1 00:00:04,360 --> 00:00:04,640 Speaker 1: Ruby. 2 00:00:07,080 --> 00:00:10,240 Speaker 2: It breaks people out. Sometimes what you don't eat breakfast, 3 00:00:10,440 --> 00:00:13,520 Speaker 2: what you don't eat launch either. Are you insane? Are 4 00:00:13,560 --> 00:00:17,159 Speaker 2: you dye like? People cannot wrap their head around the 5 00:00:17,160 --> 00:00:17,919 Speaker 2: way that I eat. 6 00:00:18,360 --> 00:00:22,720 Speaker 3: Diet is what you eat. Intermittent fasting is when you eat. 7 00:00:23,160 --> 00:00:25,520 Speaker 4: I've had a patient claim that fasting was the only 8 00:00:25,560 --> 00:00:27,160 Speaker 4: way she could lose weight. 9 00:00:27,840 --> 00:00:31,800 Speaker 1: Intermittent fasting might feel like the latest wellness grace, but 10 00:00:31,960 --> 00:00:34,919 Speaker 1: humans have actually been doing versions of it for thousands 11 00:00:35,000 --> 00:00:39,600 Speaker 1: of years, sometimes for religion, sometimes for survival, sometimes even 12 00:00:39,640 --> 00:00:43,280 Speaker 1: for politics and protests. But over the last couple of decades, 13 00:00:43,360 --> 00:00:48,240 Speaker 1: fasting has gone fully mainstream. Now it's all over TikTok, 14 00:00:48,280 --> 00:00:51,160 Speaker 1: YouTube and fitness culture, with people claiming it can help 15 00:00:51,200 --> 00:00:54,960 Speaker 1: you lose weight, boost your energy, improve your focus, and 16 00:00:55,040 --> 00:00:59,639 Speaker 1: optimize your health. The problem is intermittent fasting can mean 17 00:00:59,680 --> 00:01:02,640 Speaker 1: almost anything. Aside from your three square meals a day, 18 00:01:03,120 --> 00:01:06,440 Speaker 1: There's sixteen eight, where you fast for sixteen hours daily 19 00:01:06,520 --> 00:01:09,319 Speaker 1: and restrict your eating to an eight hour window. There's 20 00:01:09,400 --> 00:01:13,680 Speaker 1: omad one meal a day, alternate day fasting, five to 21 00:01:13,760 --> 00:01:16,559 Speaker 1: two fasting. That's five days of eating a typical diet 22 00:01:16,560 --> 00:01:19,280 Speaker 1: and two of eating a calorie restricted diet. There are 23 00:01:19,400 --> 00:01:23,520 Speaker 1: juice fasts. Basically everybody has their own version. So when 24 00:01:23,520 --> 00:01:27,160 Speaker 1: there are this many options, what actually counts as fasting? 25 00:01:27,560 --> 00:01:30,840 Speaker 1: Are we really just restricting calories? Is there something else 26 00:01:30,920 --> 00:01:34,399 Speaker 1: going on? And more importantly, is intermittent fasting good for 27 00:01:34,480 --> 00:01:38,000 Speaker 1: your health? Or is this another wellness trend getting way 28 00:01:38,000 --> 00:01:41,360 Speaker 1: ahead of the science. Clearly we have questions. Like I said, 29 00:01:41,360 --> 00:01:44,160 Speaker 1: it might just depend on who you ask. Alcavad Low, 30 00:01:44,240 --> 00:01:48,120 Speaker 1: an online fitness influencer and personal trainer, shapes his entire 31 00:01:48,240 --> 00:01:52,520 Speaker 1: life around intermittent fasting. He follows a version called OMAD 32 00:01:52,680 --> 00:01:53,600 Speaker 1: or one meal a Day. 33 00:01:54,120 --> 00:01:57,760 Speaker 2: So it started by postponing breakfast, and then it became 34 00:01:57,960 --> 00:02:01,960 Speaker 2: skipping breakfast, and then it became skipping breakfast and launch 35 00:02:02,520 --> 00:02:05,280 Speaker 2: and for the most part, I eat one meal a day. 36 00:02:05,320 --> 00:02:08,880 Speaker 1: And then there's Jen Stevens, a former elementary school teacher 37 00:02:08,919 --> 00:02:12,000 Speaker 1: who got so into intermittent fasting that she turned it 38 00:02:12,080 --> 00:02:15,360 Speaker 1: into a whole second career. She's written multiple best selling 39 00:02:15,360 --> 00:02:18,000 Speaker 1: books on the topic, built a massive online following, and 40 00:02:18,040 --> 00:02:22,720 Speaker 1: now hosts a podcast dedicated to the intermittent fasting lifestyle. 41 00:02:23,200 --> 00:02:25,960 Speaker 3: I was on that yo yo. I was either gaining 42 00:02:26,080 --> 00:02:29,320 Speaker 3: or losing, and since I lost, the weight with intermittent 43 00:02:29,360 --> 00:02:33,480 Speaker 3: fasting over ten years ago. I am steady and it 44 00:02:33,560 --> 00:02:34,400 Speaker 3: just feels amazing. 45 00:02:35,080 --> 00:02:38,720 Speaker 1: And of course, doctors know what's science and what's bunk. 46 00:02:39,040 --> 00:02:42,760 Speaker 1: People like doctor Jennifer Shreever, a family physician at Sanford 47 00:02:42,800 --> 00:02:46,919 Speaker 1: Health who specializes in obesity medicine and long term weight management. 48 00:02:47,240 --> 00:02:50,160 Speaker 1: She spends a lot of time separating what intermittent fasting 49 00:02:50,240 --> 00:02:53,600 Speaker 1: can do from what social media claims it can do. 50 00:02:53,639 --> 00:02:57,320 Speaker 4: They think that intermittent fasting might optimize our health so 51 00:02:57,360 --> 00:03:00,360 Speaker 4: that they can live longer, or they're just looking for 52 00:03:00,400 --> 00:03:03,040 Speaker 4: that structured, easy to follow approach and they want to 53 00:03:03,080 --> 00:03:05,560 Speaker 4: work on their health and that seems the simplest way 54 00:03:05,560 --> 00:03:05,960 Speaker 4: to do it. 55 00:03:06,680 --> 00:03:10,079 Speaker 1: Welcome back to Health Versus Hype with the American Medical Association. 56 00:03:10,280 --> 00:03:14,600 Speaker 1: I'm your host Trace Tominguez. Today we're talking about intermittent fasting. 57 00:03:14,880 --> 00:03:18,000 Speaker 1: What is it? Can skipping breakfast really improve your health? 58 00:03:18,240 --> 00:03:22,000 Speaker 1: What does intermittent fasting do to your body? Join me 59 00:03:22,040 --> 00:03:25,280 Speaker 1: as we find out whether intermittent fasting is all health 60 00:03:25,600 --> 00:03:44,400 Speaker 1: or just hype. For millions of people, intermittent fasting isn't 61 00:03:44,480 --> 00:03:48,200 Speaker 1: just a diet. It's become a lifestyle, and few people 62 00:03:48,280 --> 00:03:52,320 Speaker 1: embody that more than Jenn Stevens, who discovered intermittent fasting 63 00:03:52,360 --> 00:03:55,280 Speaker 1: while trying to lose weight after years of struggling with 64 00:03:55,320 --> 00:03:59,240 Speaker 1: traditional dieting. But while stories like hers have helped fuel 65 00:03:59,320 --> 00:04:04,160 Speaker 1: the trends explosive popularity online, doctors and researchers are still 66 00:04:04,200 --> 00:04:08,480 Speaker 1: working to understand exactly what fasting does inside the body. 67 00:04:08,960 --> 00:04:11,720 Speaker 1: I want to start by understanding why someone would want 68 00:04:11,760 --> 00:04:15,160 Speaker 1: to adhere to such a strict way of eating. For that, 69 00:04:15,400 --> 00:04:16,200 Speaker 1: let's hear from Jin. 70 00:04:17,400 --> 00:04:20,640 Speaker 3: I have a background, probably like a lot of women 71 00:04:20,760 --> 00:04:24,000 Speaker 3: and men, in that I was always chasing the next 72 00:04:24,080 --> 00:04:27,000 Speaker 3: best diet plan, right, you know. The first time I 73 00:04:27,120 --> 00:04:29,800 Speaker 3: needed to do a diet, turned to calorie counting like 74 00:04:29,960 --> 00:04:33,479 Speaker 3: most people. But that didn't work. It wasn't sustainable. I 75 00:04:33,520 --> 00:04:37,120 Speaker 3: tried literally everything that came along. I was officially obese, 76 00:04:37,400 --> 00:04:40,680 Speaker 3: I weighed two hundred and ten pounds, and I was 77 00:04:40,760 --> 00:04:43,120 Speaker 3: sick of it. And so of course I heard about 78 00:04:43,160 --> 00:04:46,440 Speaker 3: intermittent fasting. A few people were talking about it, and 79 00:04:46,480 --> 00:04:49,560 Speaker 3: I tried it, and I have never stopped since. So 80 00:04:49,720 --> 00:04:53,279 Speaker 3: I've been doing intermittent fasting since August of twenty fourteen 81 00:04:53,320 --> 00:04:56,680 Speaker 3: without stopping, and for the first time in my entire life. 82 00:04:56,760 --> 00:04:57,640 Speaker 1: I have not yoyod. 83 00:04:57,839 --> 00:04:59,920 Speaker 3: I've been able to maintain after I lost eighty p 84 00:05:00,400 --> 00:05:02,320 Speaker 3: I've been able to maintain since I. 85 00:05:02,320 --> 00:05:02,960 Speaker 1: Lost the weight. 86 00:05:03,080 --> 00:05:06,520 Speaker 3: So it is completely different than anything else I ever did. 87 00:05:07,160 --> 00:05:10,680 Speaker 1: So what is intermittent fasting for people who might not know. 88 00:05:11,360 --> 00:05:15,080 Speaker 3: Well, it's basically when we intentionally have periods of time 89 00:05:15,440 --> 00:05:18,679 Speaker 3: when we choose to fast, and then we have periods 90 00:05:18,680 --> 00:05:21,200 Speaker 3: of time when we choose to eat in an eating window, 91 00:05:21,600 --> 00:05:26,719 Speaker 3: so we are either intentionally fasting or our eating window 92 00:05:26,800 --> 00:05:29,760 Speaker 3: is open and we are intentionally eating. It's basically a 93 00:05:29,880 --> 00:05:32,360 Speaker 3: boundary around the times that you're eating. 94 00:05:33,080 --> 00:05:36,400 Speaker 1: Jin came to intermittent fasting to lose weight, but many 95 00:05:36,440 --> 00:05:39,400 Speaker 1: followers of this lifestyle have found their way to intermittent 96 00:05:39,400 --> 00:05:43,800 Speaker 1: fasting through wellness and fitness advice. Alcavadlo is an influencer 97 00:05:43,839 --> 00:05:46,760 Speaker 1: who focuses on exercise for men in their forties who 98 00:05:46,800 --> 00:05:49,240 Speaker 1: are looking for new ways to stay fit and healthy. 99 00:05:49,760 --> 00:05:53,120 Speaker 2: Fitness and exercise was kind of my gateway into being 100 00:05:53,120 --> 00:05:57,479 Speaker 2: interested in nutrition. I got more into improving the quality 101 00:05:57,520 --> 00:05:59,640 Speaker 2: of the food I was eating and also starting to 102 00:05:59,640 --> 00:06:03,240 Speaker 2: pay more attention to the fasting aspect. It all happened 103 00:06:03,360 --> 00:06:06,680 Speaker 2: very naturally For me, it never really felt forced. It 104 00:06:06,760 --> 00:06:09,279 Speaker 2: never feels like I'm depriving myself. It never feels like 105 00:06:09,279 --> 00:06:13,240 Speaker 2: I'm starving myself. To be frank, I'm not super dogmatic 106 00:06:13,279 --> 00:06:16,880 Speaker 2: about it. If there's a day where I am absolutely famished, 107 00:06:17,120 --> 00:06:18,400 Speaker 2: I'll eat a snack in the middle of the day. 108 00:06:18,440 --> 00:06:19,440 Speaker 2: It's fine. 109 00:06:19,520 --> 00:06:21,160 Speaker 1: I want to take a break here and talk about 110 00:06:21,240 --> 00:06:24,880 Speaker 1: hunger for a minute. It's more complicated than simply having 111 00:06:24,920 --> 00:06:28,560 Speaker 1: an empty stomach. People feel hunger because the body and 112 00:06:28,600 --> 00:06:33,320 Speaker 1: the brain are constantly working together to monitor our energy needs. 113 00:06:33,839 --> 00:06:36,479 Speaker 1: One of the biggest players is a hormone called grellin. 114 00:06:36,880 --> 00:06:40,279 Speaker 1: It's often nicknamed the hunger hormone. When your stomach has 115 00:06:40,320 --> 00:06:42,920 Speaker 1: been empty for a while, grellin levels rise and send 116 00:06:42,960 --> 00:06:45,560 Speaker 1: signals to the brain telling you it's time to eat. 117 00:06:46,120 --> 00:06:50,200 Speaker 1: But blood sugar levels, hormones, sleep, stress, emotions, habits, and 118 00:06:50,279 --> 00:06:54,400 Speaker 1: even smell can all influence hunger too. For example, if 119 00:06:54,440 --> 00:06:56,960 Speaker 1: you have a habit of always eating lunch at noon, 120 00:06:57,360 --> 00:07:00,840 Speaker 1: your body may start triggering hunger signals around that time, 121 00:07:01,000 --> 00:07:05,240 Speaker 1: whether you actually need calories or not. During fasting, people 122 00:07:05,279 --> 00:07:09,800 Speaker 1: often notice hunger comes in waves rather than increasing endlessly. 123 00:07:10,240 --> 00:07:13,520 Speaker 1: That's because hormones like Grellin rise and fall throughout the day, 124 00:07:13,840 --> 00:07:16,760 Speaker 1: and the body can gradually adapt to new eating patterns 125 00:07:16,760 --> 00:07:19,040 Speaker 1: over time. Al alluded to this a. 126 00:07:18,960 --> 00:07:23,000 Speaker 2: Little Just try to wait a little longer to eat breakfast, 127 00:07:23,080 --> 00:07:25,960 Speaker 2: because most people wake up and immediately start eating. They're 128 00:07:25,960 --> 00:07:28,880 Speaker 2: not hungry. They do it because it's part of their routine. 129 00:07:29,320 --> 00:07:31,680 Speaker 2: And if you actually are hungry fifteen minutes after you 130 00:07:31,720 --> 00:07:35,400 Speaker 2: wake up, god bless eat. But sometimes people find out, Oh, 131 00:07:35,440 --> 00:07:38,080 Speaker 2: you know what, I drank a glass of water and 132 00:07:38,440 --> 00:07:41,120 Speaker 2: I didn't get hungry for a couple hours. And that's 133 00:07:41,120 --> 00:07:43,640 Speaker 2: sort of how it happened. Familiar, and I've been doing 134 00:07:43,640 --> 00:07:44,640 Speaker 2: that for a long time now. 135 00:07:45,520 --> 00:07:47,080 Speaker 1: Jin shared something similar. 136 00:07:47,720 --> 00:07:50,600 Speaker 3: The thing about hunger is, let's imagine you're not an 137 00:07:50,640 --> 00:07:53,080 Speaker 3: intermittent faster, You're just someone who eats typically. 138 00:07:53,440 --> 00:07:56,840 Speaker 1: Yeah, do you have hunger in your day? Sometimes yes, 139 00:07:56,960 --> 00:07:59,280 Speaker 1: yeah you do. You have hunger. 140 00:08:00,960 --> 00:08:03,280 Speaker 3: And then you eat and then it goes away, and 141 00:08:03,320 --> 00:08:05,120 Speaker 3: then later you're hungry, good, and then you eat and 142 00:08:05,120 --> 00:08:09,080 Speaker 3: then it goes away. For intermittent fasters, we have hunger too, 143 00:08:09,760 --> 00:08:13,040 Speaker 3: and then it goes away, It fades without eating, and 144 00:08:13,080 --> 00:08:16,440 Speaker 3: your body is like, all right, I guess I'll munch 145 00:08:16,480 --> 00:08:19,800 Speaker 3: on some stored fat for a while. So the thing 146 00:08:19,880 --> 00:08:23,800 Speaker 3: about hunger is once you understand it doesn't build and 147 00:08:23,840 --> 00:08:26,320 Speaker 3: build and build and build. When you're fast and clean, 148 00:08:27,120 --> 00:08:30,000 Speaker 3: it's not an emergency. You have a little wave of hunger, 149 00:08:30,160 --> 00:08:33,120 Speaker 3: you acknowledge it, you do something else, and then you're 150 00:08:33,120 --> 00:08:34,040 Speaker 3: not hungry anymore. 151 00:08:34,840 --> 00:08:37,280 Speaker 1: And let's face it, for all of us, but especially 152 00:08:37,280 --> 00:08:41,160 Speaker 1: for people trying to lose weight, specifically, evolving diet information 153 00:08:41,400 --> 00:08:43,880 Speaker 1: and guidelines can feel confusing. 154 00:08:44,480 --> 00:08:46,520 Speaker 3: You know, should you be vegan, should you be carnivore? 155 00:08:46,760 --> 00:08:46,920 Speaker 4: You know? 156 00:08:47,040 --> 00:08:48,880 Speaker 3: Or plants trying to kill you? I mean, you know, 157 00:08:48,920 --> 00:08:51,040 Speaker 3: I can talk about every single diet out there and 158 00:08:51,080 --> 00:08:53,400 Speaker 3: what they want you to avoid or what you're allowed 159 00:08:53,400 --> 00:08:56,360 Speaker 3: to have or not allowed to have, but we get 160 00:08:56,400 --> 00:08:58,920 Speaker 3: so confused. We don't even know what we're supposed to 161 00:08:58,920 --> 00:09:02,120 Speaker 3: be eating anymore. But the best part about intermittent fasting 162 00:09:02,240 --> 00:09:06,479 Speaker 3: is that it isn't a diet at all. Because diet 163 00:09:06,760 --> 00:09:10,800 Speaker 3: is what you eat. Intermittent fasting is when you eat. 164 00:09:11,160 --> 00:09:13,600 Speaker 3: So we're all eating a diet, whether it's the standard 165 00:09:13,640 --> 00:09:16,439 Speaker 3: American diet or your vegan or your carnivore, or you're 166 00:09:16,440 --> 00:09:20,360 Speaker 3: following the Mediterranean diet. You're eating some sort of diet, 167 00:09:20,640 --> 00:09:24,360 Speaker 3: but intermittent fasting is when, so it's definitely not a diet. 168 00:09:24,360 --> 00:09:26,800 Speaker 3: Like I never say I'm doing the intermittent fasting diet. 169 00:09:28,800 --> 00:09:31,920 Speaker 1: I want to introduce our medical expert now, doctor Jennifer Shreever. 170 00:09:32,120 --> 00:09:35,559 Speaker 1: She's been a family physician and obesity medicine specialist for 171 00:09:35,600 --> 00:09:38,400 Speaker 1: more than twenty years. I played that clip from Jen 172 00:09:38,559 --> 00:09:41,160 Speaker 1: for her, and here's doctor Shreever's reaction to it. 173 00:09:42,000 --> 00:09:45,560 Speaker 4: You know, nutrition is complex, and it kind of seems like, 174 00:09:46,080 --> 00:09:49,520 Speaker 4: I'm sure to the normal population that our nutrition advice 175 00:09:49,600 --> 00:09:51,960 Speaker 4: has changed a lot across the years. I mean low 176 00:09:52,000 --> 00:09:55,479 Speaker 4: carved and low fat. So that's very confusing. 177 00:09:56,040 --> 00:09:58,760 Speaker 1: And she's saying that because it's when you eat, it's 178 00:09:58,800 --> 00:09:59,960 Speaker 1: not a diet. 179 00:10:00,800 --> 00:10:03,560 Speaker 4: That seems like a strange way to represent that. I 180 00:10:03,559 --> 00:10:05,520 Speaker 4: guess it depends on how you think of the word diet. 181 00:10:05,600 --> 00:10:08,360 Speaker 4: I mean, historically, diet is something that helps you lose weight, 182 00:10:09,120 --> 00:10:11,240 Speaker 4: and if that's a claim for internet and fasting, I 183 00:10:11,240 --> 00:10:14,200 Speaker 4: guess I would classify it as a diet. We try 184 00:10:14,240 --> 00:10:17,080 Speaker 4: not to use the word diet because it just has 185 00:10:17,240 --> 00:10:21,320 Speaker 4: kind of a negative connotation and it's something that you 186 00:10:21,360 --> 00:10:26,320 Speaker 4: do temporarily, right, and maybe that's what she's trying to 187 00:10:26,520 --> 00:10:27,080 Speaker 4: say too. 188 00:10:27,720 --> 00:10:30,400 Speaker 1: She definitely talks a lot more about how this is 189 00:10:30,440 --> 00:10:36,080 Speaker 1: a lifestyle change and diets are temporary and lifestyle is permanent. 190 00:10:36,600 --> 00:10:40,920 Speaker 4: Yeah, And my practice treating patients for weight management, I'm 191 00:10:40,960 --> 00:10:44,200 Speaker 4: trying to create and help you improve your lifestyle in 192 00:10:44,240 --> 00:10:47,280 Speaker 4: a way that you feel good in the process, lose weight, 193 00:10:47,360 --> 00:10:50,920 Speaker 4: have more energy. I don't want to have a plan 194 00:10:51,080 --> 00:10:55,199 Speaker 4: that you graduate from or finish. This is something that 195 00:10:55,320 --> 00:10:58,559 Speaker 4: we might continually have to adjust and manage over time. 196 00:10:59,200 --> 00:11:02,240 Speaker 4: So I think even people on intermittent fasting are going 197 00:11:02,280 --> 00:11:04,280 Speaker 4: to find that they're going to have to adjust and 198 00:11:04,360 --> 00:11:09,320 Speaker 4: adapt something over time. So that's giving the sense that 199 00:11:09,400 --> 00:11:13,240 Speaker 4: this is a long term solution. Life happens, life changes. 200 00:11:13,600 --> 00:11:15,360 Speaker 4: Some of that's under control, a lot of it's not. 201 00:11:16,000 --> 00:11:18,960 Speaker 4: There's nothing that is the final answer. 202 00:11:19,400 --> 00:11:24,439 Speaker 1: Yeah, So when someone starts doing intermittent fasting, what happens 203 00:11:24,480 --> 00:11:25,360 Speaker 1: to our bodies. 204 00:11:25,960 --> 00:11:29,200 Speaker 4: So what happens is your body will start to shift 205 00:11:29,280 --> 00:11:33,440 Speaker 4: from burning blood sugar or glucose to using your stored energy, 206 00:11:33,600 --> 00:11:38,240 Speaker 4: so you're fatty tissue during those fasting periods. During your 207 00:11:38,280 --> 00:11:43,680 Speaker 4: fed state, you'll probably return to using more sugar. Often also, 208 00:11:44,040 --> 00:11:47,880 Speaker 4: as one starts intermittent fasting depending on how they approach it, 209 00:11:47,920 --> 00:11:51,280 Speaker 4: but many will have less calorie intake. A person might 210 00:11:51,320 --> 00:11:54,640 Speaker 4: cut out that meal and not replace that nutrition later 211 00:11:54,679 --> 00:11:56,959 Speaker 4: in the day, so then you're just reducing your caloric 212 00:11:57,000 --> 00:12:01,000 Speaker 4: intake and that can contribute to some earth onset of 213 00:12:01,040 --> 00:12:04,040 Speaker 4: some initial weight loss, so then that makes you feel successful. 214 00:12:04,280 --> 00:12:08,280 Speaker 4: So by fasting, you know, one might have insulin resistance, 215 00:12:08,360 --> 00:12:12,360 Speaker 4: So that means that typically with having extra fatty tissue 216 00:12:12,360 --> 00:12:15,800 Speaker 4: around that doesn't recognize the insulin you're making, and so 217 00:12:15,960 --> 00:12:18,320 Speaker 4: if your blood sugar is not well managed and creeping up, 218 00:12:18,360 --> 00:12:20,319 Speaker 4: your body is going to make more insulin because it's 219 00:12:20,320 --> 00:12:23,280 Speaker 4: not recognizing that signal that that insulin is there. The 220 00:12:23,360 --> 00:12:26,720 Speaker 4: disadvantage to that is insulin wants to store calories, so 221 00:12:27,200 --> 00:12:29,280 Speaker 4: it's not managing your blood sugar as well because your 222 00:12:29,280 --> 00:12:31,560 Speaker 4: body isn't recognizing but it's still doing its job of 223 00:12:31,559 --> 00:12:32,400 Speaker 4: storing calories. 224 00:12:33,200 --> 00:12:36,840 Speaker 1: Let me see if I can explain this a little more. Normally, 225 00:12:36,920 --> 00:12:40,200 Speaker 1: after you eat, your body releases insulin to help move 226 00:12:40,240 --> 00:12:43,240 Speaker 1: sugar from the blood into your cells so it can 227 00:12:43,280 --> 00:12:46,960 Speaker 1: be used for energy. But with insulin resistance, the cells 228 00:12:47,280 --> 00:12:52,400 Speaker 1: stop responding to the insulin efficiently, so the sugar stays 229 00:12:52,440 --> 00:12:56,400 Speaker 1: in the bloodstream longer to compensate, the pancreas pumps out 230 00:12:56,600 --> 00:13:00,760 Speaker 1: more insulin, and then over time, consistently elevated blood sugar 231 00:13:00,800 --> 00:13:04,120 Speaker 1: can lead to pre diabetes or type two diabetes and 232 00:13:04,280 --> 00:13:07,120 Speaker 1: increase the risk of things like heart disease, nerve damage, 233 00:13:07,120 --> 00:13:11,560 Speaker 1: and kidney problems. So creeping up basically means blood sugar 234 00:13:11,600 --> 00:13:15,560 Speaker 1: levels are gradually rising beyond what the body can comfortably regulate. 235 00:13:16,240 --> 00:13:20,280 Speaker 4: So if internet and fasting has been shown to reduce 236 00:13:20,440 --> 00:13:25,120 Speaker 4: insulin levels and that's their intention, then you might be 237 00:13:25,200 --> 00:13:29,080 Speaker 4: storing less of your calories in fat. So that happens 238 00:13:29,400 --> 00:13:33,240 Speaker 4: pretty quickly as far as early in the fasting states, 239 00:13:33,280 --> 00:13:36,640 Speaker 4: at least as far as what evidence is currently leaning towards. 240 00:13:36,679 --> 00:13:39,040 Speaker 4: But does that lead to actual blood sugar control and 241 00:13:39,160 --> 00:13:41,160 Speaker 4: improved A one CS is yet to be seen. 242 00:13:42,200 --> 00:13:45,160 Speaker 1: More research is needed. As I like to say, yeah, 243 00:13:45,200 --> 00:13:47,199 Speaker 1: and just so we all understand, A one C is 244 00:13:47,240 --> 00:13:50,600 Speaker 1: a blood test that measures your average blood sugar levels 245 00:13:50,640 --> 00:13:53,280 Speaker 1: looking back over the past two to three months. When 246 00:13:53,360 --> 00:13:56,640 Speaker 1: researchers talk about whether intermittent fasting improves A one C, 247 00:13:57,040 --> 00:14:02,040 Speaker 1: they're asking whether it meaningfully improves long term blood sugar control, 248 00:14:02,440 --> 00:14:06,040 Speaker 1: not just short term changes during the fast But I'm 249 00:14:06,080 --> 00:14:10,280 Speaker 1: really curious if intermittent fasting is just a different way 250 00:14:10,360 --> 00:14:14,080 Speaker 1: to restrict calories than your average diet, or if something 251 00:14:14,200 --> 00:14:18,040 Speaker 1: special is taking place in the body during intermittent fasting. 252 00:14:18,960 --> 00:14:23,040 Speaker 4: The evidence shows, and really good studies, including like randomized 253 00:14:23,040 --> 00:14:25,920 Speaker 4: controlled trials and everything, where they compare people who are 254 00:14:25,920 --> 00:14:31,360 Speaker 4: doing intermittent fasting and those doing caloric restriction. There really 255 00:14:31,440 --> 00:14:36,520 Speaker 4: isn't any significant difference in weight loss, There's no significant 256 00:14:36,520 --> 00:14:42,160 Speaker 4: difference in heart health or other metabolic markers. So really 257 00:14:42,280 --> 00:14:45,520 Speaker 4: the difference when it comes down to intermittent fasting is 258 00:14:45,640 --> 00:14:49,800 Speaker 4: if your coloric intake remains the same, you aren't going 259 00:14:49,880 --> 00:14:52,080 Speaker 4: to see that weight loss. You aren't going to see 260 00:14:52,080 --> 00:14:55,400 Speaker 4: the metabolic changes or the other reported benefits. 261 00:14:56,240 --> 00:14:59,000 Speaker 1: Okay, interesting, So if you consume the same number of 262 00:14:59,040 --> 00:15:01,400 Speaker 1: calories during your ear window as you would have had 263 00:15:01,440 --> 00:15:06,160 Speaker 1: throughout the day, there's no significant difference right right now 264 00:15:06,200 --> 00:15:08,800 Speaker 1: in terms of the claims around the benefits of internet 265 00:15:08,840 --> 00:15:11,920 Speaker 1: and fasting, what does the current medical evidence say and 266 00:15:12,040 --> 00:15:13,680 Speaker 1: where is it still kind of weak? 267 00:15:14,200 --> 00:15:17,840 Speaker 4: So the benefits will show short term studies, and most 268 00:15:17,920 --> 00:15:19,920 Speaker 4: of those are up to twelve weeks. There are a 269 00:15:19,920 --> 00:15:22,960 Speaker 4: few that last a year, but they will shows a 270 00:15:23,080 --> 00:15:26,720 Speaker 4: moderate weight loss, but similar to what we see in 271 00:15:26,760 --> 00:15:30,920 Speaker 4: cleric restriction. There is some improvement in insulin sensitivity, and 272 00:15:31,000 --> 00:15:34,560 Speaker 4: we have reasonable evidence for that. If we're going to 273 00:15:34,560 --> 00:15:38,200 Speaker 4: improve insulin sensitivity, maybe we'll see some improvement in pre 274 00:15:38,320 --> 00:15:43,080 Speaker 4: diabetes and metabolic syndrome and type two diabetes management, and 275 00:15:43,160 --> 00:15:48,320 Speaker 4: maybe some improvement in LDL or blood pressure, but those 276 00:15:48,520 --> 00:15:53,680 Speaker 4: changes aren't necessarily significant. Not very clear evidence for living longer, 277 00:15:53,800 --> 00:15:59,040 Speaker 4: healthier lives than humans. That's mainly in animals. Cancer prevention 278 00:15:59,120 --> 00:16:03,400 Speaker 4: immortality is something that can be widely advertised, but there's 279 00:16:03,560 --> 00:16:07,280 Speaker 4: very limited data, no high quality studies for this, No 280 00:16:07,360 --> 00:16:11,200 Speaker 4: high quality studies that shows intermittent fasting can prevent cancer 281 00:16:11,840 --> 00:16:15,640 Speaker 4: nor improve your treatment. Are there studies that are ongoing 282 00:16:15,720 --> 00:16:19,760 Speaker 4: to look at this, absolutely, but nothing convincing currently. 283 00:16:20,640 --> 00:16:24,240 Speaker 1: Doctor Shreever, I want to play you something from our guest, Alcavadlo. 284 00:16:24,480 --> 00:16:27,200 Speaker 1: He talked a bit about intermittent fasting and mental clarity. 285 00:16:27,760 --> 00:16:32,040 Speaker 2: I don't know how much scientific validation there is to 286 00:16:32,040 --> 00:16:35,240 Speaker 2: what I'm about to say, but anecdotally speaking, I've certainly 287 00:16:35,280 --> 00:16:37,680 Speaker 2: experienced this, and I've talked to other people who've experienced this. 288 00:16:38,400 --> 00:16:42,080 Speaker 2: It feels like your senses become a little more acute 289 00:16:42,160 --> 00:16:44,440 Speaker 2: when you haven't eaten for a long time. Your mind 290 00:16:44,480 --> 00:16:46,640 Speaker 2: just gets a little sharper. Everything seems to get a 291 00:16:46,640 --> 00:16:47,320 Speaker 2: little sharper. 292 00:16:49,040 --> 00:16:52,479 Speaker 1: Are there studies around the cognitive benefits to add sharpness 293 00:16:52,560 --> 00:16:54,480 Speaker 1: or focus or anything like that. 294 00:16:55,280 --> 00:16:58,880 Speaker 4: Just like most of the studies for intermittent fasting, there 295 00:16:59,240 --> 00:17:02,680 Speaker 4: is some possibility of improvement and cognitive benefits, but these 296 00:17:02,720 --> 00:17:07,680 Speaker 4: are very short term studies and it isn't consistent across populations. 297 00:17:08,160 --> 00:17:11,800 Speaker 4: The high quality meta analysis data doesn't show any benefit 298 00:17:12,640 --> 00:17:15,359 Speaker 4: versus a fed state. You know, so fasting is not 299 00:17:15,400 --> 00:17:18,439 Speaker 4: any better than a fed state. It's very neutral in 300 00:17:18,520 --> 00:17:21,840 Speaker 4: healthy adults in general. As far as studies go, the 301 00:17:21,880 --> 00:17:25,240 Speaker 4: best evidence for improving your cognition is still back to 302 00:17:25,280 --> 00:17:29,359 Speaker 4: exercise and adequate sleep. The studies on this again, we're 303 00:17:29,359 --> 00:17:33,800 Speaker 4: just not finding significantly long enough studies or even significant 304 00:17:33,920 --> 00:17:38,359 Speaker 4: data that fasting in whatever form is superior to just 305 00:17:38,400 --> 00:17:39,200 Speaker 4: a healthy diet. 306 00:17:39,960 --> 00:17:42,880 Speaker 1: What's your overall take on the internet and fasting trend? 307 00:17:43,119 --> 00:17:44,879 Speaker 1: Do you have like a top level Here's how I 308 00:17:44,920 --> 00:17:45,560 Speaker 1: feel about it. 309 00:17:46,240 --> 00:17:49,080 Speaker 4: Yeah, I guess in general, I just don't think that 310 00:17:49,200 --> 00:17:52,080 Speaker 4: evidence is there. There really is an evidence to show 311 00:17:52,080 --> 00:17:54,520 Speaker 4: that it's a better plan than others, or that it's 312 00:17:54,560 --> 00:17:58,720 Speaker 4: really even good. For one, if it does meet your 313 00:17:58,800 --> 00:18:02,800 Speaker 4: needs to improve your health, I think it's okay, but 314 00:18:02,840 --> 00:18:05,480 Speaker 4: you still have to get back to looking at what 315 00:18:05,600 --> 00:18:08,560 Speaker 4: is the content of what you're eating. There's risk to 316 00:18:08,600 --> 00:18:10,520 Speaker 4: it too, and so you have to think about that. 317 00:18:10,600 --> 00:18:13,800 Speaker 4: It can sound great, but it still takes some insight 318 00:18:13,880 --> 00:18:16,560 Speaker 4: in knowing what you're eating and what does that do 319 00:18:16,640 --> 00:18:19,080 Speaker 4: for your body, and are you including things that are 320 00:18:19,119 --> 00:18:24,440 Speaker 4: important to maintain your muscle mass, your bone density, your 321 00:18:24,440 --> 00:18:27,800 Speaker 4: basal metabolic rate, and even to live longer healthier. Because 322 00:18:27,840 --> 00:18:29,920 Speaker 4: if you're just focusing on that this is a great 323 00:18:29,960 --> 00:18:34,000 Speaker 4: plan for weight loss and you're not improving your nutritional choices, 324 00:18:34,080 --> 00:18:37,080 Speaker 4: you're not going to see the long term benefits of 325 00:18:37,320 --> 00:18:40,760 Speaker 4: what we're looking for as we improve our lifestyle, which 326 00:18:40,800 --> 00:18:44,439 Speaker 4: is improved heart health, less disease, less cancer risk, and 327 00:18:44,520 --> 00:18:47,920 Speaker 4: living longer and healthier and have more energy. So it's 328 00:18:47,960 --> 00:18:52,480 Speaker 4: really not a great plan just isolated by itself. 329 00:18:54,240 --> 00:18:56,400 Speaker 1: I should point out here that both our guests Jin 330 00:18:56,520 --> 00:19:00,359 Speaker 1: and Al talk to me about eating clean, and I 331 00:19:00,359 --> 00:19:02,240 Speaker 1: have to be honest, I didn't know entirely what that 332 00:19:02,280 --> 00:19:05,320 Speaker 1: meant from a scientific perspective, so I went to the dictionary, 333 00:19:05,640 --> 00:19:08,760 Speaker 1: and I found that it means consuming food that has 334 00:19:08,800 --> 00:19:12,040 Speaker 1: been processed or refined as little as possible, and is 335 00:19:12,080 --> 00:19:15,879 Speaker 1: free from additives or other artificial substances. You may have 336 00:19:15,920 --> 00:19:19,960 Speaker 1: heard this called whole food, so they eat clean whole 337 00:19:20,000 --> 00:19:23,320 Speaker 1: foods during their eating windows. The quality of their diet, 338 00:19:23,400 --> 00:19:27,679 Speaker 1: though is important, it's likely also a contributing factor to 339 00:19:27,760 --> 00:19:31,000 Speaker 1: their overall results. Okay, doctor Shreever, I want to play 340 00:19:31,000 --> 00:19:33,760 Speaker 1: one more clip from Gin because she sounds very clinical 341 00:19:33,800 --> 00:19:37,560 Speaker 1: and official while describing her three goals of intermittent fasting. 342 00:19:39,440 --> 00:19:41,679 Speaker 3: So our first fasting goal is we want to keep 343 00:19:41,760 --> 00:19:45,040 Speaker 3: insulin low. So of course we don't eat food because 344 00:19:45,040 --> 00:19:48,760 Speaker 3: insulin is released in response to eating. That's normal, that's physiology, 345 00:19:49,240 --> 00:19:52,040 Speaker 3: and so we keep insulin low. We don't have anything 346 00:19:52,080 --> 00:19:54,879 Speaker 3: that tastes sweet or fruity. We're not having you know, 347 00:19:55,400 --> 00:19:59,120 Speaker 3: herbal tea that has a sweet flavor profile, black coffee. 348 00:19:59,160 --> 00:20:03,480 Speaker 3: Bitter flavors not cause insulin response. So that's why black coffee, 349 00:20:03,480 --> 00:20:06,000 Speaker 3: plain tea with the bitter flavor profiles, those are fine. 350 00:20:06,160 --> 00:20:09,439 Speaker 3: So we're not chewing gum, We're not having breath mints, 351 00:20:09,520 --> 00:20:12,320 Speaker 3: all of that, nothing with any kind of sweetener in it. 352 00:20:13,000 --> 00:20:16,040 Speaker 1: Okay, doctor Shreever, what's your reaction to the first. 353 00:20:15,800 --> 00:20:20,760 Speaker 4: Goal, Well, any intake is going to trigger insulin, So 354 00:20:20,920 --> 00:20:25,600 Speaker 4: I think saying that just avoiding sweet or fruity things 355 00:20:25,880 --> 00:20:28,640 Speaker 4: is going to help keep your insulin low. I mean 356 00:20:28,760 --> 00:20:31,440 Speaker 4: that makes it sound like if we just avoid those things, 357 00:20:31,440 --> 00:20:35,120 Speaker 4: we won't have insulin levels spike. I mean, certainly it's 358 00:20:35,160 --> 00:20:37,800 Speaker 4: going to be maybe more steady, but I feel like 359 00:20:37,840 --> 00:20:42,600 Speaker 4: it's overstated and how low. And she really did say 360 00:20:42,640 --> 00:20:46,919 Speaker 4: that bitter flavors don't trigger insulin, and I just I 361 00:20:46,960 --> 00:20:49,200 Speaker 4: don't think that's the case. I don't think there's any 362 00:20:49,240 --> 00:20:53,400 Speaker 4: evidence to support, because any intake could really trigger insulin. 363 00:20:54,280 --> 00:20:56,760 Speaker 1: Okay, great, let's hear Jin's second goal. 364 00:20:57,720 --> 00:21:00,520 Speaker 3: Our second fasting goal is we want to happen to 365 00:21:00,640 --> 00:21:03,760 Speaker 3: stored fat for fuel. And that is why you're not 366 00:21:03,920 --> 00:21:07,520 Speaker 3: putting in, you know, butter in your coffee, because if 367 00:21:07,520 --> 00:21:09,800 Speaker 3: you're doing that, you're going to be burning the fuel 368 00:21:09,840 --> 00:21:12,920 Speaker 3: from your coffee cup instead of fuel from your body. 369 00:21:13,720 --> 00:21:15,160 Speaker 1: And what are your thoughts about that? 370 00:21:16,000 --> 00:21:20,200 Speaker 4: She talked about tapping a distored fat for fuel. That 371 00:21:20,280 --> 00:21:23,359 Speaker 4: could take longer in some people than others, depending on 372 00:21:23,400 --> 00:21:27,560 Speaker 4: your stored glycogen levels. But I think in the fastest state, 373 00:21:27,600 --> 00:21:31,600 Speaker 4: eventually you're going to use more fat for fuel. That's 374 00:21:32,080 --> 00:21:34,840 Speaker 4: what some of our weight management medications are good at 375 00:21:34,840 --> 00:21:38,840 Speaker 4: helping our metabolic state change too. But I think that's 376 00:21:38,840 --> 00:21:43,159 Speaker 4: going to vary among people, and to some extent I 377 00:21:43,200 --> 00:21:44,200 Speaker 4: think that is true. 378 00:21:44,640 --> 00:21:47,080 Speaker 1: Great, and now her third fasting goal. 379 00:21:47,920 --> 00:21:51,000 Speaker 3: Our third fasting goal is we want to have increased autopogy, 380 00:21:51,119 --> 00:21:54,800 Speaker 3: but it's upregulated when we are fast and clean and 381 00:21:54,880 --> 00:21:58,840 Speaker 3: what down regulates autophagy well, eating, but especially like if 382 00:21:58,880 --> 00:22:02,879 Speaker 3: we're eating protein, downregulates autophogy. We want our bodies to 383 00:22:02,920 --> 00:22:05,280 Speaker 3: be cleaning up all the junkie stuff so we're not 384 00:22:05,320 --> 00:22:08,000 Speaker 3: putting new stuff in. So you want to avoid having 385 00:22:08,440 --> 00:22:11,760 Speaker 3: pre workouts or bone broth or anything that's going to 386 00:22:11,760 --> 00:22:13,840 Speaker 3: be a source of protein during the fast. 387 00:22:14,520 --> 00:22:16,879 Speaker 1: She's using a lot of medical terms or you know, 388 00:22:16,960 --> 00:22:19,840 Speaker 1: science y words here, like autophagy. I had to look 389 00:22:19,840 --> 00:22:21,920 Speaker 1: that one up. By the way, I understand it to 390 00:22:22,040 --> 00:22:24,920 Speaker 1: mean the process where cells break down and recycle damaged 391 00:22:25,040 --> 00:22:29,360 Speaker 1: or old parts to keep the body functioning efficiently. Upregulated 392 00:22:29,480 --> 00:22:33,679 Speaker 1: is another way to say autopogy is increased, and downregulated 393 00:22:33,800 --> 00:22:37,080 Speaker 1: means the process is suppressed. It's also one of those 394 00:22:37,080 --> 00:22:41,560 Speaker 1: concepts that social media tends to very much oversimplify. A 395 00:22:41,560 --> 00:22:44,840 Speaker 1: lot of influencers make it sound like fasting instantly flips 396 00:22:44,840 --> 00:22:48,840 Speaker 1: some kind of magical cell reset switch. So is what 397 00:22:48,880 --> 00:22:51,400 Speaker 1: she's saying here accurate, doctor Schreeber. 398 00:22:52,160 --> 00:22:55,359 Speaker 4: There's no good studies that that happens in humans, And 399 00:22:56,200 --> 00:22:59,879 Speaker 4: I think the main thing with people really into intimate 400 00:23:00,080 --> 00:23:03,919 Speaker 4: fastening is not eating at all in that fasting window, 401 00:23:04,440 --> 00:23:10,120 Speaker 4: and eating protein will decrease the supposed autophagy that's occurring 402 00:23:10,320 --> 00:23:14,960 Speaker 4: in there, and so fasting stage is really what helps 403 00:23:15,240 --> 00:23:18,159 Speaker 4: they claim with autophagy. But we don't have evidence for 404 00:23:18,240 --> 00:23:18,840 Speaker 4: in humans. 405 00:23:19,400 --> 00:23:22,000 Speaker 1: So it seems like generally speaking, she's not saying things 406 00:23:22,040 --> 00:23:25,240 Speaker 1: that are necessarily incorrect, but maybe brightening them up a bit, 407 00:23:25,280 --> 00:23:27,240 Speaker 1: adding some saturation to it a. 408 00:23:27,280 --> 00:23:30,800 Speaker 4: Little bit, right right, being very confident in them and 409 00:23:30,840 --> 00:23:34,159 Speaker 4: that these are true and valid versus the evidence that 410 00:23:34,200 --> 00:23:36,720 Speaker 4: doesn't support them completely or strongly. 411 00:23:37,760 --> 00:23:40,760 Speaker 1: Intermittent fasting is not for everyone, I asked doctor Shreever, 412 00:23:40,880 --> 00:23:42,800 Speaker 1: who specifically should avoid it. 413 00:23:43,400 --> 00:23:46,520 Speaker 4: Anyone with a history of eating disorder really should be 414 00:23:46,560 --> 00:23:51,639 Speaker 4: cautious about considering that, you know, eating disorder. Anyone with 415 00:23:52,160 --> 00:23:55,920 Speaker 4: diabetes should do it cautiously and not without medical supervision. 416 00:23:56,359 --> 00:24:00,240 Speaker 4: Anyone who is older, you know, that would be one 417 00:24:00,240 --> 00:24:02,840 Speaker 4: that I'd be worried about because we want to watch 418 00:24:03,119 --> 00:24:08,480 Speaker 4: their nutritional intake. Anyone with nutritional deficiencies or otherwise, I'd 419 00:24:08,520 --> 00:24:12,199 Speaker 4: be really cautious of anyone with lower muscle mass. And 420 00:24:12,280 --> 00:24:15,119 Speaker 4: back to people with diabetes, anyone with any signs of 421 00:24:15,160 --> 00:24:19,520 Speaker 4: insulin resistant should really do that in a supervised fashion. 422 00:24:19,880 --> 00:24:22,679 Speaker 1: Yeah, I mean that makes total sense. I'm glad you 423 00:24:22,720 --> 00:24:26,359 Speaker 1: brought up people who have struggled with disordered eating, only 424 00:24:26,400 --> 00:24:28,840 Speaker 1: because I lived in San Francisco for a while and 425 00:24:28,880 --> 00:24:31,479 Speaker 1: intermittent fasting was very popular. But then there was this 426 00:24:31,680 --> 00:24:35,520 Speaker 1: kind of underlying discussion of well, are these men who 427 00:24:35,600 --> 00:24:39,080 Speaker 1: are very into intermittent fasting kind of falling into disordered 428 00:24:39,160 --> 00:24:42,080 Speaker 1: eating by over controlling their intake. 429 00:24:43,400 --> 00:24:46,160 Speaker 4: Definitely a concern because then they might continue to escalate 430 00:24:46,560 --> 00:24:47,600 Speaker 4: the time of fasting. 431 00:24:48,000 --> 00:24:50,399 Speaker 1: Yeah. So if a patient asked, you know, they come 432 00:24:50,400 --> 00:24:52,639 Speaker 1: into your office and they say, hey, I've been seeing 433 00:24:52,640 --> 00:24:57,560 Speaker 1: these trends online intermittent fasting, how would you guide that conversation. 434 00:24:57,480 --> 00:25:00,320 Speaker 4: I would get back to the evidence for it and 435 00:25:00,400 --> 00:25:03,720 Speaker 4: talk about studies looking at intermittent fasting and what the 436 00:25:03,800 --> 00:25:08,000 Speaker 4: benefit is and why does it work. So intermittent fasting 437 00:25:08,119 --> 00:25:11,800 Speaker 4: works when people are reducing their calories and then that 438 00:25:11,920 --> 00:25:15,440 Speaker 4: leads to weight loss. It can certainly be a plan 439 00:25:15,520 --> 00:25:18,560 Speaker 4: we can talk about if you're interested, but we still 440 00:25:18,600 --> 00:25:21,840 Speaker 4: need to look at the big picture for you. So 441 00:25:22,320 --> 00:25:26,000 Speaker 4: when we are working with patients on weight management, not 442 00:25:26,040 --> 00:25:29,119 Speaker 4: only are we looking at nutrition, we're looking at physical activity, 443 00:25:29,200 --> 00:25:31,040 Speaker 4: how much they move throughout the day, what is their 444 00:25:31,080 --> 00:25:34,480 Speaker 4: exercise like behavior, how is their mental health, do they 445 00:25:34,480 --> 00:25:37,760 Speaker 4: have a history of eating disorder otherwise, how is their sleep? 446 00:25:37,960 --> 00:25:40,720 Speaker 4: Are we looking at medications to help you with weight management, 447 00:25:40,840 --> 00:25:43,280 Speaker 4: and then how does this fit into that picture? And 448 00:25:43,320 --> 00:25:46,320 Speaker 4: if you're doing intermittent fasting, it might be really hard 449 00:25:46,760 --> 00:25:49,199 Speaker 4: to manage side effects of some of the medications we 450 00:25:49,320 --> 00:25:52,760 Speaker 4: use in weight management. But back to nutrition, we're still 451 00:25:52,760 --> 00:25:55,960 Speaker 4: going to talk about what is that content of your 452 00:25:56,000 --> 00:25:59,200 Speaker 4: eating window, and if we're going to focus on physical activity, 453 00:25:59,680 --> 00:26:03,240 Speaker 4: when your exercise and when is your nutrition and how 454 00:26:03,280 --> 00:26:05,800 Speaker 4: do we make you feel like well enough and have 455 00:26:05,880 --> 00:26:09,160 Speaker 4: the energy to complete that exercise? And do it well 456 00:26:09,200 --> 00:26:12,200 Speaker 4: and make it effective. That's all still part of the picture. 457 00:26:12,359 --> 00:26:15,400 Speaker 4: So I think, yeah, it would go back to does 458 00:26:15,440 --> 00:26:17,560 Speaker 4: this fit for you? This is why it works, this 459 00:26:17,720 --> 00:26:20,560 Speaker 4: is why it doesn't work. If you're looking at living 460 00:26:20,960 --> 00:26:23,880 Speaker 4: longer and healthier, it's back to what is the content 461 00:26:24,000 --> 00:26:27,399 Speaker 4: of what you're eating, not the timeframe that's going to 462 00:26:27,520 --> 00:26:30,800 Speaker 4: change things for you. If you want to improve your diabetes, 463 00:26:31,080 --> 00:26:32,840 Speaker 4: maybe we could use it as a tool and do 464 00:26:32,920 --> 00:26:35,040 Speaker 4: some monitoring and see if it's helpful for you. But 465 00:26:35,080 --> 00:26:38,359 Speaker 4: we got to watch you closely depending on the type 466 00:26:38,359 --> 00:26:42,000 Speaker 4: of diabetes you have. There are studies ongoing for those 467 00:26:42,040 --> 00:26:45,040 Speaker 4: with type one diabetes, but I definitely would not want 468 00:26:45,160 --> 00:26:47,560 Speaker 4: a person like that unless they're very good at managing 469 00:26:47,600 --> 00:26:50,359 Speaker 4: their own blood sugar levels and have good control and 470 00:26:50,520 --> 00:26:53,520 Speaker 4: without the direction of their doctor to do that on 471 00:26:53,600 --> 00:26:54,080 Speaker 4: their own. 472 00:26:54,920 --> 00:26:58,119 Speaker 1: You mentioned other medications. Is this something where say I 473 00:26:58,320 --> 00:27:00,000 Speaker 1: come in and I say, you know, oh, I've heard 474 00:27:00,040 --> 00:27:02,440 Speaker 1: of these GLP ones that can help me lose weight, 475 00:27:03,000 --> 00:27:05,359 Speaker 1: or I could try this intermittent fasting thing. Would you 476 00:27:05,400 --> 00:27:08,480 Speaker 1: say that those are options that kind of reflect each other. 477 00:27:08,520 --> 00:27:11,240 Speaker 1: Are the two tools in your tool belt? How do 478 00:27:11,280 --> 00:27:11,880 Speaker 1: they compare? 479 00:27:12,520 --> 00:27:15,879 Speaker 4: The best evidence that we can find to correlate the 480 00:27:15,880 --> 00:27:19,240 Speaker 4: weight loss with the use of weight loss medicines compared 481 00:27:19,240 --> 00:27:23,359 Speaker 4: to intermittent fasting is fairly challenging because the duration of 482 00:27:23,480 --> 00:27:27,240 Speaker 4: studies is often different. The best data I can find 483 00:27:27,320 --> 00:27:31,480 Speaker 4: on intermittent fasting and the various methods within that last 484 00:27:31,640 --> 00:27:35,840 Speaker 4: up to twelve months. So to summarize just the twelve 485 00:27:35,840 --> 00:27:41,960 Speaker 4: month data, intermittent fasting produces around three percent at it's 486 00:27:42,000 --> 00:27:45,080 Speaker 4: honestly six to twelve months. So if you want to 487 00:27:45,119 --> 00:27:48,480 Speaker 4: be specific, alternate day fasting and time restricted eating have 488 00:27:48,600 --> 00:27:52,240 Speaker 4: about six percent at twelve months, and then Benjamin and 489 00:27:52,280 --> 00:27:56,879 Speaker 4: topepuremate has thirteen percent. Now truck Zone and the appropriate 490 00:27:57,200 --> 00:28:01,280 Speaker 4: has ten percent at twelve months. Thetide or what goov 491 00:28:01,600 --> 00:28:04,760 Speaker 4: at two point four milligrams is eight point three percent 492 00:28:04,800 --> 00:28:08,600 Speaker 4: at twelve months, and that's real world data versus studies. 493 00:28:09,160 --> 00:28:14,480 Speaker 4: And turns uppatide is fifteen point three percent at twelve months, 494 00:28:14,520 --> 00:28:18,040 Speaker 4: and again that's real world data. So the real world 495 00:28:18,359 --> 00:28:22,000 Speaker 4: data means we're just studying people out in the general population, 496 00:28:22,480 --> 00:28:27,119 Speaker 4: working with their individual physicians and clinicians, and the various 497 00:28:27,400 --> 00:28:31,120 Speaker 4: education around that nutrition might or an exercise might be different. 498 00:28:32,040 --> 00:28:35,840 Speaker 1: One big takeaway is that intermittent fasting can be effective 499 00:28:35,920 --> 00:28:38,840 Speaker 1: for weight loss. That is what those percentages that doctor 500 00:28:38,840 --> 00:28:42,600 Speaker 1: Shreever just mentioned are referring to, but its results are 501 00:28:42,640 --> 00:28:47,680 Speaker 1: generally modest compared to newer medical obesity treatments. In other words, 502 00:28:47,880 --> 00:28:50,640 Speaker 1: intermittent fasting may help you lose weight, but it's not 503 00:28:50,720 --> 00:28:54,400 Speaker 1: a magic bullet, and the online hype around intermittent fasting 504 00:28:54,520 --> 00:28:58,400 Speaker 1: can outpace the actual data. Doctor Shreever also warned that 505 00:28:58,520 --> 00:29:01,520 Speaker 1: fasting comes with its own own set of complications. 506 00:29:02,200 --> 00:29:04,800 Speaker 4: Well, then you have a shorter timeframe to get your 507 00:29:04,880 --> 00:29:08,360 Speaker 4: nutrients in, so you might become vitamin deficient or might 508 00:29:08,400 --> 00:29:11,360 Speaker 4: struggle to get enough protein and to keep your muscle 509 00:29:11,440 --> 00:29:14,680 Speaker 4: mass up. Those would be some of the main concerns. Also, 510 00:29:14,960 --> 00:29:18,440 Speaker 4: depending on how your insulin response is and blood sugar responses, 511 00:29:18,480 --> 00:29:20,640 Speaker 4: you might run a lower blood sugar and just really 512 00:29:20,640 --> 00:29:26,000 Speaker 4: feel foggy or not well, and also that can disrupt sleep. 513 00:29:26,560 --> 00:29:30,440 Speaker 1: There's also the social media trend it's promoting this intermitten 514 00:29:30,480 --> 00:29:34,800 Speaker 1: fasting as a metabolic reset. Another kind of sound science 515 00:29:34,880 --> 00:29:37,640 Speaker 1: y is there any medical basis for that idea? 516 00:29:38,280 --> 00:29:41,480 Speaker 4: It's more of a marketing phrase really than a medical one. 517 00:29:41,920 --> 00:29:44,600 Speaker 4: Our body is very highly adapted and doesn't reset in 518 00:29:44,640 --> 00:29:49,040 Speaker 4: any permanent way, and any benefits will tend to level 519 00:29:49,080 --> 00:29:52,360 Speaker 4: off as your body adjusts. So it kind of sounds 520 00:29:52,440 --> 00:29:55,959 Speaker 4: like it's a permanent solution, when really it's temporarily. Our 521 00:29:55,960 --> 00:29:59,680 Speaker 4: body is going to readjust to the current situation and 522 00:29:59,680 --> 00:30:05,320 Speaker 4: we can permanently reset anything. Obesity is a disease, so 523 00:30:05,360 --> 00:30:09,040 Speaker 4: it takes a lifetime of treatment or monitoring or watching 524 00:30:09,080 --> 00:30:12,120 Speaker 4: for you can improve someone's be ami to normal. That 525 00:30:12,200 --> 00:30:14,440 Speaker 4: your body's going to tend to go back if you 526 00:30:14,520 --> 00:30:15,400 Speaker 4: don't keep an. 527 00:30:15,360 --> 00:30:15,840 Speaker 2: Eye on it. 528 00:30:16,600 --> 00:30:20,520 Speaker 1: So when would one medically recommend an intermittent fast. 529 00:30:22,200 --> 00:30:25,000 Speaker 4: I think if it makes it easy for one to 530 00:30:25,240 --> 00:30:28,880 Speaker 4: work on improving their nutrition and you help them create 531 00:30:28,920 --> 00:30:31,840 Speaker 4: a plan about what does that look like for them 532 00:30:31,960 --> 00:30:35,600 Speaker 4: and what they typically eat, If that's the best way 533 00:30:35,600 --> 00:30:38,280 Speaker 4: to help someone simply get into a process for weight 534 00:30:38,360 --> 00:30:43,360 Speaker 4: management that might be acceptable to use, but follow up 535 00:30:43,400 --> 00:30:46,640 Speaker 4: with them closely to see how is it going, how 536 00:30:46,680 --> 00:30:50,360 Speaker 4: do they feel doing it, how is their hunger responding, 537 00:30:50,840 --> 00:30:54,800 Speaker 4: how sustainable is it for them? And when it becomes challenging, 538 00:30:54,880 --> 00:30:56,320 Speaker 4: then how do we move on from there? 539 00:30:57,200 --> 00:31:00,520 Speaker 1: So there are times to recommend it. Potentially it is 540 00:31:00,680 --> 00:31:01,560 Speaker 1: very personal. 541 00:31:01,720 --> 00:31:04,640 Speaker 4: Yeah, just like anything in weight management, it's very personal 542 00:31:04,840 --> 00:31:07,280 Speaker 4: discussion on how to help them improve. 543 00:31:07,480 --> 00:31:10,400 Speaker 1: And that discussion, of course, should be with your doctor. 544 00:31:11,040 --> 00:31:12,840 Speaker 1: That seems like a good note to end on. I 545 00:31:12,880 --> 00:31:17,240 Speaker 1: think intermittent fasting seems like a very personal decision and lifestyle. 546 00:31:17,560 --> 00:31:20,200 Speaker 1: If weight management is your goal, there are better, more 547 00:31:20,200 --> 00:31:24,040 Speaker 1: researched methods like quality of diet, physical activity, and medical 548 00:31:24,040 --> 00:31:27,280 Speaker 1: options to consider. And there are folks who should definitely 549 00:31:27,320 --> 00:31:31,240 Speaker 1: avoid trying intermittent fasting altogether. But if you're curious about 550 00:31:31,240 --> 00:31:34,680 Speaker 1: intermittent fasting, check in with your physician first just to 551 00:31:34,720 --> 00:31:37,000 Speaker 1: make sure it's the right decision for your health. If 552 00:31:37,000 --> 00:31:39,479 Speaker 1: you have tried intermittent fasting, let us know about your 553 00:31:39,480 --> 00:31:42,040 Speaker 1: experience down in the comments and what you thought of 554 00:31:42,080 --> 00:31:45,000 Speaker 1: this episode. Thanks again to doctor Jen Shreeverer for breaking 555 00:31:45,000 --> 00:31:48,760 Speaker 1: down the science behind intermittent fasting, and to Jen Stevens 556 00:31:48,880 --> 00:31:52,440 Speaker 1: and Alcavadlo for sharing their stories and experiences with us. 557 00:31:53,000 --> 00:31:55,000 Speaker 1: We did it again, y'all. We got to the bottom 558 00:31:55,040 --> 00:31:57,520 Speaker 1: of another popular health trend and we still have a 559 00:31:57,600 --> 00:32:00,280 Speaker 1: couple episodes to go. In the next episode, we're going 560 00:32:00,360 --> 00:32:04,040 Speaker 1: to talk about contrast therapy, you know, going from a 561 00:32:04,080 --> 00:32:06,520 Speaker 1: sauna to a cold plunge. We used to do this 562 00:32:06,560 --> 00:32:09,840 Speaker 1: in the Midwest all the time. Claims around contrast therapy 563 00:32:09,920 --> 00:32:12,880 Speaker 1: are flooding the Internet and popular culture right now, but 564 00:32:13,040 --> 00:32:15,920 Speaker 1: don't sweat it. We'll get to the bottom of what's real, 565 00:32:16,040 --> 00:32:18,320 Speaker 1: what's not, and what we're still learning. If you have 566 00:32:18,360 --> 00:32:20,920 Speaker 1: it already, please hit the subscriber follow button and join 567 00:32:21,000 --> 00:32:23,200 Speaker 1: us next time on Health Versus Hype with the American 568 00:32:23,200 --> 00:32:26,800 Speaker 1: Medical Association. For more information on all the topics we're covering, 569 00:32:26,880 --> 00:32:31,840 Speaker 1: visit Amahealth versus Hype dot org. That's am health vs 570 00:32:32,040 --> 00:32:36,040 Speaker 1: Hype dot org. Health Versus Hype is a production of 571 00:32:36,160 --> 00:32:40,520 Speaker 1: Ruby Studio from iHeartMedia and the American Medical Association. I'm 572 00:32:40,520 --> 00:32:44,120 Speaker 1: traced him Gez. Our producers are Matt Stillow and Pamela Lawrence. 573 00:32:44,440 --> 00:32:47,040 Speaker 1: Michael Depoe Wilson is our writer. The show is engineered 574 00:32:47,080 --> 00:32:50,400 Speaker 1: and features original music by Matthew Ernest Filler. Health Versus 575 00:32:50,480 --> 00:32:53,560 Speaker 1: Hype is intended for educational and informational purposes only and 576 00:32:53,600 --> 00:32:58,560 Speaker 1: does not constitute medical advice, diagnosis, or treatment. Always seek 577 00:32:58,600 --> 00:33:01,360 Speaker 1: the advice of your physician with any questions you may 578 00:33:01,400 --> 00:33:02,880 Speaker 1: have regarding a medical condition.