Episode #219
In this Fasting Q&A episode, hosted by Coach Lisa Chance, Dr. Jason Fung answers questions from the TFM Community:
- I realize the relationship between bitters, incretins, and autophagy is more complex than a direct cause-and-effect relationship. The incretin response doesn’t directly “promote” autophagy - it primarily regulates blood sugar and satiety. Autophagy is mainly triggered by nutrient scarcity and low insulin levels, not by bitter compounds themselves. Can you weigh-in on using bitter greens during this reset? [16:07]
- I have had some success lowering weight a couple times using fasting and time restricted eating but the weight creeps back up after a while even with doing TRE. What's nice is that I can get it to go back down again with discipline. I'm wondering what scientific evidence exists that your body set weight can successfully be reset for the long term as mine holds for a while but then wants to creep up and if there's a foolproof method to resetting your body set weight? [19:26]
- Your kidney patients who are T2D and close to needing dialysis, but are skinny, I’m assuming they need to fast for about a year to reverse the kidney damage, but how do they do it with so little fat mass? [26:56]
- I know that vitamin D is fat soluble and best taken with a meal. I’ve also heard that all supplements are better absorbed when taken with a meal. Is this true? What timeframe is considered “with a meal”? Is it before, during or after the meal? Is vitamin D a stimulant and can disrupt sleep so best taken in the morning? [30:32]
- How do you rate the risk of new gallstones formation if a patient already has one or more when it comes to fasting protocols? [33:46]
Links:
Dr. Fung’s YouTube video, 5 Ways to Naturally Boost the Ozempic Effect
https://www.youtube.com/watch?v=le3Ifc7D5Vk&t=2s
Gallstones discussed on TFM Podcast #171
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
01:49 Introducing TFM’s new 5-Day Fasting Reset
16:07 Bitter greens
19:26 Body set weight
26:56 Reversing kidney disease possible?
30:32 Timing of taking fat-soluble vitamins
30:32 Gallstones
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 adjusting any medication or supplements, or adopting any treatment for a health problem. The use of any other products or services purchased by you as a result of this podcast does not create a healthcare provider-patient relationship between you and any of the experts affiliated with this podcast. 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 prevent any disease.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
About a year and a bit ago I had a lot of
Achilles tendonitis and I did all
the usual stuff, right?
So I looked in the books and it said, okay,
yeah, you do physiotherapy, you do
ultrasound, you do stretching.
So I did all that and it was just terrible.
So I couldn't really run.
And it was like a year I did it.
Now I normally do sort of shorter fasts -
(00:20):
16, 24 - I did some
two-day fasts and so on.
But a friend of mine, he had tennis elbow,
and he did a longer fast and it really
helped him a lot. So I thought, okay, well,
maybe I should try it too.
So I did a five-day fast
and really the tendonitis
was like 70% better.
It was just stunning to me what
(00:41):
a difference it made
made. [music]
Hello everyone.
Welcome to our monthly Q&A with
our very own Dr. Fung where he's going
to tackle questions submitted
by our TFM Community members.
And hello to our podcast listeners who will
(01:03):
be able to listen to this Q&A with
Dr. Fung a few weeks after our
Community members. So hi, Dr. Fung.
How are you doing today?
I'm good. How are you?
I'm so excited.
We're doing this five-day reset, which
is a new reset protocol in
our TFM Community this week, and so many
people are jumping in and enjoying
(01:26):
it, learning about ourselves, about
it. But can you expand a little bit on
it and tell us a little bit more about it?
Yeah, absolutely.
So this is one of the things that we've done
a lot, not in the Community, but in
coaching and private conversations,
which is doing a longer fast, which
is this five-day fast.
And it's not necessarily a full
(01:47):
fast. And the reason we're
doing it is we're trying to create a bit more
structure to the Community and
try and get people on the same sort
of timelines, because
it's important to have a supportive
community. Doing things all together is
generally easier, whether it's running
or whether it's, you know, knitting or
(02:08):
whether it's-- anything really is better.
So fasting is really no different.
So we're doing this five-day reset challenge.
I'm doing it too. The idea is to
do things together so that we can
support each other, learn from each other,
share tips, and all that sort of thing.
The reason we're doing it is because,
recently, there's been more and more evidence
that these sort of longer fasts
(02:30):
have a lot of benefits.
And I'll say that, from a personal
standpoint, I actually noted
some difference with it.
So about a year and a bit ago I had
some-- not some, I had a lot of Achilles
tendonitis.
And I did all the usual stuff, right?
So I looked in the books and it said, okay,
well, you do physiotherapy, you do
ultrasound, you do stretching.
(02:51):
So I did all that and it was just terrible.
Like, it was just really difficult.
So I couldn't really run and it was like a
year I did it.
Now, I normally do sort of shorter fasts
- a lot of 24s, 16, 24 -
I did some two-day fasts and so on, but
a friend of mine said, well-- he had tennis
elbow and he did a longer fast and
it really helped him a lot.
(03:12):
So I thought, okay, well, maybe I should try
it too, right? So I did a five-day fast
and really the
tendonitis was like 70%
better. It was just stunning to me
what a difference it made, because there's
not actually a lot of literature on that
and tendonitis. But clearly the
five-day fast was very anti-inflammatory,
(03:35):
in that it was really settling down
the inflammation that was at the cause of
this Achilles tendonitis.
So it was very striking.
But I thought, meh, maybe it's just a
coincidence.
So then, you know, about a month later, I did
it again. And again, it was like 70,
80% better after that.
And then I did the third time and then it was
(03:56):
completely gone. I'm like, this is crazy
because I can't find-- there's no literature
on it. You know, there's anecdotal reports,
but that's not really evidence, but there's
nothing in there. But I'm like, it doesn't
really matter, right?
It doesn't matter what the studies say.
If it helps me, it helps me, and that's all
it is.
But the data has actually
been increasing.
So these modified five-day
(04:18):
fasts, there's a lot of data now to suggest
that there's a lot of benefits to them, not
simply the weight loss and all that sort
of stuff, but also decreased
inflammation, perhaps a bit of anti-cancer
effects. And what happens is
that, when you do the longer fasts, you
really pump up that growth hormone.
(04:38):
If you remember, during fasting, your insulin
drops, but these other hormones go up,
and that's the counterregulatory hormones.
So that's things like cortisol (which does go
up, yes), but also growth hormone and
sympathetic tone.
But growth hormone skyrockets as
you go. So they've done these studies for up
to five days.
And what you see is a bit of increase in the
first day. So if you're doing 24, 36,
(05:00):
you're getting a little bit of increase, but
by the time you're getting to 4 or 5 days,
you're just getting a lot of growth hormone.
I suspect that that may have helped with
a lot of what I felt.
The other thing is that sympathetic tone
goes up, so appetite decreases.
So as you increase sympathetic tone,
hunger decreases and ghrelin decreases with
the longer fast. So again we see this when
(05:21):
you're doing multiple-day fasts - the ghrelin
sort of steadily goes down - which means
hunger tends to go down and sympathetic
tone goes up. So again hunger tends to go
down. So both very, very good effects, but
only when you push out to the longer effects.
Some of the studies show the
anti-inflammatory effects take sort of
5 to 7 days.
So therefore, rather than simply saying let's
just do a lot of the 24s, let's
(05:43):
do once in a while the longer ones, because,
hey, some people might find that they really
do well with that.
And like anything else, the more you do it,
the easier it gets.
And the more support you have, and the more
groups you have to do it, it's better.
So I've really found-- so today is day three
because it's Wednesday. So we started-- my
last real meal was on Sunday.
A lot of the data shows that, even if you
(06:05):
take a little bit of food during that
fasting day, you still retain a lot
of the benefits.
So really, it makes it easier.
So then, you know, if you retain 80%
of the benefits, but it's like 50%
is hard or 40% is hard, hey, that's a-- the
net benefit is there, right?
So, you know, if you're nervous about
(06:25):
it, you can take a little bit more calories.
If you're less nervous about it, you can take
less. So you know, we have a whole schedule
set out for you in terms of that.
We have the teas, which are
coming. So I know we've talked about
this. The Fasting Method is working with
my son actually to bring these teas
and bone broths so that we'll actually
(06:45):
have more recipes. That's probably coming in
a couple of months. There's certain things we
recommend, such as the bone broth,
which will have-- not only do you get the
hydration, but then you can add salt in it.
This is going to be a powdered bone broth to
make it easy. Because I make bone broth, but
honestly it's like a whole-day process.
It's sort of a pain in the butt.
So this is just going to be a powdered one.
(07:07):
It'll be a chicken broth to start, but you
just stir it up in water and you might boil
it for a minute or two.
But the great thing about this one that we're
working on is that there's really only
one ingredient, which is chicken bones.
There's nothing else. And then you get all
the nutrients from the chicken, right?
You get the collagen, you get the proteins,
and that really supports the fast.
And what I do is I stir in
(07:29):
a little bit of miso, which gives me the salt
and actually a bit of taste to it.
So it really tastes really good.
I put a little bit of green onion to make it
really tasty. So I had that yesterday and
it really just makes it like a meal,
but you're getting really very little
calories, but you're getting the nutrients,
the salt, and the electrolytes.
The electrolytes we're working on too, but
that may take a bit longer.
So the potassium, the sodium, and so on.
(07:52):
We're getting it all together to support
everybody with this.
You know, I encourage people to go on the
daily supports because that's what
everybody's for - to talk about how they're
feeling, you know, how to deal with the
hunger. Because the hunger, it does come, so
you have to be ready for it.
You have to know what you're doing, you know,
and how you're feeling, right?
Because we're on day three now.
So this is sort of my favorite time
(08:13):
of the fast - day three, day four,
day five - because this
is where I really start to notice,
you know, my pants just fit a little bit
different. You know, I notice a little
less of the bloating because, again, when you
do the fasting, it's antidiuretic, meaning
you're going to pee out some of the fluid.
You're not holding on to so much water.
(08:34):
You know, as you get older, you start to
notice things like the sock line and stuff,
right? So, you know, [laughs] when take off
your sock, there's a little bit of line
there, right, because the circulation is not
as good as 25 years ago, but I get
it less. So I notice a lot less bloating.
I notice my pants are fitting a bit better,
probably because of the bloating, but also,
you know, I know that I've gotten through
(08:56):
that sort of the burning of the sugar, the
glycogenolysis part.
I've gotten through the gluconeogenesis, and
now I'm in fat burning.
And I know that, hey, for the next two days,
I'm just going to be burning fat, which is
great. Then it's only a few more days and
then I'll eat again. So, you know, it's
really-- this is where I really like it.
I remeber a couple months ago, it was strange
(09:17):
because I was going to do a five-day fast and
we wound up having dinner with family
on like the day three.
And I remember thinking, damn right?
It's like, you know, of all the days,
like, why did you have to do it?
And like, didn't we doing next week?
Right? But of course it was, you know,
family. So of course I cut it short.
And then I just did it again because there's
always time to do it again.
(09:37):
But again, this is the-- you know, what we're
trying to do is really follow the science but
really provide the support and
the structure.
So every month we're actually going to change
it up. I think Megan's going to work on it, I
think-- I'm not sure if you're working on it,
Lisa, but we're going to change it up a
little bit in terms of what you're doing,
what you're taking, and then really focus in
on those daily sessions, on the mindset,
(09:58):
on the habits, and so on.
Because once it gets into a habit, it's
actually not bad at all.
And I know actually two other, three other
people personally, like family members,
who have been doing it for a while.
Like, they do these five-day fasts, and, you
know, they've kept the weight off, they're
feeling really good.
And that's where we're going with this.
And I think it's been helpful for me
(10:19):
personally, even though I'd done the fasting
before, I usually had stuck to the shorter
ones. But really pushing that envelope has
really helped me.
I mean, yes, it took the Achilles tendonitis
to really push me, but the science is moving
in that direction too, and that's where
I think that we can really help people.
And we can really help each other, right?
I know I talked to Megan about maybe
(10:40):
doing some in-person meetups for people
during this. You know, that's often very
useful to talk about things, maybe
going for a walk in the park, that kind of
thing, and, you know, if the locations are
nice. Or arranging meet-ups so that people
can do this where you can really support each
other. Because, you know, one of the things
is that, if you have dinner normally,
(11:01):
you want to be doing something else because
the hunger is going to come up during that
time. But if you schedule something
like a nice walk in the park or something
like that, hey, that might be something to
take your mind off, really talk about
something else, and then, by the time you get
back, sort of get over that period.
So yeah, I think it's going to be really,
really useful.
(11:21):
I think it's going to be really helpful.
It's something that we've actually had a lot
of people doing over the years, but never
formally like this.
And that's where I think it's pretty exciting
to be a Fasting Method Community member.
But really, we're bringing these sort of
advanced tools from the coaching, from
the personal side of things.
We've never done it sort of like this before,
because we've always been afraid that people
(11:42):
get into trouble, you know, with the longer
fasts if they're on medications and stuff.
But again, the science is moving towards
this. So, hey, there's nothing stopping us
from doing it.
One of the questions in the Q&A box
is, "Can we continue doing
this for five days, seven, ten
days? How long?
Is it unsafe to go on?"
Oh, there's nothing to stop you from going
(12:03):
longer. So if you're feeling good, you
can go longer.
To me, it's a balance of the physiology
and the social stuff, because usually--
so what I do is I do it on a Sunday, I
finish dinner, and then I plan to eat again
Friday. Because Friday, Saturday, Sunday is--
often there's social things.
You know, family dinners, friends,
(12:25):
going out, that make it very difficult
for me to really sustain that for seven
days. So everybody's different, but if--
there's nothing wrong with going seven days
because, remember, by the time you get into
that fifth day, you're basically in the
fat-burning state and your hunger levels tend
to be lower.
So if you don't have anything and you want
to keep going, then keep going.
You're going to continue reaping the benefits
(12:46):
of that because you're-- you know that if
you're not eating, you're burning something.
And there's not much sugar, right?
The body stores calories in two forms -
sugar and fat.
If you have excess sugar like diabetes,
actually, it's a very good thing.
If you don't have any more sugar, then you're
going to burn fat. And of course, everybody
loves to do that.
So yeah, you can go seven days, ten days,
whatever you want.
(13:07):
We're just doing five as a sort of good
intermediary.
It's long enough that you're going to start
seeing the benefits of the really pumped-up
growth hormone, sympathetic tone.
You're going to feel that energy.
I noticed it yesterday, even playing tennis,
I was like a little bit more focused than
usual. So you're going to start seeing those
benefits of the longer fast.
(13:27):
And of course, we're not doing this all the
time. We just plan for doing it once a month
and then changing it up and doing some other
things. But yeah, if you want to go longer,
by all means.
Same with people who's never done a 72.
Yeah.
You know, you can use this to try to get
to three days and see how you feel.
Yeah.
And don't feel bad about pulling back, you
know? And all the things that you need to do,
(13:48):
like if you're feeling shaky or something
like that, you know, to break your fast of
course.
Yeah. And of course, there's the check-ins
every day for that to help you.
So that's another thing.
Sometimes, if you're feeling like that, you
know, there's olives.
Olives or half an avocado.
There's all sorts of things that are on the
list that you can try.
[music]
(14:08):
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Or have you been working on fasting
for a while now and keep running
into obstacles?
We have coaches at TFM that can help
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We can help you learn the necessary skills,
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(14:28):
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Some of our coaches offer one-on-one
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(14:50):
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(15:11):
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(15:32):
[music]
You did a wonderful YouTube video -
Five Ways to Naturally Boost
the Ozempic Effect.
And I will put the link to that in the show
notes for this podcast, which is great
for understanding the incretin hormones like
the GLP-1 and the GIP.
So [question] "I realize that the
relationship between bitters, incretins, and
(15:54):
autophagy is more complex than a
direct cause-and-effect relationship,
but the incretin response doesn't directly
promote autophagy, it primarily
regulates blood sugar and satiety,
from my understanding.
Autophagy is mainly triggered by the nutrient
scarcity.
Correct?"
(16:14):
Yeah.
"And low insulin levels, not the
bitter compounds themselves.
But could you expand on why
using bitter greens can help reset
a lot of this? "
Yeah, the bitterness is interesting.
The nutrient sensors-- there's a couple of
main ones, right? Insulin is one we talk
about, which switches you into that sort of--
instead of storing calories as
(16:36):
sugar or fat, insulin switches.
When you fast insulin, goes down, which
switches you into an energy-burning mode.
So glycogen and fat.
So there's denovolipogenesis and glycogen
synthesis, right?
So if you have high insulin, you're going to
want to store calories.
When insulin is low, you're flipping that
switch and going the other way.
For autophagy it's mostly protein.
(16:57):
So mTOR is the main one.
You know, a little bit of protein is okay,
but you notice that when we have our
things to eat during it, it's relatively low
in protein. There's a bit in the bone broth
and stuff, but that's very little.
Mostly it's going to be like olives and
avocados and stuff, sort of a high-fat,
low-carb sort of thing.
And relatively low in protein too, because we
don't want to-- we do want that sort of bit
(17:18):
of autophagy. A little bit of protein's okay,
but you notice that we're not putting like
salmon or something in there, right?
It's like olives and stuff.
A little hit of salt is actually really,
really nice during the fast as well.
It actually tastes really, really good.
The bitterness works on a different pathway.
And again, it probably works along
the GLP-1 and satiety pathway
(17:39):
rather than the nutrient sensor.
Bitterness, initially, was thought
to be sort of a protective mechanism
against poison.
That's how people used to think about it -
hey, if it's bitter, you're not going to eat
it. But actually, that's not strictly true
because there's a lot of bitter things that
people like.
Lots of bitter things, actually.
So even if you have drinks, you have bitters,
(18:01):
right? People put bitterness directly in, or
quinine, or something like that.
So all these very bitter compounds or things
like eggplant, which is a little bit bitter,
kale, which is a little bit bitter.
People love these things so it's not so
strictly true, because it's not simply
like people avoid bitterness.
So the bitterness can be good,
but mostly it has benefits
(18:22):
in terms of GLP-1 and satiety.
And also people have traditionally used these
bitter melon and stuff for diabetes.
It's actually a very traditional remedy for
diabetes. So it really seems to help blood
sugars probably through that same
GLP-1 pathway.
So it sort of all ties in with
what people have done traditionally.
That is, it's not necessarily the bitterness,
(18:44):
it's that these bitter compounds may
stimulate the GLP-1 pathway,
which is good.
Yeah, you may get to satiety quicker,
especially at that 24-hour
mark, 28-hour mark.
Sometimes that's the witching zone to get
through when you're doing a fast.
So you have some greens.
Have some arugula or other greens
that are listed.
Yeah. Arugula and that sort of
(19:06):
thing.. Perfect.
Great.
The next question is this person has had
some success lowering their weight
a couple of times using fasting and
doing time-restricted eating.
But the weight creeps back up after a
while, even when still maintaining TRE.
They're very happy that they can get back to
doing what they need to do to get the weight
(19:28):
down, but they're wondering what
the scientific evidence is
that shows your body weight
set point. And we've talked about this.
I'll post some of the podcasts
in the past where you talked about body set
point. Is there a foolproof
method for setting that.
Are there steps that you have to do?
(19:48):
Is there a length of time?
Is it three months or six months that you
have to maintain that weight at?
It's not like that.
I mean, the body set point is basically like
the thermostat in your house, right?
So you set a room temperature.
If it gets too hot, it turns on the air
conditioning to cool it down.
It gets too cold, it turns on the heat to
bring it back up.
(20:09):
Your body does have a set point.
So like that thermostat, it wants to be at a
certain weight. So the question of why
people are over-- you know, if you're
overweight, it means you're set point is set
very, very high.
And you see this of course.
So if you take a person who
is overweight and make
them lose weight, they will very rapidly
(20:30):
regain that weight.
If you take a lean person, make them
overweight, and then once you stop, they'll
actually very quickly go down to their
lean weight because the thermostat had been
set there.
So the question of why people gain weight
isn't just the calories, right?
It's the thermostat. Because if your
thermostat is set very high, then
you're either going to be very hungry (so
(20:51):
that you gain weight to go back up) or,
if you don't eat calories, then your
energy expenditure (how much energy you burn)
is going to go down until you gain that
weight. You know, that's why the 'calories
in, calories out' is sort of all wrong,
because it doesn't tell you how to affect
that thermostat. And it's really affected by
your hormones. So insulin is one, GLPs
(21:12):
are one, sympathetic tone is one.
So there's a list of, you know, four, five,
or six major hormonal pathways
that are going to influence the weight.
So if you push up the insulin, your
body's set weight is going to get pushed up.
You see this, of course, when you give people
insulin. When you give people insulin,
it doesn't matter how much willpower they
have, they gain weight. Why?
(21:32):
Because you're telling your body to gain
weight. There are other pathways like the
GLP-1. So if you give people Ozempic and you
really stimulate the GLP-1s, that
forces the body set weight down, and then you
see they're not so hungry.
So this idea is that it's really set by
the hormones. So it goes up, it goes down.
And it's not influenced just
by a single hormone, but sort of multiple
(21:54):
hormonal pathways do converge on
that. I actually go into a little bit more of
that in The Hunger Code, which is coming up.
It's the sort of follow up to The Obesity
Code, which is coming out next year, I think,
spring 2026.
It's in editing.
You've got a new book coming out.
That's great.
Yeah. So that's going to talk a bit more
about the body fat thermostat and how to
reset it, how ultra-processed
(22:15):
foods are really one of the keys to avoid,
fasting is the other real big key.
Because ultra-processed food actually affects
the insulin in a lot of ways other than the
carbohydrate. So the speed
at which you eat food affects it.
So if you have very soft foods, easy-to-eat
foods, like a lot of ultra-processed
foods, you eat it quickly, it gets absorbed
(22:37):
very quickly, your insulin spikes like that,
your glucose and insulin spike like that.
You can take the same number of
carbohydrates, but in a whole form,
and your blood glucose will be much flatter.
You see this in the glycemic index.
You know, so commercial white bread is very
high, but if you take something like
pumpernickel bread, it's actually much lower.
It's like 20 or 30% lower, even
(22:57):
though it has the same number of
carbohydrates. The difference is how quickly
you absorb it. So speed of digestion,
speed of absorption, speed of eating
all make a difference to that insulin
level. So the key is not eat, necessarily, a
low-carbohydrate diet but a low-insulin diet.
So food order matters.
You know, you can go through some of these
articles that I've posted on Medium.com.
(23:18):
And remember you can always get the friend
link from The Fasting Method.
So if you're not part of The Fasting Method,
you have to pay for the Medium.com
articles.
If you are part of The Fasting Method, you
can get these friend links which will allow
you to read them all for free.
So that's one of the things is to
look at the insulin particularly.
There's no set time period, but just
(23:39):
cutting down the carbohydrates sometimes
isn't enough.
The TRE is beneficial, but again,
I've actually thought recently that
doing these longer fasts every so often
is actually a really great way just
to force that thermostat down.
And it's really made it a lot easier,
honestly, I have to say, compared to what
(24:00):
I used to do, which is a lot of the shorter
ones. I've actually found it a lot easier
using these five-day resets.
And how you break too.
Don't go crazy when you break.
Go right back to a couple of days of
TRE, no snacking, and then go back
to your regular fasting which you've been
doing. So, yeah, this is exciting,
and it's so neat to see the Community
(24:22):
kind of get a new shot in the arm.
You know because the first meeting Jill had,
there were like 220 people in there,
and they were all supporting one another, and
everybody had different helpful hits
that they did. Some things work for some
people and some things don't.
Like you mentioned bone broth.
I don't do well with bone broth, but you
mentioned miso.
I do quite well with miso.
(24:43):
So finding out what works for you is
all part of this.
Yeah, and then if
you find something that works better, of
course, then do that.
You don't have to follow what we say because
everybody's different.
So, you know, some people, for example,
will really like-- we recommend green tea
a lot because green tea has certain hormones
(25:03):
that help reduce the hunger.
It affects a different pathway, the COMT
[catechol-O-methyltransferase], which helps
break down the sympathetic hormone,
sympathetic nervous system hormones, so it
allows that-- so it gives you a bit more
energy but also suppresses the hunger a
little bit better. Some people don't like
that, but I do.
I actually drink it-- one
of the keys I think is-- I drink it
(25:23):
in the summertime.
I make a big pot all the time.
I put it in the fridge.
It tastes-- I think it tastes great.
Some of these ones.
And we're getting this lemon and ginger one,
actually. I don't know when, but the teas are
supposed to be coming.
It's a slow process.
I've been using it iced, and it just
tastes great, right?
So I drink it all through the day and I'm
(25:44):
like, oh, this is just fantastic.
It's as good as anything else, you know?
And experiment with those teas because green
tea works great for me.
Peppermint works great for me.
Chamomile not so much, but that's probably
because it's in the ragweed family and I
don't do well with ragweed.
So, you know, don't just
give up after you try one thing and it
doesn't work, try something else.
(26:05):
Yeah, we have a herbal tea coming, I think,
that has a little bit of licorice in it,
which I actually think is fantastic.
But again, it's one of these compounds (some
people don't like it), but it's got a little
bit of that bitterness, right, and I actually
think it really lends a really great
sort of dimension to it.
The one that we're making, I think-- it's a
caffeine-free one. That's why it has a bit of
(26:25):
mint, a bit of licorice, and a bit of ginger.
It's an herbal tea. It's not a green tea, but
it's-- you know, I just really think it's
great. So that should be coming within a
couple of months.
So yeah, very exciting.
Yeah, I'm excited.
[laughs]
So this next question is, "Dr.
Fung, your kidney patients
who are type two diabetics and
close to getting dialysis but are
(26:46):
skinny, I'm assuming they need to fast
for more than a year to reverse
the kidney damage.
Is this true?
But how do they do so with so little
fat mass?"
Well, kidney disease is not necessarily--
you know, there's a lot of kidney diseases
that have nothing to do with diabetes.
So the biggest cause of kidney disease
(27:07):
is diabetes, but once you have the damage to
the kidneys, it doesn't necessarily
reverse because a lot of the damage is done.
It's sort of like if you don't change the oil
in your car, then it breaks down and you say,
"Now I'll change the oil on my car," it
doesn't make your car run better.
It may prevent further damage.
But the thing about kidney disease is that,
once you have the kidney disease, that
(27:28):
can lead to more kidney disease because
the remaining kidney has to take over, so
it's working harder and it will wear out
faster.
There is a little bit of data in other types
of kidney disease that these five-day
fasts can be useful, some very
preliminary data that it's useful in other
types of kidney disease as well.
And I think it's actually due to the lowering
of the insulin levels.
(27:49):
Because insulin is a growth hormone, it
actually promotes a lot of scarring, which
leads to this nethrosclerosis.
So that's why certain medications, the
new medications that lower insulin-- so the
Ozempic lowers insulin, right?
It makes you nauseated so you don't eat.
When you don't eat, your insulin goes down.
And also the SGLT-2s, which are diabetic
medications, they make you pee out sugar, but
(28:10):
they lower insulin.
So then you can lose a bit of weight, but it
actually turns out to have massive kidney
protective effects.
So it's not necessarily the weight.
Fasting may or may not help.
It may be the inflammation, it may be the
lower insulin, but if you have an underlying
kidney disease process (such as IgA
nephritis, which is the most common cause of
glomerular nephritis overall), it may or may
(28:32):
not reverse, the inflammation may or may not
reverse, so they may still progress.
You know, I wish everybody could just do that
and it would be fine, but it actually-- you
have to understand what the underlying
process is and whether it's helped.
Fasting helps in a lot of different ways,
so probably less scarring.
And that's why, in this very preliminary
study, what they found in the five-day sort
(28:54):
of reset fast is that a number
of kidney diseases were actually helped by
the five-day fast.
It's not that it reverses.
It slows down the progression.
It still progresses, but it slows down the
progression of how quickly the kidney disease
goes on. I mean, it's like trying to get
younger, right? It's very hard to do.
[laughs]
Well, I had a client that was-- I believe he
(29:15):
was like 32 on his eGFR
(estimated glomerular filtration rate) and he
did a lot of fasting. He did fantastic.
And he actually got his eGFR
up above 90.
And then, after staying there
for a year or two, his wife passed,
and he dived
back into problematic food.
(29:36):
Not quite too much processed
food, but still, you know,
he gained some weight back.
Then he had a heart issue.
I think part of it was broken heart syndrome,
but he had to go in for a cat lab
and everything. But his eGFR
remained good.
So now he's back on track, he's back
(29:57):
fasting. So he was very pleased
because that's why he originally came to TFM.
Yeah. Yeah, I've had a few cases where
people's kidney function's just completely
got better, but more cases where
they really just-- you just sort of slow it
down.
You stop the progression of it.
Yeah.
Okay, great.
So this person says, "I know that vitamin
(30:17):
D is fat soluble and is best taken
with a meal, but I've also heard that that
all supplements are better absorbed when
taken with a meal.
Is this true and what
time frame is considered "with a meal"
when it comes to supplement?
Before, during, after?" Then
they also want to know about vitamin D
interrupting sleep, so she should take it
(30:38):
best in the morning? I'm going to say yes to
that because it interferes with melatonin,
but can you address the rest of it, Dr. Fung?
The vitamins... There's water-soluble
vitamins, like B and C, in which case, of
course, you don't need fat.
And then there's fat-soluble vitamins, right,
so A, D, E, K are fat-soluble
vitamins. So therefore, if they're fat
(30:58):
soluble, you know fat and water don't mix,
right? So if you take fat-soluble vitamins,
then they don't get absorbed as well if you
don't take it with a meal.
When is "with a meal"?
Within two hours, say, of a meal
is still fine. Because remember, when you're
eating, that food doesn't go
right into your intestines.
It gets held in the stomach.
So when you eat a meal, it gets held in the
(31:19):
stomach, and your stomach sort of pushes a
little bit out at a time into your
intestines, because your intestines cannot
absorb that much nutrients so quickly.
So your body has a reservoir.
It holds it and then just gives a little bit.
So if you take somebody whose stomach is cut
out for, you know, cancer, for example,
you get this thing called 'dumping syndrome'.
Because they don't have this reservoir to
(31:40):
slowly parcel out a little bit of food
to the intestines, the intestines get all
this food right away. Then you get all these
symptoms and people feel terrible.
So if you take it sort of an hour after
meal, there's still food in the stomach.
You know, there's a bit of fat, there's-- you
know, everything's all mixed up, but then you
can still take it. If you take it before,
well, it's probably not ideal.
(32:00):
It may still be held there, but, on an empty
stomach, of course-- you know, if your
stomach has nothing in it and you take the
vitamin, first thing that's going to get
pushed out into the intestines is your
vitamin. So therefore you're not going to
have the fat that needs to do that.
So if you are worried about that, then,
yeah, take it with a meal or within
two hours, say, two to three hours,
(32:21):
even up to four hours sometimes, depending on
what meal it is, because certain foods get
pushed out much faster.
So if you were to compare, say, an apple
slice to apple
sauce, which is actually baked and--
you know, so you take an apple, you bake it,
you puree it. So it's exactly the same
nutrients.
It gets pushed out into the stomach much
faster because with the apple, the stomach's
(32:43):
sort of churning it and making sure it's good
to go, and then it gets pushed out.
So I think the apple slice
leaves the stomach in like 65 minutes,
and the apple sauce is like 44 minutes.
So it gets pushed out much faster.
But the point is that, depending on what the
meal is, what you're eating, it gets
pushed out faster or slower.
But, say, two hours is
(33:04):
a reasonable amount.
That's why when you eat, after you eat,
your sugars sort of continue to go up,
right? Your insulin levels don't go down the
minute you put down your fork because there's
still food in the stomach.
It's still slowly going into the intestines.
You know, your insulin levels still go up
after a meal and then slowly come down, same
as your sugars still goes up after a meal.
(33:25):
So I'm going to let you pronounce
the medical term for this, but this person
is asking about gallstones
and the formation of them.
And you did talk about this in episode
#171, which is like well over a
year ago, but we're going to revisit here
because this person has said, "How do you
rate the risk of cholelithiasis
(33:46):
in various fasting protocols?
How do you rate the risk of the newer
formation of gallstones if the patient
has already had one or more?
What's your experience with fasting on this?"
Yeah. So there's generally less formation
of new gallstones.
Like, if the gallstone is there, it's a
stone. It's like a little rock, right?
(34:06):
You can't dissolve it.
But if you're eating less carbohydrates and
stuff-- you know, if you're eating more fat,
which is what we often recommend (cutting or
lowering the carbs, increasing the fats),
when you eat more fat, it forces
the pancreas to squeeze out more
of the pancreatic juices and stuff,
including from the gallbladder, to solubilize
(34:28):
the fat.
Therefore, you're continually using
up the stuff in the gallbladder
so it keeps the flow going better.
So if you're eating a super low-fat diet,
which is of course what we told people to do
20 years ago, then you get a lot
of gallstones because your gallbladder
is holding on to this stuff
(34:48):
to solubilize the fat.
There's no fat, so it's just sitting there.
So you get a stasis of that and then you get
stones forming.
If, on the other hand, you're eating fat,
so you're always squeezing your gallbladder
down and shooting it out, it's not going to
sit there, right?
It's not going to be stagnant, and then
therefore you get the stones.
For new stones as opposed to old stones,
(35:10):
you're going to get less if you're going to
eat the higher-fat diet, yeah.
One other thing-- I was just reading
comments. Tara was just saying that
she felt much hungrier day one using the aids
as opposed to the water, salt only.
If that's the case, then don't use it.
So I'll tell you that, on day one and two,
I do the same thing.
I actually don't eat all of that.
(35:30):
I don't need it and I don't really want
it. I do make adjustments too.
So this is sort of a-- you know, it's just a
guideline. So if you do better without it,
I'm the same, right?
I don't need it
to get through day one and two, and it
actually probably doesn't work as well for
me. For a lot of people, they find it very
useful because they have that witching hour
(35:51):
at sort of 24 hours.
And that's what it's meant for, right, to get
over that. I discussed this with Megan.
I said, "Do we really need the sort of
mid-afternoon snack?" And she said, "That's
the worst period for most people." So that's
why we put that in there, right?
I'm like, "Oh, that makes sense." Like, I
don't have that problem personally, so I
actually don't do that.
Day one and two actually, I don't barely eat
anything at all.
I'm mostly just teas and a bit of bone broth.
(36:14):
But again, if you find that it's useful
for you, let us know so that everybody
else can benefit and say, "Hey,
what is your experience?" And if they don't
need it, then don't take it.
It's totally okay.
It's all what works best for you.
For you.
Individual. Yeah.
It's totally individual, and that's why it's
great to be in a group like this where we can
(36:34):
say, "Hey, this is what works for me," and I
can say, "That's what works for me too,"
right? I mean, I'm like-- even though
we use something that we know for a lot
of people it helps, it may not help you, and
that's okay. You don't have to do it,
right? If you want to take a bit more or a
bit less.
And you do fine for a day or two, and then on
the third or the fourth feel you're
struggling, then try the steramed asparagus
and see if that gets you through,
(36:56):
and you can carry on. So yeah, it's
great.
Exactly.
Adapt it to you. Personalize it.
All right, thank you.
That's perfect.
Thank you so much, Dr. Fung.
This was fun.
Okay. Thanks so much.
Thank you for bringing this to the Community.
All right, everyone.
See you next month.
All right.
(37:22):
Bye
About a year and a bit ago I had a lot of
Achilles tendonitis and I did all
the usual stuff, right?
So I looked in the books and it said, okay,
yeah, you do physiotherapy, you do
ultrasound, you do stretching.
So I did all that and it was just terrible.
So I couldn't really run.
And it was like a year I did it.
Now I normally do sort of shorter fasts -
(00:20):
16, 24 - I did some
two-day fasts and so on.
But a friend of mine, he had tennis elbow,
and he did a longer fast and it really
helped him a lot. So I thought, okay, well,
maybe I should try it too.
So I did a five-day fast
and really the tendonitis
was like 70% better.
It was just stunning to me what
(00:41):
a difference it made
made. [music]
Hello everyone.
Welcome to our monthly Q&A with
our very own Dr. Fung where he's going
to tackle questions submitted
by our TFM Community members.
And hello to our podcast listeners who will
(01:03):
be able to listen to this Q&A with
Dr. Fung a few weeks after our
Community members. So hi, Dr. Fung.
How are you doing today?
I'm good. How are you?
I'm so excited.
We're doing this five-day reset, which
is a new reset protocol in
our TFM Community this week, and so many
people are jumping in and enjoying
(01:26):
it, learning about ourselves, about
it. But can you expand a little bit on
it and tell us a little bit more about it?
Yeah, absolutely.
So this is one of the things that we've done
a lot, not in the Community, but in
coaching and private conversations,
which is doing a longer fast, which
is this five-day fast.
And it's not necessarily a full
(01:47):
fast. And the reason we're
doing it is we're trying to create a bit more
structure to the Community and
try and get people on the same sort
of timelines, because
it's important to have a supportive
community. Doing things all together is
generally easier, whether it's running
or whether it's, you know, knitting or
(02:08):
whether it's-- anything really is better.
So fasting is really no different.
So we're doing this five-day reset challenge.
I'm doing it too. The idea is to
do things together so that we can
support each other, learn from each other,
share tips, and all that sort of thing.
The reason we're doing it is because,
recently, there's been more and more evidence
that these sort of longer fasts
(02:30):
have a lot of benefits.
And I'll say that, from a personal
standpoint, I actually noted
some difference with it.
So about a year and a bit ago I had
some-- not some, I had a lot of Achilles
tendonitis.
And I did all the usual stuff, right?
So I looked in the books and it said, okay,
well, you do physiotherapy, you do
ultrasound, you do stretching.
(02:51):
So I did all that and it was just terrible.
Like, it was just really difficult.
So I couldn't really run and it was like a
year I did it.
Now, I normally do sort of shorter fasts
- a lot of 24s, 16, 24 -
I did some two-day fasts and so on, but
a friend of mine said, well-- he had tennis
elbow and he did a longer fast and
it really helped him a lot.
(03:12):
So I thought, okay, well, maybe I should try
it too, right? So I did a five-day fast
and really the
tendonitis was like 70%
better. It was just stunning to me
what a difference it made, because there's
not actually a lot of literature on that
and tendonitis. But clearly the
five-day fast was very anti-inflammatory,
(03:35):
in that it was really settling down
the inflammation that was at the cause of
this Achilles tendonitis.
So it was very striking.
But I thought, meh, maybe it's just a
coincidence.
So then, you know, about a month later, I did
it again. And again, it was like 70,
80% better after that.
And then I did the third time and then it was
(03:56):
completely gone. I'm like, this is crazy
because I can't find-- there's no literature
on it. You know, there's anecdotal reports,
but that's not really evidence, but there's
nothing in there. But I'm like, it doesn't
really matter, right?
It doesn't matter what the studies say.
If it helps me, it helps me, and that's all
it is.
But the data has actually
been increasing.
So these modified five-day
(04:18):
fasts, there's a lot of data now to suggest
that there's a lot of benefits to them, not
simply the weight loss and all that sort
of stuff, but also decreased
inflammation, perhaps a bit of anti-cancer
effects. And what happens is
that, when you do the longer fasts, you
really pump up that growth hormone.
(04:38):
If you remember, during fasting, your insulin
drops, but these other hormones go up,
and that's the counterregulatory hormones.
So that's things like cortisol (which does go
up, yes), but also growth hormone and
sympathetic tone.
But growth hormone skyrockets as
you go. So they've done these studies for up
to five days.
And what you see is a bit of increase in the
first day. So if you're doing 24, 36,
(05:00):
you're getting a little bit of increase, but
by the time you're getting to 4 or 5 days,
you're just getting a lot of growth hormone.
I suspect that that may have helped with
a lot of what I felt.
The other thing is that sympathetic tone
goes up, so appetite decreases.
So as you increase sympathetic tone,
hunger decreases and ghrelin decreases with
the longer fast. So again we see this when
(05:21):
you're doing multiple-day fasts - the ghrelin
sort of steadily goes down - which means
hunger tends to go down and sympathetic
tone goes up. So again hunger tends to go
down. So both very, very good effects, but
only when you push out to the longer effects.
Some of the studies show the
anti-inflammatory effects take sort of
5 to 7 days.
So therefore, rather than simply saying let's
just do a lot of the 24s, let's
(05:43):
do once in a while the longer ones, because,
hey, some people might find that they really
do well with that.
And like anything else, the more you do it,
the easier it gets.
And the more support you have, and the more
groups you have to do it, it's better.
So I've really found-- so today is day three
because it's Wednesday. So we started-- my
last real meal was on Sunday.
A lot of the data shows that, even if you
(06:05):
take a little bit of food during that
fasting day, you still retain a lot
of the benefits.
So really, it makes it easier.
So then, you know, if you retain 80%
of the benefits, but it's like 50%
is hard or 40% is hard, hey, that's a-- the
net benefit is there, right?
So, you know, if you're nervous about
(06:25):
it, you can take a little bit more calories.
If you're less nervous about it, you can take
less. So you know, we have a whole schedule
set out for you in terms of that.
We have the teas, which are
coming. So I know we've talked about
this. The Fasting Method is working with
my son actually to bring these teas
and bone broths so that we'll actually
(06:45):
have more recipes. That's probably coming in
a couple of months. There's certain things we
recommend, such as the bone broth,
which will have-- not only do you get the
hydration, but then you can add salt in it.
This is going to be a powdered bone broth to
make it easy. Because I make bone broth, but
honestly it's like a whole-day process.
It's sort of a pain in the butt.
So this is just going to be a powdered one.
(07:07):
It'll be a chicken broth to start, but you
just stir it up in water and you might boil
it for a minute or two.
But the great thing about this one that we're
working on is that there's really only
one ingredient, which is chicken bones.
There's nothing else. And then you get all
the nutrients from the chicken, right?
You get the collagen, you get the proteins,
and that really supports the fast.
And what I do is I stir in
(07:29):
a little bit of miso, which gives me the salt
and actually a bit of taste to it.
So it really tastes really good.
I put a little bit of green onion to make it
really tasty. So I had that yesterday and
it really just makes it like a meal,
but you're getting really very little
calories, but you're getting the nutrients,
the salt, and the electrolytes.
The electrolytes we're working on too, but
that may take a bit longer.
So the potassium, the sodium, and so on.
(07:52):
We're getting it all together to support
everybody with this.
You know, I encourage people to go on the
daily supports because that's what
everybody's for - to talk about how they're
feeling, you know, how to deal with the
hunger. Because the hunger, it does come, so
you have to be ready for it.
You have to know what you're doing, you know,
and how you're feeling, right?
Because we're on day three now.
So this is sort of my favorite time
(08:13):
of the fast - day three, day four,
day five - because this
is where I really start to notice,
you know, my pants just fit a little bit
different. You know, I notice a little
less of the bloating because, again, when you
do the fasting, it's antidiuretic, meaning
you're going to pee out some of the fluid.
You're not holding on to so much water.
(08:34):
You know, as you get older, you start to
notice things like the sock line and stuff,
right? So, you know, [laughs] when take off
your sock, there's a little bit of line
there, right, because the circulation is not
as good as 25 years ago, but I get
it less. So I notice a lot less bloating.
I notice my pants are fitting a bit better,
probably because of the bloating, but also,
you know, I know that I've gotten through
(08:56):
that sort of the burning of the sugar, the
glycogenolysis part.
I've gotten through the gluconeogenesis, and
now I'm in fat burning.
And I know that, hey, for the next two days,
I'm just going to be burning fat, which is
great. Then it's only a few more days and
then I'll eat again. So, you know, it's
really-- this is where I really like it.
I remeber a couple months ago, it was strange
(09:17):
because I was going to do a five-day fast and
we wound up having dinner with family
on like the day three.
And I remember thinking, damn right?
It's like, you know, of all the days,
like, why did you have to do it?
And like, didn't we doing next week?
Right? But of course it was, you know,
family. So of course I cut it short.
And then I just did it again because there's
always time to do it again.
(09:37):
But again, this is the-- you know, what we're
trying to do is really follow the science but
really provide the support and
the structure.
So every month we're actually going to change
it up. I think Megan's going to work on it, I
think-- I'm not sure if you're working on it,
Lisa, but we're going to change it up a
little bit in terms of what you're doing,
what you're taking, and then really focus in
on those daily sessions, on the mindset,
(09:58):
on the habits, and so on.
Because once it gets into a habit, it's
actually not bad at all.
And I know actually two other, three other
people personally, like family members,
who have been doing it for a while.
Like, they do these five-day fasts, and, you
know, they've kept the weight off, they're
feeling really good.
And that's where we're going with this.
And I think it's been helpful for me
(10:19):
personally, even though I'd done the fasting
before, I usually had stuck to the shorter
ones. But really pushing that envelope has
really helped me.
I mean, yes, it took the Achilles tendonitis
to really push me, but the science is moving
in that direction too, and that's where
I think that we can really help people.
And we can really help each other, right?
I know I talked to Megan about maybe
(10:40):
doing some in-person meetups for people
during this. You know, that's often very
useful to talk about things, maybe
going for a walk in the park, that kind of
thing, and, you know, if the locations are
nice. Or arranging meet-ups so that people
can do this where you can really support each
other. Because, you know, one of the things
is that, if you have dinner normally,
(11:01):
you want to be doing something else because
the hunger is going to come up during that
time. But if you schedule something
like a nice walk in the park or something
like that, hey, that might be something to
take your mind off, really talk about
something else, and then, by the time you get
back, sort of get over that period.
So yeah, I think it's going to be really,
really useful.
(11:21):
I think it's going to be really helpful.
It's something that we've actually had a lot
of people doing over the years, but never
formally like this.
And that's where I think it's pretty exciting
to be a Fasting Method Community member.
But really, we're bringing these sort of
advanced tools from the coaching, from
the personal side of things.
We've never done it sort of like this before,
because we've always been afraid that people
(11:42):
get into trouble, you know, with the longer
fasts if they're on medications and stuff.
But again, the science is moving towards
this. So, hey, there's nothing stopping us
from doing it.
One of the questions in the Q&A box
is, "Can we continue doing
this for five days, seven, ten
days? How long?
Is it unsafe to go on?"
Oh, there's nothing to stop you from going
(12:03):
longer. So if you're feeling good, you
can go longer.
To me, it's a balance of the physiology
and the social stuff, because usually--
so what I do is I do it on a Sunday, I
finish dinner, and then I plan to eat again
Friday. Because Friday, Saturday, Sunday is--
often there's social things.
You know, family dinners, friends,
(12:25):
going out, that make it very difficult
for me to really sustain that for seven
days. So everybody's different, but if--
there's nothing wrong with going seven days
because, remember, by the time you get into
that fifth day, you're basically in the
fat-burning state and your hunger levels tend
to be lower.
So if you don't have anything and you want
to keep going, then keep going.
You're going to continue reaping the benefits
(12:46):
of that because you're-- you know that if
you're not eating, you're burning something.
And there's not much sugar, right?
The body stores calories in two forms -
sugar and fat.
If you have excess sugar like diabetes,
actually, it's a very good thing.
If you don't have any more sugar, then you're
going to burn fat. And of course, everybody
loves to do that.
So yeah, you can go seven days, ten days,
whatever you want.
(13:07):
We're just doing five as a sort of good
intermediary.
It's long enough that you're going to start
seeing the benefits of the really pumped-up
growth hormone, sympathetic tone.
You're going to feel that energy.
I noticed it yesterday, even playing tennis,
I was like a little bit more focused than
usual. So you're going to start seeing those
benefits of the longer fast.
(13:27):
And of course, we're not doing this all the
time. We just plan for doing it once a month
and then changing it up and doing some other
things. But yeah, if you want to go longer,
by all means.
Same with people who's never done a 72.
Yeah.
You know, you can use this to try to get
to three days and see how you feel.
Yeah.
And don't feel bad about pulling back, you
know? And all the things that you need to do,
(13:48):
like if you're feeling shaky or something
like that, you know, to break your fast of
course.
Yeah. And of course, there's the check-ins
every day for that to help you.
So that's another thing.
Sometimes, if you're feeling like that, you
know, there's olives.
Olives or half an avocado.
There's all sorts of things that are on the
list that you can try.
[music]
(14:08):
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(14:28):
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We also offer small-group coaching.
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(15:32):
[music]
You did a wonderful YouTube video -
Five Ways to Naturally Boost
the Ozempic Effect.
And I will put the link to that in the show
notes for this podcast, which is great
for understanding the incretin hormones like
the GLP-1 and the GIP.
So [question] "I realize that the
relationship between bitters, incretins, and
(15:54):
autophagy is more complex than a
direct cause-and-effect relationship,
but the incretin response doesn't directly
promote autophagy, it primarily
regulates blood sugar and satiety,
from my understanding.
Autophagy is mainly triggered by the nutrient
scarcity.
Correct?"
(16:14):
Yeah.
"And low insulin levels, not the
bitter compounds themselves.
But could you expand on why
using bitter greens can help reset
a lot of this? "
Yeah, the bitterness is interesting.
The nutrient sensors-- there's a couple of
main ones, right? Insulin is one we talk
about, which switches you into that sort of--
instead of storing calories as
(16:36):
sugar or fat, insulin switches.
When you fast insulin, goes down, which
switches you into an energy-burning mode.
So glycogen and fat.
So there's denovolipogenesis and glycogen
synthesis, right?
So if you have high insulin, you're going to
want to store calories.
When insulin is low, you're flipping that
switch and going the other way.
For autophagy it's mostly protein.
(16:57):
So mTOR is the main one.
You know, a little bit of protein is okay,
but you notice that when we have our
things to eat during it, it's relatively low
in protein. There's a bit in the bone broth
and stuff, but that's very little.
Mostly it's going to be like olives and
avocados and stuff, sort of a high-fat,
low-carb sort of thing.
And relatively low in protein too, because we
don't want to-- we do want that sort of bit
(17:18):
of autophagy. A little bit of protein's okay,
but you notice that we're not putting like
salmon or something in there, right?
It's like olives and stuff.
A little hit of salt is actually really,
really nice during the fast as well.
It actually tastes really, really good.
The bitterness works on a different pathway.
And again, it probably works along
the GLP-1 and satiety pathway
(17:39):
rather than the nutrient sensor.
Bitterness, initially, was thought
to be sort of a protective mechanism
against poison.
That's how people used to think about it -
hey, if it's bitter, you're not going to eat
it. But actually, that's not strictly true
because there's a lot of bitter things that
people like.
Lots of bitter things, actually.
So even if you have drinks, you have bitters,
(18:01):
right? People put bitterness directly in, or
quinine, or something like that.
So all these very bitter compounds or things
like eggplant, which is a little bit bitter,
kale, which is a little bit bitter.
People love these things so it's not so
strictly true, because it's not simply
like people avoid bitterness.
So the bitterness can be good,
but mostly it has benefits
(18:22):
in terms of GLP-1 and satiety.
And also people have traditionally used these
bitter melon and stuff for diabetes.
It's actually a very traditional remedy for
diabetes. So it really seems to help blood
sugars probably through that same
GLP-1 pathway.
So it sort of all ties in with
what people have done traditionally.
That is, it's not necessarily the bitterness,
(18:44):
it's that these bitter compounds may
stimulate the GLP-1 pathway,
which is good.
Yeah, you may get to satiety quicker,
especially at that 24-hour
mark, 28-hour mark.
Sometimes that's the witching zone to get
through when you're doing a fast.
So you have some greens.
Have some arugula or other greens
that are listed.
Yeah. Arugula and that sort of
(19:06):
thing.. Perfect.
Great.
The next question is this person has had
some success lowering their weight
a couple of times using fasting and
doing time-restricted eating.
But the weight creeps back up after a
while, even when still maintaining TRE.
They're very happy that they can get back to
doing what they need to do to get the weight
(19:28):
down, but they're wondering what
the scientific evidence is
that shows your body weight
set point. And we've talked about this.
I'll post some of the podcasts
in the past where you talked about body set
point. Is there a foolproof
method for setting that.
Are there steps that you have to do?
(19:48):
Is there a length of time?
Is it three months or six months that you
have to maintain that weight at?
It's not like that.
I mean, the body set point is basically like
the thermostat in your house, right?
So you set a room temperature.
If it gets too hot, it turns on the air
conditioning to cool it down.
It gets too cold, it turns on the heat to
bring it back up.
(20:09):
Your body does have a set point.
So like that thermostat, it wants to be at a
certain weight. So the question of why
people are over-- you know, if you're
overweight, it means you're set point is set
very, very high.
And you see this of course.
So if you take a person who
is overweight and make
them lose weight, they will very rapidly
(20:30):
regain that weight.
If you take a lean person, make them
overweight, and then once you stop, they'll
actually very quickly go down to their
lean weight because the thermostat had been
set there.
So the question of why people gain weight
isn't just the calories, right?
It's the thermostat. Because if your
thermostat is set very high, then
you're either going to be very hungry (so
(20:51):
that you gain weight to go back up) or,
if you don't eat calories, then your
energy expenditure (how much energy you burn)
is going to go down until you gain that
weight. You know, that's why the 'calories
in, calories out' is sort of all wrong,
because it doesn't tell you how to affect
that thermostat. And it's really affected by
your hormones. So insulin is one, GLPs
(21:12):
are one, sympathetic tone is one.
So there's a list of, you know, four, five,
or six major hormonal pathways
that are going to influence the weight.
So if you push up the insulin, your
body's set weight is going to get pushed up.
You see this, of course, when you give people
insulin. When you give people insulin,
it doesn't matter how much willpower they
have, they gain weight. Why?
(21:32):
Because you're telling your body to gain
weight. There are other pathways like the
GLP-1. So if you give people Ozempic and you
really stimulate the GLP-1s, that
forces the body set weight down, and then you
see they're not so hungry.
So this idea is that it's really set by
the hormones. So it goes up, it goes down.
And it's not influenced just
by a single hormone, but sort of multiple
(21:54):
hormonal pathways do converge on
that. I actually go into a little bit more of
that in The Hunger Code, which is coming up.
It's the sort of follow up to The Obesity
Code, which is coming out next year, I think,
spring 2026.
It's in editing.
You've got a new book coming out.
That's great.
Yeah. So that's going to talk a bit more
about the body fat thermostat and how to
reset it, how ultra-processed
(22:15):
foods are really one of the keys to avoid,
fasting is the other real big key.
Because ultra-processed food actually affects
the insulin in a lot of ways other than the
carbohydrate. So the speed
at which you eat food affects it.
So if you have very soft foods, easy-to-eat
foods, like a lot of ultra-processed
foods, you eat it quickly, it gets absorbed
(22:37):
very quickly, your insulin spikes like that,
your glucose and insulin spike like that.
You can take the same number of
carbohydrates, but in a whole form,
and your blood glucose will be much flatter.
You see this in the glycemic index.
You know, so commercial white bread is very
high, but if you take something like
pumpernickel bread, it's actually much lower.
It's like 20 or 30% lower, even
(22:57):
though it has the same number of
carbohydrates. The difference is how quickly
you absorb it. So speed of digestion,
speed of absorption, speed of eating
all make a difference to that insulin
level. So the key is not eat, necessarily, a
low-carbohydrate diet but a low-insulin diet.
So food order matters.
You know, you can go through some of these
articles that I've posted on Medium.com.
(23:18):
And remember you can always get the friend
link from The Fasting Method.
So if you're not part of The Fasting Method,
you have to pay for the Medium.com
articles.
If you are part of The Fasting Method, you
can get these friend links which will allow
you to read them all for free.
So that's one of the things is to
look at the insulin particularly.
There's no set time period, but just
(23:39):
cutting down the carbohydrates sometimes
isn't enough.
The TRE is beneficial, but again,
I've actually thought recently that
doing these longer fasts every so often
is actually a really great way just
to force that thermostat down.
And it's really made it a lot easier,
honestly, I have to say, compared to what
(24:00):
I used to do, which is a lot of the shorter
ones. I've actually found it a lot easier
using these five-day resets.
And how you break too.
Don't go crazy when you break.
Go right back to a couple of days of
TRE, no snacking, and then go back
to your regular fasting which you've been
doing. So, yeah, this is exciting,
and it's so neat to see the Community
(24:22):
kind of get a new shot in the arm.
You know because the first meeting Jill had,
there were like 220 people in there,
and they were all supporting one another, and
everybody had different helpful hits
that they did. Some things work for some
people and some things don't.
Like you mentioned bone broth.
I don't do well with bone broth, but you
mentioned miso.
I do quite well with miso.
(24:43):
So finding out what works for you is
all part of this.
Yeah, and then if
you find something that works better, of
course, then do that.
You don't have to follow what we say because
everybody's different.
So, you know, some people, for example,
will really like-- we recommend green tea
a lot because green tea has certain hormones
(25:03):
that help reduce the hunger.
It affects a different pathway, the COMT
[catechol-O-methyltransferase], which helps
break down the sympathetic hormone,
sympathetic nervous system hormones, so it
allows that-- so it gives you a bit more
energy but also suppresses the hunger a
little bit better. Some people don't like
that, but I do.
I actually drink it-- one
of the keys I think is-- I drink it
(25:23):
in the summertime.
I make a big pot all the time.
I put it in the fridge.
It tastes-- I think it tastes great.
Some of these ones.
And we're getting this lemon and ginger one,
actually. I don't know when, but the teas are
supposed to be coming.
It's a slow process.
I've been using it iced, and it just
tastes great, right?
So I drink it all through the day and I'm
(25:44):
like, oh, this is just fantastic.
It's as good as anything else, you know?
And experiment with those teas because green
tea works great for me.
Peppermint works great for me.
Chamomile not so much, but that's probably
because it's in the ragweed family and I
don't do well with ragweed.
So, you know, don't just
give up after you try one thing and it
doesn't work, try something else.
(26:05):
Yeah, we have a herbal tea coming, I think,
that has a little bit of licorice in it,
which I actually think is fantastic.
But again, it's one of these compounds (some
people don't like it), but it's got a little
bit of that bitterness, right, and I actually
think it really lends a really great
sort of dimension to it.
The one that we're making, I think-- it's a
caffeine-free one. That's why it has a bit of
(26:25):
mint, a bit of licorice, and a bit of ginger.
It's an herbal tea. It's not a green tea, but
it's-- you know, I just really think it's
great. So that should be coming within a
couple of months.
So yeah, very exciting.
Yeah, I'm excited.
[laughs]
So this next question is, "Dr.
Fung, your kidney patients
who are type two diabetics and
close to getting dialysis but are
(26:46):
skinny, I'm assuming they need to fast
for more than a year to reverse
the kidney damage.
Is this true?
But how do they do so with so little
fat mass?"
Well, kidney disease is not necessarily--
you know, there's a lot of kidney diseases
that have nothing to do with diabetes.
So the biggest cause of kidney disease
(27:07):
is diabetes, but once you have the damage to
the kidneys, it doesn't necessarily
reverse because a lot of the damage is done.
It's sort of like if you don't change the oil
in your car, then it breaks down and you say,
"Now I'll change the oil on my car," it
doesn't make your car run better.
It may prevent further damage.
But the thing about kidney disease is that,
once you have the kidney disease, that
(27:28):
can lead to more kidney disease because
the remaining kidney has to take over, so
it's working harder and it will wear out
faster.
There is a little bit of data in other types
of kidney disease that these five-day
fasts can be useful, some very
preliminary data that it's useful in other
types of kidney disease as well.
And I think it's actually due to the lowering
of the insulin levels.
(27:49):
Because insulin is a growth hormone, it
actually promotes a lot of scarring, which
leads to this nethrosclerosis.
So that's why certain medications, the
new medications that lower insulin-- so the
Ozempic lowers insulin, right?
It makes you nauseated so you don't eat.
When you don't eat, your insulin goes down.
And also the SGLT-2s, which are diabetic
medications, they make you pee out sugar, but
(28:10):
they lower insulin.
So then you can lose a bit of weight, but it
actually turns out to have massive kidney
protective effects.
So it's not necessarily the weight.
Fasting may or may not help.
It may be the inflammation, it may be the
lower insulin, but if you have an underlying
kidney disease process (such as IgA
nephritis, which is the most common cause of
glomerular nephritis overall), it may or may
(28:32):
not reverse, the inflammation may or may not
reverse, so they may still progress.
You know, I wish everybody could just do that
and it would be fine, but it actually-- you
have to understand what the underlying
process is and whether it's helped.
Fasting helps in a lot of different ways,
so probably less scarring.
And that's why, in this very preliminary
study, what they found in the five-day sort
(28:54):
of reset fast is that a number
of kidney diseases were actually helped by
the five-day fast.
It's not that it reverses.
It slows down the progression.
It still progresses, but it slows down the
progression of how quickly the kidney disease
goes on. I mean, it's like trying to get
younger, right? It's very hard to do.
[laughs]
Well, I had a client that was-- I believe he
(29:15):
was like 32 on his eGFR
(estimated glomerular filtration rate) and he
did a lot of fasting. He did fantastic.
And he actually got his eGFR
up above 90.
And then, after staying there
for a year or two, his wife passed,
and he dived
back into problematic food.
(29:36):
Not quite too much processed
food, but still, you know,
he gained some weight back.
Then he had a heart issue.
I think part of it was broken heart syndrome,
but he had to go in for a cat lab
and everything. But his eGFR
remained good.
So now he's back on track, he's back
(29:57):
fasting. So he was very pleased
because that's why he originally came to TFM.
Yeah. Yeah, I've had a few cases where
people's kidney function's just completely
got better, but more cases where
they really just-- you just sort of slow it
down.
You stop the progression of it.
Yeah.
Okay, great.
So this person says, "I know that vitamin
(30:17):
D is fat soluble and is best taken
with a meal, but I've also heard that that
all supplements are better absorbed when
taken with a meal.
Is this true and what
time frame is considered "with a meal"
when it comes to supplement?
Before, during, after?" Then
they also want to know about vitamin D
interrupting sleep, so she should take it
(30:38):
best in the morning? I'm going to say yes to
that because it interferes with melatonin,
but can you address the rest of it, Dr. Fung?
The vitamins... There's water-soluble
vitamins, like B and C, in which case, of
course, you don't need fat.
And then there's fat-soluble vitamins, right,
so A, D, E, K are fat-soluble
vitamins. So therefore, if they're fat
(30:58):
soluble, you know fat and water don't mix,
right? So if you take fat-soluble vitamins,
then they don't get absorbed as well if you
don't take it with a meal.
When is "with a meal"?
Within two hours, say, of a meal
is still fine. Because remember, when you're
eating, that food doesn't go
right into your intestines.
It gets held in the stomach.
So when you eat a meal, it gets held in the
(31:19):
stomach, and your stomach sort of pushes a
little bit out at a time into your
intestines, because your intestines cannot
absorb that much nutrients so quickly.
So your body has a reservoir.
It holds it and then just gives a little bit.
So if you take somebody whose stomach is cut
out for, you know, cancer, for example,
you get this thing called 'dumping syndrome'.
Because they don't have this reservoir to
(31:40):
slowly parcel out a little bit of food
to the intestines, the intestines get all
this food right away. Then you get all these
symptoms and people feel terrible.
So if you take it sort of an hour after
meal, there's still food in the stomach.
You know, there's a bit of fat, there's-- you
know, everything's all mixed up, but then you
can still take it. If you take it before,
well, it's probably not ideal.
(32:00):
It may still be held there, but, on an empty
stomach, of course-- you know, if your
stomach has nothing in it and you take the
vitamin, first thing that's going to get
pushed out into the intestines is your
vitamin. So therefore you're not going to
have the fat that needs to do that.
So if you are worried about that, then,
yeah, take it with a meal or within
two hours, say, two to three hours,
(32:21):
even up to four hours sometimes, depending on
what meal it is, because certain foods get
pushed out much faster.
So if you were to compare, say, an apple
slice to apple
sauce, which is actually baked and--
you know, so you take an apple, you bake it,
you puree it. So it's exactly the same
nutrients.
It gets pushed out into the stomach much
faster because with the apple, the stomach's
(32:43):
sort of churning it and making sure it's good
to go, and then it gets pushed out.
So I think the apple slice
leaves the stomach in like 65 minutes,
and the apple sauce is like 44 minutes.
So it gets pushed out much faster.
But the point is that, depending on what the
meal is, what you're eating, it gets
pushed out faster or slower.
But, say, two hours is
(33:04):
a reasonable amount.
That's why when you eat, after you eat,
your sugars sort of continue to go up,
right? Your insulin levels don't go down the
minute you put down your fork because there's
still food in the stomach.
It's still slowly going into the intestines.
You know, your insulin levels still go up
after a meal and then slowly come down, same
as your sugars still goes up after a meal.
(33:25):
So I'm going to let you pronounce
the medical term for this, but this person
is asking about gallstones
and the formation of them.
And you did talk about this in episode
#171, which is like well over a
year ago, but we're going to revisit here
because this person has said, "How do you
rate the risk of cholelithiasis
(33:46):
in various fasting protocols?
How do you rate the risk of the newer
formation of gallstones if the patient
has already had one or more?
What's your experience with fasting on this?"
Yeah. So there's generally less formation
of new gallstones.
Like, if the gallstone is there, it's a
stone. It's like a little rock, right?
(34:06):
You can't dissolve it.
But if you're eating less carbohydrates and
stuff-- you know, if you're eating more fat,
which is what we often recommend (cutting or
lowering the carbs, increasing the fats),
when you eat more fat, it forces
the pancreas to squeeze out more
of the pancreatic juices and stuff,
including from the gallbladder, to solubilize
(34:28):
the fat.
Therefore, you're continually using
up the stuff in the gallbladder
so it keeps the flow going better.
So if you're eating a super low-fat diet,
which is of course what we told people to do
20 years ago, then you get a lot
of gallstones because your gallbladder
is holding on to this stuff
(34:48):
to solubilize the fat.
There's no fat, so it's just sitting there.
So you get a stasis of that and then you get
stones forming.
If, on the other hand, you're eating fat,
so you're always squeezing your gallbladder
down and shooting it out, it's not going to
sit there, right?
It's not going to be stagnant, and then
therefore you get the stones.
For new stones as opposed to old stones,
(35:10):
you're going to get less if you're going to
eat the higher-fat diet, yeah.
One other thing-- I was just reading
comments. Tara was just saying that
she felt much hungrier day one using the aids
as opposed to the water, salt only.
If that's the case, then don't use it.
So I'll tell you that, on day one and two,
I do the same thing.
I actually don't eat all of that.
(35:30):
I don't need it and I don't really want
it. I do make adjustments too.
So this is sort of a-- you know, it's just a
guideline. So if you do better without it,
I'm the same, right?
I don't need it
to get through day one and two, and it
actually probably doesn't work as well for
me. For a lot of people, they find it very
useful because they have that witching hour
(35:51):
at sort of 24 hours.
And that's what it's meant for, right, to get
over that. I discussed this with Megan.
I said, "Do we really need the sort of
mid-afternoon snack?" And she said, "That's
the worst period for most people." So that's
why we put that in there, right?
I'm like, "Oh, that makes sense." Like, I
don't have that problem personally, so I
actually don't do that.
Day one and two actually, I don't barely eat
anything at all.
I'm mostly just teas and a bit of bone broth.
(36:14):
But again, if you find that it's useful
for you, let us know so that everybody
else can benefit and say, "Hey,
what is your experience?" And if they don't
need it, then don't take it.
It's totally okay.
It's all what works best for you.
For you.
Individual. Yeah.
It's totally individual, and that's why it's
great to be in a group like this where we can
(36:34):
say, "Hey, this is what works for me," and I
can say, "That's what works for me too,"
right? I mean, I'm like-- even though
we use something that we know for a lot
of people it helps, it may not help you, and
that's okay. You don't have to do it,
right? If you want to take a bit more or a
bit less.
And you do fine for a day or two, and then on
the third or the fourth feel you're
struggling, then try the steramed asparagus
and see if that gets you through,
(36:56):
and you can carry on. So yeah, it's
great.
Exactly.
Adapt it to you. Personalize it.
All right, thank you.
That's perfect.
Thank you so much, Dr. Fung.
This was fun.
Okay. Thanks so much.
Thank you for bringing this to the Community.
All right, everyone.
See you next month.
All right.
(37:22):
Bye
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