Intermittent Fasting for Weight Loss w/ Jason Fung, MD

the ketogenic diet and intermittent fasting are really just along that same spectrum they're actually close cousins basically because the ketogenic diet by being ultra low carb and lowers insulin if you compare fasting to a low carb diet the low carb diet actually delivers 71 percent of the insulin lowering has fasting now you can't get better than fasting because you can't get lower than zero right but it gets you most of the way there this sort of ketogenic diet so it actually is very very effective so a lot of the diseases of hyperinsulinemia which is obesity type 2 diabetes can be treated very effectively with a ketogenic diet so I have no problem the other thing that most people have found is that if you're on a ketogenic diet or if you're on a low-carb diet fasting is like really really easy and it's the same thing because your body's so adopted to fat metabolism right so after that first two weeks your body's so used to burning fat it makes a difference if it's burning fat like butter or fat like Barney if I just sing fat right so it just burns it so if you think about it it makes a lot of sense and maybe the in the ketones maybe suppress the appetite so you don't have to eat [Music] hey folks welcome back to another episode it's Mike melt so here with high intensity help calm very excited to be with dr. Jason funk to talk about his latest book the complete guide to fasting and also if you may remember he wrote the obesity code so we're gonna talk a little bit about that today but dr. Fung first of all I want to welcome you to high-intensity Health Radio thank you and commend you for your work and really encouraging people to learn more about fasting and although it seems like a novel idea humans have been doing this for quite a while is everything that's right well really they've been doing it since the dawn of humanity and that's the whole point is that what we have here is a therapeutic modality that's been used for thousands and thousands and thousands of years and now for some reason we all have decided that this is like the worst thing that people have ever done in their life right and like that's ridiculous and if you even look back at all the religions you know they all have prescribed periods of fasting rate some religions more than others but people have always done it and certain cultures like the ancient Greeks they did it for different reasons for them they did it for the mental clarity but there is a long long tradition with fasting in the last 50 years or so there's been this real move against it now for example you mention it and people just roll their eyes they think it's like the dumbest thing they've ever heard I'm like well what's a dumb about it right and that was the point I was at a few years ago when I was working with type 2 diabetics so I'm a kidney specialist and we see a lot of type 2 diabetics and many of them are overweight what you realize is that you have to take care of that diabetes otherwise they're going to progress to have kidney disease and to take care of the diabetes they have to lose weight so one somehow we got to the point where we are discussing fasting I thought well that's the dumbest idea ever right and then I thought well why is it so dumb like what's wrong with it right so then I started to look and really there's nothing wrong with it there's all these benefits and but the bottom line for me was that it's a way that people lose weight and people have always used it to lose weight right and it doesn't mean you have to do fast for 40 days and 40 nights it just means that you have to extend the time let your body burn off some of the fat nothing wrong with that so as I started to look into the physiology and so on then I realized that there was actually all this important benefits that were going on with the fasting and that there is no reason why we didn't use it so that's why we started to use it for all our patients yeah and did you notice blood sugar regulation improved commensurate with the weight loss or was that after the fact like because you're working with that excites you diabetes the the blood sugar often gets better before a lot of the weight is lost so you can often pull people off of their medications take them off of their insulin and so on and that's one of the things that you have to be careful about is that you don't take the same dose of all your medications especially if you're they're diabetic medications and change your diet at the same time because of course there's a risk that your sugars go too low and luckily I'm able to monitor that and advise patients and that sort of thing but yeah absolutely blood sugar comes down it's not really that hard to understand you don't eat your blood sugar comes down right so nothing hard about it yeah and in these diabetic patients do they have a trouble with doing this fasting protocol are they getting into ketosis is that what we're saying or are they when I don't measure ketones so I don't actually know if they're going into ketosis certainly some are going into ketosis but I couldn't tell you because we don't measure we don't have a good system I mean there's systems for it but it's not absolutely necessary either so to simplify things we actually don't do we don't require it of our patients as many people like to see it to know if they're burning fat and so on and if it helps them great but for many of our patients they're older they don't really want to do something extra so yeah what about hypoglycemia yeah I mean that's the major risk right so if you're taking blood sugar medications then you may go hypoglycemic right the question is if you're not taking medication so for somebody who's either not diabetic or diabetic but not taking medications there's always this worry oh you're gonna hypoglycemia well no that's not how the world works right and this is the same thing so if then people always tell you these crazy crazy things about fast one of them is Yoko hypoglycemic and like died or something right so it's like okay if that was true then 100 200 years ago and it was winter and you're living in a cave somewhere and there's no food you don't eat for a couple days well you'd go hypoglycemic and thigh right that's what happens to all the Lions and the Tigers and the Bears they all just have seizures and I know it's like come on that's just ridiculous right if you actually measure the blood sugar of people who fast it typically goes down a bit then stays in that normal range and every single study lei has has shown the same thing the reason is your body will produce some of the sugar the other thing it will do of course is reduce the need for sugar so your body your most of your muscles for example will start burning fat your brain which cannot the body produces ketone bodies and the ketone bodies will provide most of the energy needed for the brain so you do need a little bit of glucose but luckily you can get that from your body fats as well so if you look at glycerol which is the backbone of the fat molecule so it's a glycerol plus three fatty acid chains when you don't eat your body cuts off those three fatty acids the muscles use the fatty acids the cliffs rogas turn into glucose and you have a little bit of glucose but since most of your body is not using glucose you don't really need that much right so that's the point you don't go hypoglycemic right there's the same thing you hear this all the time that the brain needs a hundred and thirty grams of carbohydrates every day so that therefore you must eat every single day otherwise you're gonna die and it's like okay that is just the most ridiculous thing ever that anybody would ever think that honestly boggles my mind because this is basic physiology right not even like physiology 101 this is like high school physiology right like not even like grade 12 and grade 9 it's like the thing is that if you don't eat what happens is that your body breaks down glycogen provides glucose so why do you need to eat you don't when you eat you store energy when you don't eat your body pulls that energy back out so for example we asked people to fast all the time if you're going for surgery you don't eat if you're going for a colonoscopy you don't eat if you're going for a fasting blood work you don't eat if you're going for an ultrasound you don't eat sometimes it's 18 hours sometimes it's 20 hours it depends on what the procedure is yeah so people fast all the time does any one of them ever go hypoglycemic or have a seizure or there's no brain functions they've turned into like slobbering idiots no they feel pretty normal pretty good yeah almost every single one of them yeah you'll hear some idiot writing somewhere that oh the brain needs a hundred and thirty grams of carbohydrates to function you must eat what batma mount every single day each and every day of your adult life otherwise you will become a slobbering idiot it's like oh my god it's like you can't be more idiotic if you cry right because the basic physiology has been worked out fifty years ago and everybody knows it's false so but this is a thing right there's these truths that get passed on and they get repeated so often that no matter how stupid they are people believe them because they've been repeated over and over it's like the calories thing right I'll cut your calories you'll lose weight hasn't work for anybody right no not really I don't think it's ever worked okay the studies have proved it right so it's like why do we think that cutting calories will make you lose weight because everybody says so that's the only reason is there any Brenda my child no right so there's so many examples here where people gonna repeat this and the fasting has more than the usual number of things starvation mode muscle loss there's so many of these myths that go around but definitely the hypoglycemia is not one of the big concerns unless you're taking medications then you have to be careful and so in which case you would work with a practitioner obviously to make sure that we're okay you mentioned muscle loss I think that's a big hurdle or mental hurdle for a lot of people because that you know people are interested in like fine-tuning their health are generally active they're exercising doing Crossfit weight lifting we know that muscles anti aging it's where insulin and so forth you have a great argument as to why it's so it's so silly that to think that you would lose all this muscle when you do intermittent fasting yeah and this is the thing again people have a little bit of knowledge sometimes extrapolate and it's not really warranted so there's differences in terms have what happens as you fast you will start with the glycogen so your your liver so glycogen is change of glucose so as you eat you fill up your glycogen stores and these are all chains of glucose that lasts anywhere from 24 to 36 hours right so if you don't eat for 24 hours for the most part you have enough glucose in your liver you simply break all those glycogen back into little chains of sugar and send it back up so you're not burning muscle and everybody kind of knows that at the other extreme if you're fasting for more than about 36 hours or so you're burning mostly fat but there's a window in there where you do this so called gluconeogenesis where you use protein to kind of produce glucose and that's where people say wow you're gonna lose and I've heard these numbers oh you're gonna lose a quarter pound of muscle for every day you fast you know again you'd have to realize that if you believe that then you'd have to believe that mother nature designed our bodies to store food energy as fat and sugar but when we actually need it to burn protein right it's like okay well that sounds pretty dumb right no system would work very well if it was designed that way if you had it's like you store firewood for your wood-burning oven but as soon as you need it you chop up your sofa and throw it into the fires like why would you do that why would you think that why would you be so stupid right why do you think our body is so stupid that it does that if you're gonna store energy as sugar and fat you're gonna burn sugar and fat right there is a portion in there where you're using some protein so again if you look at extended fasting what you see is that there is a turnover every day of protein and the protein gets turned into the glucose but you don't ramp up that protein it's not like you're increasing the burning of your protein so if you think about it if you have repeated so assume let's assume for example that's true that you lose a quarter pound of muscle for every day you fast so that means in a year I should lose let's see I do maybe three days a week perhaps right so you know so say in a couple years I should lose all my muscle right I should be like 100 percent fat right and I'm not I've got bone right got skin right it's not like I burned off all my skin and turned it into a giant blob of fat that's just sitting here right it's like come on that's just the most ridiculous argument I've ever heard and if you go back to studies of fasting so it's like if you think you're gonna lose muscle while fasting then do the study fast people measure their muscle mass at the end of it don't look at urea kinetics and all this stuff because that's not your question I didn't ask you about urea kinetics so urea is the breakdown product of protein do the study where you take somebody you fast measure their muscle mass is it changed and it's like when you compare them no there's not much change right I mean obviously it depends again if you are very obese versus if you're very lean then it's different - okay so a very obese person will burn much more fat percentage-wise than a lean person you make sense again the body's just not that stupid right so the the estimates is an obese person will burn about 90% of their calories as fat whereas the lean person is down at 78 so they are burning more protein interesting so absolutely and this is why because there's just a lot more fat than the fat person right so you're gonna burn that that's just smart right so this is the thing if you're worried about that you do the study so recently there is a study where they compared caloric restriction to alternate daily fasting so you got to remember that anytime you lose weight your lean mass also goes down right so it's not like pure fat that you're losing so you can't take your baseline as zero Pro lean body mass loss right and this is the mistake everybody always makes again they say wow you're losing lean mass well you lose lean mass anyway right which one is worse mmm so they compared the lean mass loss in a fasting regimen versus a daily caloric restriction and so if you look at the lean mass percentage so after I think 32 weeks so 6 months they've measured it and the lean mass percentage went up because you're losing more fat than lean mass in the caloric restriction by 0.5 percent and 2.2 percent in the alternate daily fasting in other words the fasting group was four times better at preserving lean mass compared to caloric restriction in other words it's way better more agen yeah way better right and the reasons are simple right it increases growth hormone it increases noradrenaline those are so-called counter regulatory hormones counter regulatory hormones are so named because they counter the effect of insulin so insulin lowers your blood glucose when you're fasting you want to pull that sugar back out so raised blood glucose so that's what they do so growth hormone noradrenaline so what the noradrenaline does is of course give you more energy and keeps your metabolic rate high and the human growth hormone means that when you start eating again you will lay down lean mass right so your body's not that stupid right it knows that you're gonna have periods of starvation or fasting right fasting is basically the controlled version but in the cavemen days it was starvation you had nothing eat for seven days it says you know there's no there's no you know Robbins around right so you can't eat anything and your body knows that so what it does is is that it's evolved as mechanism where you're not going to lose all your lean muscle because you can't if you did you'd be dead right after five days you burn all your muscle and you've gained all this fat right now you've just got fat right like you you know all these native Indians and Native Americans and Kalahari Bushmen and the you know aboriginals they have these repeated feasts famine cycles so they should be like little balls of hundred percent of fat right every single one of them right it's like that doesn't happen right so this is again another myth that gets perpetuated because everybody wants you to not fast there's no money in it right there's no money in it for anybody nobody wants to promote it you know nobody wants to be a champion for it because it's just like hey how am I gonna make money if I promote it right yeah so it doesn't make sense for most people really interesting and going back to the evolutionary aspect of it you know that the people that couldn't do this the people that couldn't preserve lean muscle mass and burn glycogen and then fat overtime their genes probably are not here because they didn't make it right yeah exactly so that's another come the other thing is that not all that protein is good right everybody has this inherent bias that all that protein is really good stuff right well there's all kinds of situations where that protein is not good stuff right so for example an Alzheimer's disease there's all this abnormal protein gumming up your brain and that's why you can't think right well what if you had a process which could actually break down this junky old protein and get rid of it well that's what fasting does because again your body's like Huah I'm not getting any nutrients here let me look for any other junky old proteins that I don't need let me break them down and that process is called a toff adji and it's been a super hot topic because the 2016 Nobel Prize in medicine went to one of the pioneer research and etaf adji it's super important because you can theoretically prevent all kinds of disease cancers for example because all those cancer cells they need glucose are gonna die but also your body's gonna target them say what the hell is this let's burn it for energy right all that flabby excess skin I never I have never referred a patient to a plastic surgeon to take off that excess skin from weight loss why because your body can take care of that right and everybody says oh how can you know how you know well think about it first if you look at pictures of Holocaust survivors or American prisoners of war in Japan from World War two they were big guys they went and got starved for a long time when you saw those pictures that they have like flabby loose skin everywhere you know no because your body says I don't want that flabby loose skin and I need energy I'm burning that protein right now right so it takes it burns it all down into energy and that's it because it's not necessary right and that's the thing is that everybody thinks these excess proteins are good I don't think they're all that good I think that there's actually a lot of protein that could be gotten rid of like if you are obese then it's a very good option for you because you know for a fact that you're going to be burning more fat than protein if you're very lean it may not be the best option for you if you're lean and you want to build muscle these long fasts are probably not your best is not probably not your best idea right and it's not that fasting as bad is that you're not applying your the knowledge that we have to your situation right so we get it exactly so if you're 400 pounds and types you diabetic yeah maybe a long fast is good for you if you're a hundred and fifty pounds an all muscle and you're worried about performance athletics that five-day fast not necessarily good for you right because you don't have a lot of fat you're gonna be burn more protein proportionally and maybe you don't have a lot much excess protein anyway right so yeah maybe not the best idea so there's there's a lot of context in this right and it's like anything else right it's like running do we ever say oh I went out I ran a marathon I didn't do any training but ran a marathon I just about died right it's like well that was stupid right that's what we tell them right we didn't say oh writing so bad for you right but we do that in fasting some guy so I'm gonna do a 30-day fast water only I'm like and you're like 110 pounds and then it's like oh he really almost died I'm like well that's because he was stupid right not because the fasting was bad you've got to take it in context it's a therapeutic tool that means you can use it or not use it right you got to know where to use it and apply the knowledge and this is a thing right it's it's it's you know we get to this point of hysteria where we just look at and say oh they'll be fasting so bad for you right there's so much inherent bias against it yeah what I've heard is it lowers glutathione and in burns muscle those are the two big ones that I've heard quite a bit but I want to go back a little bit you there's a lot of things that we just want to catch everyone up make sure we're all on the same speed you said you fast three days a week periodically what does that look like so I typically do 24-hour fast so the thing is about fasting is that there really is any duration you want to do right so you can do longer ones you can do so Jimmy Moore did a 21-day fast for example and you can do kind of sixteen eight which is a 16 hour fast everyday which is also a very good thing our number one rule is to fit it into your lifestyle to where you get the results that you want right so that's probably our number one rule so if you are very obese and type 2 diabetic well maybe you'll have to adjust your life a little bit to fit this in right because you're not getting the results that you want but otherwise if you're getting good results then there's no reason to change so you don't want to change your life to fit the fasting necessarily unless there's health concerns you because it's hard in that you're not going to be able to sustain it because that's not your regular life but for me this is what works well I do a 24 hour fast which means I don't eat breakfast I don't eat lunch so I go dinner to dinner so 24 hour fast if you want to be technical maybe it's a 23 hour fast right but either way it's most of the 24 hours I'm fasting and I'll do that two to four times a week and it all depends on the week right some weeks I have lunch plans right and therefore all eat lunch if I that week I don't then I won't right so that's basically it right so I have no idea some some weeks are very good and some weeks are very bad right so it really fluctuates I haven't down depending on how busy I am so that's really all it is right but I what I do is I fit that into my life and it doesn't interrupt my life in any way right so today for example I'm doing this so I won't eat lunch that means I can go to the hospital and get my work done on time because normally I would go a lot I mean not that I do that much anymore anyway but normally I would take out 45 minutes and go to lunch or if I had lunch plans I would do you know lunch meeting or whatever right that would take that time but now I kind of go in and I'm at the same point so I can go home on time even though I've done something over lunch right but I haven't think to take the time right so this is the thing yeah gotta fit that into your life and nobody even knows right it's it's like it fits seamlessly in so that's why I do it yeah what do I do longer ones occasionally not very often because I tend to have dinner with my family most nights so it would be very disruptive for me to be sitting there not eating well everybody else is eating right now they know I talk about all the time obviously so if I were to say oh I'll sit down with you but I won't eat but again it's a social thing it's you're there you know with your family it's dinner time your talk and you eat and that's what we do right so for me it would be disruptive to do a lot more than that so I don't well I said I mean you're very lean you don't look like you need to lose much weight you're just going after the anti-aging benefits of this and um it helps me maintain my weight honestly I do it more because it gives me a lot more time to do stuff but it also it not just that but I mean there's other benefits but a lot of some of them like the toffee and stuff you probably have to go a bit longer right but it's it's I don't have any specific reason to go longer right I'm where I want to be in terms of my weight and I'm not diabetic so there's no reason for me to do longer right other than if I was you know really just for the challenge of it that'd be about it right yeah I feel particularly today that so yeah I mean either I do like the 24-hour fast periodically I've been doing once a week I'm after listening reading your book and hearing yeah you talk about that let's talk about the anti-aging properties a lot of people are spending a lot of their discretionary income on Botox and liposuction whatever trying to slow down the aging process and you mentioned that when you go into this when you when you're fasting you increase growth hormone and other anti gene hormones get rid of the junk you don't need what have you seen I mean this can be anecdotal - dr. Fung from your patients like skin tightening do they look younger I perceive notice that with people that do intermittent fast yeah I mean definitely because a lot of these sort of things are the skin for example is protein so therefore you can have differences in the skin that come around with intermittent fasting so some people have noticed it definitely I mean Jimmy Moore was talking about this other skin tags popped off and so on and you know when I looked at his you know that's a fairly extended fat so it gives you a good idea when you look at him or the other day when he finished the 21 days it's like wow he looks really good yeah you know that's what I thought the other day he he just looks very healthy obviously has more weight to lose that he'd like to lose her life so does everybody right but he just looked like he had that kind of vitality right and it's not all about weight right you can be all you know thin and still not look you know healthy so definitely what happens during the during the process of fasting is that you get rid of all the kind of old old cells which is the tofu G and it's whenever you want to renovate for example a house you actually have to tear down all that old stuff first right so what you do if you have kitchen cabinets you want a renovate you got to tear all the old ones down then you put up new ones right you can't simply put up new ones and that's kind of our mistake is that we think that oh everything's good everything's good but you can't build a new cabin on top and an old one right you got to tear it down that's what fasting does right it tears down all the old stuff then when you do eat again then you'll build new stuff right and that's a lot healthier it's a lot better for you then just trying to add on right and that's that's one of the kind of secrets and you know it's it's obvious it's intuitive when you think about it but most people don't really think that deeply so they always think Oh more protein is better more protein is better let's just keep doing this with the protein yeah really interesting I love that analogy it makes a lot of sense intuitively like like you said and to kind of get rid of the weaker cells let's talk about a toff Ajit so this is a hot topic in the anti-aging community as well and I heard you say I actually got this question I did a kind of Lunch and Learn yesterday for some integrative naturopathic doctors and one of the questions came up about so etapa gee it takes like they were asking is it 36 hours 48 hours I haven't looked at that particular research it actually depends on mammalian target of rapamycin that's one of the big was we just called mTOR so mTOR is a major regulator of at otha g and it's actually protein that is the big turn-off right so what happens is that mTOR is essentially a nutrient sensor it kind of senses how much nutrients are coming in so if if you've got have a little bit of protein it actually kind of senses that very very quickly and the mTOR is what turns on and on off at otha g so you could be fasting and so if one of the things we use is bone broth and it has a lot protein if you want a toff a G then it may be best not to use it because you may turn off that kind of esophageal so you on the other hand theoretically and there's not a lot of research into this right but theoretically you could eat pure fat and still get a Tov G right so if you ate zero carb because again it's not the calories it's not a calorie sensor it's a protein sensor so it's very interesting that if you pure fat so some people do this right thank you fast and MCTS or bulletproof coffee or whatever it is you could actually theoretically not fast at all you could be taking hundreds and hundreds of calories Rea with bulletproof coffee all times a day right you could easily get 1,500 calories if you take a couple of cups of that right you can get almost all you could get almost all the benefits right so that's very interesting now there's not a lot but in terms of length you're probably so it could be zero right as long as you're kind of avoiding all the protein if you are taking protein you could be doing this kind of bone broth fasting and never get at auction right so but if you're doing kind of classic water-only fast my guess is somewhere between 24 and 48 hours my guess is also that it depends a little bit on your underlying state so if you have a lot of you know kind of underlying protein then you're gonna get rid of it right but if you don't then you're not that's right so again if you take those say Holocaust survivors right it's not a good idea to turn on a talk guys have nothing Yeah right so I think you have to kind of take that into account too so for regular people assuming you're doing kind of classic water only I'd say somewhere between 24 and 48 hours again because of the glycogen stores and so on obviously if you're in a kind of low carb state already it may not take that long because you're kind of in that kind of pre ketosis state kind of thing yeah two things come up without that that I think people are interested what's the link between so elevated levels of mTOR Drive the tofu Jie is that kind of signaling molecule that triggers that or is it the opposite I think it's an opposite I think it's a negative regulator I see yeah so it's it's it goes so I think it senses protein as the main thing M Torres and then I think when a Matar goes up it goes down or something like that so a lot of people are taking like branched chain amino acids while they're fasting so that wouldn't it gate the etapa G this is whatever I was getting yes interesting so it would but certain ones are worse than others so I haven't looked specifically then to which which ones I had written it down but honestly there's yeah I can't remember it's not important but there are certain ones that are more important for mTOR than others is is it's a I don't remember if it was the branched chain ones but it's the same thing right bone broth which is relatively healthy and branched chain amino acids and stuff yeah you could lose some of the benefits from that and again to me it's like well if you're not gonna do if you're gonna do it and you're worried about it then do classic water only when you eat take your branch chain amino acids right and what's wrong with that take it when you eat right so it doesn't it doesn't mean that you can't take it but when you're doing your fasting then just do the fasting right don't don't try and mix up the two the same thing with the bone broth which is again a fairly healthy thing if you want to do that you can change the schedule so that you take the bone broth when you eat right so we get the benefits there's all these other kind of traditional benefits of bone broth yeah we use it to increase compliance truthfully so ok feel like it's easier the other reason we use it in more extended fast because then you can put some salt in it's easier to get salt so if you do water only getting very little salt which sometimes causes people to get a bit dizzy and sometimes causing some headaches and stuff so other people have done salt and water which sounds super gross but apparently when your salt complete it tastes pretty good so for that we say well then use a broth or a vegetable broth for those vegetarians because then you can put a lot of salt in and then you won't get that those sort of symptoms so it increases compliance because it makes it easier you still get most of the benefits of the fasting it's not a true fast but yeah most of it right so I'm not big on saying that oh you have to do it because then technically it's not fine I only care about results right how you get there you know makes no difference to me if you do a standard diet and get to where you want to go then hey we like to tell you not to do what you're doing right right but if you want to change its because whatever you're doing is not working then I'll show you what I think is the best way right and then you try it and see if it works yeah and so those recommendations how specific are they in terms of weaving in the bone broth or the salt is it after day two or three or just when you feel a little no we usually have people use it just whenever they like it and if people don't do well then we simply tell them to cut it out okay but we have older patients so typically we will stick to shorter fast iterations so again this is that kind of context if you're trying to treat like seventy five year olds which I am then you probably shouldn't be so aggressive because then somebody could get hurt right so we'd shy away from like a 30-day fast right but if you're like looking for a challenge and you're 400 pounds and you're 40 years old and you're pretty diabetic well you probably could do an extended fast as long as you're kind of monitoring yourself you got family around you and stuff right sure go ahead right there's nothing wrong with that but there the context got to use it where you think it's appropriate mm-hmm and as a nephrologist what have you seen in terms of restoration and kidney function through fasting in these elderly folks there's very little okay so yeah I'd hoped that people would get better but then truth they don't the kidney disease once if the damage is done is almost irreversible so there are a few people who have reversed some of the mild art so kidney disease the fewer than I would have liked and the truth is that that kidney damage takes many decades and you know even making them better you can't reverse that damage it's like if you have a car and you don't change the oil then it breaks down oh now I'm gonna change the oil well you know it's still broken down right yeah it doesn't matter if you change it now right you had to you have to prevent the damage it actually goes for a lot of organ systems the organ is very good at repairing damage but when that damage happens it's very rarely reversible pranams damaged anyway so you have to prevent it yeah which is the whole point of this podcast is preventative medicine so people don't have to worry about that so much one thing that's come up is hormone issues like low testosterone we know that you know low hormones low androgens and Men precipitates in some resistance that obesity and so forth so what have you seen as a practitioner in men like hypogonadism maybe you see and testosterone increases fasting there's not much of a difference so we get this question with women and fasting a lot so the main hormone that's affected in terms of fasting is insulin because that's really the main hormone involved in energy metabolism energy regulation and some people say wow about the thyroid I'm like there's may be minor effects but nothing major yeah we've put hundreds of people on and we haven't seen a lot of thyroid disease some people will have thyroid disease anyway yeah but it doesn't seem to precipitate it because it has nothing to do with thyroid and it's the same with the testosterone is the same with the sex hormones and estrogen so it doesn't make it better and it doesn't really make it worse so there are certain issues like polycystic ovarian syndrome which are actually part of the metabolic syndrome which do get better but for the most part it's no difference and that's why some people say all women shouldn't fast I'm like well where do you get that from right and it's always the same studies of five rats that somebody pointed out at one point yeah and it's kind of ridiculous because you know women have fasted for thousands of years right you know literally millions of women today fast rate all the Muslims all the Christians right Muslims doing and Ramadan we just passed Yom Kippur and yeah it's day of fasting during Lent millions of women fast right so literally hundreds of millions of women fast at some point during the year so if they're gonna have problems like don't you think we would have heard about them right yeah and if we heard about him then somebody would have said you know maybe the Prophet Muhammad or Jesus Christ or Buddha would have said well you know look at all these problems women are having with fasting you know we shouldn't do it right there's and otherwise we're gonna kill them all right or if you're gonna but again it's all context right so there are women who shouldn't fast pregnant women breastfeeding women and if you're underweight because if you're underweight and you have no fat you shouldn't be fasting man or woman but the women are gonna lose their periods right so yeah they should be fasting that's just common sense right yeah but we turn around and blame the fasting when it's like well you should blame your own stupidity because if you are seriously underweight then fasting is a super bad idea right you see the same kind of hysteria around anorexia nervosa yeah no you know the it's ironic actually because when you talk about fasting the first thing people say after they roll their eyes is they say nobody's gonna do that and then you say oh well I have hundreds of people who do that and then shortly thereafter then you're gonna give them all anorexia I'm like okay first you thought nobody would do that now you think they're gonna love it so much that they won't stop doing that right it is like come on you can't have it both ways and it's always funny because it's like okay first of all anorexia nervosa is a psychiatric disorder of body image right so it's not simply that you're not eating it's because your mental state is disturbed so that you think you're seriously overweight when you're not that's not what fasting is right so it's like saying oh you shouldn't wash your hands you're gonna get obsessive-compulsive disorder it's like okay that's dumb right it's the same thing the second thing is that it's not that much fun right it's not like I'm gonna get hooked on it like cocaine right I mean I've treated hundreds of people it's a challenge to get them to do it Yeah right even when they have a lot of motivation to do it anorexia is almost the last thing on my mind but again here's the context if you're a 60 year old woman who is 250 pounds type-2 diabetes you need to lose that weight anorexia is not my concern anywhere in the top 1,000 medical problems that could come up right so don't talk to me about I'm gonna give them anorexia nobody in that patient profile is going to develop anorexia nervosa in fact many of them won't do it because they just don't want to right if it's in 18 year old model from New York who has a body mass index of 16 yeah I wouldn't do fasting for her but that's just common sense right so this is the whole thing anorexia nervosa is a serious problem but fasting which is only the symptom is only part of it right it's a it's not the disease right it's only what they do because they have this disease but it doesn't mean that you should throw it out as a therapeutic option for everybody so in terms of hormones you know thyroid hormone and sex hormones and all these other hormones they're really not that affected that much interest we're really talking about the insulin and the counter regulatory hormones cortisol is a question though because it does go up mm-hmm right cortisol does go up it's part of the counter raikage our hormones so if you have problems with high stress levels increased cortisol remember fasting is a stress to the body right yeah there are things that stress the body that are good right there's also bad things too but exercise is a stress to the body too right you stress the body and the body responds by getting stronger fasting is much the same it's also a stress to the body it can go overboard right so again you have to know what you're doing but for the most part I mean people have been humans have been doing it for thousands of years right if you start fasting you feel really bad and you think your cortisol levels for whatever reason are sky-high and then you can't deal with it then yeah then it may be not for you or maybe you need to shorten or maybe you need to change you may mean to alter it some way because there's insulin flexibility the other hormone that does go up of course is noradrenaline so you do get more energy and you don't get that basal metabolic rate decrease that you get with caloric restriction which interest are key to weight loss right it also sometimes causes sleep disturbances and it's because they're so full of energy that they actually can't sleep or wake up and can't go back to sleep yeah and I tell them then don't go do something read a book you have to do some work whatever you want because your body is telling you you don't need to go to sleep right you've got lots of energy and the thing is that that's that's okay you're listening to your body but getting back to the basal metabolic rate decrease actually that is the most important part of weight loss losing weight and never a problem right every single diet you can lose weight for six months you can lose weight the problem is almost all diets they go back up yeah all right and this is the problem is that as you lose weight your basal metabolic rate will go down so you're burning less calories and then that weight plateaus and then it goes back up and it happens for almost all diets and it's interesting because we've known about it for like a hundred years but what doesn't decrease your basal metabolic rate is fasting okay so that is a huge advantage in weight loss because that means you can keep that weight off right so it's huge so if you compare for example this recent study that is telling you about where they compared daily calorie caloric reduction to alternate daily fasting you can see that the caloric reduction decreased their basal metabolic rate by about 80 calories a day which was statistically significant whereas the the fasting one decreased it by about 29 which was not statistically significant all right p-value of like 0.48 or something like that right so in other words what that tells you is that caloric reduction reduces your basal metabolic rate fasting does not make a huge huge huge huge huge advantage it's like almost impossible to emphasize that enough because that is the one problem that always occurs with weight loss if the weight regain weight plateau forget about the weight loss everybody can lose weight on almost any diet right that's why the six-month results are always great it's the BMR right the BMR the other one is a hunger of course but what I think is interesting about that particular study that you're talking about is if you look at the end of one week I would imagine the calorie intake is pretty equivalent would you say where it's for which one for well between both the intermittent fasting group or the alternate day fasting where there's two studies actually one of them actually controlled for calories which is very interesting because they controlled for calories so intermittent fasting versus caloric reduction same number of calories same weight loss at the end of six months right but that's not the key the key is the long-term right and unfortunately they didn't go past six months but what you found was that the insulin resistance was much better with the with the fasting group and the insulin level was much better so again a reflection of the insulin resistance the other study was actually not calorically matched so the fasting people were eating less calories than the caloric reduction people yet did not reduce their metabolic rate hmm right powerful very very powerful oh yeah it's it's so important that part is like so important because that is the key like I don't know why nobody else talked about it because that is we know that right all those studies for example that recently came out about the Biggest Loser studies right so that got a lot of press rightfully so they're good studies right but what they pointed out was that the reason why nobody practically nobody could keep that weight off was the decrease in basal metabolic rate except for I think there is one person and is very interesting because the other person had bariatric surgery which is you know another form of very severe caloric restriction right what happened to his metabolic grade was they went back up yeah very interesting so really I mean if we can kind of summarize the intermittent fasting or alternate day fasting as a kind of a protocol people when embark on why how is it different than calorie restriction is it probably is affecting similarly molecules throughout the body in a different way than just cutting your calories isn't epigenetically remains yeah see the thing is that everybody tries to pretend like it's all about calories but you've got to get out of that mindset because the calories really has nothing to do with it fasting is about time not eating right it has nothing to say about calories the calories zero right but it's really about the time that you don't eat it's about changing your hormones changing your insulin changing your growth hormone changing all that right it has nothing to do with calories right so everybody says wow fasting works because it reduces calories well no because you can compare the two and you will see that there are differences so it's not all about the calories there's the same thing if you say it's all the same well you can say wow it should be the same if you jump off a one foot wall a hundred times or if you jump off a 100 foot wall once it's the same it's all about the foot to the feet right it's a I don't eat exactly I'm like oh except that one you died and one of them you don't right that's a huge difference it's the same thing so fasting even if there is the same calories is not the same the hormonal changes are not the same and that's the point of the obesity code is that it's not a caloric just imbalance it's a hormonal imbalance right so cutting calories does not fix that hormonal imbalance right fasting to some degree helps it much better right and there are other things you have to change the diet maybe stress maybe sleep there's all kinds of things to do with obesity that have to be changed in order to for you to fix it yeah of which one is fasting you know it's not everything right some people it stresses cortisol right so some people have chronic pain syndromes and stuff I'm like well your cortisol is like through the roof right fasting not it's gonna help you at all right it's gonna shoot it up even more right and you shouldn't do it right so you have to kind of understand that but the problem is that we've got to the point where we just kind of poopoo it for everybody right yeah it's also not a cure-all for everybody ya know the quarters are you testing that serum is that what you're saying or you don't test it I mean we do we have looked at studies of people who test it then we're we're not a research lab or anything so we don't test it it's not it's not easily available none of the hormones are easily available because hormones in general are pulsatile so you can't actually measure it easily you didn't do things like 24-hour urinary cortisol but they're hard to do and you know and yeah and we just make our clinical judgment yeah and just tell people I mean my personal experience with fasting I don't get that like fight-or-flight response it you get in traffic but you definitely feel more energized that's an end of one but some people and so I think this is a lifestyle shift and so meditation and heart math and doing you know mindful base therapies as part of the equation yeah for people yeah I mean there's so many different ways you can incorporate it and that's really the key right you could do once a year long fasts right some people recommend that for sure you could do short daily fast 16:8 right every day you eat within an eight-hour window and remember this in the in the 50s for example there's very little obesity you know people are eating white bread right yeah right cookies ice cream right there's no whole wheat bread or if there was nobody ate it right I know I grew up in the seventies nobody ate whole-wheat bread ever right there is no whole-wheat pasta right everybody ate regular pasta but the key was there is no snacking either right so what happened is that you eat within usually a 10 hour window right you had breakfast at 8:00 you had dinner at 6:00 and everything outside of that there's no snacks you didn't eat in the car you didn't eat up the theater you didn't eat anywhere else except at a table right with family or coworkers family or whatever right you're not eating at your desk you're not eating in front of the computer you're not doing any of these things where you're eating but doing something else this is kind of mindless eating sort of thing right so what that means is that you've got a 10-hour eating window you've got a 14 hour everyday fast right guess what there's no obesity but they're eating white bread and jam like crazy it's there every day yeah I packed the sandwich with white bread every day right you know to school so it's like that's crazy because this is the thing you can you can go back to that time where you kind of take those three meals a day and you know lots of people at that time like in France for example they'd have coffee in the morning that's it nothing they were really healthy right and even the word itself break fast right it means you have to fast you can't break the fast if you're not fasting it's a part of everyday life and we lost that balance and for some reason we listen to you no real fools that keep telling us oh you got to eat the minute you roll out of bed like if your feet at the ground and you don't have like a you know cereal in your mouth you're gonna die right it's like okay you guys are idiots right now and then you have to eat right up until the time you could bet it has to be breakfast snack lunch snack dinner snack and then another bedtime snack there's like that's supposed to lose weight you're supposed to eat more to lose weight like that doesn't sound like it's gonna work right right you have all these kind of you know even doctors who kind of spout this tremendous nonsense and it's like okay where's your trial to tell us that that's really useful advice because that advice sounds really dumped right of course they have none but now it gets in trying to guess repeat enough it gets enshrined into this kind of wisdom it's like you know is there any historical background of this no yeah right nobody's ever done that before and nobody's ever had this obesity crisis before well you may they might be connected right yeah really all the time obesity crisis right it's like not that hard right there eating Oreo cookies in the 50s there eating kid dad's right nobody cared that much because they have that daily fast to kind of reset themselves reset themselves and if you tried to take a snack that's like there's no food to eat in the house right there's a cold pot roast from leftover from dinner right actually cook and prepare mom it yeah exactly it's not like it's not like their stuff just lying around but now we pretend like oh oh yeah we're gonna leave like granola bars around and stuff sugary go-to enola bars so that you can have a little snack at nighttime so you can lose weight and like yeah it's really good I can't believe people actually tell you this right yeah I'm saying really insane really interesting so let's go back a little bit to the bolt proof coffee situation where some people are using like MCTS to kind of mirror the where we want to see it the metabolic phenotype of calorie restriction or of intermittent fasting by going into ketosis is there any problems that you see with that and you're really so if you understand the physiology all the benefits of fasting or many of the benefits of fasting come from reducing insulin right well pure fat has almost no insulin effect so if all your consuming is pure fat you're getting a lot of calories but you're not getting a lot of insulin right so therefore you're getting almost all the benefits of fasting and guess what that's a lot of people have said that it's really helped them and the fat keeps them full and makes the fasting easier and I'm like hey if that works for you then I'm good with that right now for other people they find that it slows down their their their weight loss and I said well then don't do it right but theoretically from a physiologic standpoint yeah if the point of fasting is to lower insulin and the fat fasting or the bulletproof coffee also lowers insulin then yes this is fine so I actually think that there's a lot of good reasons to believe that that would work yeah and along those lines a lot of the folks like John Rowe and other folks in the ketogenic diet space during research and drug resistant seizures and so forth have found that intermittent fasting and the ketogenic style of eating go hand-in-hand well actually so there's a lot of the crossover there so I think it's important that we're having this conversation yeah the ketogenic diet and intermittent fasting are really just along that same spectrum they're actually close cousins basically because the ketogenic diet by being ultra low carb lowers insulin if you compare fasting to a low-carb diet the low-carb diet actually delivers 71% of the lowering as fasting they can't get better than fasting because he can't get lower than zero right but it gets you most of the way there this sort of ketogenic diet so it actually is very very effective so a lot of the diseases of hyperinsulinemia which is obesity type 2 diabetes can be treated very effectively with a ketogenic diet so I have no problem the other thing that most people have found is that if you're on a ketogenic diet or if you're on a low carb diet fasting is like really really easy mmm and it's the same thing because your body's so adapted to fat metabolism right after that first two weeks your body's so used to burning fat it makes no difference if it's burning fat like butter fat like Barney back it's the same fat right so it just burns it so if you think about it it makes a lot of sense and maybe the in the ketones maybe suppress the appetite so you don't have to eat right so there's so many ways that they kind of go together that they're really you know one is just kind of a ramped up version of the other one yeah that's it right you know a lot of people worry about nutrition or nutrient density and so on but again you have to take it into context right it depends on what you're treating so if you're worried about getting enough nutrients okay then yeah you have to worry about nutrient density all that I'm typically I typically treat people who are obese so I'm not worried at all about nutrient density because they have way too much in nutrients right so I don't care so they can fast because I don't need them to get more nutrients they have had enough nutrients right I don't need more nutrients why do they need more like what nutrient are you talking about right are they gonna get like scurvy or something right I don't think so Yeah right so that's a thing so if you're on the other hand kind of one of these performance athletes and you're looking to build muscle so if you want to build muscle you're gonna take more muscle because you got to deposit it to build muscle then yeah you better worry about getting enough protein sure right if you're obese and trying to lose weight for health reasons then you don't need to right so there's there's a difference right and you got to kind of keep in mind all the time when you take what somebody says because that's where everybody gets into trouble right somebody takes what I say at a context where I'm treating a 65 year old diabetic women and they're you know they're like a 22 year old CrossFit athlete exactly I'm like yeah what I say doesn't apply to you all right whereas the ketogenic person who's taking super high protein because they're looking to build muscle yet that doesn't apply to this 70 year old man who weighs 350 pounds right he doesn't need more protein he needs to break down some of that protein on his body before he starts taking more right so always keep that in mind because we're talking about different things and it all depends on what you want to do if you want to build muscle then yeah you got to adjust it if you want to lose weight you can adjust it if you want to treat Type 2 diabetes you got just what you're doing yeah really good I love that context it's everything it's really worth everything yeah and so that encourages people need to think for themselves a little bit and do the trials on themselves like take this information and customizes a little bit to their own lifestyle needs and speaking of your own lifestyle it needs dr. Fong I want to kind of pick your brain a little bit these are three final questions that we asked every guess in the podcast about your morning routine so you've written two books you have busy practice here and then also in the hospital with the kidney patients I know your mornings pretty valuable probably with family but you stay up on research you have a great blog and all that so what is the first couple hours every day look like well I don't eat breakfast right I usually just have a coffee that's kind of Monday to Friday Saturday on Sundays I usually will have breakfast because it's again a family time right and then usually I'm right to work I drop off the kids and I'm right at work right yeah and then I'm either in the office or I'm in the hospital depending on which day it is so when you do your creative time writing thinking reading staying up on research the writing I mean I write mostly I mean I it's mostly like one blog post per week that's about what I do is I try to maintain that it's not bad the book itself the books are kind of more compilations of the blog posts but there's a lot of work to be done taking them organizing them so that yourself flows properly write the blog post it's whatever I think is interest me that that would be right so there is a lot of that that gets put together I usually again when it gets busy I do more fasting I get a few extra hours and it adds up right so for example I've been fairly busy the last few weeks and I estimate that it's at least three to four times a week I've been fasting kind of 24 hours but again I don't have to waste my time at breakfast I don't have to waste my time at lunch not that it's waste but sure you know it gives me time to do something else so that's like what an hour 15 every day a lot four days is five hours a week in a month that's like 20 hours right it's a lot of time yeah and if you need the time then it's it's good to be able to be able to kind of use that when you need to so that's where I kind of get a bit of extra time to do what I interests me and what I want to do right so that's that's kind of what I that's what I what I do right in in the kind of down periods it's more like twice a week right sure yeah everybody likes to eat right so I go eat more right lunchtime or whatever it is but when I get really busy then I probably do it less hmm that's really awesome I mean because a lot of people complain I don't have time to exercise you don't have playing time to do this you know that's a great way to create time is just I mean let's face it eating meal prep driving to go get food even healthy if you like Whole Foods you're sitting in traffic and driving around and waiting in line so yeah it's not just the eating but you got to remember it's the planning the shopping the cooking then the eating then the cleaning off right so it's the same at breakfast right it's like it's not like shower and get out of here right it's like the coffee doesn't take any time just hit the button right that's it ready to go yeah that's really funny so let's talk about your favorite herb nutrient botanical or whole food substance so your macronutrients are covered on a desert island vitamin D omega-3s are covered what other performance boosting substance or longevity promoting substance would you bring with you I don't know I'm not really big into that I mean it's not my major it's not really what I'm interested in because I deal with mostly the opposite spectrum in that I treat mostly excess right so people hire over have over nutrients right so really cutting them down is the main thing so I other than a general multivitamin I don't make many recommendations the only thing that I use sometimes is the omega-3s and I find that it helps me with a bit of inflammation at times like in the joints and so on so the other thing I use quite a bit of is epsom salts which are magnesium salts so a lot of people are deficient in magnesium probably the one thing more than any of the other minerals and so on that we see people deficient in is magnesium if you take magnesium by mouth then it often doesn't get absorbed and it just runs out the other side right so what you do with epsom salts there magnesium salts you dump them in your bath you stir it up and then it soaks through your skin so if you're soaking it for half an hour a lot of magnesium kind of soaks in through your skin yeah it's also very relaxing right you get it the ones that have like some scents and stuff and I think that that's maybe one of the you know more important things to do once in a while is to kind of take a bath right and I always tell this to my kids it's like they go go take a bath I'm like everybody feels better after a bath right yeah it's like that kind of thing you did when you're a kid right nobody wants to go into the bath but when you're in there's something just relaxing about it right it's like the ocean everybody loves the ocean there's just something about it right it's a salt on the sea I think it's the same thing so it's relaxing and so you should do it every so often it's cheap right it's just some water and some salt that's it right it's not like I'm telling you to go to the Four Seasons Maui or something right it's cheap it's like ten bucks a big bag of salt and run a bath and and and it's actually I think those people a lot of good to do that every once in a while soak in it allows you to kind of ruminate on things think about things because let's face it when you're just driving around and shopping and doing errands and you know getting birthday cards and taking your kids to this and then there's not a lot of time to just kind of sit down and think and sometimes that that bath and the epson salts and a bit of that you know the aroma theorem the sort of idea i think it's sometimes really helpful for people like the cortisol it's the cortisol story right it kind of takes it down a notch absolutely and like you said it's a good delivery system systemically for that magnesium yeah interesting that just as a side note dr. fund a lot of interviewed a lot of people that treat autism and that was one of their therapies in addition to like gluten free dairy free diet was epson salt baths well my parents reported great feedback with that so after learning about that about a year ago I started doing that a lot with my daughter you know so it's a cool way to calm her down to she does even kids let me know he just pour the men ease him in there and they're goof around the bathtub and having a good time little do they know they're getting all the many Xion which is pretty cool well they have all these nice scents so I do that for my children as well one is kind of a teenager now so he doesn't take baths right but the other one still likes to take a bath sometimes and he actually likes the scent of it so then he loves to take it he doesn't know anything about the magnesium either I just throw it in because he like it's fruity or whatever I got one more ever he wants right but it's a it's that kind of scent he likes that and so he uses it right yeah really great a great point so final question if you were to bump shoulders with a future President of the US or Prime Minister of Canada someone from the World Health Organization in an elevator just had 30 seconds to share with them a wife a health health or lifestyle tip that you would want them to know to may be influence policy around what comes to mind and what's the most important thing that they should know about well I think that we need to teach people about the therapeutic potential of fasting because if you think about it what we have here is a therapy that has the potential to change the entire health system of the whole world because most of what we do now is diabetes high blood pressure and all the downstream stuff heart attacks strokes and all that but you can take care of all of that for free right the only thing that you need to do is apply that knowledge right you don't need to put money in it you already have all the dietitians you have everybody there but we need to spread the knowledge of how to do it because hey if you don't need you lose weight and hey if you lose weight your diabetes will go away and hey if you don't have diabetes you won't get that better kidney disease right so now you've been able to prevent all this disease probably like 50% of the healthcare budgets of the US and Canada for free right that's an amazing amazing thing so who wouldn't want to do that right right right I mean that's why we have to do it because you know it has so many benefits but it has like real consequences for the patient it's a it's it's preventing diabetes preventing amputations preventing heart attacks or ending strokes from a society standpoint it's saving a hell of a lot of money mmm right and not only that it's saving it the right way which is by preventing people from getting sick that's why we're using less you know hospitals right and all that stuff and moreover people can be more productive they feel better anti-anxiety and productivity workplace marketplace you know be more friendly with your friends and family because you're in a better mood I found so yeah love that tip so as a final kind of parting ways here I know you have a you're big on social media you have a great blog that folks want to connect with you online what's the best way they can do that they can go to my blog it's WWE intensive dietary management calm I'm also on diet doctor calm which is like a great great resource for low carb recipes intermittent fasting there's a subscription site for that where you get kind of extra material but there's tons and tons a free material that's just tremendous stuff so definitely either of those sites is is great cool dr. Fung really appreciate you come on the show okay thanks so much

Channel: High Intensity Health

Views: 3,759,338

Rating: 4.8667049 out of 5

Keywords: Intermittent Fasting, Fasting for Weight Loss, Fasting, Ketosis, low-carb, ketogenic diet, keto, Jason Fung, Keto diet, Dr. Fung, Mike Mutzel, MYOXCIENCE

Id: v9Aw0P7GjHE

Length: 69min 22sec (4162 seconds)

Published: Thu Dec 08 2016

Reddit Comments

[u/Fox_Bravo]

This dude is funging awesome.

[u/rcoronado]

Anyone have a tldr of this? It's an hour long.

[u/Alpine_Newt]

It's not long ago that he would have been ostracised by the medical community for going against the established doctrine.

[u/kleancut]

I dont know, I've been bodybuilding forever and I'm def losing mass by fasting.