gets
1:07:38
Eating beans like very few people.
1:07:41
He's soaking I like Black beans, kidney beans, is these sort of things beans?
1:07:45
Yeah. The type of carbohydrate they contain is amylopectin see which is harder to digest and therefore leads to much lower blood glucose levels, much lower insulin levels, but insulin is sort of that key. So, even within carbohydrates, so so people think, well, one of the things is to cut carbs which is, which is a reasonable thing, but cutting the refined carbs does a lot better because you have to
1:08:08
And that a lot of countries, a lot of cultures have had high carbohydrate intake. Sand in the past have never had a big problem. So, China for example, was classic in the 80s, it was eating 300 grams a day of carbohydrates, almost all white rice and there's almost no obesity. This is 1980. Then, of course, recently, they started eating a lot more processed foods, a lot more sugary Foods. Now, their obesity is just exploding, but it was not just the car.
1:08:37
Why do you think this is? What
1:08:38
Trusting for me. So why Try says a refined carbohydrates? Why do we have societies with high volumes of carbohydrates who are not putting on weights and who are not getting type 2 diabetes and that example, use of China, there's really interesting 300 grams of whites twice a day. You would think would spike insulin and would, you know, cause people to get sick but it wasn't and it was. And what?
1:09:08
If, you know, one of the theories I put forward in my first thought was this idea that maybe in the West, in the modern world, in which we now live, where people are chronically stressed, they're chronically under slat, they're chronically under active and they're eating a lot of Highly processed foods all together that's creating the perfect conditions, for high levels of insulin resistance. And I thought, well, maybe the low-carb diet has a particular utility in modern stressed out. Cultures
1:09:38
I don't know if you got any comments on that and how do you explain that in the 1970s they were eating this in China and not getting sick?
1:09:46
I think there's a few things. One, is that the amount of sugar they were eating was just almost zero. Yeah. So sugar, which is fructose is metabolized quite differently than glucose. So when you metabolize glucose all your cells in the body can use glucose. When you metabolize fructose only the liver can use fractals.
1:10:08
So the fructose goes straight to your liver. And there it gets converted and causes fatty liver causes all kinds of things, when you're eating too much from those, so it can get converted back into glucose, but for a lot of reasons, it just gets turned into fat through de novo lipogenesis, you get fatty liver, you get insulin resistance, which causes hyperinsulinemia. So the fructose is actually much worse for you than the glucose in my opinion. Because, you know, if you are 150 pounds, you have
1:10:38
50 pounds of the body. That's using glucose versus sort of five pounds of liver that can metabolize fructose. So the front toes is much, much, more obese genic I think than the glucose. So therefore, the Practical side is that sugar and sweet things like that are just much more fattening than
1:10:59
starchy Foods. So, maybe you're saying that in China back then because they're not having much fructose. Yeah, almost zero therefore they can actually the body scan
1:11:08
Can handle for 300 grams of white rice each day, whereas on the background if a lot of fructose which which is of course, how many of us live these days too much sugar, too much fruit juice. All these kind of things maybe with a background of that suddenly, the white rice starts to become problematic.
1:11:27
Yeah, I think so. I think the fructose really makes that that much worse, but the other thing is that there's different reasons. What and to they weren't eating all the
1:11:38
I'm right, they weren't you constantly. It's not like they're eating eight times a day of white rice. And the third thing, I think that's sort of always overlooked because it doesn't fit into this neat. Little square is that there's different reasons why we eat, like there's the hunger the nutrition part of things, which we think is important. But in this day and age, and probably the least important of the reasons that we eat, there's two habits, right? You eat because it's time to eat. That's really the only reason
1:12:08
And you eat because it's delicious. So if you take any diet that is monotonous. So no matter what diet it is. So you can eat say say you love pizza but I give you Pizza breakfast, lunch and dinner. Okay? Very soon my sooner than you think you are going to be so sick of pizza that if I continue to feed you pizza.
1:12:34
You're just going to say, okay, I'm going to eat as little of this pizza as I possibly can until I'm no longer hungry because I just don't like to eat it. This is same thing with white rice. If you eat white, rice and vegetables every single day, three meals a day, which is, you know what they're eating in China, like different types of, you know, vegetables with white rice, pretty soon. You're going to be like I will eat the rice because I'm hungry as soon as I stop being.
1:13:04
I'm hungry. I am stopping eating because I know what the hedonic effect of food the pleasure giving sense of food goes away when it's completely monotonous. So you can eat all that and you know, you're not going to over eat it because you don't want to. You just want to make sure you're not hungry. And therefore, any monotonous, diet always works because you've just very quickly run out of things that you want to eat. Yeah, so,
1:13:34
We've done. Of course, in the modern age is we introduced all kinds of varieties of food, which keeps us eating Beyond, these were full sort of stage. I've got my nutrition. I'm done. I don't want to eat anymore. You never get that stayed because we're always like, well, you know, we want to keep meeting and then you get around it by snacking because even if there's lots of good things to eat, so you go to a buffet, you know, all-you-can-eat restaurant.
1:14:04
You know, after a certain point, you have to stop like you can't keep going. It's, you know, if you've eaten everything and somebody says, hey, why don't you have a bit more of this pork chop? You'd be like, that's gonna make me throw up, right? Is the same pork chop as you ate like 20 minutes ago but you're now full. So the point is that if you, if you take away the sort of pleasure giving part of food, then you're going to be able to control a lot of overweight obesity.
1:14:34
Which is what the right race was, right. It was a monotonous. It was just every single day, was the same thing. Like I can tell you, I hate rice a lot growing up because my parents were immigrants. They came from from Hong Kong. We wrecked a Trice probably every single day. So yeah, I like rice. All right. But, you know, until your fault and that's it. Like yeah. You know, I don't want any more than I do. Because I've eaten too much of it at all ready. So
1:15:04
So that's why it's always, you know, people say oh they're for carbs are good, or you have to Kempner rice diet from the 40s. Hey, that proves that carbs aren't the enemy. It's like, no, no, no. It's very complicated. Like you can't just simplify things into like, this food is good and this food is bad, right? So there's a lot that goes into sort of understanding it and Society plays a big role in that, that is why the things that are most successful at controlling.
1:15:34
Rolling weight are hormonal agents, that control your appetite. So nicotine is a classic example that actually suppresses your appetite people notice this when they stop smoking that their appetite goes up and it's probably because it was chronically suppressing, things to magnetize the drugs that some of the drugs that are used now. But anyway so it means that the carbohydrates are not. The only thing that matters, it matters. The type of carbohydrate. So is it amylopectin AML pregnancy?
1:16:04
How often you're eating it because it's not just how high is Spica and and how refined it is going to affect how high it spikes the foods. You eat it with are also going to make a difference and this is always very interesting to me because
1:16:18
You can take the same foods and your that's not what's important. The hormonal response is what's important. If you take the same food at breakfast versus dinner you're going to have a different insulin response to it. So you're going to actually have a much higher insulin response at night time versus breakfast. Same thing with something like vinegar. And this is very interesting, actually, I think so when you take sushi rice, for example, which has been a good rice
1:16:47
When you take an acid or lemon juice with bread or vinegar with bread, for example, you can take say 100 grams of bread and you can measure how much your glycemic index goes up. And when you take it with the acid, it's like 50% 60% of what it was without the acid, which is fascinating because of the same hundred grams of carbohydrate. So, say you take white rice versus vinegared rice.
1:17:17
The glucose level and the insulin level goes up to about 65-69, something like that versus 100. So you have much less effect and there's an interesting reason why that is, and it's because there's the in terms of digestion of starch is digested by a hormone called amylase. There's salivary amylase and there's pancreatic amylase. So the Assumption. So you eat, Brad, the saliva contains a Malay starts breaking down that
1:17:46
Starch. Remember starch is a chain of glucose. You need to break it into little pieces so that you can absorb it. The saliva contains amylase that immediately starts to work it and we had assumed always that most of the digestion is through the pancreas. The turns out that up to 80% 60 to, 80% of the adjusting can be salivary, amylase. Because salivary amylase is deactivated by low stomach pH. So we assume you chew it. Boom. It goes into the stomach and all of a sudden
1:18:16
Salivary amylase. Stop it, stops breaking down the starch. But, in fact, because of the bolus of food, the pH of the stomach actually never gets down there, and it doesn't get low enough to deactivate salivary amylase. So, if you take something like bread with vinegar, like they do, you know, olive oil and vinegar, for example, turns out that your do, don't break down the same amount of starch, and therefore, your glycemic index goes much lower, your insulin,
1:18:46
Bikes, go much lower and it's because of the acid. In the food pay lemon juice, does that fermented food does that? Which is lactic acid vinegar, which is acetic acid does that. So, there are things that you can take with the carbs that will also affect it. If you take carbs first versus last in the meal, you take it with protein or with fat. It's going to make a difference but there's so many things that make a difference rather than just cutting the total
1:19:08
number. Yeah, I love that. Another thing that officially called the fires as a hack, you know, that's him. Hack is, you know, thrown around a lot.
1:19:16
Phase. But that seems like a really practical thing that people can do within the concerts at their own diet, just to lower that glucose and lower, that insulin response in the body. The other thing, of course, I can do is think about the food order and I know you've released a video recently on your YouTube channel about this. Why is the order in which we eat Foods important when we're thinking about glucose and
1:19:38
Insulin? Yeah, and it's again is the same sort of thing where they did a study where they had people to eat carbs first.
1:19:46
Then waited ten minutes, then have their fat and protein versus taking the fat and protein than waiting 10 minutes and eating the carbs. And again, same number of carbs, same type of carbs, right? Same food, same amount of food, in the carbs exactly. Yet the rise in the insulin was like fifty percent of what it was and we remember the insulin is what's telling your body to, hey, store, this, this energy store these calories away. So the less of this insulin, you have trying to sort away the
1:20:16
You're going to leave out in the body for you to use its energy and it's going to keep you Fuller longer. So that's, that's the the food order. So basically the whole hack would be just shift your carbohydrate intake to the last part of the meal instead of the first part of the meal. And that's going to do two things, one is going to make you less wanting to eat the carbs because you're already full from the fat and protein and to the amount of carbs that you take even if it's the same is going to have less of an effect on
1:20:46
Autumn you. So it's so so you know this is what I mean when I say it's a complicated topic and people who try and simplify it to total calories, or total carbs always wind up. Missing a few things because there are ways to get around it because, you know, we we have eating carbs in the past without without gross. Yeah. You know, worldwide obesity epidemics, right?
1:21:09
Yeah, this is something I've done for a good couple years now and more recently with the kids, my kids are
1:21:16
79 at the moment and I will if it if I'm cooking dinner I will serve them their protein source and their vegetables first. And when that's finished or almost finished then I'll put on I drive the sweet potato mash or whatever else, you know, whatever whole food card was serving with it and you know, because it's very hard for me as a parent knowing the science, knowing the impact, not to try and implement it because it's pretty straightforward to do actually. And it's something that I think anyone listening to this
1:21:46
You're watching this right now can can experiment with themselves, you know, eat the carbs last and you know there's a really good video on your YouTube channel that I think will help people understand the science of that as well. Jason moving to fasting intermittent fasting. What if someone's kind of heard what you've had to say? So far and singing, okay? All right, I'm interested in trying intermittent fasting. Where would you encourage them to start?
1:22:16
And before you answer, I also want to say one of the things I think is so great about the practice of intermittent fasting is that it doesn't really matter what diet to tribe, you belong to, you can still practice this and get benefits, right? So I think it cuts through straight away through all that noise. So yeah, maybe maybe some tips for people on where they might want to start,
1:22:41
Yeah, I think that the first place to start really is just to go back to sort of, you know, 8 hours, 10 hours of eating sort of thing. If you want to eat sort of breakfast at 8:00 9:00 in the morning and finish by like, 6:00 in the evening, and then let the rest of the time be fasting, you know, you're talking about a 8, 9, 10 hour, or eating window, they may be 14 to 16 hours and that's relatively easy to do. And, of course,
1:23:11
think that people have done for many, many years with cutting out the snacks, cutting out the late-night eating. And then, you know, so if you cut out the eating after dinner,
1:23:22
And push your breakfast a little bit later then then you're automatically going to get that period of time and that's a great place to start and then you can experiment you can go longer file or shorter depending on what you like. But I think that's that's probably a good place to start off with that's going to be safe for everybody. You know, there's no there's no problems with anything. You're still going to be eating a relatively normal, you know meal.
1:23:52
Jewel and so on. But you know, there's so many where there used to be at least so many sort of myths about fasting about how it was so damaging to you and all this. I think, you know, it's important to get that right information as well. People used to think, oh well, you know, it's going to burn muscle. It's like you hear this all the time and I'm always like, okay, if you're in a big lead athlete, sure, maybe maybe that's something you have to be mindful of
1:24:22
But for most people who are not Elite athletes, you're just sort of regular people, you know, this idea that it's going to burn muscle is still very much ingrained. You see it out there, lots of people talk about it. It's like, do you really think that our body is just so stupid that we would store calories as glucose and body fat? But the minute that you don't eat anything you're going to burn muscle like do you think that we survived as a species to become the dominant species?
1:24:52
He's on Earth because our body is so intrinsically stupid like it's sort of like storing firewood you know for the winter and then as soon as it gets a little cold you chop up your sofa and throw it in the fire. Like what like what like why are you storing body fat if you plan to use that fat that muscle? It's like ridiculous. And I think it's a huge misunderstanding of the physiology. So I have a video about the five stages of fasting and there's a period of time in there. That actually is called
1:25:22
Gluconeogenesis. So, when you think about the physiology of fasting, there's a lot of good things that happen, but essentially, your body goes from eating food, then it starts using glycogen, which is sugar. It's basically chains of glucose that are stored in your liver. And then after glycogen, then there's a stroke period of gluconeogenesis which is protein. And that's where people say, wow, that's your that's where you're breaking down muscle. In fact, say no protein is not the same.
1:25:52
As muscle protein is a lot of things. There's lots of excess protein, our bodies skin. For example, is protein connective tissue, the thing that binds it all together is protein. When you break down proteins, your body is going to break it down, and then rebuild, whatever it is that you need. So if you need muscle, you will build it. If you don't need it, it won't build it. Like, the only thing that builds muscle what builds muscle and loses muscle is not how much or how little you eat or protein, you need
1:26:22
e. It's the exercise that you do. Like I'd love it if I could eat and build muscle, but I don't think it doesn't happen ever as much as I wanted to and it's the same thing when you're breaking down protein, it's not necessarily muscle. If you're using the muscle, it's not going to get broken down. But what you are going to do is break down the skin, the connective tissue, the stuff that you don't need. And this is this process called at off of G where your body is actually going to break down organelles in the body.
1:26:52
Because it's not necessary and it's a process of cleaning out the unnecessary stuff. So people who did intermittent fasting, we have people lose, you know, 100 150 pounds. It will send anybody for skin removal surgery because that was protein that was removed, not fat, and that's all anecdotal. I know it's not sort of proof, but we have a lot of people say, wow, my skin has tightened up to, it's like, you don't get that with just body fat loss that's protein loss. If you look at the amount of protein,
1:27:22
On the human body.
1:27:24
In somebody who's overweight, it's far in excess. They have more protein than somebody. Who's, who weighs less? It's not just the fat. It's all the stuff that helps to support. The fact that the blood vessels, the skin that connective tissue, right. And that also has to go with that. So, yes, there is a period of breaking down proteins During the period of fasting, sort of around 18, to 24, to 30 hours, something like that. But it's not necessarily a bad thing. It doesn't mean your body is,
1:27:54
Is breaking down muscle, you will lose muscle when you don't use Muscle.
1:27:58
So you're saying starts off for people, maybe a 10 hour reaching Windows, you say, let's say 8:00 a.m. till 6 p.m. is you're eating window out with that, what in your view because you take a lot of people through these fasting programs. I know in your clinic, what are they permitted to do outside that eating window in terms of drinks and other things? That's the first question and then
1:28:24
Going beyond that. It's like what benefits and might people once they start there and go, okay this is pretty easy. I can do that. I'm feeling better lost a better way. I'm sleeping better. I feel lighter. What are the benefits or why should some people consider going further? Because I think in your clinic do it, is it am I right in saying that sometimes you take people into 36 hour, fast 48-hour fast, those sort of things. So maybe we just yeah. Just just just walk us through that if you if you
1:28:53
will. Yeah. So
1:28:54
You know, classic fastest water only, but really you don't have to be that strict. There's no rules. Like, you know, when you're talking about fast and there's two main variables, one is the length of us into is, what is allowed during that fast and you can put your there's lots of things. So T, for example, is something that I recommend for a lot of people we can drink coffee and then those really don't have too much effect on, you know, your body, there's no calories and you know, Green
1:29:24
Tea and it really doesn't have much effect. On the other hand, the coffee and stuff, it's going to have the coffee and tea, they both have things like stimulants, like caffeine and that may keep your sort of energy, you know, your metabolic rate a little bit higher. So yea it maybe there's a little benefit from those. Although the effect is relatively small, so, teas, coffees herbal teas. Those are all great to do then you get into things that are more clearly food. So things like bone broth, for example.
1:29:54
Then people even take like, small salads and stuff within that fasting window. You know, if they get very hungry for example, and those are, you know, people think well, you know, I just broke my fast, right? I have to start all over. That's not what happens because what happens is that when you're fasting, you trying to force that insulin level down. So if your insulin levels going down, your body's going to switch towards using your store calories, not not the food, if you break that fast with say you know, oh I had
1:30:24
Add, you know, some bone broth. Yeah. Your instance been a blip up for a little bit but it's a very small amount and then it's just going to start going back down. Again, it's not going to have a huge effect, so even if you take something during that fasting, we know it doesn't mean that all of your progress has been lost. We have to start from scratch again, so you don't have to worry so much. But generally, I tend to tell people, you know, just stick with, like, cheese coffee. If you put a little bit of cream in the coffee because that's what you're used to go ahead. It's not going to make it.
1:30:54
Use different, but don't put, like the whole, you know, carton of cream in it. Then you're talking about food, more than anything else. And then the other thing is, in terms of the benefits of
1:31:05
Fox and why continue with it. There's a lot of reasons. Like if you think about the physiology of what happens during fasting, there's a lot of good things that happen. People always assume that they're going to be tired during fasting, but that's not actually what happens. So, if you, if you, if you don't eat, there's a very sort of stereotyped response that is instant is going to go down but certain other hormones are going to go up. And one of those hormones is the sympathetic nervous system.
1:31:35
And growth hormones. So both of those go up as you fast. Sympathetic nervous. System is part of this sort of parasympathetic is sort of relaxing. Sympathetic is sort of stimulating, some sort of fight or flight response. So it's it's the hormones involved, they're mostly noradrenaline and adrenaline. So you actually activate the sympathetic nervous system when you don't eat. And this is sort of basic first year. Medical school stuff, it's it's a number of hormones called the counter regulatory.
1:32:05
Latorre hormones, you get a spike of this counter regulatory hormone in the morning around, 5:00 a.m. 4 a.m. 5 a.m. and it sets you up for the day, it's pushing the, do the calories, the energy into the system, so that you have energy for the day ahead. So that's why you don't necessarily have to eat the minute that you get up because your body's already started. Fueling yourself from its stores and because you're having higher levels of sympathetic nervous system, you're going to be able to concentrate better.
1:32:35
Are you're going to have more energy as you saw is not less energy, like think about it. You know, if you have a lion who just ate it's sort of sleepy. Just wants to lie there and digest but you have a Hungry Wolf, is it sort of like falling over because it can't concentrate? No, the hunger is what makes it dangerous, because it's dialed in its concentrated and it's got energy to burn. It's just getting his energy from its stores. Not from its food. And that's
1:33:05
Because that you've in it, you know again it's not some beauty magic psychology, it's just physiology. Your body is ramping up at the time that you're fasting. What that's great. You're going to have more energy. I've had people come in, you know, women and their husbands would be like I can't keep up with her anymore. Like she walks so fast. I can't even, I have to tell her to slow down and says, she's like that. Yeah, it's because I have so much energy. It's like, yeah. Because now you're releasing that
1:33:35
Energy. You've now finally allow your body to access the stores of energy by allowing instant to Fall by fasting. You're allowing your body to access this huge store of calories this 100,000 calories that you had stored away. That you've never been able to access before because insulin is always blocking you. Now you have access to this energy. They're like, well, okay, let's use it. Let's use it. Your body's pumping up the sympathetic tone, some people actually can't sleep because because they're so pumped.
1:34:05
Up when they're fasting, but then they can focus better. We know that people, you know, in terms of their mental abilities are do better with fasting. So it's a fascinating, not process a lot of good stuff
1:34:17
there, it's just crazy. How many people have never ever experienced anything like that? Because of what we were talking about right at the start this conversation where, you know, the fifty percent of the u.s. population who don't work in shifts are consuming Foods over 15 hours a day so there no way near.
1:34:37
Able to actually experience these things that you're talking about. And I think another thing, which I often think about with fasting is that humans have been fasting for donkey's years, right? If it was dangerous. How would we possibly have survived this far? Now on that? I think a couple of caveats, I know you deal with a lot of patients with type 2 diabetes. Do people in your opinion needs to be careful if they are taking blood sugar lowering medications or
1:35:06
Or injecting insulin. I think we should just sort of briefly mention that in case people jump straight
1:35:12
in.
1:35:14
Yeah, absolutely. So remember that, when you're fasting in your body is going to be using glucose stored glucose, whether it's in your blood or whether it's in the liver. If you're taking medication, in addition to lower your blood glucose, you could possibly go too low. And yes, it can be very, very dangerous. So if you're on medications, you should always speak to your doctor. But for a long time, people used to say, well, that's why type 2 diabetics, can't fast. It's like, no, that's why you have to be careful. Because
1:35:44
The thing about the fasting is that it is a way to help lower your blood glucose. If you're lowering it with fasting and you're taking your medication, then you'll go to though, but it doesn't mean that you should not find, it means you need to take less medication. It means you're overmedicated. So you need to adjust that Medicare and not that the fasting was wrong because the, you know, this is a natural way to lower your blood glucose. Like what could be better than that? You
1:36:13
haven't we
1:36:13
We don't see that starts as do it. You don't look like no, it's a given that you stay on the medication. Oh no, this is dangerous or adding in fasting. It's like, well, hold on it. It's just, you can think of it as a third medication and just think, oh, if I'm going to add this one, and maybe I need to take this one down, or take this one off, but it's not, it's speaks at this wider problem, that we don't as a profession in my view give things like fasting or changes in food quality the same priority.
1:36:43
The same level of importance as you know, tinkering this medication by 10. Mg said, you know what I mean? It's kind of like nope and it's very
1:36:52
frustrating. It is because for example you have if somebody is on insulin for example and their blood glucose goes down. So what is the advice that we as a profession give or eat something right? It's like okay well sure that one specific time. I yes I agree but in general if you're going down and
1:37:13
You're overmedicated because I'm giving you this insulin to get your sugar's low and your sugars are going to low. So you're overmedicated. So you need to reduce the dose but we don't think that way because we think okay, well what you should do, and this is, I've heard actually dietitians say this all the time, you need to eat to cover your insulin. It's like what? So if you take insulin, your sugars go low. Then you eat. What do you think is going to happen? You're going to gain weight. If you gain weight, what happens to your type 2 diabetes? It gets worse. Why?
1:37:43
Don't you instead, not eat take lessons Lynn and then you're going to lose weight. As you lose weight, your type 2, diabetes will get better but you're absolutely right. Like we've gone in the wrong direction, thinking that the the medications are, what's good for us and everything else has to fit around that. And it's part of problem is medical education because again, I've gone to so many meetings and these are given by the heads of, you know, diabetes.
1:38:13
Asians and stuff right on the go. Okay. The number one two and three treatments for type 2 diabetes is you know diet diet diet, right? Okay great then they spend the next 59 minutes out of that 60 minute lecture telling you about drugs. So the message to all the doctors, these are training doctors and establish doctors is that yes, we will give you lip service about diet and lifestyle. But what we're really here to talk about is meds
1:38:43
He's right, and that's wrong. That's absolutely wrong thing. Because
1:38:48
Think about the simplistically, right? Type 2 diabetes is largely a dietary disease and we're using drugs to control a dietary disease. While you're not going to get as much effect as you think you will, because you're not focused on the root cause which is the dial. Yeah,
1:39:06
this is such an important part 1, when I teach doctors on this, prescribing lifestyle medicine course. A lot of doctors will say initially that old patients. Don't do what I tell them to do.
1:39:17
Do you know and I often give the example of a 10-minute or a 15 minute consultation with a patient in general practice where they've just been diagnosed with type 2 diabetes and we do a role play on stage. I basically try and demonstrate two different consultations one where basically you spend the first nine of those 10 minutes or 14 out of those 15 minutes talking about medication. And the fact that this will stabilize your blood sugar, you're probably going to need another medication in the next year and within
1:39:47
Years, you're going to be on insulin and then I'd say walking out, you stay on. If you could lose a bit of weight and move a bit more, it's going to help you. And then we do another one, where actually spend the first 90 percent of that consultation helping them understand what's caused it. Giving them help us to how they might change their lifestyle, or these kind of things. And then you also mentioned that there may be some medications and you ask the question to the dots as well. What message is that? Patient? Can a get, if you spend 90% of the time on lifestyle and 10% on medication versus
1:40:17
The opposite. What's going to happen? Of course, the patient's going to go out with the impression. Yeah, he mentioned die at the end, but really it was all about these medications, but it is starting to change. That is for sure, maybe not fast enough for people. You mentioned women before and a woman who was full of energy and her husband wasn't able to keep up. There's another kind of maybe a myth about fasting, which is that it suits men better than women have you heard that myth? And what is your experience being with
1:40:45
that? Yeah, I've heard this.
1:40:47
If before that women shouldn't fast or they can't fast or they don't get results from Fast thing and it's really I think just not true like not all men do well. Like the men, we don't do well you just don't hear about them. The women can fast. Like there's nothing inherently dangerous about fasting and women they do probably respond a little bit differently. Like men tend to some men lose. A lot of weight like
1:41:17
Right up front like very, very quickly. Like, you know, sort of like 60 pounds and like, you know, a month or thing like really, really fast and whereas women do tend to be sort of like more slower and stable. And I think some of it is just the sort of Baseline. Like some men really just like their diets are just
1:41:41
Really like they're obviously not good like they're just eating out fast food like 100% of their meals sort of thing, right? So it's just such a horrific Baseline of processed food that as soon as you change that. Like and you don't see that with women, women are tend to be a lot more diet conscious so then you don't get people who have those horrific baselines of McDonald's for every meal sort of thing.
1:42:10
Whereas you do that, you do see that with men, like with menu, you get that. And therefore, you know, as soon as you change them to sort of like Whole Foods, their weight, just undergoes dramatic changes. So I think that it's, you know, not just the fasting Minister Foods as well, right? So there's two components, right? There's the foods that you eat, and then there's the time that you're not eating, and I think it's, yes. There probably are some differences with men and women like people talk about sex hormones, you know.
1:42:40
Pause, for example, and I think that there is definitely something there, like the sex hormones, do play a role in how much fat you gain and lose. It's just a fact. And this is another part of this whole calories thing that I always find incredibly. Like I don't understand how any serious scientists can think about calories is the only thing because think about adolescent girls and boys. Okay, so pre-puberty girls and boys are roughly the same sort of wait.
1:43:10
And body fat and so on. Then you go through puberty and women in general. Are have about fifty percent more fat than boys.
1:43:20
It's not that they have less willpower like obviously not the difference was that the boys had a bunch of testosterone. They gain more muscle whereas women tend to develop fat in their hips and their brass, right. It's just that physiology. That's a difference between exposing somebody to a lot of east region versus testosterone. What does not a willpower problem is not a problem with their diets necessarily, right? So. So it's not like, you know, and this is, you know,
1:43:49
No people who say, well, you know it's all about willpower. It's like well then you must think that women have less willpower than men is like that. That's not true. Like it's not true in any sense. So therefore it's sex hormones that play a huge role, women do have a difference in sex hormones and during menopause. So we know that there's a certain number of changes and that may play a role in weight loss. But there's nothing you can do about it. Like I'm not gonna be there menopause.
1:44:19
So, therefore, you just have to deal with it. So, does it mean they can't fast? No, it doesn't mean they may respond differently than men? Yes, absolutely. Yeah. They may take a little bit more time because their bodies had been programmed program by nature to carry more fast, that's not their fault or anything necessarily bad, it's just physiology, that's the hormones speaking,
1:44:43
I'm think,
1:44:45
Well, these things are very individual rights things work well and quickly for some people. Some things don't bus, it's kind of the way it is. And then also, we have to be careful about how we're measuring the impact. I mean, if weight loss is the only metric people are looking at. They may think that intermittent fasting potentially his failed for them, but actually the benefits as we've touched on on multiple occasions throughout this conversation. Go far beyond. Just wait. So they're at their
1:45:14
Your gut function often I found people with IBS type sensors. It really clears up massively when they have periods of fasting. Sleep can improve. You know, all kinds of things, other things can benefit. So you know, I definitely encourage people to experiment and see the other thing. Jason often comes up with fasting. Particularly these days is the issue of Eating Disorders which as you know, are rampant that on the rise, particularly in adolescence you've at least a video on this Reese.
1:45:44
May I saw on your YouTube channel, which I found really, really interesting. What is your view on whether intimate and fasting, whether me and you having a conversation like this is toxic for people who may be suffering with eating disorders? Mean what is your view on
1:46:00
that?
1:46:02
Yeah, and and the literature really says that there is not a lot of danger with that. So when we're talking Eating Disorders, generally we're talking about anorexia nervosa and bulimia. Those are the two big sort of eating disorder. So they've done studies where they've basically looked at it. So they take people not, you know, there's two two main concerns right with dieting or
1:46:31
Fasting and eating disorders. One is that you're going to be so hungry that you're going to trigger like overeating or binge eating and too is that there's you maybe you don't take enough, you know amino acids and tryptophan therefore you're going to get a little bit depressed and then therefore you're going to overeat well neither of those possibilities turned out to be true. So in the studies what they did was there's one study where they looked at this where they had people they fasted them and then said
1:47:01
You know, what are your levels of hunger? Do you overeat and so on and and the bottom line was that we people tend to eat a bit more the meal after a fast, and this is a 24-hour fast, but if you look at the full 24 hours, they're still not eating nearly as much as they used to. And then to was that they did, you know, they took people with diagnosed anorexia and bulimia, this was a separate study and they, again, put them through fasting and they were
1:47:31
I basically wanted to see if this was going to trigger their eating disorder and again the conclusion from that study, was that it did not. So it sounds like it's a plausible concern and you know I don't want to minimize it because Eating Disorders is a very serious problem, of course. But the available data so far hasn't hasn't really born out the danger that it does. Like it doesn't suggest
1:48:01
That there is any danger from that, you know, I want to just be careful because there's just not a lot of research into that. And I always want to be careful because, you know, fasting is a tool and tools. Always they can help or they can hurt. It's not the tool, it's how you use that tool. So if you use, you know, blade you can cut out a tumor. For example, you can cure somebody, but you can also kill somebody. So, yeah, if you're talking about intermittent fasting, like in,
1:48:31
And you know, somebody, you know, you have a 16 year old girl, who weighs like, next to nothing with a BMI of 15. No, you do not want to be talking about, but you have a 60 year old man with type 2 diabetes, who weighs sort of like, you know, has a body mass index of 45. Well then, yes, absolutely. You want to be talking about it, but it's a skill of the person using it. So, you know, you have to choose your situation like to say, that fasting is back.
1:49:01
Everybody. Well that's 60 year old man who's you know super super you know morbidly obese his risk of anorexia nervosa is almost zero like there's no reason not to talk about it with him. The risk of a 16 year old girl who weighs almost nothing and has a BMI of 16 yes there are risks is extremely high. You should not be talking about that with her so you know it's not the knife it's the way you use that knife in fastings. Exactly the same.
1:49:30
Yeah.
1:49:31
It's a great point, hba1c is a common blood marker, that many people get done at their daughters, which is a, an average measurement of our blood sugar over the past two or three months with all your experience. Of course, if it hits a certain point we call that type 2 diabetes. If it hits a slightly lower point, we call it. Prediabetes
1:49:56
Do you have a sense? These days of what an optimal level might look like for someone, I understand that you deal with a lot of type 2 diabetics and your kidney clinic and you help them put their type 2 diabetes into remission. Certainly get there a lot better using the things that we're speaking about but I but I I've often thought in medicine that we it's very black and white. You either have pre-diabetes and type 2 diabetes or your normal but clearly that's not the case. This is a progression that at some point. You flip into
1:50:25
Diabetes. And at some points you flip into the top two diabetes diagnosis. So do you have a sense of what an optimal level might look like for someone who's trying to safeguard their health for the
1:50:39
future? If you look at studies really the lower the better. And I think that those definitions are mostly because the the whole, the whole thing is,
1:50:55
That you have to have definitions to do studies. So you need to classify. So 6.4 is not debit, 6.5 is diabetic. Like the difference is very small, but at some point, you have to draw that line in an instant. It's an artifact of doing studies. So, you have to classify people because you can't just say, six point one, six, one Tuesday. You can't have like, you know, 15 different categories in the study of be really confusing. So you break it up and you say, okay, well,
1:51:25
At 6.5 here, this and 6.0 26.4 is this and less than that, but it's really a Continuum. So there's no real mass number in clinical practice though. I've seen a lot of people who are like 5.9 6.0 and they seem to do fine, what I think is important from an individual basis to it's not just the level but also the stability of that level over time. So I've actually seen a number of people and I always thought this was right.
1:51:55
Oh, you're like almost pre-diabetic or your pre-diabetic, but they actually just trundle along just fine and they're always at 6.0 and I think that that's another thing that I'm not sure is captured with the actual number is sort of if they've been like this for this, many years, is it really bad? Or is it not? I actually thought this because it was a relative of mine who I tracked relatively closely for like 20 years and it was like, six point one. Six point zero.
1:52:25
21 6.0, and they did find. They actually never had any problems plan whatsoever. And I thought, I wonder if it's just like their diet and change the weight and change and they're pretty healthy throughout. But I just always wondered, is it really bad or is it that person who goes from five point three to five point five two five point seven two six point zero two six point two, maybe that's what's bad. So I think you know, there's two things, one is the actual level and to is if it's at a sort of
1:52:55
Borderline level is it going up? Or is it sort of stable because what's really going to be bad? Of course is when it goes up and over 6.5 then clearly you're in the abnormal right
1:53:06
now. I felt super interesting and I suspect over the next few years will get a lot more clarity on this as science in this area. Progresses Jason had we had more time I was wanting to get into your latest book. The cancer code which is just brilliant. Maybe I can tempt you with the pot to at some point in
1:53:25
Future because I think the way you've articulated your thoughts on cancer and how our understanding of it is developing is pretty profound and it's a brilliant read for anyone to finish up this conversation. We've covered a lot so far. This podcast is called feel better live more. When we feel better in ourselves, we get more out of life, right at the end. Now, Jason in all your years of experience. Yes, and clinic. But also, you know, spreading information on
1:53:55
The web through your books. What are some of your very best tips? For people who have heard what you had to say. Go right? I'm in I want to make some changes, I want to start looking after my health, I want to start lowering my insulin. What practical advice have you for them right at the end
1:54:11
here?
1:54:14
I think that the, the most important thing I think is to focus on sort of foods and less on nutrients like carbs, or, you know, that kind of thing focus on the sort of eating Whole Foods is still probably the most important thing, whether it's a car, or whether it's not, I think that's still. Probably the biggest thing we don't talk about it as much as we probably should.
1:54:42
Should write in the whole thing about carbs and you know keto and this diet and if that diet it all winds up and you know vegetarianism and that's what it always comes back to eating sort of natural foods and eating in a way that's not constantly stimulating. So you know to me it's relatively simple and not that controversial one, don't need too much sugar. I don't
1:55:12
That's very controversial to try to eat unprocessed foods which is again, I don't think is all that controversial and three do need all the time. Like if you're overweight, don't eat all the time. I cut out those things but I, you know, to me just seems like, hey, this is just what it was in the 1970s. Like there was none of this count your carbs, count your calories count, this count that meat whole unprocessed Foods, whether it's, you know, vegetables or even meat, enjoy your food.
1:55:42
When you do eat them but don't eat constantly give your body a break once in a while from eating so that you can digest your foods. Like that's all your grandmother ever. Wanted to tell you like, give your body a chance to digest the food that you ate. Don't just keep shoveling it in. You got to use it because when you're putting it in, is going to come out at some point, otherwise you're going to get into problem. So those three things I think are sort of still the core of everything without getting too complicated. Don't eat too much sugar, you know?
1:56:12
Unprocessed foods and don't eat all the time.
1:56:15
Great advice to finish off. Jason want to acknowledge a you doing. Fantastic work. You're helping so many people. Thank you, books are fantastic. Which books would you drive people to? And we're asking people stay in touch with you. They want to keep up to date with your work.
1:56:28
Yeah. So I think the best place to start is the Obesity code. It sort of goes into the science of weight gain and weight loss. I have a number of YouTube videos now which sort of covers, a lot of that material and sort of
1:56:42
Less than 10 minute chunks. So I think that's, that's what I've been doing. Sort of the last year to sort of help spread the message and the other the other ones, you know, you can also follow me on Twitter at. Dr. Jason Fung and then, you know, but the cancer code that just to address that I actually think is the most interesting them to me. It was the most new information about cancer but not, it doesn't follow along with diets and insulin and so on.
1:57:12
Quite as much as the others, it's more of an exploration of sort of what this disease is to me that which is a, you know, and actually a really fascinating story but it's not it's not going to change in terms of what you do, what the medicines that you do. It's not a diet, it's not completely a dietary disease. So therefore it's not a dietary solution as opposed to say that the Obesity and diet type 2 diabetes which are dietary diseases. So the Obesity code, the die.
1:57:42
BT's code are both there to you know just for you to get more information about that.
1:57:47
Yeah, thanks guys and I'll see you work and hopefully get you back on some point in the future.
1:57:56
I really hope you enjoyed that conversation before you go to Quick reminders. Number one, my latest book, happy mind, happy life, the new science of mental well-being is now also available in America and Canada. If you enjoy my weekly podcast I really think you're going to enjoy this book. It contains lots of simple and free ideas and tools to help you think differently deal with conflict and stress in your life better look after.
1:58:24
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