Fasting Q&A with Dr Jason Fung: Smoothies and Protein Drinks, Iodine, High Uric Acid, ADHD, and More
February 25, 2025 • 30 mins
Episode #193
In this Fasting Q&A episode, hosted by Coach Lisa Chance, Dr. Jason Fung answers questions from the TFM Community:
- Are home-made smoothies and protein drinks helpful or detrimental as meal replacement when trying to lose weight or reverse type two diabetes? If so, what kind would you recommend? (05:14)
- Is it acceptable for someone 4’10” to eat 0.6 grams of protein per kilogram instead of TFM’s recommended 0.8-1.2 gram, since they are so petite? (08:32)
- How does iodine intake and storage work in the body from a scientific perspective? Since iodine is water soluble, what is known about how long the body can maintain adequate iodine levels between dietary intake? Are there any established research findings about the need for iodine during different eating patterns, such as an extended fast? (12:02)
- Will consistently high uric acid levels from fasting adversely affect my health even if I don't have symptoms of hyperuricemia? (14:08)
- I believe you addressed this at the time Dr. Peter Attia was a guest on Thomas DeLauer’s YouTube channel, but I can’t remember which one of our podcasts that was. Wasn’t he cautioning about extended fasts and muscle loss for people who were already in great shape - “shredded” if you will? Don’t you quickly regain any muscle lost once you start eating nutrient-dense food again? (15:21)
- Is there more autophagy happening during exercise or fasting? (21:17)
- What is the best fasting regime for someone with a low BMI but who has non-alcoholic fatty liver disease? How long should alternate-day fasting (just started two 42-48 hour fasts a week) combined with a whole-food, low-carb diet continue? (23:46)
- What are your thoughts on fasting while taking ADHD medication? (25:04)
- Do you have any recommendations for a diet that will starve or kill cancer? (26:23)
- How long does it take to reverse insulin resistance while doing fasting and low-carb and how do you know when you have? (27:42)
Please note that you need to be a member of the TFM Community to submit questions to the Q&A webinars with Dr. Fung but you can submit questions to our regular Q&A episodes here: https://bit.ly/TFMPodcastQs
LINKS
The two videos from the Fasting & Longevity Summit mentioned in this episode can be found here:
Dr Ben Bikman - https://youtu.be/3GKiT2Ihek8?si=IHDMFHN3xpp4sEIf
Dr Brian Lenzkes - https://youtu.be/Qqi8sumxGZY?si=p2QvYcCIjnk_vDLC
CHAPTERS:
00:00 Disclaimer
05:14 Smoothies as meal replacements
08:32 Protein allowance
12:02 Iodine intake
14:08 High uric acid levels
15:21 Muscle loss
21:17 Autophagy from exercise vs fasting
23:46 ADF for low BMI and NAFLD
25:04 Fasting while on ADHD medication
26:23 Diet to starve/kill cancer
27:42 How long to reverse insulin resistance
Transcripts of all episodes are available at www.thefastingmethod.com on the Podcast page.
Learn More About Our Community: https://www.thefastingmethod.com
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This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical pr
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
Before we get started with today's episode,
I would like to quickly read you our podcast
disclaimer.
This podcast is for educational purposes
only, and it is not a substitute
for professional care by a doctor
or other qualified medical professional.
You should always speak with your physician
(00:27):
or other healthcare professionals before doing
any fasting, changing your diet
in any way, taking or adjusting
any medications or supplements, or
adopting any treatment plan
for a health problem.
The use of any other products or
services purchased by you as a result
of this podcast does not create
(00:50):
a healthcare provider-patient
relationship between you and any
of the experts affiliated with this
podcast.
Any information and statements
regarding dietary supplements have not
been evaluated by the Food and Drug
Administration and are not intended
to diagnose, treat, cure, or
(01:11):
prevent any disease.
All right. And now we'll get started with
today's episode.
Welcome, everyone.
My name is Lisa Chance. I'm a fasting coach
here at TFM, and today we are here with
our very own Dr. Jason Fung
for our monthly Q&A.
This is a monthly discussion with Dr. Fung
(01:32):
where he answers questions submitted by
our TFM Community members.
Hello to our podcast listeners,
who will be able to listen to this Q&A with
Dr. Fung in a few weeks after our Community
members. Okay.
Hi, Dr. Fung. How are you doing today?
I'm good. How are you?
Good. I have to tell you, I absolutely
loved the Fasting and Longevity
(01:54):
Summit that you hosted.
Oh, thanks.
You were a co-host.
It was so interesting to see you
as the person who was asking the questions,
as opposed to giving the answers.
The dialog between the doctors was
just great. I haven't seen them all, but
the one with Dr. Bikman, Ben Bikman
I've watched like three times.
(02:16):
All of that about the fat is so
fascinating, how the fat works.
Yeah, he's a super smart guy, Dr.
Bikman. I mean, he knows a lot.
I think he's really a sharp guy.
So I really enjoyed that.
And it was something that the L-Nutra
people (who make the fasting-mimicking diet
actually) had put on.
So they asked me to help out, and I said,
(02:37):
"Sure," because it's, you know, one
of these things-- there's people who are
promoting fasting, and I'm happy to help them
because it's certainly something that can be
very useful.
And that was a free thing.
I think they're doing an encore as well, so
it's possible you might be able to catch them.
But, in either case, the interviews that I
did are all posted to YouTube.
They sent me the videos and said, "You can
(02:58):
post them to YouTube," so all of those are
available. So if you aren't able to
make the summit, you can still go on to my
YouTube channel and find all the
videos if you want to replay them or whatever.
So it's always available.
So that's the other reason I was like, "Yeah,
this will be great. It'll be such an
interesting thing." So yeah, I had fun doing
it too.
It was great. And I like the one with Dr.
Brian Lenzkes, I think he has such a big
(03:20):
heart. And I noticed that, towards the end,
you guys were talking about him going to
Guatemala, and you mentioned that The
Obesity Code is in Spanish and that you
were looking into getting your YouTube channel
in Spanish also.
Let me know when that happens because my
housekeeper is Hispanic, and she has
type two diabetes and was told it was a
(03:40):
progressive disease, there was nothing she
could do about it.
I gave her a copy of your book in Spanish,
but I'd like her to be able to get access
to the videos also.
Yeah. I
started, actually, the Spanish channel
and then it got shut down.
[laughter] It was when my email
got hacked. They were able to put
(04:02):
up my old YouTube channel, but then, for
some reason, they wouldn't restore my Spanish
channel, which was sort of bizarre.
But anyway [laughs],
I may try to redo some of
that. It's just sort of time consuming, so
I haven't done it for a bit, but,
you know, if I get some help, I may
(04:24):
try to do that.
I mean, what I did in the Spanish
Channel actually was use this
AI-- there's this AI dubbing, which is
basically, if you upload the video, it'll
translate directly into Spanish for you.
And then I uploaded that video.
The problem is that the translation
is on the level of a Google Translate,
which is not great.
(04:45):
Like, it's sort of understandable but riddled
with errors is what people told me.
[laughs] So I was like, "Well,
let's see," because at least some information
will be still good.
But it was a little slow going.
So that may be something I may try to do
again if it comes around.
Well, I applaud your efforts for
(05:06):
making a dent in this, right?
[laughter]
All right, let's get started with some of
these questions here because I know you gotta
leave promptly on time.
So, "Can you address the use
of home-made smoothies and protein
drinks as a meal replacer?
How are they helpful or detrimental
to weight loss or reversing type two
diabetes?
(05:27):
If they're useful, which kinds would you
recommend?" They know not to
add a lot of fruit, but does
the protein powder in a smoothie have any
benefit at all?
I think so. So a lot of these smoothies
are often based on-- a
lot of them are yogurt based, so if you use
Greek yogurt, for example, that's very good,
low in carbs.
(05:48):
Whey protein and other protein powders
are also fine.
I mean, I tend to shy away
from them just because they are very highly
processed. You know, as a general
concept, you want to eat natural foods
as opposed to sort of ultra processed foods,
but, as far as that goes, it's probably not
one of the really bad ones.
(06:09):
So, as a meal replacement, I think it's
reasonable to make your own smoothies.
A lot of the commercial stuff that you can
get is sort of packed full of fructose,
a lot of them.
They're not bad, and if you add some berries--
so berries tend to be the best of the fruits,
especially if you blend them.
I did a video or a Medium post,
something about blending fruit, which is
(06:31):
actually very interesting because, when you
blend the fruit, it actually lowers the
glycemic index of that fruit, which
is probably because if you blend
berries or seeded fruits (so
strawberries, raspberries, passion fruit)--
when you blend them, the theory is that
the seeds sort of get shorn up,
and therefore it releases a lot of the fiber
(06:53):
that's inside, and a lot of these other
sort of antioxidants that are actually highly
beneficial.
The thing is that the best thing to do is
to use some kind of berries in
there to give it flavor.
So making it yourself is very good because,
you know, sometimes if you get commercial
preparations, they use strawberry extract or
whatever, you're not getting the whole fruit
(07:13):
that's blended.
If you blend non-seeded fruits like
mangoes and stuff, it actually makes things
a little bit worse, but if you blend the
seeded fruits it's fine.
So berry smoothies actually tend to be very
good because you've got the blended berries
(berries being one of the better fruits), but
you've got the seeds which are blended, which
is good, and then you can add the yogurt,
especially Greek yogurt (which is higher in
(07:34):
protein, which is good), and then you can add
the protein powder on top of that.
So you can actually do pretty well with it.
It's fairly low in carbs, very high in
protein.
So, as a meal replacement, it can be actually
very, very good for that if
that's what you like, especially for people
who enjoy that kind of thing, then, yeah,
absolutely. You can also blend things like
(07:54):
kale and other-- you know, these green
smoothies, which are fairly popular these
days. And I think those are also, again, very
low in sugar and so on.
So they really can be very good for you,
depending on how you make it.
Thank you, Dr. Fung.
I do use a protein powder every once in a
while because I have trouble getting protein
in, but I use it about maybe once or twice a
(08:15):
month is all just because I'm basically
plant-based. But yes, what delays me is it's
just highly processed.
Yeah, yeah. And that's not necessarily bad,
but, you know, it's just, as a general
principle, it's better to eat real
foods. That's always sort of a core principle
of what we teach.
This person-- I'm trying to ask this question
without getting into the medical side
(08:36):
of it, but she's a very petite
woman. So is it acceptable for someone
4' 10" to eat 0.6 grams
of protein per kilogram instead of
TFM's recommended 0.8
to 1.2 grams, just because they're
so petite?
That's a good question.
(08:57):
I mean, it's usually based per kilo, so
the height doesn't tend to matter so much.
And it's based on the recommended
daily allowance (which is a
nationally-published sort of guideline),
which is 0.8 grams per kilo per day.
0.6 is on the low side, but, honestly,
a lot of vegetarians and vegans
(09:17):
actually fall in that lower category.
The average American is sort of closer to
1.2 to 1.5 grams per
kilo. So an average diet, average American
diet, is much higher in protein than that.
So going ultra-low protein
has some risks because of course you need
the proteins to build your
own protein. Every day you break
(09:39):
down some proteins.
There are some obligatory losses like hair
and fingernails and stuff.
So you do have to get a little bit.
0.6 tends to be on the lower side of
things. You see this sometimes in-- you know,
sometimes online you see vegans and stuff,
and sometimes you see them and you're like,
"Oh, I think you should get a little
bit hard on nutrients there,"
(10:01):
because the problem, of course, with
vegetarian and vegan diets
is that the proteins are not
ideal for humans.
The bioavailability is not ideal and
sometimes they don't have a complete protein.
The point is that if you eat meat--
meat has a lot of proteins,
and when you're sort of rebuilding
(10:22):
human flesh it's obviously
very close to the meat,
like, you know, whatever meat you're eating.
So therefore, it has a very much more complete
amino acid profile as opposed
to eating a bean, for example.
A bean is nothing like a human versus
a cow is much closer to a human than a bean
(10:42):
is. So when you eat beans, you're not getting
all of the proteins that you really need in
the right proportions that you need, and
it's not always bioavailable (that is, it's
not absorbed properly and used properly).
So sometimes vegans, not only are they eating
very low protein (like, if you look at the
total grams of protein), but, because they're
eating all vegetarian and vegan sources
of protein, they may not be getting the
(11:04):
full bang for their buck sort of thing
compared to somebody who eats meat.
So I would tend to still stick
to the 0.8 to 1.2,
just because there's a lot of people who worry
that going too low can be an issue.
In the past, the main issue with protein
was actually cost.
It's a lot cheaper to eat
(11:26):
carbohydrates, so that's why a lot of--
you know, in the past, a lot diets were based
on rice, or based on potatoes, or based
on bread, or whatever, because that's the way
to feed a lot of people, whereas the meat
was very expensive.
These days, it's not as
much of an issue anymore.
But you do see it sometimes in vegans
who do it for other reasons.
(11:47):
But you know, if you're looking at overall
health just on that aspect, yeah,
I would still go with the 0.8 to
1.2.
Thank you. Again, another one about
thyroid function and iodine so I reworded
this for the person who sent it in.
"How does iodine intake and storage
work in the body from the scientific
(12:08):
perspective?
Since iodine is water-soluble,
what is known about how long the body
can maintain adequate iodine levels
between dietary intake?
Are there any established research findings
about the need for iodine during different
eating patterns, such as an extended fast?"
Yeah, so iodine is--
(12:30):
I mean, I haven't looked a lot into iodine
because the main issue
with iodine is mostly deficiency,
iodine deficiency.
You don't need a lot of iodine, but there
is a trace amount of iodine that you do
need. If you don't have enough iodine,
then what happens is you develop a goiter,
which is this enlarged thyroid gland that
(12:51):
people used to get, this big sort of football
in their neck.
That's largely gone because
most salt is now sort of fortified
with iodine.
So if you're eating salt, you're getting
enough iodine, generally.
That's why, in North America, you almost never
see goiter anymore as a disease.
So even if you're doing a fast, you can still
(13:12):
take salt, or if you want to take some bone
broth or something.
And most of the time, even if you're doing a
fast for a few days, it's stored
in the body for extended periods of time, so
you have to be sort of deficient for a
long period of time.
I don't know the specifics about how long
exactly it stays in the body.
It's not generally
(13:33):
a huge medical issue anymore because
it's in the salt, so therefore it's not like--
if you're a vegetarian, you're still-- a lot
of people will still use salt.
If you're eating regular food, most
Americans get more than enough salt
so they're not at risk of iodine deficiency.
I actually can't remember the last time I saw
a case of iodine deficiency.
It's got to be very rare in Canada,
(13:54):
in North America.
You know, in other places in the world, of
course-- India was one of these places
that used to have a lot.
I think it's mostly gone there as well.
So, yeah, it's not a big issue anymore,
medically speaking.
Next question.
"Will consistently high uric
acid levels from fasting
adversely affect my health, even
(14:15):
if I don't have any symptoms
of hyperuricemia? "
No, it shouldn't.
It can trigger sometimes gout.
The reason it goes up-- so everything, almost
everything else goes down with fasting because
you're not eating, but uric acid is reabsorbed
in the urine. And that's why sometimes the
levels can actually go up during fasting,
(14:36):
which is sort of unusual amongst all
the other things. So if you look at
cholesterol and you look at sodium and
potassium, you know, it all goes down because
you're not eating anything, but uric acid can
go up, but it doesn't usually cause any
symptoms at all.
The only issue is if you do have a diagnosis
of gout, or if you have gout, you have to be
aware that it can precipitate gout.
(14:57):
So that's why you just have to be careful with
that.
It usually gets worse before it gets better.
Taking lime juice helps, right?
So all those things.
Yeah, there can be various things, although I
actually think these days a lot of it can be
genetic as well.
Certainly, I've seen it run in families
quite extensively.
So there could be some other issues there.
(15:17):
All right. Thank you.
I am also rewording this one.
I believe you addressed this at the
time that Dr. Peter Attia was
a guest on Thomas DeLauer's
YouTube channel, but I can't remember which
one. I was looking through our past podcasts
and trying to figure it out so that I could
reference them.
(15:37):
In it he was cautioning people
with regards to extended fasts and
muscle loss, but I think he was
talking-- because I remember watching it at
the time, and then your comment was,
"These are people who were already in shape,
these people were already shredded,"
to use that vernacular, if you will.
So the person's question is, "How
(15:59):
would you respond to somebody that says,
'You're losing muscle?'" And I know you've got
that great article that is underneath the
'Medium Articles' about 'You're not losing
muscle', but don't you quickly
regain the muscle once you start eating-- any
that you do lose during a fast, if it's
small amount-- and you do rebuild even more
after?
Yeah. So this is a
(16:20):
sort of persisting concern.
And certainly if you're a high level athlete,
and both Dr. Attia and Thomas
DeLauer are relatively-- you know, they don't
have a lot of body fat, they tend to be very
muscular. They're not the usual people
that I'm treating, so it's
a totally different situation.
So, in short, if you look at the
(16:42):
way muscle is measured,
it looks very similar to water.
So when you measure body fat
with, you know, one of those machines that
sends an electrical pulse-- you know, you step
on the scale and it sends an electric pulse,
or even if you do it through DEXA,
they assume that your body water is constant,
but it's not. When you're fasting, you're
(17:02):
actually losing water because insulin is
an antidiuretic hormone, which means that
insulin makes you retain water.
When insulin falls, you tend to lose water.
So when you lose water, it actually looks
like (to the machine) that you're losing
muscle. So you get these crazy results.
We have people who do like a five-day fast
or whatever, and then they're all in a panic
because they're like, "I lost 10 pounds of
(17:24):
muscle." And it's like, you can't really
lose 10 pounds of muscle.
And then I ask them, "How are you feeling?"
and they're like, "Oh, pretty normal." They're
working out and everything's pretty normal,
right? It's like, well, how do you lose 10
pounds of muscle and not even feel it?
And the weird part, of course, is that then
they'll start re-eating after whatever,
after the fast, and then they'll check it
again and they'll have regained 10 pounds of
(17:45):
muscle. It's like, sooo.... [laughs]
It's like you think that without doing any
extra exercise, you gained 10 pounds of muscle
for no reason? Like, you lost 10 pounds of
muscle for no reason and then you gained it
again. Or do you think it was just the way
it was measured?
And obviously it was the way it was measured.
When they did the studies-- this was in the
Buchinger [Wilhelmi] clinic in Germany, where
they do a ten-day fast (it's a modified fast,
(18:07):
it's not a full fast), they found the same
thing. If you measure it with those things,
you see this sort of 3 or 4 or 5%
loss in muscle, but when you actually test
them for muscular strength, there's no
decrease, and, in some cases, there's an
increase in muscular strength.
And I don't think it's because you gain
muscle. I think it's because of some of the
other things, such as the sympathetic nervous
(18:27):
system activation.
When you actually test it functionally, like
with muscular strength (or you can test it
with grip strength or repetition of grip,
and how long it takes you to go up 40 steps,
these kind of things), you don't see any
changes with fasting.
And it makes sense. Like, why would your body
store energy in the form of
(18:48):
body fat, but, as soon as you need
it, it's going to start burning off
all your muscle.
Don't you think nature's just not that
stupid? Like, the human body is just not that
stupid. Like, how would humans
have survived if we had this crazy,
stupid mechanism of eating our own
body muscle, right, the functional tissue
(19:09):
that we need to survive in the wild.
[laughs]
So the whole thing is just--
you know, it's one of these things where I
think a little bit of information is dangerous
because people get out there and say, "Fasting
burns your muscle," and it's like,
"No, it doesn't." You have to understand
a little bit more about what you're doing, but
then, you know-- and again, if
(19:30):
you're at like very low body fat
and very high muscle mass,
why are you fasting?
What is your reason?
If there's no reason, why are you doing it?
Yes, you might get a problem.
They might be at 10, 12%
body fat. The people I'm treating are
minimum like 20, 25%
body fat and many of them 40, 50%
(19:53):
body fat, which is a huge
difference, right?
So, you know, when they go on and on
about, "Oh, you have to be careful,"
sure, you have to be careful.
You have to know what you're doing, but you
have to apply it to the specific situation.
If you're overweight and diabetic, then,
yeah, this could be very, very important for
you. And if you get scared
(20:14):
away because you're trying to apply
results from people who exercise
an hour a day and have 8%
body fat, well, those might not
be the most applicable people.
It doesn't make any sense to take those
results and apply it to the
people who I'm dealing with, most of whom are
trying to lose weight because they are
(20:35):
overweight, right?
So, yeah, the whole thing is just one of
these things where there are very influential
people out there, and a lot of them have
turned sort of against fasting.
And I'm always like, I don't understand why.
I just don't think they've been applying it to
the right people, because, when I apply
it apply to the right people, I see incredible
results. But I'll tell you that I don't
(20:57):
recommend, I have never recommended,
repeated, extended fasts to somebody with
low-- I'm always like, "You can
do it if you want, but I don't think you need
to," whereas they do it because they want to
learn about it and so on.
This leads us right on into the next question,
which is about autophagy that is happening
during exercise.
(21:17):
This person said that some scientists
are now advocating against fasting for
autophagy and claiming that more autophagy
happens during exercise.
Could you please comment on that?
Oh, yeah. I mean, exercise is good.
I mean, they're different.
I'm not sure about autophagy during exercise.
So the whole idea of autophagy is that
(21:40):
it's controlled through mTOR, which is
related to protein intake.
So therefore, if you're eating a very
high-protein diet, you're stimulating a lot
of mTOR, which is a pro-growth agent.
And that's sort of been a bit of the worry
of people.
You know, lately, it seems like a lot of
people are recommending high-protein diets and
that's been tried, that's been done.
(22:01):
Twenty years ago, there was a huge
number of people who were advocating
high-protein-- basically, low carb
plus low fat, high protein.
And it was really not all that sustainable.
It didn't really work in the long-term
because, one, people didn't like it that much.
The diet wasn't all that palatable because
you're basically restricting two out of three
(22:22):
of your macronutrients, which leaves you very
little that you can actually eat.
And the other thing is that there's always
this sort of persistent concern that, if
you're stimulating a lot of mTOR, are you
going to put yourself at risk of
other diseases, including cancer.
Because rapamycin, which blocks mTOR
is an anti-cancer agent, has been used as
(22:43):
a longevity agent, so
they block mTOR.
If you're stimulating mTOR, are you
going to be pro aging?
That's the real concern.
There's no answer to that question, but
that's why I don't recommend
ultra-high-protein diets.
I mean, people say, "Oh,
protein is the most satiating of the
(23:04):
macronutrients," which is true.
It doesn't mean you can take that and just
ramp it from, you know, 15, 20%
to 80%.
It doesn't mean that there's not other
problems along the way, right?
It's a highly artificial diet.
That's why massive amounts of protein
supplementation are not things that
I generally recommend.
I'm more conservative.
I like to say, you know, "Eat natural foods
(23:26):
and stuff," right? So there is a bit
of concern. Exercise, if it doesn't do
some autophagy, is going to be different from
fasting-induced autophagy, and I think that
they probably work together.
I do. [laughs] I always exercise in the
fasted state. It's working well for me.
My muscle mass just keeps going up, so...
This question comes from the Q&A box.
"What is the best fasting regimen for
(23:48):
a female with lower BMI of 20
but with nonalcoholic fatty liver disease?
Just started 42-48-hours two times
a week. How long should alternate-day
fasting continue if combined
with whole foods, low-carb,
high-fat diet, or does this
alternate day fasting need to continue
(24:09):
forever?"
I don't think it needs to continue forever.
I mean, people certainly have done well
without extended (over 24-hour)
fasts, as long as you're eating a natural
diet. Fatty liver disease was actually
quite unheard of 30, 40 years ago.
They actually didn't even have any literature.
It sort of was discovered,
if you will. In the 1980s,
(24:31):
it was always considered to be alcoholic.
Alcoholic fatty liver disease was well known,
but nonalcoholic fatty liver disease was
basically unknown until the 80s.
So people who ate natural
foods had a relatively normal
fasting period.
Not long, but, you know, 16 hours,
14 hours a day combined
(24:53):
could still maintain that.
So once you get that down-- mostly cutting
down refined foods. If you're eating a lot of
refined foods and ultra-processed foods, then
you may have to continue it for longer.
One last question here.
"Thoughts on fasting while taking
ADHD medication?"
It's hard to know because
fasting will stimulate the sympathetic nervous
(25:15):
system which can activate the body.
It's a potential problem if you're
overactive anyway, but how
it will affect each individual person is not
known. There's just not a lot of research on
that, so I can't really tell you.
In fact, because fasting was discouraged for
so long, there's actually not a lot of data on
fasting. That's why the fasting-mimicking-diet
(25:37):
people have actually done probably the most
research of all of those people into various
disease states.
So that's why I'm kind of interested in that.
We were talking about that earlier.
But yeah, I don't think that there's much
research. I haven't come across any that has
really addressed that question specifically.
I think, if I'm not mistaken--
I can't remember the name of the podcast,
though you, I'm sure, know it.
(25:57):
Dr. Bret Scher is doing a new podcast
that is something with the...
Yeah, The Metabolic Mind.
Metabolic Mind.
Thank you. I think he has
one on ADHD,
but I haven't listened to it yet so I couldn't
tell you what's on it.
He's another one of my favorites, Bret Scher,
because he's a cardiologist, and I just--
I wish all the cardiologists followed him.
(26:19):
Yeah, that's great. Maybe I can answer a
couple of questions in the chat.
There was one question about
recommendation for a diet to starve
or kill cancer.
That's difficult to do.
I mean, people talk about how cancers
can use glucose but not
fat very easily, whereas your body
can switch from glucose.
(26:39):
If you don't have any glucose, like you're
taking very low carbs, then you can switch
over to fat metabolism so you use
triglycerides. Your muscles, for example,
when you don't have any glucose, will just
switch over to burning fat.
Cancer can't do that.
So low-carbohydrate diets can be very useful
in that, but they're mostly adjunctive
treatment. That is, you know, low
(27:00):
carb is not going to kill the
cancer. For most cancers, you're still going
to need to use, you know, either the
radiation, or the chemo, or whatever the
oncologist recommends, but a low-carb
diet can be an adjunct to try
to improve the results.
And it's the same with fasting.
If you put yourself in a fasted state,
then you're, again, trying to switch yourself
(27:21):
over to the
metabolism-- fat metabolism, because you're
sort of fueling yourself on body fat.
So, therefore, it's a sort of a high-fat diet,
if you will (it's your own body fat), but very
low glucose, and, again, trying to get
yourself-- so low carb and fasting can
be a very useful adjunct to that case.
And then maybe we can do one more.
(27:41):
"How long does somebody who has high
insulin resistance, is on insulin,
on average, take to lower the insulin
resistance while doing fasting and low carb?"
That's quite variable.
It sort of depends on
how bad the insulin resistance is
and how long.
I've seen people reverse their insulin
resistance within a month, but it depends
(28:02):
on how much fasting you do as well, and the
individual person.
So it's always very hard to predict,
but, for most people, as long as you're
cutting down the carbs substantially, the
insulin resistance will get better.
And remember, it's a reversible disease.
So it's important to try to reverse
that insulin resistance, try to get off
of the insulin. But there are also cases,
(28:24):
and this is why it's important to talk to your
doctors about it, is that there are
lots of cases of type one diabetes in
adults, which is called LADA, which
is not quite the same as type two
and is not always reversible.
And we're seeing that more actually.
So why that happens we don't know,
but it is something that can be,
(28:44):
for the most part, reversed, unless
it's this sort of type one pathophysiology.
Do know you've reversed your insulin
resistance just by your insulin level or are
there other markers that you're going to look
at?
Fasting insulin is a good one.
C-peptide is a good one.
You can also do a measurement called a
HOMA, which is you do a fasting glucose and a
fasting insulin, which basically compares how
(29:06):
much insulin you need to get that
glucose down. Because we see people-- and
Shawn Baker, I think, was one of these people
who had actually a relatively high A1C,
but the thing was that his insulin was quite
low, I think. I think he had talked about it
at one of the podcasts or something like that.
But the point is that you can have-- if
your insulin is not that high, then
(29:27):
your body is going to release some of the
glucose, so your glucose is a bit higher.
But the problem is that-- the thing is that,
because it's how much insulin you have to how
much glucose you have, insulin is relatively
low, glucose is a little bit on the high side.
But the insulin resistance,
because it compares it to, is actually not bad
compared to the usual, which is that your
glucose is relatively normal, but you have a
(29:49):
very, very, very sky-high insulin to
keep that glucose down.
And that actually has a lot of insulin
resistance. So a lot of-- some of these low
carbers actually have A1Cs
that are actually on the higher end, and
sometimes they wonder why.
And it's like, well you have to actually
compare insulin and glucose, not
just glucose alone.
(30:09):
That gives you a more complete picture.
Also, sometimes, as you get healthier, your
red blood cells last longer, right?
And so then you accumulate more
sugar on them.
[laughs]
Yeah, exactly.
So it's sort of like a healthy-user
type of thing you have to look at.
Well, thank you so much, Dr. Fung,
and I will see you again next month.
(30:29):
Alrighty?
Okay, thank you.
Take care.
Bye.
Bye.
Before we get started with today's episode,
I would like to quickly read you our podcast
disclaimer.
This podcast is for educational purposes
only, and it is not a substitute
for professional care by a doctor
or other qualified medical professional.
You should always speak with your physician
(00:27):
or other healthcare professionals before doing
any fasting, changing your diet
in any way, taking or adjusting
any medications or supplements, or
adopting any treatment plan
for a health problem.
The use of any other products or
services purchased by you as a result
of this podcast does not create
(00:50):
a healthcare provider-patient
relationship between you and any
of the experts affiliated with this
podcast.
Any information and statements
regarding dietary supplements have not
been evaluated by the Food and Drug
Administration and are not intended
to diagnose, treat, cure, or
(01:11):
prevent any disease.
All right. And now we'll get started with
today's episode.
Welcome, everyone.
My name is Lisa Chance. I'm a fasting coach
here at TFM, and today we are here with
our very own Dr. Jason Fung
for our monthly Q&A.
This is a monthly discussion with Dr. Fung
(01:32):
where he answers questions submitted by
our TFM Community members.
Hello to our podcast listeners,
who will be able to listen to this Q&A with
Dr. Fung in a few weeks after our Community
members. Okay.
Hi, Dr. Fung. How are you doing today?
I'm good. How are you?
Good. I have to tell you, I absolutely
loved the Fasting and Longevity
(01:54):
Summit that you hosted.
Oh, thanks.
You were a co-host.
It was so interesting to see you
as the person who was asking the questions,
as opposed to giving the answers.
The dialog between the doctors was
just great. I haven't seen them all, but
the one with Dr. Bikman, Ben Bikman
I've watched like three times.
(02:16):
All of that about the fat is so
fascinating, how the fat works.
Yeah, he's a super smart guy, Dr.
Bikman. I mean, he knows a lot.
I think he's really a sharp guy.
So I really enjoyed that.
And it was something that the L-Nutra
people (who make the fasting-mimicking diet
actually) had put on.
So they asked me to help out, and I said,
(02:37):
"Sure," because it's, you know, one
of these things-- there's people who are
promoting fasting, and I'm happy to help them
because it's certainly something that can be
very useful.
And that was a free thing.
I think they're doing an encore as well, so
it's possible you might be able to catch them.
But, in either case, the interviews that I
did are all posted to YouTube.
They sent me the videos and said, "You can
(02:58):
post them to YouTube," so all of those are
available. So if you aren't able to
make the summit, you can still go on to my
YouTube channel and find all the
videos if you want to replay them or whatever.
So it's always available.
So that's the other reason I was like, "Yeah,
this will be great. It'll be such an
interesting thing." So yeah, I had fun doing
it too.
It was great. And I like the one with Dr.
Brian Lenzkes, I think he has such a big
(03:20):
heart. And I noticed that, towards the end,
you guys were talking about him going to
Guatemala, and you mentioned that The
Obesity Code is in Spanish and that you
were looking into getting your YouTube channel
in Spanish also.
Let me know when that happens because my
housekeeper is Hispanic, and she has
type two diabetes and was told it was a
(03:40):
progressive disease, there was nothing she
could do about it.
I gave her a copy of your book in Spanish,
but I'd like her to be able to get access
to the videos also.
Yeah. I
started, actually, the Spanish channel
and then it got shut down.
[laughter] It was when my email
got hacked. They were able to put
(04:02):
up my old YouTube channel, but then, for
some reason, they wouldn't restore my Spanish
channel, which was sort of bizarre.
But anyway [laughs],
I may try to redo some of
that. It's just sort of time consuming, so
I haven't done it for a bit, but,
you know, if I get some help, I may
(04:24):
try to do that.
I mean, what I did in the Spanish
Channel actually was use this
AI-- there's this AI dubbing, which is
basically, if you upload the video, it'll
translate directly into Spanish for you.
And then I uploaded that video.
The problem is that the translation
is on the level of a Google Translate,
which is not great.
(04:45):
Like, it's sort of understandable but riddled
with errors is what people told me.
[laughs] So I was like, "Well,
let's see," because at least some information
will be still good.
But it was a little slow going.
So that may be something I may try to do
again if it comes around.
Well, I applaud your efforts for
(05:06):
making a dent in this, right?
[laughter]
All right, let's get started with some of
these questions here because I know you gotta
leave promptly on time.
So, "Can you address the use
of home-made smoothies and protein
drinks as a meal replacer?
How are they helpful or detrimental
to weight loss or reversing type two
diabetes?
(05:27):
If they're useful, which kinds would you
recommend?" They know not to
add a lot of fruit, but does
the protein powder in a smoothie have any
benefit at all?
I think so. So a lot of these smoothies
are often based on-- a
lot of them are yogurt based, so if you use
Greek yogurt, for example, that's very good,
low in carbs.
(05:48):
Whey protein and other protein powders
are also fine.
I mean, I tend to shy away
from them just because they are very highly
processed. You know, as a general
concept, you want to eat natural foods
as opposed to sort of ultra processed foods,
but, as far as that goes, it's probably not
one of the really bad ones.
(06:09):
So, as a meal replacement, I think it's
reasonable to make your own smoothies.
A lot of the commercial stuff that you can
get is sort of packed full of fructose,
a lot of them.
They're not bad, and if you add some berries--
so berries tend to be the best of the fruits,
especially if you blend them.
I did a video or a Medium post,
something about blending fruit, which is
(06:31):
actually very interesting because, when you
blend the fruit, it actually lowers the
glycemic index of that fruit, which
is probably because if you blend
berries or seeded fruits (so
strawberries, raspberries, passion fruit)--
when you blend them, the theory is that
the seeds sort of get shorn up,
and therefore it releases a lot of the fiber
(06:53):
that's inside, and a lot of these other
sort of antioxidants that are actually highly
beneficial.
The thing is that the best thing to do is
to use some kind of berries in
there to give it flavor.
So making it yourself is very good because,
you know, sometimes if you get commercial
preparations, they use strawberry extract or
whatever, you're not getting the whole fruit
(07:13):
that's blended.
If you blend non-seeded fruits like
mangoes and stuff, it actually makes things
a little bit worse, but if you blend the
seeded fruits it's fine.
So berry smoothies actually tend to be very
good because you've got the blended berries
(berries being one of the better fruits), but
you've got the seeds which are blended, which
is good, and then you can add the yogurt,
especially Greek yogurt (which is higher in
(07:34):
protein, which is good), and then you can add
the protein powder on top of that.
So you can actually do pretty well with it.
It's fairly low in carbs, very high in
protein.
So, as a meal replacement, it can be actually
very, very good for that if
that's what you like, especially for people
who enjoy that kind of thing, then, yeah,
absolutely. You can also blend things like
(07:54):
kale and other-- you know, these green
smoothies, which are fairly popular these
days. And I think those are also, again, very
low in sugar and so on.
So they really can be very good for you,
depending on how you make it.
Thank you, Dr. Fung.
I do use a protein powder every once in a
while because I have trouble getting protein
in, but I use it about maybe once or twice a
(08:15):
month is all just because I'm basically
plant-based. But yes, what delays me is it's
just highly processed.
Yeah, yeah. And that's not necessarily bad,
but, you know, it's just, as a general
principle, it's better to eat real
foods. That's always sort of a core principle
of what we teach.
This person-- I'm trying to ask this question
without getting into the medical side
(08:36):
of it, but she's a very petite
woman. So is it acceptable for someone
4' 10" to eat 0.6 grams
of protein per kilogram instead of
TFM's recommended 0.8
to 1.2 grams, just because they're
so petite?
That's a good question.
(08:57):
I mean, it's usually based per kilo, so
the height doesn't tend to matter so much.
And it's based on the recommended
daily allowance (which is a
nationally-published sort of guideline),
which is 0.8 grams per kilo per day.
0.6 is on the low side, but, honestly,
a lot of vegetarians and vegans
(09:17):
actually fall in that lower category.
The average American is sort of closer to
1.2 to 1.5 grams per
kilo. So an average diet, average American
diet, is much higher in protein than that.
So going ultra-low protein
has some risks because of course you need
the proteins to build your
own protein. Every day you break
(09:39):
down some proteins.
There are some obligatory losses like hair
and fingernails and stuff.
So you do have to get a little bit.
0.6 tends to be on the lower side of
things. You see this sometimes in-- you know,
sometimes online you see vegans and stuff,
and sometimes you see them and you're like,
"Oh, I think you should get a little
bit hard on nutrients there,"
(10:01):
because the problem, of course, with
vegetarian and vegan diets
is that the proteins are not
ideal for humans.
The bioavailability is not ideal and
sometimes they don't have a complete protein.
The point is that if you eat meat--
meat has a lot of proteins,
and when you're sort of rebuilding
(10:22):
human flesh it's obviously
very close to the meat,
like, you know, whatever meat you're eating.
So therefore, it has a very much more complete
amino acid profile as opposed
to eating a bean, for example.
A bean is nothing like a human versus
a cow is much closer to a human than a bean
(10:42):
is. So when you eat beans, you're not getting
all of the proteins that you really need in
the right proportions that you need, and
it's not always bioavailable (that is, it's
not absorbed properly and used properly).
So sometimes vegans, not only are they eating
very low protein (like, if you look at the
total grams of protein), but, because they're
eating all vegetarian and vegan sources
of protein, they may not be getting the
(11:04):
full bang for their buck sort of thing
compared to somebody who eats meat.
So I would tend to still stick
to the 0.8 to 1.2,
just because there's a lot of people who worry
that going too low can be an issue.
In the past, the main issue with protein
was actually cost.
It's a lot cheaper to eat
(11:26):
carbohydrates, so that's why a lot of--
you know, in the past, a lot diets were based
on rice, or based on potatoes, or based
on bread, or whatever, because that's the way
to feed a lot of people, whereas the meat
was very expensive.
These days, it's not as
much of an issue anymore.
But you do see it sometimes in vegans
who do it for other reasons.
(11:47):
But you know, if you're looking at overall
health just on that aspect, yeah,
I would still go with the 0.8 to
1.2.
Thank you. Again, another one about
thyroid function and iodine so I reworded
this for the person who sent it in.
"How does iodine intake and storage
work in the body from the scientific
(12:08):
perspective?
Since iodine is water-soluble,
what is known about how long the body
can maintain adequate iodine levels
between dietary intake?
Are there any established research findings
about the need for iodine during different
eating patterns, such as an extended fast?"
Yeah, so iodine is--
(12:30):
I mean, I haven't looked a lot into iodine
because the main issue
with iodine is mostly deficiency,
iodine deficiency.
You don't need a lot of iodine, but there
is a trace amount of iodine that you do
need. If you don't have enough iodine,
then what happens is you develop a goiter,
which is this enlarged thyroid gland that
(12:51):
people used to get, this big sort of football
in their neck.
That's largely gone because
most salt is now sort of fortified
with iodine.
So if you're eating salt, you're getting
enough iodine, generally.
That's why, in North America, you almost never
see goiter anymore as a disease.
So even if you're doing a fast, you can still
(13:12):
take salt, or if you want to take some bone
broth or something.
And most of the time, even if you're doing a
fast for a few days, it's stored
in the body for extended periods of time, so
you have to be sort of deficient for a
long period of time.
I don't know the specifics about how long
exactly it stays in the body.
It's not generally
(13:33):
a huge medical issue anymore because
it's in the salt, so therefore it's not like--
if you're a vegetarian, you're still-- a lot
of people will still use salt.
If you're eating regular food, most
Americans get more than enough salt
so they're not at risk of iodine deficiency.
I actually can't remember the last time I saw
a case of iodine deficiency.
It's got to be very rare in Canada,
(13:54):
in North America.
You know, in other places in the world, of
course-- India was one of these places
that used to have a lot.
I think it's mostly gone there as well.
So, yeah, it's not a big issue anymore,
medically speaking.
Next question.
"Will consistently high uric
acid levels from fasting
adversely affect my health, even
(14:15):
if I don't have any symptoms
of hyperuricemia? "
No, it shouldn't.
It can trigger sometimes gout.
The reason it goes up-- so everything, almost
everything else goes down with fasting because
you're not eating, but uric acid is reabsorbed
in the urine. And that's why sometimes the
levels can actually go up during fasting,
(14:36):
which is sort of unusual amongst all
the other things. So if you look at
cholesterol and you look at sodium and
potassium, you know, it all goes down because
you're not eating anything, but uric acid can
go up, but it doesn't usually cause any
symptoms at all.
The only issue is if you do have a diagnosis
of gout, or if you have gout, you have to be
aware that it can precipitate gout.
(14:57):
So that's why you just have to be careful with
that.
It usually gets worse before it gets better.
Taking lime juice helps, right?
So all those things.
Yeah, there can be various things, although I
actually think these days a lot of it can be
genetic as well.
Certainly, I've seen it run in families
quite extensively.
So there could be some other issues there.
(15:17):
All right. Thank you.
I am also rewording this one.
I believe you addressed this at the
time that Dr. Peter Attia was
a guest on Thomas DeLauer's
YouTube channel, but I can't remember which
one. I was looking through our past podcasts
and trying to figure it out so that I could
reference them.
(15:37):
In it he was cautioning people
with regards to extended fasts and
muscle loss, but I think he was
talking-- because I remember watching it at
the time, and then your comment was,
"These are people who were already in shape,
these people were already shredded,"
to use that vernacular, if you will.
So the person's question is, "How
(15:59):
would you respond to somebody that says,
'You're losing muscle?'" And I know you've got
that great article that is underneath the
'Medium Articles' about 'You're not losing
muscle', but don't you quickly
regain the muscle once you start eating-- any
that you do lose during a fast, if it's
small amount-- and you do rebuild even more
after?
Yeah. So this is a
(16:20):
sort of persisting concern.
And certainly if you're a high level athlete,
and both Dr. Attia and Thomas
DeLauer are relatively-- you know, they don't
have a lot of body fat, they tend to be very
muscular. They're not the usual people
that I'm treating, so it's
a totally different situation.
So, in short, if you look at the
(16:42):
way muscle is measured,
it looks very similar to water.
So when you measure body fat
with, you know, one of those machines that
sends an electrical pulse-- you know, you step
on the scale and it sends an electric pulse,
or even if you do it through DEXA,
they assume that your body water is constant,
but it's not. When you're fasting, you're
(17:02):
actually losing water because insulin is
an antidiuretic hormone, which means that
insulin makes you retain water.
When insulin falls, you tend to lose water.
So when you lose water, it actually looks
like (to the machine) that you're losing
muscle. So you get these crazy results.
We have people who do like a five-day fast
or whatever, and then they're all in a panic
because they're like, "I lost 10 pounds of
(17:24):
muscle." And it's like, you can't really
lose 10 pounds of muscle.
And then I ask them, "How are you feeling?"
and they're like, "Oh, pretty normal." They're
working out and everything's pretty normal,
right? It's like, well, how do you lose 10
pounds of muscle and not even feel it?
And the weird part, of course, is that then
they'll start re-eating after whatever,
after the fast, and then they'll check it
again and they'll have regained 10 pounds of
(17:45):
muscle. It's like, sooo.... [laughs]
It's like you think that without doing any
extra exercise, you gained 10 pounds of muscle
for no reason? Like, you lost 10 pounds of
muscle for no reason and then you gained it
again. Or do you think it was just the way
it was measured?
And obviously it was the way it was measured.
When they did the studies-- this was in the
Buchinger [Wilhelmi] clinic in Germany, where
they do a ten-day fast (it's a modified fast,
(18:07):
it's not a full fast), they found the same
thing. If you measure it with those things,
you see this sort of 3 or 4 or 5%
loss in muscle, but when you actually test
them for muscular strength, there's no
decrease, and, in some cases, there's an
increase in muscular strength.
And I don't think it's because you gain
muscle. I think it's because of some of the
other things, such as the sympathetic nervous
(18:27):
system activation.
When you actually test it functionally, like
with muscular strength (or you can test it
with grip strength or repetition of grip,
and how long it takes you to go up 40 steps,
these kind of things), you don't see any
changes with fasting.
And it makes sense. Like, why would your body
store energy in the form of
(18:48):
body fat, but, as soon as you need
it, it's going to start burning off
all your muscle.
Don't you think nature's just not that
stupid? Like, the human body is just not that
stupid. Like, how would humans
have survived if we had this crazy,
stupid mechanism of eating our own
body muscle, right, the functional tissue
(19:09):
that we need to survive in the wild.
[laughs]
So the whole thing is just--
you know, it's one of these things where I
think a little bit of information is dangerous
because people get out there and say, "Fasting
burns your muscle," and it's like,
"No, it doesn't." You have to understand
a little bit more about what you're doing, but
then, you know-- and again, if
(19:30):
you're at like very low body fat
and very high muscle mass,
why are you fasting?
What is your reason?
If there's no reason, why are you doing it?
Yes, you might get a problem.
They might be at 10, 12%
body fat. The people I'm treating are
minimum like 20, 25%
body fat and many of them 40, 50%
(19:53):
body fat, which is a huge
difference, right?
So, you know, when they go on and on
about, "Oh, you have to be careful,"
sure, you have to be careful.
You have to know what you're doing, but you
have to apply it to the specific situation.
If you're overweight and diabetic, then,
yeah, this could be very, very important for
you. And if you get scared
(20:14):
away because you're trying to apply
results from people who exercise
an hour a day and have 8%
body fat, well, those might not
be the most applicable people.
It doesn't make any sense to take those
results and apply it to the
people who I'm dealing with, most of whom are
trying to lose weight because they are
(20:35):
overweight, right?
So, yeah, the whole thing is just one of
these things where there are very influential
people out there, and a lot of them have
turned sort of against fasting.
And I'm always like, I don't understand why.
I just don't think they've been applying it to
the right people, because, when I apply
it apply to the right people, I see incredible
results. But I'll tell you that I don't
(20:57):
recommend, I have never recommended,
repeated, extended fasts to somebody with
low-- I'm always like, "You can
do it if you want, but I don't think you need
to," whereas they do it because they want to
learn about it and so on.
This leads us right on into the next question,
which is about autophagy that is happening
during exercise.
(21:17):
This person said that some scientists
are now advocating against fasting for
autophagy and claiming that more autophagy
happens during exercise.
Could you please comment on that?
Oh, yeah. I mean, exercise is good.
I mean, they're different.
I'm not sure about autophagy during exercise.
So the whole idea of autophagy is that
(21:40):
it's controlled through mTOR, which is
related to protein intake.
So therefore, if you're eating a very
high-protein diet, you're stimulating a lot
of mTOR, which is a pro-growth agent.
And that's sort of been a bit of the worry
of people.
You know, lately, it seems like a lot of
people are recommending high-protein diets and
that's been tried, that's been done.
(22:01):
Twenty years ago, there was a huge
number of people who were advocating
high-protein-- basically, low carb
plus low fat, high protein.
And it was really not all that sustainable.
It didn't really work in the long-term
because, one, people didn't like it that much.
The diet wasn't all that palatable because
you're basically restricting two out of three
(22:22):
of your macronutrients, which leaves you very
little that you can actually eat.
And the other thing is that there's always
this sort of persistent concern that, if
you're stimulating a lot of mTOR, are you
going to put yourself at risk of
other diseases, including cancer.
Because rapamycin, which blocks mTOR
is an anti-cancer agent, has been used as
(22:43):
a longevity agent, so
they block mTOR.
If you're stimulating mTOR, are you
going to be pro aging?
That's the real concern.
There's no answer to that question, but
that's why I don't recommend
ultra-high-protein diets.
I mean, people say, "Oh,
protein is the most satiating of the
(23:04):
macronutrients," which is true.
It doesn't mean you can take that and just
ramp it from, you know, 15, 20%
to 80%.
It doesn't mean that there's not other
problems along the way, right?
It's a highly artificial diet.
That's why massive amounts of protein
supplementation are not things that
I generally recommend.
I'm more conservative.
I like to say, you know, "Eat natural foods
(23:26):
and stuff," right? So there is a bit
of concern. Exercise, if it doesn't do
some autophagy, is going to be different from
fasting-induced autophagy, and I think that
they probably work together.
I do. [laughs] I always exercise in the
fasted state. It's working well for me.
My muscle mass just keeps going up, so...
This question comes from the Q&A box.
"What is the best fasting regimen for
(23:48):
a female with lower BMI of 20
but with nonalcoholic fatty liver disease?
Just started 42-48-hours two times
a week. How long should alternate-day
fasting continue if combined
with whole foods, low-carb,
high-fat diet, or does this
alternate day fasting need to continue
(24:09):
forever?"
I don't think it needs to continue forever.
I mean, people certainly have done well
without extended (over 24-hour)
fasts, as long as you're eating a natural
diet. Fatty liver disease was actually
quite unheard of 30, 40 years ago.
They actually didn't even have any literature.
It sort of was discovered,
if you will. In the 1980s,
(24:31):
it was always considered to be alcoholic.
Alcoholic fatty liver disease was well known,
but nonalcoholic fatty liver disease was
basically unknown until the 80s.
So people who ate natural
foods had a relatively normal
fasting period.
Not long, but, you know, 16 hours,
14 hours a day combined
(24:53):
could still maintain that.
So once you get that down-- mostly cutting
down refined foods. If you're eating a lot of
refined foods and ultra-processed foods, then
you may have to continue it for longer.
One last question here.
"Thoughts on fasting while taking
ADHD medication?"
It's hard to know because
fasting will stimulate the sympathetic nervous
(25:15):
system which can activate the body.
It's a potential problem if you're
overactive anyway, but how
it will affect each individual person is not
known. There's just not a lot of research on
that, so I can't really tell you.
In fact, because fasting was discouraged for
so long, there's actually not a lot of data on
fasting. That's why the fasting-mimicking-diet
(25:37):
people have actually done probably the most
research of all of those people into various
disease states.
So that's why I'm kind of interested in that.
We were talking about that earlier.
But yeah, I don't think that there's much
research. I haven't come across any that has
really addressed that question specifically.
I think, if I'm not mistaken--
I can't remember the name of the podcast,
though you, I'm sure, know it.
(25:57):
Dr. Bret Scher is doing a new podcast
that is something with the...
Yeah, The Metabolic Mind.
Metabolic Mind.
Thank you. I think he has
one on ADHD,
but I haven't listened to it yet so I couldn't
tell you what's on it.
He's another one of my favorites, Bret Scher,
because he's a cardiologist, and I just--
I wish all the cardiologists followed him.
(26:19):
Yeah, that's great. Maybe I can answer a
couple of questions in the chat.
There was one question about
recommendation for a diet to starve
or kill cancer.
That's difficult to do.
I mean, people talk about how cancers
can use glucose but not
fat very easily, whereas your body
can switch from glucose.
(26:39):
If you don't have any glucose, like you're
taking very low carbs, then you can switch
over to fat metabolism so you use
triglycerides. Your muscles, for example,
when you don't have any glucose, will just
switch over to burning fat.
Cancer can't do that.
So low-carbohydrate diets can be very useful
in that, but they're mostly adjunctive
treatment. That is, you know, low
(27:00):
carb is not going to kill the
cancer. For most cancers, you're still going
to need to use, you know, either the
radiation, or the chemo, or whatever the
oncologist recommends, but a low-carb
diet can be an adjunct to try
to improve the results.
And it's the same with fasting.
If you put yourself in a fasted state,
then you're, again, trying to switch yourself
(27:21):
over to the
metabolism-- fat metabolism, because you're
sort of fueling yourself on body fat.
So, therefore, it's a sort of a high-fat diet,
if you will (it's your own body fat), but very
low glucose, and, again, trying to get
yourself-- so low carb and fasting can
be a very useful adjunct to that case.
And then maybe we can do one more.
(27:41):
"How long does somebody who has high
insulin resistance, is on insulin,
on average, take to lower the insulin
resistance while doing fasting and low carb?"
That's quite variable.
It sort of depends on
how bad the insulin resistance is
and how long.
I've seen people reverse their insulin
resistance within a month, but it depends
(28:02):
on how much fasting you do as well, and the
individual person.
So it's always very hard to predict,
but, for most people, as long as you're
cutting down the carbs substantially, the
insulin resistance will get better.
And remember, it's a reversible disease.
So it's important to try to reverse
that insulin resistance, try to get off
of the insulin. But there are also cases,
(28:24):
and this is why it's important to talk to your
doctors about it, is that there are
lots of cases of type one diabetes in
adults, which is called LADA, which
is not quite the same as type two
and is not always reversible.
And we're seeing that more actually.
So why that happens we don't know,
but it is something that can be,
(28:44):
for the most part, reversed, unless
it's this sort of type one pathophysiology.
Do know you've reversed your insulin
resistance just by your insulin level or are
there other markers that you're going to look
at?
Fasting insulin is a good one.
C-peptide is a good one.
You can also do a measurement called a
HOMA, which is you do a fasting glucose and a
fasting insulin, which basically compares how
(29:06):
much insulin you need to get that
glucose down. Because we see people-- and
Shawn Baker, I think, was one of these people
who had actually a relatively high A1C,
but the thing was that his insulin was quite
low, I think. I think he had talked about it
at one of the podcasts or something like that.
But the point is that you can have-- if
your insulin is not that high, then
(29:27):
your body is going to release some of the
glucose, so your glucose is a bit higher.
But the problem is that-- the thing is that,
because it's how much insulin you have to how
much glucose you have, insulin is relatively
low, glucose is a little bit on the high side.
But the insulin resistance,
because it compares it to, is actually not bad
compared to the usual, which is that your
glucose is relatively normal, but you have a
(29:49):
very, very, very sky-high insulin to
keep that glucose down.
And that actually has a lot of insulin
resistance. So a lot of-- some of these low
carbers actually have A1Cs
that are actually on the higher end, and
sometimes they wonder why.
And it's like, well you have to actually
compare insulin and glucose, not
just glucose alone.
(30:09):
That gives you a more complete picture.
Also, sometimes, as you get healthier, your
red blood cells last longer, right?
And so then you accumulate more
sugar on them.
[laughs]
Yeah, exactly.
So it's sort of like a healthy-user
type of thing you have to look at.
Well, thank you so much, Dr. Fung,
and I will see you again next month.
(30:29):
Alrighty?
Okay, thank you.
Take care.
Bye.
Bye.
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