Episode #213
In this Fasting Q&A episode, hosted by Coach Lisa Chance, Dr. Jason Fung answers questions from the TFM Community:
- Can you compare T1D, T2D, LADA, and MODY? [01:52]
- What are the best fasting protocols and diet for autoimmune conditions? [11:40]
- Is it possible to be successful if you eat mostly vegan/vegetarian, as I worry about the higher carbs with this type of eating? [13:44]
- Does each hour you fast have added benefits? [20:44]
- A recent study done by University of Colorado Boulder confirms that metabolically healthy women tend to experience menopause later, with the study linking later menopause (age 55+) to better vascular health and reduced heart disease risk. Could you discuss how this research connects metabolic health factors like mitochondrial function and insulin sensitivity to delayed menopause onset and improved cardiovascular outcomes? [25:44]
LINKS
University of Colorado Boulder article “Later-onset menopause linked to healthier blood vessels, lower heart disease risk”
https://www.sciencedaily.com/releases/2025/02/250205131905.htm
Dr. Fung’s YouTube video “How to Eat and Fast around the Menstrual Cycle and Perimenopause”
https://www.youtube.com/watch?v=9j4AX9WxWHY&t=379s
#202 Fasting Q&A with Dr Jason Fung: Fasting and Insomnia, Autophagy Research, HDL/Trigs Ratio, Perimenopausal Weight Gain, Weight-Loss Stalls, and More.
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
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Summary Timestamps
00:00 Intro
01:52 T1D, T2D, LADA, MODY explained
11:40 Best autoimmune fasting and diet protocols
13:44 Vegan/Vegetarian diets - too high carb?
20:44 Length of fasting important?
25:44 Fasting and weight gain during perimenopause
Disclaimer
This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. You should always speak with your physician or other healthcare professional before doing any fasting, changing your diet, taking or adjustin
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
If you eat a meal at 9 p.m.
Versus 6 p.m., there's a measurable
difference. You can take the same meal, but
there's a measurable difference in terms of
how high your glucose and how high you're
insulin goes.
Same meal, same food.
[music]
Hello, my name is Lisa Chance,
(00:21):
and I'm a fasting coach here at TFM.
And we are here today with our very own Dr.
Jason Fung for our monthly Q&A.
In this monthly Q& A, Dr. Fung
answers questions submitted by our
TFM Community members.
And hello to our podcast listeners
who will be able to listen to this Q&
A with Dr. Fung in a few weeks after our
(00:43):
regular Community members.
So, Dr. Fung, I'm going to dive right
in here and I had somebody
send several questions in
about LADA, and the
difference between that and type one
diabetes, and the diagnostic
on that. And I realized that we really hadn't
looked at MODY either.
Is that how you pronounce it?
(01:04):
M-O-D-Y?
MODY, yeah.
And I thought it would be nice if you could
compare those three - type one,
LADA, and MODY - and tell us
how you differentiate insulin
level and fasting blood sugar levels.
Yeah, so there's really two types
of diabetes - type one and type two
- and they're basically-- when you say
(01:24):
diabetes, it basically means
that there's too much glucose
in the blood, right?
That's how it's diagnosed.
But the pathophysiology is different between
type one and type two.
Essentially, you have too much
insulin in type two diabetes and too little
insulin in type one diabetes.
And it seems strange, but they both actually
cause the same high blood glucose.
(01:46):
So diabetes itself just means high blood
glucose. You could have something completely
separate like steroid induced diabetes,
which is caused by a certain medication, and
that is separate, but, again, causes high
blood sugars and therefore it's called
diabetes. But the two main ones are type one
and type two, so too little insulin, too much
insulin.
The way you have to think of it is that
insulin is the hormone that tells
(02:08):
your body to take the sugar that's
in the blood and then take it into the cells,
and the cells are going to burn that for
energy. So if you have type one diabetes,
which is too little insulin, what you have is
that all you have all this sugar in the but
you don't have the insulin to open up the
cell so that it can take the sugar inside
the cell. So inside the cell there's too
little sugar, outside the cell there
(02:29):
is too much sugar, right?
So, if you think about a-- you know, a bar or
something like that. So imagine a bar and
it's Super Bowl Sunday and everybody wants to
go to the bar, but the bar has its doors
locked. So insulin, normally, would open
the door and allow all the people to go in.
But if you don't have that, the door is
locked and everybody's outside, right,
standing outside. So that's just like the
(02:49):
glucose. The glucose is sitting outside the
cell. Inside the cell, there's nobody there,
but outside the cell, there's too many people
there.
So that mismatch is because there's no
insulin. That is type one diabetes,
and that usually happens in kids,
classically.
Kids usually have this disease,
so 10, 11 years old, it develops very quickly
and it's not a dietary condition, it's
(03:10):
a autoimmune condition.
So for some reason, and we don't know exactly
why, their own body attacks the
insulin-producing cells in the pancreas.
So therefore, they don't produce insulin,
so therefore they can't move the sugar from
the outside to the inside.
LADA is the same type one
diabetes when it presents in adults,
and it presents quite differently.
(03:32):
So LADA is L-A-D-A,
which is latent autoimmune disease
in adults.
So, instead of a 10-year-old,
what you see is like a 50-year-old, and
the 50-year-old is relatively
skinny because you don't have any of the
sugar inside the cell.
so you don't have the overweight and all that
sort of thing. So these people are
(03:54):
not overweight, but because they're adults,
it looks like type two diabetes (which is
too much insulin), but they actually have two
little insulin. So the only way to really
tell is to measure the insulin levels.
And what you find when you measure insulin
levels is that-- what you do is you measure
C-peptide, which is-- C-peptide is a
different test, which indicates how much--
insulin goes up and down quite a bit, it
bounces up and like a yo-yo, whereas
(04:16):
C-peptide is more stable, so you measure the
C-peptide. And what you find is that
it's relatively lower than you expect.
So in type two diabetes, you expect very high
levels, so you expect a very high C-peptides.
And in this disease, LADA, you see
normal to low-normal C-peptide
levels. And what happens over time, because
I've actually followed these patients for
(04:37):
many, many years, you see this slow,
gradual drop.
And then everything makes sense.
It's like, well, so in type one, classic type
one, it's going to be like a 10-year-old and
it's going to develop over like a month,
right? It's going be like, oh, boom, it
happens all of a sudden.
In a 50-year old, which is LADA, it
tends to happen older, and it tends to
(04:57):
happen over decades - 5
years, 10 years, 15 years.
You'll see this slow fall.
For some reason we don't know of, it's
becoming more and more common, and it's still
felt to be autoimmune.
So classically, you needed to measure the
autoantibodies.
So you would send off an antibody test and
say, "Oh, we can detect these autoantibodies
(05:17):
and that's why I make the diagnosis." But it
turns out that that's a very, very
low-sensitivity test, so
you'll pick up maybe like 15-20%
of people like that.
In fact most people won't have the
autoantibodies that are testable because
there's actually lots that you can develop.
So that's LADA.
And the thing about that is that,
because it's not a dietary, it's caused by
(05:38):
a dietary problem, you can't cure it with a
dietary solution the same way you can with
type two diabetes.
With LADA, you can manage it because,
if your body doesn't produce as much insulin
as it should, if you eat less carbohydrates
and you do more fasting, well, you don't need
as much insulin. So you can still manage it,
but you're not going to cure that disease.
There is some thought that longer fasting
(06:00):
(five days, seven days) may be
helpful in terms of resetting the immune
system. So perhaps there may be some benefit
there, but that's questionable.
Type two diabetes is classically in adults
and somebody who's very overweight and
heavy. And the idea is that there's too
much insulin. And so how does that lead to
all this excess glucose outside the cell?
(06:21):
Again, if you think about that sports bar,
this time the doors are open, right?
So insulin is what opens the door.
And the problem is that there's just too many
people overall.
So all the people from outside who wanna get
into the bar, they go in for the Super Bowl
Sunday, but now the bar is completely full,
so the people outside can't get in.
So there's still a lot of people outside, but
the reason they can't get in is not because
(06:42):
the doors won't open (the doors will open)
but the bar is full.
Here, the cell is full of glucose,
and even though insulin says, "Well, we
have a lot of glucose in the blood, we want
to push it into the cell," they can't push it
into the cell because the cell is already
full. So you have too much insulin.
And in that case, which is classically 95%
of adults who have type two diabetes, then
fasting and low-carbohydrate diets are going
(07:04):
to help, because, if you fast, your body
is going to burn off some of the sugar, so
therefore the cell gets rid of some of the
sugar. The sugar from the blood can now get
into the cell and that's going to help.
MODY stands for maturity onset
diabetes of the young.
So essentially, what you have
is a type two diabetes that's
(07:25):
presenting much younger.
So it's maturity onset diabetes,
because, again, this used to be called-- type
one and type two sort of tells you about the
pathophysiology. So it's sort of like a type
two, but instead of in a 50-year-old,
it presents in like a 12-year-old, and
they usually have all the classic features.
There's still type one and type two, but
(07:46):
there's this confusion between how it used to
be-- you know, they used to call it 'juvenile
diabetes' and they used to call it 'maturity
onset diabetes', so young people, old people,
it wasn't differentiating.
But you can have type one, either in young or
old, and you can have type two in either
young or old.
So it's still two types of diabetes, but how
it presents is a little different.
You mentioned doing like a five-day fast.
(08:09):
If you catch it early, is there
a possibility that you can stimulate your
beta cells so that your
C-peptide will go back up?
Possibly, yeah.
For type two diabetes, the insulin
levels are typically very high, and then they
actually go back down a little bit.
And it was thought that that meant that it
was a chronic and progressive disease, that's
(08:29):
what they used to say about that.
So in type two diabetes, your insulin
levels are high, but not sky-high
as they are early on in the process.
And that's because the pancreas
starts to fill up with fat and then it clogs,
so you get fatty liver and you get fatty
pancreas as well.
As you get rid of the fatty pancreas, it
actually starts to release more insulin, so
(08:50):
you actually see that insulin level go back
up. That was demonstrated, probably
about seven or eight years ago now, in a
couple of studies which were very good.
The pancreas in type two diabetes gets
clogged up. You can actually see it.
My radiologist at our hospital also
notes fatty pancreas all the time as well,
so it's just less well known.
But yeah, in type two diabetes,
(09:11):
your pancreas is still producing a lot of
insulin, it's just not as high
as it used to be.
And what about stem cell?
What's the study with using stem cells
in the pancreatic area with the--
[unintelligible]
There's been a lot of studies, but nothing
definitive as far as I've seen.
I haven't seen anything that said, "Here's
(09:32):
a very successful treatment you know just
give stems cells." And stem cells have been
around for a long time actually.
People use them for joint pains and all this
sort of stuff, but they usually travel to
like Thailand or something to do it because
most places here don't do it, and it's
because most people here don't think it
actually really does much.
Like, it might make you feel better, but it's
like a placebo effect, right?
(09:53):
That's why most places here (like if you
go to any of the university hospitals),
they don't do stem cell treatments because
they're not convinced that it works.
So I'm not an expert on that.
I haven't seen anything convincing for type
one diabetes.
Certain autoimmune diseases, I've seen,
you know, and we've seen a lot of people
with, say, Hashimoto's thyroiditis, they
do the fasting and then the thyroid, they're
(10:15):
like, "Oh, my thyroid's all better now." It's
like it's possible that you reset the
immune system with the fasting.
Because again, remember autoimmune diseases
are your own body's immune system, which is
overactive and attacking itself.
When you fast, your body starts to
sense that, "Hey, I need to start conserving
my resources. I can't have all these
(10:35):
cells active all the time." So one
of the systems, including the immune system,
sort of gets ramped down just to take care of
any real problems.
But because it's sort of ramping itself
down, it may be that it reduces
that autoinflammation.
Well, that leads right into our next
question, which is, "Can you discuss
the potential fasting protocols and
(10:57):
diet for somebody who has autoimmune
condition?"
Yeah, that's a great question.
And I think you actually have to go into the
data. And the only data, and it's very
preliminary, is with the longer fasts.
We were talking about this earlier, in terms
of these five-day, modified fasts where,
if you go five to seven days,
then your body really starts to get that
(11:18):
message that, "Hey, we really need to
go into this sort of preservation mode.
Let's not have too many cells active."
So it looks like you have to go longer
rather than like a 16, 18,
20-hour fast because those may
not do much. So when you're go into a five or
seven-day fast, there's some interesting data
that suggests that you don't
(11:40):
have to do a zero calorie
diet, you can actually preserve a lot
of the benefits, even if you take
a few hundred calories at a time.
And we're putting together a protocol,
actually, here at The Fasting Method, where
we're gonna try and spell that out exactly
what you're going to eat, what you can do.
So hopefully-- I talked to Megan about this
and we're hopefully going to start that in
(12:00):
July or August, give a protocol.
And then we should be developing some
products - bone broth, some teas, and some
electrolytes - to take with it, and then
take a little bit of extra sort of probably
vegetables.
You know, it could be some olives, could be
some avocados. We're still developing it.
And then that way we can get that sort of
five to seven-day fast that we're going to
(12:20):
hopefully all do together in the Community
and reap the benefits.
That's the protocol that I've seen the most
data on, is this sort of
longer fasting period.
And it's possible that the immune system
doesn't ramp down as quickly as some
of the other system, you know, the metabolic
systems, the insulin, the fat burning,
all that. That we know how it works, right?
(12:42):
You can get into ketosis and fat burning
within 24 hours (or faster if you're
on a low-carb diet), but the inflammatory
ones, we don't know quite yet, but it
seems like we have to go longer.
Thank you, Dr. Fung.
This next question is, "Is it possible
to be successful if you eat mostly
vegan or vegetarian, as I
(13:03):
worry about the higher carbs with
this type of eating?"
Yeah, so the carbohydrates...
For sure, refined carbohydrates
are a real problem, but a lot of
people ate relatively high-carbohydrate
diets in the past without having
obesity. So if you think about Chinese people
and Japanese people, like they eat a lot of
(13:24):
carbohydrates. If you look at Japan now, they
have one of the lowest rates of obesity
in the world, and yet they're eating a lot of
rice, and Italians have relatively low
obesity. They're eating quite a bit of pasta.
So there's other factors other than the total
number of carbohydrates, and we've
discussed this a couple of times.
It's how quickly your body absorbs
(13:44):
and digests that carbohydrate that makes
a big difference. So if you're eating white
bread, which has got a whole number of
bad things happening, commercial white bread.
What they do is they take the wheat, they
take out all the protein, they take all the
fat, they grind it into a very fine dust,
and then you eat it with some jam, so
carbohydrate on carbohydrate.
(14:04):
When it goes into the stomach, the stomach
goes into the intestines, what you get is
this 100% carbohydrate, but it's finely
ground up, and, therefore, your glucose
spikes like this, your insulin spikes like
this, and then it crashes.
So you go low and you're hungry, so then you
go look for like a muffin or something.
That isn't just because of carbohydrate, it's
because of the way it's absorbed.
There's been studies where, if you take say
(14:26):
steel-cut oatmeal (which is also
carbohydrates)-- however, it's
absorb much slower because it's not ground as
fine. And if you eat it with
other things-- so there's a number of
factors. I've written a couple of articles
about it, I've done some YouTube videos about
it, and my next book (which is
gonna be sort of follow up to The Obesity
Code) talks about this speed of
(14:46):
absorption. But essentially, if you
take the wheat and you don't take out
all the fiber, that's gonna help slow down
the absorption. So whole wheat bread.
If you don't grind it so fine then,
again, that slows down the absorption.
And for all of these you can measure how
quickly this glucose rises and it makes a big
difference. So stone ground wheat instead.
You can use things like pumpernickel, you can
(15:08):
use acid (so vinegars).
And then sourdough, which has a bit of acid
in it, is going to also slow
down the absorption by inactivating salivary
amylases.
If you eat carbohydrates with other foods,
for example, like eating the
carbohydrates last.
So say you take some chicken breast and
then you take the bread.
What happens is that, in the stomach when it
(15:30):
all turns together, when the stomach releases
a bit of food to the intestines it's not like
100% carbohydrate, you've got like
you know 50%chicken and 50% carbohydrate.
Therefore, the glucose doesn't spike
up like that, it gets smoothed out,
and that makes a massive massive difference.
So the food order, and also things
like how quickly you eat-- If it's
(15:51):
easy to chew (like a lot of ultra-processed
food) and easy to swallow, then it
doesn't activate the satiety mechanisms.
There's also how late you
eat it. So if you eat a meal at 9
p.m. versus 6 p.m., there's a measurable
difference. You can take the same meal, but
there's a measurable difference, in terms of
how high your glucose and how high you're
(16:12):
insulin goes.
Same meal, same food, right?
So there's so many other factors that
come into play when you're talking about
carbohydrates, or trying to incorporate
those carbohydrates, and still have
a low-- like, the key is not to have a big
spike in glucose and insulin.
You can still do that by using some
of these other things.
(16:33):
Resistant starch is another factor, so fiber.
Cooking and then cooling rice increases
the resistant starch.
So there's a number of these factors.
If you are vegan, it's harder.
Eating beans, which have a much lower
glycemic index, for example, that can
make a big difference. So, yeah, there's
certainly a number of-- like, total number of
carbohydrates is one factor.
(16:53):
So cutting down all carbohydrates, of course,
is a good way to go.
If you can't cut down all carbohydrate, then
you can use these other things to still
eat the carbohydrates but have less, not
zero, but less of that effect, right?
If you eat zero carbohydrates, you'll have
sort of zero effect of that.
So that's great, but not everybody can do
that. So if you still eat carbohydrates,
(17:14):
there's still ways to bring it down.
And that's why people in the 70s and 60s,
they still ate carbohydrates, they were still
eating potatoes and stuff, but there wasn't
the same amount of obesity.
And one of the things you mentioned-- I'm
basically plant-based, I'm about 80%
plant-based. So I do eat what I call 'meat on
the side', and I don't usually go over
150. I find it hard to lose-- like
(17:35):
Mark Sisson says, it's hard to lose weight if
you're doing over 150, but I also
look at net carbs as opposed to
total carbs, so I'm including the
fiber with that.
And if you have a processed food, you gotta
go with total carbs, and if you having a
real food, whole food, you can go with net
carbs.
And what you said about late-night eating,
(17:55):
when I got my CGM, that's what I
noticed, Dr. Fung.
Man, I would eat the same thing in the
daytime and it would not spike me like it
would at night.
It was amazing.
Yeah, the effect is quite large.
I mean, if you simply think about the effect
of eating late and changing your food
order, for example (so instead of eating
the bread up front, you change it to the
(18:16):
back), you can reduce the effect of
that insulin spike by like 60,
70%.
And then if you add on, say, a
walk after the meal, which again, there's
good data on that as well.
If you compare the effect of
walking, and you compare the
effect of a meal (so walking before
a meal versus walking after a meal),
(18:38):
what you find is that if you walk before a
meal, there's no difference in terms of how
high your blood glucose goes up.
If you walk after the meal (like immediately,
within 30 minutes of the meal) then you
can reduce that by 20-ish%.
And then the further you go.
So if you walk like 60 minutes after a meals,
you get much less of an effect.
What's happening? Well, what's happening is
that, when you're walking, you've got all
(19:00):
this glucose, right, because your glucose is
shooting up, but because you're using
your muscles your body actually
helps disperse all that excess
glucose in the muscles by using it off right
away so you don't have to store it, and don't
have to spike the insulin, and all that.
So even if you don't change the actual meal
itself, you can still change
(19:20):
the-- you know, eat earlier, eat
slower (because that makes a difference)-- so
eating slower, eating earlier,
eating the carbs last, and then walking
after a meal.
You haven't changed the food at all, but yet
you can reduce your insulin effect by like
60, 70%.
If you actually change the food to use like
stone-ground instead of machine-ground,
(19:42):
and sourdough versus-- you know,
there's all these various things.
Pasta, for example, is much better than bread
just because of the way the proteins are
incorporated.
So you can actually do quite well still
eating carbohydrates.
This person asks, "Does each
hour you fast have added benefits?
Meaning, is 17 hours better
(20:03):
than 16?
Is 20 better than 19?
That kind of thing."
In general, yes.
The longer you go-- remember that body
fat or glucose is
really just a way of storing excess calories,
and fasting is the time you're going to
allow your body to use those stored
calories, whether it's sugar or fat.
(20:24):
So the longer you go, the better you are.
Where it starts to tip is the sort of
psychological side. So if you start to go
really long and then you start to get a lot
of cravings, and then when you eat, you wind
up binging, well, that's not good, right?
You're not supposed to do that.
In which case then you have to back it off.
Or if you started doing long fasts and
then you're always missing meals with your
(20:44):
friends and then you get depressed and then,
you know, you binge eat because you're
depressed, again, you screwed the whole thing
up. That's not what you're supposed to do.
We've seen so many mistakes with people doing
fasting. They're not incorporating it in
their life. I mean, that's why we have this
community, so people can share, right?
Or they wait.
And I've seen this so many times because this
was put out by not us, but by a lot of other
(21:06):
people who jumped on that sort of fasting
bandwagon.
They said, "Oh, well, I'll just fast for 16
hours and then I'll eat whatever I want."
It's like, no, I don't think I've ever said
that in my whole life.
We've never said that here.
Megan's never said because we've never
promoted that. But other people, when they
started saying, "Oh, OK--" I remember a
couple of studies where they had people fast
(21:27):
for 16 hours and then eat whatever they want.
And then it's like, "Oh, they found no
benefit." And I'm thinking, yeah, because you
did it all wrong because you didn't know what
you're doing.
And the point is that there are social
factors, there are psychological factors.
So if you wind up fasting too
long and your body really can't
handle it, you really get too hungry and then
(21:47):
you binge and you eat really bad stuff.
Well, then you're not doing yourself any
good. Then you might as well go shorter or do
something else, like what we talk about with
a lot of our fasting aids and stuff (you
know, fat fasting or doing this or doing
that), or finding a group to
create that social connection with.
So there's a lot of nuances.
In general, though, the longer you go, the
(22:08):
better. You do have to take into account
some of these other factors because they
do play an important role.
We saw so many mistakes, especially with
the binge eating afterwards, and then it gave
fasting (for everybody) a bad name.
And it was like, yeah, that's because you
listen to all these people online who jumped
on the bandwagon and said, "Oh, fasting's
great, fasting's great, fasting's great."
(22:29):
It's like, no, you've got to apply it
in the right direction while knowing what
you're doing. There's a couple of very vocal
proponents of fasting, and then they were
like, oh, well now they hate fasting.
It's like, yeah, because you did the whole
thing wrong, right?
You didn't do it the way you're supposed to
do it.
Yeah, there's a kind of a saying that goes
around in our community - the best fast is
the one you can do.
(22:49):
And I always add on to that the best
fast is the one you can do and not overeat
or binge when you break.
And I have heard you say many,
many times, "You fast, and
then, when you eat, you go back to eating
normal, your regular meal that you
would eat, not making up for it in any way."
Yeah, and I think a lot of that is
(23:11):
actually due to the
mindset. So if you
change your mindset, it's
so important because, once you change that
mindset, then you can actually do
that properly.
Again, I talk about it in the next book,
which is-- and again, keep an eye out.
A lot of this stuff is also going to be
released on medium.com, which all the TFM
(23:33):
members can get the friend link.
You know, I use it because it was very
convenient at the time, but then they
paywalled everything.
So TFM has all the stuff to get you behind
the paywall. So I'm releasing some of those
things about-- right now about
ultra-processed foods, but upcoming will be
stuff about mindset that will come up in the
upcoming book but in the sort of unfinished
version you'll be able to get it.
(23:53):
But the mindset plays a huge,
huge, huge role and that's why we've always
emphasized the coaching and the
working with somebody because, you know, if
we could just tell you, "Do this," it's like
that's fine but you may or may not do
it. Just because-- if I tell you, "Oh, you
should always change your fries for salad,"
that's good advice.
I won't always do it, right, because
there's all these other things.
(24:14):
But it's the mindset.
The mindset of people who do that
is that, "After I fast, I can now binge,"
right? And that's what's got to change.
Until you change your mindset, you'll never
change it. And we see it all the time.
They think that, oh, all I have to do is
fast. No, it only works
when you change your mindsets and your
behaviors, not just the
(24:34):
knowledge itself of, oh, I should eat this or
I should eat this. or I should fast this
long. That itself is not going to do anything
because if all you do is fast and
create this mindset of deprivation,
then you're going to binge afterwards and
you're not going be successful.
This person-- I love it when people send me
articles for you to read.
It's like, I'm going to give Dr. Fung
homework? I don't think so.
(24:56):
[laughs] But this person wanted to know if
you happen to know about that recent
study that was done in the University of
Boulder, Colorado, which confirms that
metabolically healthy women tend to
experience menopause later.
And I know you talked about how to
fast around your cycle.
And I'm going to put that hyperlink to
(25:17):
that YouTube video in the show notes.
But the study linked menopause
(age 55+) to better vascular
health, reduced heart disease risk,
and they were really talking about factors
like your mitochondrial function and
health, and insulin sensitivity.
Can you comment on that?
Yeah, I mean, I'd have to look at it.
(25:38):
I can't remember the specific article
or what they actually showed, but it makes
sense because there is a link there between
sex hormones (and that's what the YouTube
video is talking about).
There's actually a link between the sex
hormones and how you deposit
fat, for example.
So if you look at estrogen,
obviously, there's a difference between-- if
(25:58):
you look at puberty, estrogen goes up in
women and testosterone goes up in boys.
So at the end of whole process,
women have more fat distributed
in the hips and breasts and the
boys have more muscle.
That's not because of willpower or their
diet, their diets are like roughly the same
going through.
The boys wind up eating actually a hell of a
(26:20):
lot more, but it all goes into
developing muscle.
That's why, because the testosterone is
telling the body build muscle.
As they build muscle, they're like, "I need
to eat more." So if you've ever had a teenage
boy in your house, you know, all your food
just goes, right?
And they're not eating that healthy or
anything, but it's the hormones.
So as you go with estrogen it
(26:40):
reduces. So during perimenopause, estrogen
goes down, and estrogen acts as
an appetite suppressant.
So as you lose that estrogen, your
appetite tends to go up and that's when you
start to eat more.
And that's actually one of the highest
periods in a woman's life where you're at
highest risk of weight gain is actually
perimenopause.
So this whole idea that's all about
(27:02):
calories and willpower, it's so simplistic
as to be stupid, right?
I talked about that recently on some of the
medium.com articles, but it's just-- I can't
believe people don't even understand that.
It's just crazy that they accept
this sort of idea of 'calories in,
calories out' as if that's the only thing
that's happening. It's like, oh, it's
because-- anyway, I won't get
(27:23):
into that.
But the point is that there's a link there.
So if you fast, you may be able to influence
some of those sex hormones, and then pushing
out the menopause a bit longer may
actually be helpful because, you know, that
there's actually a number of things that
happen with estrogen, particularly with
estrogen.
The distribution of fat moves subcutaneous
into the breast and the hips, and less
(27:44):
into the visceral fat, which is the stuff
that we really, really worry about, right?
That's the actual dangerous fat.
So if you have a longer period
where you have higher estrogen, then more
of the fat is going to be subcutaneous as
opposed to visceral. And that's why women in
their premenopausal state have a much lower
risk of heart disease than men.
And this is well-known. This has been known
(28:05):
for decades.
After menopause-- so premenstrually, women
and men have a much different rate of heart
attacks and strokes.
Women have way less, and that's probably
because the estrogen shifts their metabolic
profile from visceral fat to subcutaneous
fat. After menopause,
that rate catches up.
So, in fact, women and men have heart attacks
(28:25):
and strokes at the same rate post-menopause
because women no longer have that protection
of the estrogen. So if you're fasting, it can
actually help you maintain that.
You're going to get less symptoms, right, all
the peri-menopausal symptoms, you're gonna
have less chance of weight gain, and you're
gonna have a lower risk of some of these
diseases. So it's interesting and it's
not well studied because for the last 50
years everybody's just been studying
(28:45):
calories.
This link between the sex hormones
(estrogen, progesterone) and appetite...
Because where do intersect?
Classically, they don't.
Insulin, glucagon - all those
don't actually intersect with the sex
hormones, barely at all.
They do, but very tangentially.
But there may be much more to it than that,
so that study would be very interesting
(29:06):
because it would confirm what we've been
saying all along, which is that, one, it's
all about the hormones, and, two, fasting may
be a very, very beneficial thing.
I'll put the link to the article too, also
in the show notes.
And the name of Dr. Fung's video is "How
to Eat and Fast Around the Menstrual Cycle
and Perimenopause." It's a good one.
I really liked it. You've got diagrams and
(29:26):
everything, showing all the things you just
talked about.
And somebody else also sent in a question
about CAT scores.
And you can find that on podcast
#202, where Dr. Fung addresses that,
along with triglycerides to HDL
ratio.
So thank you so much, Dr. Fung, and
I will see you next month.
Okay.
(29:47):
I'm looking forward to this fasting we're
going to be doing coming up here in a couple
of months.
Yeah, yeah, I think it'll be great, actually.
Alright. Bye.
Bye.
If you eat a meal at 9 p.m.
Versus 6 p.m., there's a measurable
difference. You can take the same meal, but
there's a measurable difference in terms of
how high your glucose and how high you're
insulin goes.
Same meal, same food.
[music]
Hello, my name is Lisa Chance,
(00:21):
and I'm a fasting coach here at TFM.
And we are here today with our very own Dr.
Jason Fung for our monthly Q&A.
In this monthly Q& A, Dr. Fung
answers questions submitted by our
TFM Community members.
And hello to our podcast listeners
who will be able to listen to this Q&
A with Dr. Fung in a few weeks after our
(00:43):
regular Community members.
So, Dr. Fung, I'm going to dive right
in here and I had somebody
send several questions in
about LADA, and the
difference between that and type one
diabetes, and the diagnostic
on that. And I realized that we really hadn't
looked at MODY either.
Is that how you pronounce it?
(01:04):
M-O-D-Y?
MODY, yeah.
And I thought it would be nice if you could
compare those three - type one,
LADA, and MODY - and tell us
how you differentiate insulin
level and fasting blood sugar levels.
Yeah, so there's really two types
of diabetes - type one and type two
- and they're basically-- when you say
(01:24):
diabetes, it basically means
that there's too much glucose
in the blood, right?
That's how it's diagnosed.
But the pathophysiology is different between
type one and type two.
Essentially, you have too much
insulin in type two diabetes and too little
insulin in type one diabetes.
And it seems strange, but they both actually
cause the same high blood glucose.
(01:46):
So diabetes itself just means high blood
glucose. You could have something completely
separate like steroid induced diabetes,
which is caused by a certain medication, and
that is separate, but, again, causes high
blood sugars and therefore it's called
diabetes. But the two main ones are type one
and type two, so too little insulin, too much
insulin.
The way you have to think of it is that
insulin is the hormone that tells
(02:08):
your body to take the sugar that's
in the blood and then take it into the cells,
and the cells are going to burn that for
energy. So if you have type one diabetes,
which is too little insulin, what you have is
that all you have all this sugar in the but
you don't have the insulin to open up the
cell so that it can take the sugar inside
the cell. So inside the cell there's too
little sugar, outside the cell there
(02:29):
is too much sugar, right?
So, if you think about a-- you know, a bar or
something like that. So imagine a bar and
it's Super Bowl Sunday and everybody wants to
go to the bar, but the bar has its doors
locked. So insulin, normally, would open
the door and allow all the people to go in.
But if you don't have that, the door is
locked and everybody's outside, right,
standing outside. So that's just like the
(02:49):
glucose. The glucose is sitting outside the
cell. Inside the cell, there's nobody there,
but outside the cell, there's too many people
there.
So that mismatch is because there's no
insulin. That is type one diabetes,
and that usually happens in kids,
classically.
Kids usually have this disease,
so 10, 11 years old, it develops very quickly
and it's not a dietary condition, it's
(03:10):
a autoimmune condition.
So for some reason, and we don't know exactly
why, their own body attacks the
insulin-producing cells in the pancreas.
So therefore, they don't produce insulin,
so therefore they can't move the sugar from
the outside to the inside.
LADA is the same type one
diabetes when it presents in adults,
and it presents quite differently.
(03:32):
So LADA is L-A-D-A,
which is latent autoimmune disease
in adults.
So, instead of a 10-year-old,
what you see is like a 50-year-old, and
the 50-year-old is relatively
skinny because you don't have any of the
sugar inside the cell.
so you don't have the overweight and all that
sort of thing. So these people are
(03:54):
not overweight, but because they're adults,
it looks like type two diabetes (which is
too much insulin), but they actually have two
little insulin. So the only way to really
tell is to measure the insulin levels.
And what you find when you measure insulin
levels is that-- what you do is you measure
C-peptide, which is-- C-peptide is a
different test, which indicates how much--
insulin goes up and down quite a bit, it
bounces up and like a yo-yo, whereas
(04:16):
C-peptide is more stable, so you measure the
C-peptide. And what you find is that
it's relatively lower than you expect.
So in type two diabetes, you expect very high
levels, so you expect a very high C-peptides.
And in this disease, LADA, you see
normal to low-normal C-peptide
levels. And what happens over time, because
I've actually followed these patients for
(04:37):
many, many years, you see this slow,
gradual drop.
And then everything makes sense.
It's like, well, so in type one, classic type
one, it's going to be like a 10-year-old and
it's going to develop over like a month,
right? It's going be like, oh, boom, it
happens all of a sudden.
In a 50-year old, which is LADA, it
tends to happen older, and it tends to
(04:57):
happen over decades - 5
years, 10 years, 15 years.
You'll see this slow fall.
For some reason we don't know of, it's
becoming more and more common, and it's still
felt to be autoimmune.
So classically, you needed to measure the
autoantibodies.
So you would send off an antibody test and
say, "Oh, we can detect these autoantibodies
(05:17):
and that's why I make the diagnosis." But it
turns out that that's a very, very
low-sensitivity test, so
you'll pick up maybe like 15-20%
of people like that.
In fact most people won't have the
autoantibodies that are testable because
there's actually lots that you can develop.
So that's LADA.
And the thing about that is that,
because it's not a dietary, it's caused by
(05:38):
a dietary problem, you can't cure it with a
dietary solution the same way you can with
type two diabetes.
With LADA, you can manage it because,
if your body doesn't produce as much insulin
as it should, if you eat less carbohydrates
and you do more fasting, well, you don't need
as much insulin. So you can still manage it,
but you're not going to cure that disease.
There is some thought that longer fasting
(06:00):
(five days, seven days) may be
helpful in terms of resetting the immune
system. So perhaps there may be some benefit
there, but that's questionable.
Type two diabetes is classically in adults
and somebody who's very overweight and
heavy. And the idea is that there's too
much insulin. And so how does that lead to
all this excess glucose outside the cell?
(06:21):
Again, if you think about that sports bar,
this time the doors are open, right?
So insulin is what opens the door.
And the problem is that there's just too many
people overall.
So all the people from outside who wanna get
into the bar, they go in for the Super Bowl
Sunday, but now the bar is completely full,
so the people outside can't get in.
So there's still a lot of people outside, but
the reason they can't get in is not because
(06:42):
the doors won't open (the doors will open)
but the bar is full.
Here, the cell is full of glucose,
and even though insulin says, "Well, we
have a lot of glucose in the blood, we want
to push it into the cell," they can't push it
into the cell because the cell is already
full. So you have too much insulin.
And in that case, which is classically 95%
of adults who have type two diabetes, then
fasting and low-carbohydrate diets are going
(07:04):
to help, because, if you fast, your body
is going to burn off some of the sugar, so
therefore the cell gets rid of some of the
sugar. The sugar from the blood can now get
into the cell and that's going to help.
MODY stands for maturity onset
diabetes of the young.
So essentially, what you have
is a type two diabetes that's
(07:25):
presenting much younger.
So it's maturity onset diabetes,
because, again, this used to be called-- type
one and type two sort of tells you about the
pathophysiology. So it's sort of like a type
two, but instead of in a 50-year-old,
it presents in like a 12-year-old, and
they usually have all the classic features.
There's still type one and type two, but
(07:46):
there's this confusion between how it used to
be-- you know, they used to call it 'juvenile
diabetes' and they used to call it 'maturity
onset diabetes', so young people, old people,
it wasn't differentiating.
But you can have type one, either in young or
old, and you can have type two in either
young or old.
So it's still two types of diabetes, but how
it presents is a little different.
You mentioned doing like a five-day fast.
(08:09):
If you catch it early, is there
a possibility that you can stimulate your
beta cells so that your
C-peptide will go back up?
Possibly, yeah.
For type two diabetes, the insulin
levels are typically very high, and then they
actually go back down a little bit.
And it was thought that that meant that it
was a chronic and progressive disease, that's
(08:29):
what they used to say about that.
So in type two diabetes, your insulin
levels are high, but not sky-high
as they are early on in the process.
And that's because the pancreas
starts to fill up with fat and then it clogs,
so you get fatty liver and you get fatty
pancreas as well.
As you get rid of the fatty pancreas, it
actually starts to release more insulin, so
(08:50):
you actually see that insulin level go back
up. That was demonstrated, probably
about seven or eight years ago now, in a
couple of studies which were very good.
The pancreas in type two diabetes gets
clogged up. You can actually see it.
My radiologist at our hospital also
notes fatty pancreas all the time as well,
so it's just less well known.
But yeah, in type two diabetes,
(09:11):
your pancreas is still producing a lot of
insulin, it's just not as high
as it used to be.
And what about stem cell?
What's the study with using stem cells
in the pancreatic area with the--
[unintelligible]
There's been a lot of studies, but nothing
definitive as far as I've seen.
I haven't seen anything that said, "Here's
(09:32):
a very successful treatment you know just
give stems cells." And stem cells have been
around for a long time actually.
People use them for joint pains and all this
sort of stuff, but they usually travel to
like Thailand or something to do it because
most places here don't do it, and it's
because most people here don't think it
actually really does much.
Like, it might make you feel better, but it's
like a placebo effect, right?
(09:53):
That's why most places here (like if you
go to any of the university hospitals),
they don't do stem cell treatments because
they're not convinced that it works.
So I'm not an expert on that.
I haven't seen anything convincing for type
one diabetes.
Certain autoimmune diseases, I've seen,
you know, and we've seen a lot of people
with, say, Hashimoto's thyroiditis, they
do the fasting and then the thyroid, they're
(10:15):
like, "Oh, my thyroid's all better now." It's
like it's possible that you reset the
immune system with the fasting.
Because again, remember autoimmune diseases
are your own body's immune system, which is
overactive and attacking itself.
When you fast, your body starts to
sense that, "Hey, I need to start conserving
my resources. I can't have all these
(10:35):
cells active all the time." So one
of the systems, including the immune system,
sort of gets ramped down just to take care of
any real problems.
But because it's sort of ramping itself
down, it may be that it reduces
that autoinflammation.
Well, that leads right into our next
question, which is, "Can you discuss
the potential fasting protocols and
(10:57):
diet for somebody who has autoimmune
condition?"
Yeah, that's a great question.
And I think you actually have to go into the
data. And the only data, and it's very
preliminary, is with the longer fasts.
We were talking about this earlier, in terms
of these five-day, modified fasts where,
if you go five to seven days,
then your body really starts to get that
(11:18):
message that, "Hey, we really need to
go into this sort of preservation mode.
Let's not have too many cells active."
So it looks like you have to go longer
rather than like a 16, 18,
20-hour fast because those may
not do much. So when you're go into a five or
seven-day fast, there's some interesting data
that suggests that you don't
(11:40):
have to do a zero calorie
diet, you can actually preserve a lot
of the benefits, even if you take
a few hundred calories at a time.
And we're putting together a protocol,
actually, here at The Fasting Method, where
we're gonna try and spell that out exactly
what you're going to eat, what you can do.
So hopefully-- I talked to Megan about this
and we're hopefully going to start that in
(12:00):
July or August, give a protocol.
And then we should be developing some
products - bone broth, some teas, and some
electrolytes - to take with it, and then
take a little bit of extra sort of probably
vegetables.
You know, it could be some olives, could be
some avocados. We're still developing it.
And then that way we can get that sort of
five to seven-day fast that we're going to
(12:20):
hopefully all do together in the Community
and reap the benefits.
That's the protocol that I've seen the most
data on, is this sort of
longer fasting period.
And it's possible that the immune system
doesn't ramp down as quickly as some
of the other system, you know, the metabolic
systems, the insulin, the fat burning,
all that. That we know how it works, right?
(12:42):
You can get into ketosis and fat burning
within 24 hours (or faster if you're
on a low-carb diet), but the inflammatory
ones, we don't know quite yet, but it
seems like we have to go longer.
Thank you, Dr. Fung.
This next question is, "Is it possible
to be successful if you eat mostly
vegan or vegetarian, as I
(13:03):
worry about the higher carbs with
this type of eating?"
Yeah, so the carbohydrates...
For sure, refined carbohydrates
are a real problem, but a lot of
people ate relatively high-carbohydrate
diets in the past without having
obesity. So if you think about Chinese people
and Japanese people, like they eat a lot of
(13:24):
carbohydrates. If you look at Japan now, they
have one of the lowest rates of obesity
in the world, and yet they're eating a lot of
rice, and Italians have relatively low
obesity. They're eating quite a bit of pasta.
So there's other factors other than the total
number of carbohydrates, and we've
discussed this a couple of times.
It's how quickly your body absorbs
(13:44):
and digests that carbohydrate that makes
a big difference. So if you're eating white
bread, which has got a whole number of
bad things happening, commercial white bread.
What they do is they take the wheat, they
take out all the protein, they take all the
fat, they grind it into a very fine dust,
and then you eat it with some jam, so
carbohydrate on carbohydrate.
(14:04):
When it goes into the stomach, the stomach
goes into the intestines, what you get is
this 100% carbohydrate, but it's finely
ground up, and, therefore, your glucose
spikes like this, your insulin spikes like
this, and then it crashes.
So you go low and you're hungry, so then you
go look for like a muffin or something.
That isn't just because of carbohydrate, it's
because of the way it's absorbed.
There's been studies where, if you take say
(14:26):
steel-cut oatmeal (which is also
carbohydrates)-- however, it's
absorb much slower because it's not ground as
fine. And if you eat it with
other things-- so there's a number of
factors. I've written a couple of articles
about it, I've done some YouTube videos about
it, and my next book (which is
gonna be sort of follow up to The Obesity
Code) talks about this speed of
(14:46):
absorption. But essentially, if you
take the wheat and you don't take out
all the fiber, that's gonna help slow down
the absorption. So whole wheat bread.
If you don't grind it so fine then,
again, that slows down the absorption.
And for all of these you can measure how
quickly this glucose rises and it makes a big
difference. So stone ground wheat instead.
You can use things like pumpernickel, you can
(15:08):
use acid (so vinegars).
And then sourdough, which has a bit of acid
in it, is going to also slow
down the absorption by inactivating salivary
amylases.
If you eat carbohydrates with other foods,
for example, like eating the
carbohydrates last.
So say you take some chicken breast and
then you take the bread.
What happens is that, in the stomach when it
(15:30):
all turns together, when the stomach releases
a bit of food to the intestines it's not like
100% carbohydrate, you've got like
you know 50%chicken and 50% carbohydrate.
Therefore, the glucose doesn't spike
up like that, it gets smoothed out,
and that makes a massive massive difference.
So the food order, and also things
like how quickly you eat-- If it's
(15:51):
easy to chew (like a lot of ultra-processed
food) and easy to swallow, then it
doesn't activate the satiety mechanisms.
There's also how late you
eat it. So if you eat a meal at 9
p.m. versus 6 p.m., there's a measurable
difference. You can take the same meal, but
there's a measurable difference, in terms of
how high your glucose and how high you're
(16:12):
insulin goes.
Same meal, same food, right?
So there's so many other factors that
come into play when you're talking about
carbohydrates, or trying to incorporate
those carbohydrates, and still have
a low-- like, the key is not to have a big
spike in glucose and insulin.
You can still do that by using some
of these other things.
(16:33):
Resistant starch is another factor, so fiber.
Cooking and then cooling rice increases
the resistant starch.
So there's a number of these factors.
If you are vegan, it's harder.
Eating beans, which have a much lower
glycemic index, for example, that can
make a big difference. So, yeah, there's
certainly a number of-- like, total number of
carbohydrates is one factor.
(16:53):
So cutting down all carbohydrates, of course,
is a good way to go.
If you can't cut down all carbohydrate, then
you can use these other things to still
eat the carbohydrates but have less, not
zero, but less of that effect, right?
If you eat zero carbohydrates, you'll have
sort of zero effect of that.
So that's great, but not everybody can do
that. So if you still eat carbohydrates,
(17:14):
there's still ways to bring it down.
And that's why people in the 70s and 60s,
they still ate carbohydrates, they were still
eating potatoes and stuff, but there wasn't
the same amount of obesity.
And one of the things you mentioned-- I'm
basically plant-based, I'm about 80%
plant-based. So I do eat what I call 'meat on
the side', and I don't usually go over
150. I find it hard to lose-- like
(17:35):
Mark Sisson says, it's hard to lose weight if
you're doing over 150, but I also
look at net carbs as opposed to
total carbs, so I'm including the
fiber with that.
And if you have a processed food, you gotta
go with total carbs, and if you having a
real food, whole food, you can go with net
carbs.
And what you said about late-night eating,
(17:55):
when I got my CGM, that's what I
noticed, Dr. Fung.
Man, I would eat the same thing in the
daytime and it would not spike me like it
would at night.
It was amazing.
Yeah, the effect is quite large.
I mean, if you simply think about the effect
of eating late and changing your food
order, for example (so instead of eating
the bread up front, you change it to the
(18:16):
back), you can reduce the effect of
that insulin spike by like 60,
70%.
And then if you add on, say, a
walk after the meal, which again, there's
good data on that as well.
If you compare the effect of
walking, and you compare the
effect of a meal (so walking before
a meal versus walking after a meal),
(18:38):
what you find is that if you walk before a
meal, there's no difference in terms of how
high your blood glucose goes up.
If you walk after the meal (like immediately,
within 30 minutes of the meal) then you
can reduce that by 20-ish%.
And then the further you go.
So if you walk like 60 minutes after a meals,
you get much less of an effect.
What's happening? Well, what's happening is
that, when you're walking, you've got all
(19:00):
this glucose, right, because your glucose is
shooting up, but because you're using
your muscles your body actually
helps disperse all that excess
glucose in the muscles by using it off right
away so you don't have to store it, and don't
have to spike the insulin, and all that.
So even if you don't change the actual meal
itself, you can still change
(19:20):
the-- you know, eat earlier, eat
slower (because that makes a difference)-- so
eating slower, eating earlier,
eating the carbs last, and then walking
after a meal.
You haven't changed the food at all, but yet
you can reduce your insulin effect by like
60, 70%.
If you actually change the food to use like
stone-ground instead of machine-ground,
(19:42):
and sourdough versus-- you know,
there's all these various things.
Pasta, for example, is much better than bread
just because of the way the proteins are
incorporated.
So you can actually do quite well still
eating carbohydrates.
This person asks, "Does each
hour you fast have added benefits?
Meaning, is 17 hours better
(20:03):
than 16?
Is 20 better than 19?
That kind of thing."
In general, yes.
The longer you go-- remember that body
fat or glucose is
really just a way of storing excess calories,
and fasting is the time you're going to
allow your body to use those stored
calories, whether it's sugar or fat.
(20:24):
So the longer you go, the better you are.
Where it starts to tip is the sort of
psychological side. So if you start to go
really long and then you start to get a lot
of cravings, and then when you eat, you wind
up binging, well, that's not good, right?
You're not supposed to do that.
In which case then you have to back it off.
Or if you started doing long fasts and
then you're always missing meals with your
(20:44):
friends and then you get depressed and then,
you know, you binge eat because you're
depressed, again, you screwed the whole thing
up. That's not what you're supposed to do.
We've seen so many mistakes with people doing
fasting. They're not incorporating it in
their life. I mean, that's why we have this
community, so people can share, right?
Or they wait.
And I've seen this so many times because this
was put out by not us, but by a lot of other
(21:06):
people who jumped on that sort of fasting
bandwagon.
They said, "Oh, well, I'll just fast for 16
hours and then I'll eat whatever I want."
It's like, no, I don't think I've ever said
that in my whole life.
We've never said that here.
Megan's never said because we've never
promoted that. But other people, when they
started saying, "Oh, OK--" I remember a
couple of studies where they had people fast
(21:27):
for 16 hours and then eat whatever they want.
And then it's like, "Oh, they found no
benefit." And I'm thinking, yeah, because you
did it all wrong because you didn't know what
you're doing.
And the point is that there are social
factors, there are psychological factors.
So if you wind up fasting too
long and your body really can't
handle it, you really get too hungry and then
(21:47):
you binge and you eat really bad stuff.
Well, then you're not doing yourself any
good. Then you might as well go shorter or do
something else, like what we talk about with
a lot of our fasting aids and stuff (you
know, fat fasting or doing this or doing
that), or finding a group to
create that social connection with.
So there's a lot of nuances.
In general, though, the longer you go, the
(22:08):
better. You do have to take into account
some of these other factors because they
do play an important role.
We saw so many mistakes, especially with
the binge eating afterwards, and then it gave
fasting (for everybody) a bad name.
And it was like, yeah, that's because you
listen to all these people online who jumped
on the bandwagon and said, "Oh, fasting's
great, fasting's great, fasting's great."
(22:29):
It's like, no, you've got to apply it
in the right direction while knowing what
you're doing. There's a couple of very vocal
proponents of fasting, and then they were
like, oh, well now they hate fasting.
It's like, yeah, because you did the whole
thing wrong, right?
You didn't do it the way you're supposed to
do it.
Yeah, there's a kind of a saying that goes
around in our community - the best fast is
the one you can do.
(22:49):
And I always add on to that the best
fast is the one you can do and not overeat
or binge when you break.
And I have heard you say many,
many times, "You fast, and
then, when you eat, you go back to eating
normal, your regular meal that you
would eat, not making up for it in any way."
Yeah, and I think a lot of that is
(23:11):
actually due to the
mindset. So if you
change your mindset, it's
so important because, once you change that
mindset, then you can actually do
that properly.
Again, I talk about it in the next book,
which is-- and again, keep an eye out.
A lot of this stuff is also going to be
released on medium.com, which all the TFM
(23:33):
members can get the friend link.
You know, I use it because it was very
convenient at the time, but then they
paywalled everything.
So TFM has all the stuff to get you behind
the paywall. So I'm releasing some of those
things about-- right now about
ultra-processed foods, but upcoming will be
stuff about mindset that will come up in the
upcoming book but in the sort of unfinished
version you'll be able to get it.
(23:53):
But the mindset plays a huge,
huge, huge role and that's why we've always
emphasized the coaching and the
working with somebody because, you know, if
we could just tell you, "Do this," it's like
that's fine but you may or may not do
it. Just because-- if I tell you, "Oh, you
should always change your fries for salad,"
that's good advice.
I won't always do it, right, because
there's all these other things.
(24:14):
But it's the mindset.
The mindset of people who do that
is that, "After I fast, I can now binge,"
right? And that's what's got to change.
Until you change your mindset, you'll never
change it. And we see it all the time.
They think that, oh, all I have to do is
fast. No, it only works
when you change your mindsets and your
behaviors, not just the
(24:34):
knowledge itself of, oh, I should eat this or
I should eat this. or I should fast this
long. That itself is not going to do anything
because if all you do is fast and
create this mindset of deprivation,
then you're going to binge afterwards and
you're not going be successful.
This person-- I love it when people send me
articles for you to read.
It's like, I'm going to give Dr. Fung
homework? I don't think so.
(24:56):
[laughs] But this person wanted to know if
you happen to know about that recent
study that was done in the University of
Boulder, Colorado, which confirms that
metabolically healthy women tend to
experience menopause later.
And I know you talked about how to
fast around your cycle.
And I'm going to put that hyperlink to
(25:17):
that YouTube video in the show notes.
But the study linked menopause
(age 55+) to better vascular
health, reduced heart disease risk,
and they were really talking about factors
like your mitochondrial function and
health, and insulin sensitivity.
Can you comment on that?
Yeah, I mean, I'd have to look at it.
(25:38):
I can't remember the specific article
or what they actually showed, but it makes
sense because there is a link there between
sex hormones (and that's what the YouTube
video is talking about).
There's actually a link between the sex
hormones and how you deposit
fat, for example.
So if you look at estrogen,
obviously, there's a difference between-- if
(25:58):
you look at puberty, estrogen goes up in
women and testosterone goes up in boys.
So at the end of whole process,
women have more fat distributed
in the hips and breasts and the
boys have more muscle.
That's not because of willpower or their
diet, their diets are like roughly the same
going through.
The boys wind up eating actually a hell of a
(26:20):
lot more, but it all goes into
developing muscle.
That's why, because the testosterone is
telling the body build muscle.
As they build muscle, they're like, "I need
to eat more." So if you've ever had a teenage
boy in your house, you know, all your food
just goes, right?
And they're not eating that healthy or
anything, but it's the hormones.
So as you go with estrogen it
(26:40):
reduces. So during perimenopause, estrogen
goes down, and estrogen acts as
an appetite suppressant.
So as you lose that estrogen, your
appetite tends to go up and that's when you
start to eat more.
And that's actually one of the highest
periods in a woman's life where you're at
highest risk of weight gain is actually
perimenopause.
So this whole idea that's all about
(27:02):
calories and willpower, it's so simplistic
as to be stupid, right?
I talked about that recently on some of the
medium.com articles, but it's just-- I can't
believe people don't even understand that.
It's just crazy that they accept
this sort of idea of 'calories in,
calories out' as if that's the only thing
that's happening. It's like, oh, it's
because-- anyway, I won't get
(27:23):
into that.
But the point is that there's a link there.
So if you fast, you may be able to influence
some of those sex hormones, and then pushing
out the menopause a bit longer may
actually be helpful because, you know, that
there's actually a number of things that
happen with estrogen, particularly with
estrogen.
The distribution of fat moves subcutaneous
into the breast and the hips, and less
(27:44):
into the visceral fat, which is the stuff
that we really, really worry about, right?
That's the actual dangerous fat.
So if you have a longer period
where you have higher estrogen, then more
of the fat is going to be subcutaneous as
opposed to visceral. And that's why women in
their premenopausal state have a much lower
risk of heart disease than men.
And this is well-known. This has been known
(28:05):
for decades.
After menopause-- so premenstrually, women
and men have a much different rate of heart
attacks and strokes.
Women have way less, and that's probably
because the estrogen shifts their metabolic
profile from visceral fat to subcutaneous
fat. After menopause,
that rate catches up.
So, in fact, women and men have heart attacks
(28:25):
and strokes at the same rate post-menopause
because women no longer have that protection
of the estrogen. So if you're fasting, it can
actually help you maintain that.
You're going to get less symptoms, right, all
the peri-menopausal symptoms, you're gonna
have less chance of weight gain, and you're
gonna have a lower risk of some of these
diseases. So it's interesting and it's
not well studied because for the last 50
years everybody's just been studying
(28:45):
calories.
This link between the sex hormones
(estrogen, progesterone) and appetite...
Because where do intersect?
Classically, they don't.
Insulin, glucagon - all those
don't actually intersect with the sex
hormones, barely at all.
They do, but very tangentially.
But there may be much more to it than that,
so that study would be very interesting
(29:06):
because it would confirm what we've been
saying all along, which is that, one, it's
all about the hormones, and, two, fasting may
be a very, very beneficial thing.
I'll put the link to the article too, also
in the show notes.
And the name of Dr. Fung's video is "How
to Eat and Fast Around the Menstrual Cycle
and Perimenopause." It's a good one.
I really liked it. You've got diagrams and
(29:26):
everything, showing all the things you just
talked about.
And somebody else also sent in a question
about CAT scores.
And you can find that on podcast
#202, where Dr. Fung addresses that,
along with triglycerides to HDL
ratio.
So thank you so much, Dr. Fung, and
I will see you next month.
Okay.
(29:47):
I'm looking forward to this fasting we're
going to be doing coming up here in a couple
of months.
Yeah, yeah, I think it'll be great, actually.
Alright. Bye.
Bye.
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