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Time-Restricted Eating & Circadian Rhythm Emily Manoogian, PhD Watch here!

Weight Loss and FastingJason Fung, MD Watch here!

Intermittent Fasting & Ketogenic Diet David Jockers, DNM, DC, MSWatch here!

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Intermittent Fasting & Ketogenic DietDavid Jockers, DNM, DC, MS

Dr. Jockers: So, great to be on with you, Sam. I really love what you guys are doing here. I was just sharing with you how if we can get everybody doing intermittent fasting and applying this into their life, I mean, we’re going to significantly reduce chronic disease, improve just mental performance, spiritual health. We’re going to help improve people’s just ability to perform at a high level in every area of life. And so, really glad that you’re getting this info out to people.

Sam: Yeah, absolutely. It’s super exciting. And when you put it like that, it just like seems like a no-brainer, right?

Dr. Jockers: Yeah, for sure.

Sam: If we can talk to people, like yourself, to make sense of it and to give people more confidence and inspiration as to what’s behind it. Then that’s what gets me excited to get up and have a chat like this in the morning.

But today is a different topic. Because I know we’re going to touch a lot on intermittent fasting and the crossover of this. But your gig is the ketogenic diet. And we have spoken about this in the past for people that may have seen that chat. But basically, we’re looking at where our body is moving from a place of just burning sugars to moving to a place with burning fat. And so, what is that about? Like why should we be looking at burning fat instead of sugar?

Dr. Jockers: Yeah, absolutely. So, that’s a great question. So, basically, when we burn sugar,

sugar is a really quick fuel. Like we can convert glucose or sugar into energy very, very quickly, okay? And we can do it without the presence of oxygen. So, there are definitely some benefits to burning sugar for fuel. However, it’s also very metabolically expensive. And what that means is we produce a lot of waste when we burn glucose. We produce a lot of lactic acid and free radicals.

And some of the listeners may have heard of free radicals. Free radicals, they damage tissues. So, the combust. They cause what’s called oxidative stress. So, you think about that like rusting. Like when we see metal rusting because it’s been left out and in the environment. That’s oxidative stress. And that’s what happens in our body when we have too many free radicals. We get that oxidation and this rusting in our system.

And so, one of the top things that causes that is metabolizing glucose or sugar for energy. That’s going to cause that sort of oxidative stress and rusting in our body. And so, we want the ability to burn glucose for energy. But we really, we want to save that for times when we don’t have much oxygen present. Such as, if we are running a sprint. Or you know, doing intense weightlifting. Or just really performing, doing some sort of performance at a really high level. And we want the ability to burn glucose.

But for the vast majority of the time, we want a much more metabolically efficient fuel source. And that’s this thing called ketones. And ketones are basically a byproduct of fat metabolism. So,

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when our body starts to dig into stored body fat or use fat from our diet for energy, then basically it turns it into a ketone. Meaning that, ketones are basically producing the liver and they’re water soluble. So, fats are fat soluble. But the water soluble compound is able to more easily cross into the cell membrane. And get right into the mitochondria and be used for energy.

So, ketones in our body becomes good at using that. It has the metabolic machinery. It’s up-regulated certain enzymes and things like that to be able to use it. It becomes a very efficient energy source. We’re able to use it and produce energy very quickly. We produce a lot more cellular energy from a ketone than we do from a molecule of glucose. Not quite as quickly as glucose, but we still produce it fairly quickly. And we produce significantly less oxidative stress. And that’s really important.

So, we get a lot more energy. And we also are able to produce it with a lot less metabolically waste. You think about like a car that gets better gas mileage and doesn’t produce as much pollution. And is still able to have really great performance. That’s like the best, right? That’s exactly what we’d all love to drive. Something that would get 50 miles per gallon, have great performance, just as good a performance as the one that got 10 miles per gallon, right? And produces significantly less pollution every time we drive it. And that’s really what happens when we burn ketones as an energy source.

And we want this level of metabolic flexibility, where basically, metabolic flexibility is a term where we’re able to adapt our metabolism to burn fuel, to use energy based on the demands of our environment. So, for some reason our environment demands that we go off on a sprint, we have to produce a lot of energy without oxygen. We’re able to very quickly switch over and burn glucose for energy.

And when we’re at rest, like you and I sitting here having this conversation, that we’re able to really

use these ketones as energy source, having less oxidation and oxidative stress, and inflammation in our body because of that. And also, being able to produce rampant amounts of energy. Really a clean energy source for our brain. So, we can function and think more clearly.

So, that’s really what we’re trying to accomplish there with a ketogenic diet. And it goes hand in hand with fasting. Because really fasting, one of the benefits of it is we start to produce ketones, okay? We actually move from burning glucose as a primary energy source into burning ketones.

And the ketogenic diet works well with fasting because we get keto adapted, where our body gets more used to burning these ketones. So, then when we fast, it’s not as uncomfortable and it becomes easier. We don’t have quite as much hunger or cravings. You know, we kind of get to that sweet spot of fasting where we just feel awesome. We get the benefits of it, without as much discomfort.

Sam: Yeah. Wow. Okay. Awesome. And so, if somebody’s not fasting or doing the ketogenic diet. How did they get themselves to burn fat? What happens if they never get to burn fat and they’re constantly living off burning sugar?

Dr. Jockers: Yeah, absolutely. So if all we do is burn sugar as our primary fuel source and we’re not really able to burn fat. Like there are certain individuals that have genetic defects, unfortunately that basically put them in that position, where they’re just not able to use ketones for energy. But it’s extremely rare.

And so for most people they’re just chronic sugar burners because they’re living a poor lifestyle, right? They have really poor lifestyle behaviors. They’re eating all the time. In fact, when we’re continuously eating, like in our society, we’re snacking all the time. You know, when we snack, anytime we eat, eating is in a sense almost like getting a sugar. Or getting a drug fix. Like we get the same response. We have dopamine increase,

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which makes us feel good. But also, when we eat, unless it’s just like pure fat, like having a scoop of butter, which most people aren’t doing. And so, if we eat anything with carbs or protein, we’re going to get an increase in insulin, right? And insulin is a pro-inflammatory hormone. So, it increases inflammation in our body. And we get this sort of oxidative stress that takes place with that.

And so, basically, we just accelerate the aging process when all we’re doing is really consuming food throughout the day, every three hours, or whatever we need. And just grazing and snacking all day, and we create metabolically influx. Basically, create metabolic inflexibility. And one sign of that is insulin resistance, right?

And so, we hear about insulin resistance with diabetics. But you know, vast majority of people may not be diabetics. But they’re in a state of mild pre-diabetic state where they’re already starting to develop pre-diabetes.

In fact, one way to know that is, if you’re not able to go more than four to five hours without food and you feel really a lot of discomfort and hypoglycemic type responses, like having a headache, feeling dizzy, having massive hunger or cravings, just feeling like you need a nap, just feeling absolutely exhausted, and fatigued. If you’re having that sort of an experience four hours between meals during the daytime. Then that’s a sign that you are at least mildly insulin resistant, where your body’s not responding to insulin, not getting sugar out of the bloodstream and into the cells.

So, even though you’re stuck in sugar burning mode. You’re actually not a very good glucose metabolizer either. You are at this metabolically inflexible state, where you’re not good at burning sugar or fat. But you’re still going to be chronic sugar burning mode. Just because that’s really what our body does, right? When we are constantly consuming food, it’s kind of this constant trigger. As long as insulin is up in the body, we’re in this constant trigger of burning

glucose as our primary fuel source. And we’re not going to burn fat.

And that’s a key thing to remember. So, when we’re snacking and grazing all day, we’re never going to be able to burn fat as our primary fuel source. Because insulin will be elevated. And so, we’ll be in this chronic sugar burning mode, producing a lot of oxidative stress, and inflammation. So, we’ve got to really watch out for that.

And one way to start to change that is to change the foods that we’re consuming. Go on a lower carbohydrate diet. And really focus on healthy fats. Things like avocados, olives, olive oil, grass fed butter, coconut oil. Coconut products, like coconut butter, coconut milk, coconut flakes. Do moderate protein, where we’re not doing high protein. But just small amounts of meat or small amounts of protein powders.

Nuts can be another good source of protein and fat, you know. And non-starchy vegetables, like cruciferous vegetables, dark green leafy vegetables, low-glycemic fruit like lemons and limes, stuff like that. And we start to really focus on those as primary points in our diet.

And then that’s going to start to switch us over to burning fat as our primary fuel source. Because those foods keep insulin low. They’re not in slow genic where they’re not promoting the release of insulin, whereas, if we’re consuming, for example, a lot of fruit, high sugar fruit, especially like pineapples and watermelon and stuff like that. Or if we’re consuming grains of any type or starches. If we’re consuming a lot of that on a daily everyday basis. Then we’re going to probably be producing a lot more insulin. And we’re going to be stuck in sugar burning mode, producing more oxidation, and more inflammation in our body.

Sam: Okay. Awesome. And so, I know that you have a lot of recipes on your site as well. And you know, people that might be thinking, “Oh, but what about if I like having sweet foods and stuff?”

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You have some epic desserts and stuff. So, it’s not like restricting completely. Why do you think that this works on a long term opposed to a lot of other diets that never kind of work? Do you understand what I’m saying?

Dr. Jockers: Yeah, absolutely. So, a lot of diets, especially like weight loss focus diets, they use basically calorie restriction, where it’s like, basically, you eat during the day. But you’re just trying to restrict your calories to a certain amount. So, you can burn more fat. And you know, that can work short term. That can actually help your body become more of a fat burner short term.

But overall, if you’re not really watching your foods, you’re going to end up with a lot of cravings, a lot of hypoglycemic type responses, a lot of bingeing that takes place. And so, that’s really not the best approach long term as a sustainable method. Because, again, there’s just a lot of people are having trouble with long-term compliance on those sorts of Weight Watchers diets.

Plus, I think a big thing is we want to really focus on real foods. And not fake foods, artificial sweeteners, and things like that. So, we want to really focus on real foods that help our body become better fat burners. We talked about some of the best food groups. Things like avocados, coconut, coconut products, grass fed butter, olives, olive oil these are really good. Cruciferous vegetables, dark green leafy vegetables. Things like cucumbers, celery, lemons, and limes. And clean protein, so, wild caught, grass fed, pasture-raised animal products, these are going to be the most nutrient dense foods we put in our body.

And ultimately, when we look at our diet, we definitely want to make sure that we have the maximal amount of nutrients. And the minimal amount of toxins. And so, that’s one of the reasons why we want to make sure we’re getting organic pasture-raised animal products. Because these are going to be loaded with healthy nutrients.

And when we look at like grass fed butter compared to conventional butter and there’s something like six times more conjugated linoleic acid in grass fed butter. There’s like ten times more vitamin A retinol, which is really powerful for your brain, your eyes. CLA, is really powerful for your metabolism. It’s an anti-carcinogen. So, it helps prevent against cancer. You just get so much more of these sorts of micronutrients. And these lesser known nutrients in organic grass fed, pasture-raised animal products, and organic vegetables as well. Fruits and vegetables.

So, we definitely want to get the maximal amount of nutrients. And we also are going to think about toxins that we’re consuming. So, conventional animal products have significantly more toxins. They’re loaded with antibiotic residue. Oftentimes they have things like bovine growth hormone, that’s injected into the animal. They have heavy metals like arsenic, lead, and things like that are in the food products that the animals are eating. Which are oftentimes grains, genetically modified grains that are rancid and loaded with environmental toxins.

So when we’re consuming that pesticides, herbicides, and all that kind of stuff, just bio accumulates in the animal products. And then of course, if we’re consuming nonorganic vegetables clearly, it’s going to be on that as well. So, we want to reduce our exposure to conventional toxins like that. And then one other toxin that’s kind of rarely talked about, really is sugar. And so, you can get, for example an organic peach, which is going to have a lot of nutrients in it. So, definitely as nutrients.

However, it also has like 20 grams of sugar in it. And so, when we consume that, if we’re consuming that I’m okay with consuming that every now. Maybe once a month or something just if you want to cycle out of ketosis, maybe having a higher carb day, like once a week. Maybe consuming a peach, some sort of nutrient dense thing like that.

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However, for doing that on a daily basis, consuming an organic peach, organic watermelon, or whatever it is, some sort of higher carb food on a daily basis, then that blood sugar response is going to be a toxin on the body. It’s going to cause more oxidation and oxidative stress. And that oxidative stress is going to override the amount of nutrients that comes in from the peach because now our body is going to need more magnesium, more B vitamins, more antioxidants. Just in order to buffer the oxidative stress that comes about because of the big increase in blood sugar.

So, again I don’t want to like discourage people from eating any fruit. But you just got to be aware that when we do consume higher sugar foods, especially if you’re going to consume those. It’s always better to do it, like right after you exercise, where your body is, your muscle cells, take on an insulin effect, where they’re actually like pulling sugar out of the bloodstream. That would be really, again, the best time to consume a lot of fruit, would be right afterwards. So, that way it gets right into the muscle cells. It can be used. You can restore it as glycogen in your muscles and in your liver.

But in general, you want to really focus on those high fat, low, moderate protein, low carbohydrate foods that are also rich in fiber. You know, fiber we don’t count. We’re looking at total carbs or just carbs, I should say net carbs. We want to look at total carbs minus fiber. So, if you have something that has 10 grams of total carbs, 5 grams of fiber, it would be 5 grams of net carbs.

And in general, for a sitting, you really don’t want more than about 10 to 15 grams of net carbs, typically in a sitting. Unless maybe it’s your only meal of the day. Like if you are doing intermittent fasting. Then your body can typically handle a little bit more, like 20 to 30.

However, in general per meal, it’s always a good idea to restrict yourself to about 10, maybe at most 15 grams of net carbs. Again, unless it’s like right after exercise. And you’re working out at a

high intensity. Or you’re a high level athlete that’s doing very long bouts of exercise.

Sam: Okay, cool. And you mentioned before about, perhaps if you’re cycling out once a month with ketosis, is that important to do? Is it important to do that?

Dr. Jockers: Yeah. I mean, I think that’s a great question. I think, for some individuals they seem to respond better by doing that. Number one is it helps store their glycogen levels, okay? And this is especially so if you’re somebody who exercises regularly. People that aren’t exercising typically can do better with staying in ketosis for longer periods of time.

But I would definitely encourage everybody to be on a regular exercise program. So, when you’re exercising, you’re going to deplete your glycogen stores. So, basically every now and then, once a week, once every two weeks, once a month, you kind of find your ratio. Have a little bit higher carb day, where you’re consuming more carbs. Maybe somewhere around 50 to 100 grams overall for the whole day in net carbs.

And what you’ll see is that your glycogen, your performance oftentimes can really improve. It also tells your body you’re not in a state of famine. And so, that will help activate and kickstart thyroid hormone activity in your body. Which for many individuals, based on what else is going on in their body, they can have struggles with that.

And, it’s also good for adrenal balance by doing that from time to time. Now, some individuals, they’re in ketosis continuously. Meaning that they’re producing high levels of ketones and using as their energy source and their sugar stays low. And I know people that are been doing it for 5, 10, 15 years, successfully. So, not everybody needs to cycle out. But for some individuals they seem to respond better.

Also, I think for long term compliancy it’s one of those things where I think people are going to be more compliant if they think, “Hey, you know

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what, I’ll eat low carb if one day a week I can have higher carbs.” I think just for long term compliancy sake that can also be very, very effective. Because just in our mind just cognitively we are like, “Hey, I can do this. I can intermittent fast. And I can eat low carbs.” And then all of a sudden one day a week have just a higher carb day where I can have these higher carb foods that I love.

Sam: Yeah, okay. Yeah, awesome. And what about hormones and imbalanced hormones and stuff comes up a lot. Is the intermittent fasting and the keto diet, does this help balance hormones and what does it do with people that are already out of balance?

Dr. Jockers: Yeah, absolutely. So, I would say that basically fasting and the ketogenic diet, which is actually called the fasting mimicking diet...Because by following ketogenic diet, we get a lot of the same benefits that we get from fasting, without actually fasting. And so basically, it’s a mild stressor on the body just like exercise is.

Really ultimately exercise itself is very damaging to the body. If you were to actually look at the muscle cells after you, especially if you exercise at a high intensity, they’re massively damaged. They’re ripped oftentimes. They’ve got massive inflammatory processes taking place to kind of clean up the metabolic debris in those muscle cells after a workout.

But then the body adapts and gets stronger. It’s kind of this hormesis theory where what doesn’t kill us makes us stronger. If it’s like healthy stressors, right? So, there are definitely some stressors that we would love to avoid that aren’t healthy for us. But exercise, ketosis, fasting, are all really, really healthy hermetic stressors.

So, for some individuals, their body is already so overwhelmed by stress, that they may not even be able to handle some sort of a mild stressor that can help move them in the right direction. So, with those individuals, I would say the first step would be, “Hey, let’s just get the diet really right. Let’s

sort of really focus on really, really good foods.” Really good, healthy real foods. Let’s focus on that. If we’re going to do more carbs, especially for somebody that’s struggling to sleep. Then I would recommend doing them in the evening.

In the evening time, studies have shown that we are more responsive to insulin than in the morning. One of the worst things you could do would be to have like a whole big bowl of fruit, which is what many healthcare practitioners have taught for years. And I even thought that was the case. I thought that was healthy back in my early twenties, when I was a personal trainer. It was, “Hey, eat a lot of fruit or oatmeal for breakfast.”

Unfortunately, earlier in the day, we’re not as responsive to insulin. We actually need more lower carb foods earlier in the day. Things like eggs or I’m a big fan of doing like protein puddings where you put like an avocado, coconut milk, maybe a healthy protein powder in a shake. And kind of make it more like a pudding texture. You have those good fats.

Or a protein shake with a minimal amount of fruit in there, if any. And that can be really, really effective for the morning time, right? Because it’s lower carb. High good fats. You get a lot of coconut fats in there or avocado. And just a moderate amount of protein. That can be really effective if that person is not at the level where basically fasting may just push them over the threshold of stress.

So, I would start out with doing something along those lines. And then consuming food. Trying to consume food every three to four hours, right? But again, low carb foods, up until maybe the evening. And then having healthier carbs like carrots, beets, sweet potatoes, maybe berries, something along those lines. Nutrient dense carbs.

So, it’s kind of like step one for somebody that is really struggling with hypoglycemia and blood sugar imbalances. Let’s just get the diet really

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healthy. Let’s take out the most common food irritants, which are going to be grains, particularly gluten containing grains.

But I just say, “Hey, let’s take out all the grains. Let’s take out dairy, other than maybe grass fed butter.” But other than that, let’s take out the dairy products, which can oftentimes cause more inflammation in the body. Let’s take out corn. Let’s take out peanuts. Let’s take out, of course, processed sugar. Let’s take out a lot of different different sweeteners like honey, maple syrup, and stuff like that.

Things that are going to just spike the blood sugar or give us a whole bunch of different net carbs all at once. Let’s take those things out. Let’s strategically add in nutrient dense carbs. But in the evening time, again, things like carrots, sweet potatoes, beets, berries. These have a lot of antioxidants, a lot of micronutrients, per gram of carbs. So, those would be healthier sources.

And you know, in general we’re just following more of an anti-inflammatory nutrition plan right there and trying to stabilize blood sugar, okay? Meanwhile, we’re really focusing on getting good rest. Really getting extra amounts of sleep. Eight to nine, sometimes ten hours of sleep. We want to really, really rest because that’s really when our body heals.

And for an individual that’s really struggling with hypoglycemia and what we call the HPA axis dysfunction, where their brain’s communication to their adrenal glands is really, really struggling. So, they’re struggling to respond to stress. These people need extra rest. We need to really focus on that. We need to reduce things that are contributing to stress.

So, it may be relationships they are having. They may hate their job. Who knows? There are all different things that could be taken place. They may be in a house full of mold and breathing that in all day. So, they need to get out of that house or get that home remediated.

There are all these different factors that could be contributing to this overwhelming level of stress that’s in their body. So, we want to reduce that. We want to do gentle movement with those people. Just going out walking. I’m huge fan of barefoot walking, getting out, putting our bare feet on grass, dirt, sand, concrete. Even concrete will help conduct the healthy electromagnetic frequency.

And for those people, they should really, really be mindful of the amount of time they spend on electronic devices, computers, cell phones, things like that. Because that’s a stressor as well. So, they should reduce that. I tell them to turn off Wi-Fi at night before they go to bed. You know, create a really great sleep sanctuary so they can get really restorative sleep.

And that’s really most important thing for those people. And for those people, they need to be consuming food every three to four hours. Because they’re having so much trouble just even balancing their blood sugar. Again, low carb foods and high fats during the day. And then a little bit more carbs in the evenings. That’s kind of step one. Let’s go through that stage, right? Sometimes two weeks. Sometimes 90 days, right? Depending on how damaged the person is. And how good we are at identifying some of the major stressors and removing those.

And then step two would be, hey, let’s start kind of pushing back breakfast a little bit, right?” Kind of see how you do. You know, in the beginning we always try to start with 12 hours between the last meal and first meal. But then we’ll start pushing it back maybe to 14 hours, right? Kind of doing what I call a brunch fast.

So, instead of breakfast in the morning, you start out, you drink 16 to 32 ounces of water, okay? And you can do lemon water. You do herbal tea, things like that. But you do that even before you even consider eating food. And then you’ll eat if you feel like you’re hungry. So, you hydrate your body really well, we are all dehydrated when we

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first wake up in the morning. Because we’ve been breathing out water vapor. So, we start by super hydrating the body. And then we kind of see, are we really hungry after that? Do we really need food?

And oftentimes the body says, “I don’t. I was really just thirsty. I needed that water. I feel good now.” And kind of time it out to where maybe 14 hours after your dinner. So, if you ate dinner at 6:00 p.m. finished dinner, right? Then 14 hours later would be basically like 10:00 a.m. And so, that would be, you know. I’m sorry, that would be 8:00 a.m. If I do my math right. So, 8:00 a.m., and then that would be your breakfast. You’d have breakfast at 8:00 a.m. Something that you could try.

If you’re already doing a 14 hour fast because you’re really focusing on sleeping and things like that. And you’re doing that successfully. Then you could try pushing it back to 16 hours, where you wait until 10:00 a.m., okay? And you do that? And then maybe 18 hours, right? So, now we can start to expand it like that. And see how you do with that, okay?

And we can also work on the tail end, where we reduce the carbs in the evening, and see what your sleep quality is like. And so, we go lower carb in the evenings. And we just see, hey, do you feel like you’re still sleeping well? Are you sleeping successfully? And if so, great. Because that’s going to help your body just be more successful with fasting. You’re going to be in that ketogenic state.

And then we may cycle in carbs every three to four days in the beginning. And then maybe go to once a week. Or even do like a 30-day ketogenic diet where we just keep are carb levels low. Don’t cycle them in. Do that for anywhere from four to six weeks. Now, you should be at that point, really fully keto-adapted. And then, kind of figure out a cycling process from there, whether it’s once a week to add in some of those healthier carbs. Once every two weeks, kind of trying to find your sweet spot where you feel really good, where you feel at your best.

Sam: Awesome. And is there a way to know if you’re in ketosis? Or adapted to that? And how long does it take typically?

Dr. Jockers: Yeah, absolutely. So, the gold standard way is a blood test. And there is a machine you can get out, blood ketone meter. It’s a glucose and ketone meter that you can find. So keto community is fast growing. And so, there’s new products coming out all the time. So, you can do blood ketones.

And what you’re looking for is basically to be in what’s called nutritional ketosis. It’s anywhere from one to it can be up to a five or six millimoles. And so, if that’s where you’re at, we get up in that 1.0 range, you’re really what’s called a keto adapted. For some people, they say it’s 1.5. But if I say, “Hey, if you’re getting up to 1.0 and you feel good, you feel stable and your body sugar is stable. Then that’s awesome. You’re keto adapted.”

And even if you’re up in that 0.5 range, if you feel really good with that, it could just be that your body is really good at using the ketones now, right? So, sometimes, your blood ketones won’t be quite as high. But you’ll still feel really stable. You’ll feel fat adapted because you’re able to go very long periods of time without food. And feel very mentally stable. So, sometimes you’ll notice that.

And then for myself, I personally hate blood pricks. Like I freak out. It causes a stress response every time I try to prick my finger. So, I don’t want that massive stressor in my life. I just haven’t gotten over the, for me it’s just like a sensitivity thing, where I try to prick my finger and it’s like my heart starts racing and everything.

So, I use a breath ketone meter. And actually, there’s a new one on the market that I am really thrilled with. And we use this in my health clinic as well. We test all of our patients with breath ketones. Basically, you breathe out a ketone called acetone. When you’re testing your blood, you’re testing beta hydroxybutyrate, okay? Which

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is kind of the most well-known ketone. In your breath, you’re testing acetone, which is kind of a byproduct of ketone metabolism. So, it’s kind of like a test of how your body is using the ketones. Not just that you have them in your blood, but actually when you use them. A byproduct at the end is acetone. So, it’s really nice to be able to test that with this breath meter. And it’s not invasive. All you do is really blow into a tube.

But I test my breath ketones. And I’m able to see where I’m at. And they’ve been doing a lot of studies on it. Kind of measuring it and comparing it to blood ketone levels. So, as you get better with this, you kind of know. You know that when you’re able to go long periods of time, like yesterday I did a 24 hour fast where I didn’t eat until dinner.

So, I went from dinner Saturday to dinner Sunday without consuming food. And I felt really mentally stable. You know, just mentally efficient. Felt really, really good all day. Really didn’t have any hunger or cravings other than kind of like the emotional desire to eat because eating feels good. Other than that, I felt really good physically.

And so, that’s a sign. Hey, my body was using this alternative fuel source, ketones. If I wasn’t, then I would have had more hypoglycemic type of a response. I might have been irritable. I had a headache, developed a fever, been extremely fatigued. You know, I would have had responses like that, and I didn’t. So these are ways that you can know.

Sam: Yeah. Awesome. And so, the steps that you gave us before with people that are looking at balancing hormones and continue on this. Would you say that it’s the same process for someone that’s looking at giving the keto diet a go?

Dr. Jockers: Yeah, absolutely. So what you can do is really just start following a ketogenic diet, right? And I know I’ve got a ketogenic program that helps walk you through that. So, we kind of have a 30 day meal plan. We have a quick start guide. We have a snack guide, right? All these

different things. You could just start getting going on it. And we also have a whole guide that helps with keto flukes. We give you all of these different recommendations, things to follow. Just in case you start feeling a poor response, okay? And you could just go ahead and get started with that.

Now, if you’re so many out there that perhaps that if you go three hours, you’ve been trying to go lower carb. And you know, if you go within three hours of not eating, or you’ve had a really, really bad response to intermittent fasting, and if you can’t go more than three or four hours without eating or you just get a headache, you feel awful. Then you might want to start with just, again, what I was talking about before, just starting out in phase one, where you’re going lower carb in general.

And the carbs you are consuming are going to be more in the evening time and more nutrient dense. Meanwhile, you really focus on sleeping well and reducing stress, okay? So, you kind of just have to know yourself and start walking through that process.

I would say most of the people just get started like on my ketogenic plan. And as long as they’re compliant with it and follow it, they do great. I would say probably 95% are going to do great with it. But there are some individuals that maybe just the season of their life, they have excessive stress. Maybe they just had a newborn child or so they’re not sleeping well. Or they had just some sort of a major setback in their life. They’re under a lot of stress or they’ve got a really bad infection in their system.

And those people they are mold toxic and they’re living in a home full of mold. Or they’re in a really bad relationship. Some major stressors going on that could cause problems as they try to get keto adapted. So, those individuals may need to start just again from square one with just a lower carb diet. Eating every several hours to keep that blood sugar stable.

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Sam: Yeah. Okay. Awesome. And I’m a big fan of going through the experience yourself, exploring, and seeing if it works for you. So, I think that’s a great program for people to be able to follow, to go along, and do that. But that’s awesome. And you can tell like the passion and the passion that you have for the keto diet. And all things that can help people. So, it’s amazing to hear all the knowledge that you have on this topic. So, thank you so much for sharing that.

And one thing I wanted to end this today with is, what would you say is your biggest tip for people that are starting or beginning with intermittent fasting?

Dr. Jockers: Yeah, I would just say that you can do it. Don’t be afraid of it. All of our ancestors fasted. Either due to food scarcity, due to religious purposes, or just for performance. In fact, Plato, why most of us know about Aristotle, Socrates, Plato. These guys all fasted regularly. And Plato has a quote where he says, “I fast regularly for greater physical and mental efficiency.”

So, he wasn’t doing it for a religious purpose. Although in the Bible it talks all about prayer and fasting. You know, every spiritual approach incorporates fasting at some level. Like Ramadan, for example, in the Muslim tradition. I mean, so there’s fasting really throughout all the major cultures have fasted. Either again, religiously for performance, culturally, or just because they didn’t have access to food. And so your ancestors did it. You can absolutely do it.

And again, just start small, right? Start by doing 12 hours between your last meal and your first meal. Waking up in the morning and drinking water. Going to water first. You’re dehydrated. Drinking, starting out maybe 8 to 16 ounces of water. Then just asking yourself, do I really need food? Do I really need it? And then kind of keep pushing it back. And stay hydrated throughout the morning. Kind of see where the hunger starts to set in. And that’s a great place to start.

Sam: Yeah. Good. I love it. Take small steps and drink a lot of water. It’s a good tip.

Dr. Jockers: Yes, absolutely.

Sam: Awesome. And where can we go to find out more about what you’re doing?

Dr. Jockers: Yeah, you can find at DrJockers.com. That’s my main website. And we just get tons of traffic through that website. And, also my Facebook page, Dr. David Jockers. And if you’re interested in the Keto Edge product, we do have that on DrJockers.com. We also have a website, separate website for that. And that’s KetoEdge.com.

Sam: Awesome. Beautiful. Thanks so much for joining us again, Dr. Jockers. I really appreciate your time.

Dr. Jockers: Absolutely, Sam. It’s a privilege and an honor. I love the things that you guys are doing. And again, it’s an honor to be invited to speak on this Summit. And I want to encourage a listener out there, hey the strategies that she’s going through with these experts. These can have a significant impact on your health. And you know, I would definitely recommend considering owning this whole Summit. So, that way you have it in your library, you can go back to it.

And like people are paying me and many of the other experts a lot of money to do consults. Like people fly into my clinic for me to teach them how to do fasting, ketosis, and things like that. And to look at their lab work. And you’re going to have access to that for minimal cost through this Summit. So, I would definitely encourage people to do that.

Sam: Cool. Awesome. Well, thank you so much for your support. And we’ll talk very soon.

Dr. Jockers: Absolutely. Thank you, Sam.

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Time-Restricted Eating & Circadian RhythmEmily Manoogian, PhD

Sam Asser: Let’s dive into this topic today because I am really excited. So, what are the circadian rhythms first of all?

Dr. Emily Manoogian: So circadian rhythms are kind of a part of every part of our body. And we can think of it at a lot of different levels. We can think of it behaviorally. We have natural sleep-wake cycles, which is usually the easiest thing for people to relate to. We also have cycles in mood and our cognitive ability, in our alertness.

We can go to physiology and pretty much anything you get measured in a doctor’s office, so body temperature, blood pressure, heart rate, even when enzymes are produced, how you respond to glucose. All of those things also have a 24-hour rhythm and we can go down to an organ or even individual cells and they all have their own rhythm. And it all starts from a molecular clock.

So, every single cell in of the body that has DNA, you have a molecular clock. There are specific genes that get transcribed and translated so the genes get read. They turn RNA. They turn into protein and they have this feedback loop that takes approximately 24 hours and that’s where all these rhythms come from. Then it is the coordinating of all of these rhythms throughout our body that produces a certain effect on physiology or a certain behavior. It’s really kind of interesting because it is actually a major clock in the brain that coordinates all these

things and, even if you were in a completely dark environment or a completely light environment or you had no time cues. So, say you always had the same food available or you always had the same light available and you had no idea what time it was, your body would still have this 24-hour rhythm, but, because we don’t live in that environment, we also have ways to interpret, light and food and social cues and coordinate our body’s rhythms with those things.

So, really the circadian system is keeping everything in the right place at the right time so your body can do what it needs to do, and it also is coordinating us with our environments.

Sam: Wow! So, by coordinating us with our environment, does that mean that each person could be different depending on where they are in the world and what’s going on?

Dr. Manoogian: Yeah. That’s a really great question. So, a person’s individual relationship with their environment and the timing of all those things is called a chronotype. So, someone who – you typically call them like early birds or night owls – they just have a different chronotype.

So, someone who’s a morning person actually usually has an endogenous rhythm that is just a little bit shorter than 24 hours and because of that, their relationship with all these cues come a little bit sooner. So, they go to bed a little bit

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earlier and they wake up a little earlier. We see this in mice and plants and almost every living organism has been found to have these rhythms. It is a key part of functioning in a circling cycle.

The opposite is true as well, so, for night owls, they have a period that is a little bit longer than 24 hours. And the crazy thing is that this actually changes throughout your age, throughout your lifespan. So, when you are really young, you’re a little bit earlier. And this is why kids tend to go to bed earlier and get up earlier and, when you hit puberty and you’re going through your teenage years and early 20s, you’re a little bit later.

This gets really interesting with like school start times and the fact that a lot of kids, biologically, their bodies want to go to bed a little later and wake up a little later and, when we force them to wake up early, we’re throwing them off their natural rhythms and then throw in all the new hormones that they are getting and it is just very difficult. As you age, you start to become a little bit earlier, but it is still all relative. There’s some people that are always going to be really early and some people that are always going to be really late.

There’s actually two known circadian clock mutations for extreme types. So, there’s familial advanced phase sleep syndrome, called FASPD [familial advanced sleep-phase disorder], where there’s people that they go to bed at like 5 or 6 at night and they are waking up at like 3 in the morning. They have a very hard time adjusting that schedule. That’s bound to be a mutation in one of the clock genes. And there’s recently been another discovered one where it’s this severe late time and that’s another clock gene that’s disrupted. So, everyone has a different relationship.

Sam: That’s so interesting. So, if you are, say, someone that fits into the late owl or whatever

you want to call that. Is there a way to turn yourself into an early bird deliberately or is that kind of going against the brain, so to speak?

Dr. Manoogian: Yeah, so, I think there’s a range. If you are one of these really extreme types where you actually have a genetic mutation, it is near impossible because – it gets into kind of hardcore circadian terminology – but there’s what considered a range of entrainment. Meaning if my period is 24 hours, I might be able to get my body on a schedule that is 23 hours, maybe a little shorter, maybe 25 hours, a little bit longer, but I could never become 20 hour or I could never become a 28 hour.

So, it is kind of a similar idea. You can push yourself a little. This is where controlling all of the cues that we can control, our environmental cues, to help us coordinate to what the clock time is that society lives by and our environment.

So, if you want to become earlier, there are some pretty easy tricks and vice versa for later, you could make it happen. The timing of when you eat and your light exposure are the two biggest cues. Then for humans, as well, a lot of social interactions. If you are getting super stressed or being super active really late at night, your body is going to stay up.

So, the trick is, if you want to be early, you kind of want to shift your eating a little earlier, well we’ll get into what you should be doing, but, if you stop eating earlier in the day, it will be easier for you to fall asleep because eating is a cue to be awake. Decreasing your light exposure, so kind of going with the natural light/dark cycle is really what we are built for and now we have all this artificial light. All of our entertainment is on screens and we are using blue lights and that directly suppresses melatonin which keeps us awake. And then if you get into some of the other crazy stuff. The circadian system is help to keep you

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asleep, but it is really your sleep homeostat that helps you fall asleep. So, we actually have this weird little second wind that our circadian system gives us at night, so you might actually feel pretty awake. When you are like, I should go to bed early, but you are like, “Oh, I feel so awake right now. I’ll be fine.”

And then you start watching TV or playing on a computer or an iPad or a phone and then oh you start eating. And you are giving all the cues to your body to say, “I’m going to stay awake.” Then you stay awake and then you go to bed later then your body wants to wake up later because it’s tired and you’ve really shifted all these rhythms by saying now’s the time to be awake. So, to become earlier, you just kind of shift everything earlier. You stop eating earlier, decrease your light exposure.

Get a ton of bright light early in the morning. That also plays a big role, because it is another cue to say, this time of day you should be awake. The circadian system is really anticipatory. So, once you kind of train it with a few days of these bright light in the morning, low light at night, earlier eating, you really can shift your body a fair amount. You can make it work but you can’t make everything work.

Sam: Wow! That’s so interesting. OK, so what about the circadian disruption. Can we talk about that?

Dr. Manoogian: Yeah. So, there’s a lot of types of circadian disruptions. Originally, the very first kind of studies that observed this were looking at kind of survival studies or how well organisms did in a natural environment. And they actually found that, almost any organism that you study, if their natural environment is similar to their endogenous rhythms. If their natural environment is very different rhythms than their endogenous ones, they do very poorly.

Then there’s been all kinds of animal models where you can jet lag an animal or just completely disrupt their rhythms with either constant light or giving different cues around the clock, and they do very poorly, so they will be more susceptible to chronic disease. They’ll die younger. They just don’t do very well on a wide array of tasks. And in humans we see this in a lot of different ways.

So, I think the most traditional that people see is a shift worker. There’s many different types of shift work. You have people who are on 24-hour shifts for one to many days in a row. We have people that are on night shifts that are completely misaligned from their environmental cues. And a lot of times, it’s that they are shifting back and forth between these things. Then we have what we like to refer to as second-hand shift work, so the family members and the people who live with these shift workers that really end up adjusting a lot of their schedule to those shift workers.

We have typical jet lag, which everyone has felt at one point in their life. You almost feel kind of nauseated or weak and not quite right. That is the feeling of circadian disruption, sometimes mixed with sleep deprivation, depending on what your trip was. But that’s what it feels like. So, we see this kind of all the way around.

And, actually, the most common, which really doesn’t get enough attention is social jet lag. And this is what we were kind of talking about earlier with the staying up really late at night or going out really late on weekends and then sleeping in really late on a weekend but waking up super early on a work day. You are really creating this social jet lag. You didn’t fly anywhere but, to your body, you changed the timing of everything pretty dramatically.

And in animal models, like I said, we know that this causes severe disorders. The main human studies, there has been two real types. There’s

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some studies where you can actually isolate a human and disrupt them and see what happens. They don’t do very well.

And then there’s a lot of observational data on shift workers that show that a lot of different types of shift work lead to higher rates of disease, higher rates of breast cancer, higher rates of a variety of types of cancer, higher risk of cardiovascular disorders. Sometimes even infertility because it can throw hormones off so much.

So, finding a way to help resynchronize yourself in those challenging situations is one of the things we are really interested in now. Unfortunately, there is some shift work where you could get out of it but so many of our vital functions in our society have to be shift work. We need police officers and firefighters and nurses and doctors.

And they are really kind of the heroes of our society that are sacrificing themselves. And they know it feels horrible. So far, it’s just people will give sleep advice. Well, they don’t have the opportunity to sleep so that’s not going to help. So, finding some other ways to help their circadian rhythms is something we are starting to look at.

Sam: Yes. That’s really interesting. I was just about say, so what happens to people that can’t like not do shift work. Cool. Well, let’s get into that because first – do you want to look at what time restricted eating is and next we can link the intermittent fasting in with the study that you guys are going.

Dr. Manoogian: So, time restricted feeding is really kind of crazy and the first time I heard of it, it really sounded too good to be true, but it is so highly reproducible that it just is. The more you learn about it, it just makes sense. So, basically, the punch line is, and I will start with a punch line

and we will get back to it, is previously a healthy lifestyle used to be thought of kind of what and how much you eat, sleep, and move.

Now we are saying there’s a key missing piece there. That is also when, what and how much you eat, sleep, and move. The timing plays another key role. Nutrition and the quantity and exercise and sleep, all these things are also very important, but the timing of those things plays a huge role about how your body interprets those cues, how it processes food, and all those types of things.

So, time restricted feeding started in rodents. Basically, it came from this idea that there is a very standardized method of creating an obese mouse that would naturally be susceptible to diabetes and cardiovascular disorders. And all you do is feed them a high-fat diet which is very similar to a typical Western high-fat diet. And over 12 or 16 weeks, they will become obese. They’ll have diabetes. They’ll be in very poor health.

What was interesting is that one of the things that changes that people hadn’t noticed for a long time is that they actually change their eating pattern when you change their food. So, when they are on normal chow, they are nocturnal animals, they naturally will eat during the night and they rest during the day. They don’t really each much at all during the day. When you switch to this high-fat diet, they stop that consolidation of eating and they actually kind of start eating around the clock. It’s not like they are constantly eating 24 hours, but they have a large amount of calories during the day and they would normally be resting and not eating.

So, the very simple experiment was, what if we give the same high-fat diet to one group but we only allow them to eat for 8 to 12 hours day. Then the other group can eat whenever they want, the same high-fat diet. And 18 weeks later, the group on the high-fat diet when they could eat whenever

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they want was obese and had all these diseases that we expected.

And the group that was restricted to 8 to 12 hours a day was perfectly healthy. They ate the same amount of food. We weighed them every week. They don’t gain weight. They don’t develop disease. And the fact that you can consume the same high-fat diet, the same amount of it and have no health problems was just shocking. I mean that’s hugs. How does that work?

So, that’s what kind of started it. Since then, we have tried some different derivatives. If you go down to an 8 to 9 hour eating interval, meaning that you are getting a 15-16 hour fast every day. We also see this increase in endurance and energy levels in rodents. They can stand rotarods better. We even reproduced this in flies. If we restrict them to 12-hour eating intervals, it actually extends the health span of their hearts.

So, a fruit fly naturally gets this cardiac arrhythmia. They don’t have the same heart as a human, but they pump hemolin very similarly and around five weeks, they start to have this cardiac arrhythmia. It doesn’t beat regularly. If you keep them on a 12-hour eating interval, their heart stays healthy until 7 weeks of age. Two weeks doesn’t sound that long for a human but, for a fly that’s going to die in about five or six weeks, that’s a huge percentage of their life that we have been able to extend.

So, this does seem to cross species which is amazing. So, then we started studying humans. And another graduate student in the lab, who’s now post-op at Harvard, helped develop the beta version of the app which is now called my circadian clock. And really, it was just trying to find out, when do humans eat, because if humans are eating in less than 12 hours, maybe this isn’t anything for us to worry about.

Maybe it’s not as relevant as we think. It turns out that humans, over 50% of the population that we studied ate for more than 15 hours a day, meaning you’re only getting an eight or nine hour fast which really means that when your eyes are open, your mouth is open. The more nutritionists that we talk to, that’s seems to be true. People wake up. They frequently force breakfast on themselves before they are hungry. They have at least coffee and frequently that comes with sugar and milk and cream and lots of high calorie things. Then they eat throughout the day.

The 3-meal structure has dissolved. It is a lot of snacking, kind of constantly. And then, they might have their main meal at somewhat of a reasonable hour but then there’s the glass of wine or the dessert or the small snack or whatever and they’re kind of eating right up until they go to bed.

So, we have these really long eating intervals. And like some people you see it, like a 20-hour eating interval where it’s like where are you even sleeping? And it’s really, they’re sleeping very irregularly, they are staying up very late. It’s really kind of crazy. You even see these some of these secondhand shift workers where they’re not shift workers. They have a regular 9 to 5 but they have an 18-hour eating interval because they wait, and they eat when their spouse comes home or when a family member comes home.

So, we see this really, what we consider, an erratic eating style. It’s nothing that your body can anticipate. And that’s making it so all these enzymes and digestive hormones that need to be active are just completely thrown off. You are really losing the amplitude of any rhythm that you would naturally have.

So, the obvious experiment was, in a subset of those people, we said, “Hey. Why don’t you try eating for 10 hours a day for 16 weeks. You don’t have to change what you eat. You don’t have to

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change how much you eat. Just change when you eat.” And they said, “OK, we’ll try it.”

And at the end of those 16 weeks, they had lost 5% of their body weight. They were sleeping better. They reported higher energy and better endurance. They all liked it so much that they stayed on it. We stopped monitoring them and we had them come back a year later. They had all kept off the weight and they all had stuck to that eating period because, once you get used to it, it has this almost positive feedback effect because it is all anticipatory. When your body is used to not eating, it changes your appetite.

So, once you are on it for a while, you’re not hungry after your normal eating window. And you do sleep better because your body is allowed to rest because you haven’t been eating all the way up, and you really improve the amplitude of all these rhythms. So, it’s this really kind of wide-spread dynamic approach because your stopping your eating so that also means you are sleeping better. And restorative sleep is key to a lot of health factors.

So, by simply changing the eating window, we see really, a wide ray of effects. So, now we are trying to study this on a much wider scale which is why we now have the My Circadian Clock app which is available worldwide and trying to understand a base-line, what are peoples’ current eating pattern. And then what can they adopt, when do they want to eat and kind of all these other things.

Sam: Yeah, oh my gosh. I looked up the app, as well, actually. I am actually intrigued to do it myself, but – What’s the link? So, what’s the link between our circadian rhythm and intermittent fasting and what people should be doing if they’re, like how is it going to affect our circadian rhythm in a positive way specifically?

Dr. Manoogian: So, intermittent fasting is

interesting and depending on who you talk to, it may mean something else. So, it is kind of hard for me to define it or I don’t want to put it in a box. What I will say is time restricted feeding is really a daily lifestyle change where you’re getting a 12-16 hour fast on a daily basis. This is not starving yourself or feeling overly hungry. Your body will get used to it and you will kind of adapt that. We kind of think about it, it’s like brushing your teeth every day, something you should always keep up.

Longer fasts will actually have different effects on your body. So, this daily fast, the endurance, we think, is when you get to 16 hours, you’re probably getting higher ketone levels naturally produced in the body because it is breaking down into different energy sources. That 12 hours is really needed to get to the point you are ever going to break down certain types of energy. Some type of fasting where you are going to have longer periods of fast, say a day or multiple days, taps into a different type of fasting system.

So, it going to have some different types of effects on your body and they are not mutually exclusive. You could easily do time-restricted feeding as a daily pattern and then, occasionally, just like instead of brushing your teeth you go to the dentist and get a deep clean every so often. Maybe you are going to go and do an intermittent fast at different intervals as well. Because it is kind of tapping into some other interesting fasting mechanisms that the body does and can be restorative and helpful in different ways. So, they’re really not mutually exclusive.

The one thing that time restricted feeding or time restricted eating, either way is fine, taps into the intermittent fasting doesn’t is it is really a way of supporting your body’s natural rhythms. It is a way of supporting these circadian rhythms and it taps into this anticipatory behavior, so you are getting your body back on a cycle.

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Eating across the day and then fasting for a couple of days a week or for one big fast doesn’t have that circadian benefit. So, time-restricted feeding really has this additional circadian benefit. That doesn’t mean you couldn’t also do intermittent fasting at a different time. They are kind of separate but they’re friends. They kind of go together.

Sam: It’s all to the greater good, right? So, is there an optimal time that the time restricted eating should be taking place?

Dr. Manoogian: Great question. That’s something that really still needs to be studied. I will say there’s no one clock hour. There’s no like 7 a.m. to 7 p.m. is the perfect time for everyone. That will never be true because all of this is relative to your body’s own rhythms and depending on your schedule and your chronotype, those could be very different things for different people. If you are on a night schedule, it can be dramatically different.

The way that we do it with our participants, especially in some of our controlled studies is we say, “You’re eating window needs to end a minimum of three hours before you go to sleep.” That is really what we think is the minimum amount of time to allow your body to kind of rest so that when you do go to bed, your body isn’t stimulated by food. From there, we say, pick a 10-hour interval that works for you. It needs to be the same 10-hour interval. If you eat late one day, that’s a cheat day and we’ll go ahead and forgive you, but you are not changing it the next day. It’s within that interval.

Actually, one of the animal studies, we actually tried 5 days of time-restricted feeding and 2 days of eating whenever you want to simulate a weekend and they still had pretty much all the same benefits, so we think that the occasional cheat is not so horrible, as long as your regular

thing is preserving those rhythms. So, yeah, it is the same 10-hour eating interval. Depending on what you are trying to achieve, you might want to go a little bit differently. If you are really trying to be super intense about it to absolute optimal health, there’s some evidence to say that having more calories in the first half of your day is beneficial.

The whole saying eat breakfast like a king, lunch like a queen and dinner like a pauper, there’s some truth to that. I don’t think breakfast has to be your biggest meal, but I think between breakfast and lunch, you should be shooting for 50% of your calories or more should be done there. And, too commonly, we eat very small meals during the day, and we come home, and binge eat everything in our kitchen at night. Or we go to a restaurant that serves huge amounts of food and we just eat everything, and it’s very high calorie, I think that’s probably not the best.

But it’s really, because it is a lifestyle thing – I don’t see it as a diet. I see it as an important part of a lifestyle we have too commonly ignored or weren’t aware of. It’s really something that fits for you. So, give yourself the three-hour buffer before sleep, but then whatever works for you. Frequently, it is a little bit late shifted because you want to get home and see your family and eat dinner with your family. So, figure out kind of what you need to do on the end and then count backwards and that’s when you would start.

Sam: Yeah. Awesome. So, is there’s signs as to what our rhythms or clock is doing and to how we can kind of make our mind up as to what we need to do?

Dr. Manoogian: Yeah! That’s a really good question. OK, I have a few different answers for you. One, the best way to find out what your natural rhythms are or natural chronotype, how you synchronize with your environment, was

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actually done in this really cool study by Ken Wright who is at the University of Colorado, and they actually found that, if you go camping for a week with no artificial light, only firelight, your body will kind of resync to what it is supposed to be.

You’ll naturally wake up, and, frequently, it is much earlier because you don’t have all this artificial light waking you up. So, that’s one way to find kind of find out what your chronotype is. That being said, if you are not living out in the wild, and you are living in this normal schedule, it might be phase shifted a bit.

So, there’s a few things to figure out. Well, one, you can tell if you kind of have a strong rhythm a few different ways. So, when you have the opportunity where you don’t have to wake up with an alarm or eat at a specific time because of work or whatever, other responsibilities. If you wake up on a weekend, the same day you would have woken up on a workday, that probably means your body has adapted to that time and it’s set to that time and that’s what it is naturally waking up to.

Similarly, as far as food, you get hungry at the same time on a weekend as you would have on a workday, it means your body anticipated it. So, hunger is actually kind of a nice key, but also just hunger when you shouldn’t be hungry, not being hungry when you normally go to eat also kind of tells you that. Picking the exact time can be rough, especially if you are already disrupted, because your body is so confused at this point that there is no real key. So, you kind of have to train it to what you need it to be.

But the few kind of cues are somewhat obvious things. If you wake up starving and you really want to eat, maybe you should be eating a little bit earlier and don’t eat as much at night. Stop eating earlier in the day. If you are waking up and

you are not hungry at all. I think too frequently people force themselves to eat when they are not hungry.

And the same way, eating really late at night is bad for you, because your body is not able to process glucose and break down things the same way. that’s also true for super early. Eating really outside of the range of time where your body is able to produce food, whether too early or too late can be harmful. So, it is, eat when your body wants to eat but then you have got to train it a little bit to fit your schedule. So, it can be kind of a dynamic process of figuring out what works for you.

Sam: You know, that’s so interesting because I think we live in a society at the moment where we wake up with an alarm and we’ve got so much information that’s confusing to us. So, we think that breakfast is the most important meal of the day and all of this kind of stuff. We kind of stop listening to our body and we don’t know how to listen to it anymore.

So, I love what you guys are doing because it makes me think – at the moment, I am on this rampage of trying to get up so early in the morning. So, I’m like messaging a friend and he’s making sure I’m up and I’m making sure he’s up. Is that a natural thing that my body wants is or is not? It’s actually making me really curious.

Dr. Manoogian: Well, I think there’s a transition phase where you could potentially re-entrain yourself, but, after you’ve given yourself a week or two on that schedule, if you would naturally still like to have overly sleep in, you body might not be entraining to it. You can kind of figure that out. If you are always waking up tired after a period of time, like there is a training period to shift yourself. You can only shift about an hour a day.

And, if you are giving yourself all the best cues,

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you are giving a ton of bright light in the morning and maybe you start eating earlier in the day than you would have and you give dim light at night and you are not eating late at night and you are still struggling then it might be a little too early for you. Exercising in the morning can also help you shift to be a bit earlier. Exercising at night can shift you back. So, I would say, give yourself all the cues that you can to tell your body, “This is our new time.” And, if it still isn’t able to shift and you are still really struggling, then it might be a little too early.

Sam: Yeah, yeah, awesome. I’m feeling a bit of a shift, so I think I am all right but I’m going to try some of those tips. What’s the top like potential benefits that you see from people shifting to this?

Dr. Manoogian: So, people that are going on time restricted feedings – so, the studies are ongoing. We have a few different controlled studies going so, to say this is scientifically proven, I don’t have a hard answer for you yet, aside from the original study. We did see about a 5% weight loss, so it’s not going to be that you go from really overweight to really skinny, it’s not that. It is more of an optimization of your physiology. So, we do see a small moderate weight loss. We do have reports of improved energy, improved endurance, much better sleep quality, which has wide-spread effects, but what we think is really going to be happening and what a lot of our current studies are looking at, is that we think that it can improve glucose regulation.

We think you are tapping into food stores differently, so it actually changes the way that your body processes food. It’s actually going to change the way that you metabolize food. And, also, how you would regulate, how your insulin and glucagon are regulating your blood sugar. We think that will actually be an interesting effect.

Some preliminary studies have seen decreases

in blood pressure which could potentially get people on lower drugs or off drugs completely would be amazing if we can decrease the amount of some of these drugs. Drugs can be amazing to help people with diseases, just lifesaving, but, frequently – you almost have side effects and, if you don’t need them, that’s always a better scenario.

That would be amazing if we can get to a point where we can show that. That’s one of the things that we are trying to work on to see if we can change, really, cardio metabolic health. Even if it isn’t a complete treatment, if it can be a cooperative treatment to help so you don’t have to take as much medication or so you are doing better you would have regardless, even if you are on the same thing.

Then we’ve had some really fun things that we’ve seen. So, personally, I used to have acid reflux. I don’t anymore and I’ve heard a few different reports of it fixing that or heartburn. We’ve had a couple participants write in that it was really helping them with their irritable bowel syndrome, helping them much have more regular bowel movements when other things they had tried really weren’t working.

So, these are all kind of avenues that really need to be explored. We know that it is going to affect your digestive health. We know that it has a wide range of benefits. We think it will also, hopefully, decrease inflammation. The idea is, if you can optimize your body, you are really going to be a stronger version of yourself and then anything that you would naturally be predisposed to, you have a better change of fighting that off. So, it is going to depend a little bit on person to person about what they would naturally be weakened to versus someone else about what would have the best effect for them.

These are all very exciting questions and I am

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hoping that in couple of years I can come back and be like, “Look at this! This is amazing!” But we’re still – these are all avenues that we are looking at. I don’t think any one has shown definitively that this will cure anything, but there’s so much promising research, especially in the rodent models, that it really does have these huge beneficial effects. I mean really wide-spread benefits on inflammation and cardiovascular health and metabolic health and we are just starting to see some of that data come out in humans.

Sam: It’s really exciting that you are having studies done on humans. I think that’s really exciting.

Dr. Manoogian: Yeah, it’s really cool for the lab. So, even myself and most of our lab, we’re basic researchers. We all came from rodent models or more molecular work or plant work even. I personally have a background in biological rhythms, so I kind of came from that avenue. So, now to be able to apply that knowledge and get to study humans and try to help people has been really exciting. It has been a lot of fun.

Sam: Yeah, so good. Now, I seriously could continue on, like all day. I find this so interesting, but I am going to try and wrap it up. What’s your base tip for somebody who is a shift worker?

Dr. Manoogian: I think for – it depends on the type of shift you are doing. We just starting some studies right now to figure out what the best thing is to do. There’s two main ideas. First is to say pick an eating interval that is always interval and that might mean sometimes you are awake at night and not eating but try water.

The first step for anyone is figure out what you are currently doing. Figure out what your current eating patterns are. And then find a way, it doesn’t have to be all at once, but slowly decrease that eating interval and finding just one time, it might

be during the day always so your on days and off days are the same. Trying eating in that interval and see if you can get some benefit there.

The other option – and it really depends on the kind of shift you are doing. So, if you are a 24-hour shift worker, it’s much easier to stick to the same 24 hours. If you are shifting between night shift and being awake during the days on off days or between night shift and day shift for your job. The other idea is to switch your eating interval with your kind of wake cycle.

So, when you are going to be awake, you shift your eating interval to when you are awake. And this is usually better if you are going to be on that night shift of a long period of time. It’s basically tricking your body to say OK, I flew from California to Paris and now I’m shifting everything or Australia to wherever. I am saying I have a 12-hour time difference.

So, you are really just, rather than dissociating your activity from your feeding pattern, you shift everything together and that might also help you shift a little bit easier. To still pick an eating window but to shift it with you or keep the same one and that really depends on how frequently you shift your work schedules and what kind of shift you are actually working.

Sam: Awesome! And is this the same advice you would give to somebody flying to not experience jet lag? How do we not experience jet lag?

Dr. Manoogian: Yeah. Jet lag, so that’s really an interesting question and, I think, there will be some cool stuff coming out on that in a few years on some molecular stuff but right now, there’s a few tricks. So, it depends on which way you are going. It is easier to delay than advance. So, for example, I will use myself, so I am actually flying to Australia today, later today. I had to work with a collaborator.

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So, you are 19 hours ahead. I am going to choose to see that as a five-hour delay because it is much easier on my body and my body doesn’t know the date. It doesn’t matter. So, it is actually going to be much easier for me to fly to Australia where you’re 19 hours ahead than it is for me to fly to Paris where they are nine hours ahead because an advance is much harder.

So, for me, what I am going to do, and it works with my flight. It gets a little tricky with timing of flights and when you get there, but to help with that delay, I am going to force myself to stay up 5 hours later than I normally would.

And some people will naturally do this where they know that they are going to be having to delay so they stay up like an hour later each day and kind of help their bodies get there, but that can be difficult with work schedules sometimes. But I am going to try to stay up later and then knock out on the plane and then when I get there, it is going to be daytime. When I get there, I am going to get as much bright light as I can.

I am going to start eating on the new schedule and I am going to stop eating on the new schedule. This can sometimes be rough. From what we know, it is better to just fast for a longer period of time rather than eat throughout the whole time. Depending on when your flight is, that is much easier or harder to do, so I know that the professor that I work with, he always just, when he has big time zone changes, he just stops eating.

He will sometimes fast 24 hours or whatever and then whenever you get to your new time zone, you start eating then. Those are for really big time zone changes. For smaller changes, say you have a 3-hour change, usually those aren’t too hard. Again, it is all about using all these kind of cues that you can control. your activity, your light, your food, and just shifting them to the new time as soon as you can.

The other option is, if you aren’t going to be there for very long, just don’t shift. So, if I have a 3-hour delay – say you are in New York and you’re coming to California, well that means you are probably waking up three hours earlier which usually isn’t a problem. You can usually get up earlier and start your day earlier than normal. It’s not a problem and then just go to bed earlier and just stay on your other time because for every hour that you shift, it takes your body about a day, so, if you are only going to be there for three days, you are not even going to get fully shifted until you’re going to fly back. If you are going to be somewhere for two weeks go ahead and shift. Or you could do something in the middle. You could try to shift only an hour and, whatever.

But really it is a way of just tapping in to using all these cues that we know can help re-entrain our clocks and just kind of try to override a lot of these mechanisms. But fasting during that changes seems to be helpful and then figuring out if you can trick your body into delaying instead of advancing can usually be helpful but California to Europe is really hard. I am not going to lie. That one was rough on me. The nine-hour advance is not easy.

The best trick for that is just try to land at night so you can go to bed and kind of reset that way and just sleep deprive yourself so when you get there, you can fall asleep. You have enough of a sleep drive to fall asleep and then wake up the next morning and start eating on the new schedule. So, it’s kind of a combination of a bunch of little things. Which, I think, is a great representation of biology as a whole. There’s no one trick. It’s a combination of a bunch of little things that lead to health. It’s not, I did this one thing and nothing else matters. It’s a combination of everything.

Sam: And, it’s constantly changing, too. So, do you think there’s some sort of link between – because when I fly, I always fast as well and purely because

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every time I eat on a flight, I like feel sick, and I like get really bad stomach pains. Like I can’t digest food. Is there actually something going on in our bodies when we are up high?

Dr. Manoogian: You probably do have lower oxygen levels which can change some types of metabolism. It can also affect biological rhythms. Some people experience more gas or other things like that where they can get more of an upset stomach. And it depends on the airlines. Some planes now are really controlling some of these things a lot better. Even the light exposure, they are changing the lights that you are exposed to at different times of the flight.

So, a lot of it is changing a little bit. Even the amount of – so when you take off, the speed at which you hit altitude actually changes how you are going to feel after. So, some airlines go up slower, at a slower rate, and that tends to decrease this feeling of not feeling great after a flight, versus planes that go straight up quickly and then it’s harder for your body to adapt as quick. I haven’t studied that myself, so I am not an expert on that, but it is kind of interesting to think about.

I was talking to one of my other friends in lab and we were at this conference and they served food frequently. And she was like, “I feel like the control group. I have been eating all day long and I feel horrible.” I think eating constantly on it’s own has a problem and, when you are on a plane and you can’t get up and do a round, one of the few things you can do is eat as entertainment so you end up snacking a lot more than you realize and that alone can kind of cause some issues. So, fasting tends to be able to give your body a break and focus on all the other things it needs to adapt to which seems to be a little bit easier on your body.

Sam: Yeah, wow, sure. I’m just curious. Now I’m going off on tangents. So, thank you so much

for sharing everything today. Do you want to let everyone know where they can check out the app or what the app is about or any other information as to where we can kind --

Dr. Manoogian: Yeah. Absolutely, we are always trying to learn more. So, you can get to the app, you go to our website. It’s my circadianclock.org and you can sign up there. There’s an online informed consent so we can see your data. Once you sign up online, you’ll be e-mailed an access code and then you can download the app at any point, but you will need the access code to log in. And it’s free for any iPhone or Android users.

The whole idea is to understand when people eat, especially around the world which is really exciting because there’s a lot of different culture differences about food and when people eat and how that affects their health which is a whole new avenue. But for 2 weeks, we ask you to just log everything that you eat and drink. You can also enter health measures or exercise. We do capture some data from your phone if you allow it, so you don’t have to enter everything.

Then at the end of those two weeks, you get to see what your eating interval actually is. You can see everything that you logged and, then going forward, we ask you to pick a self-determined eating interval. So, say you find out that you have a 16-hour eating interval, maybe you want to go down to 12 hours and you can pick whatever time you want. Then you keep logging for 12 weeks. We like it if you can update your weight, update any health measures you would normally have.

So, don’t make an extra appointment for yourself to go get a blood test but, if you have any, update them along the way. Then we can follow what your self-determined goal was. Were you able to stick to it? Did you see any health benefits from it? And you can use it as your own. You get to see all this data. So, you get to kind of track your own

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rhythms. It’s a tool that you can use to try out a new eating pattern for yourself and then you are also contributing to research. So, it’s kind of a win-win for everyone.

Sam: Super interesting. I fully am going to get on the band wagon with that. I love that. It is good to know this stuff and keep yourself accountable and see what works and what doesn’t. And it is going to research. I love that there’s human research going on.

Dr. Manoogian: Yeah. Absolutely. We need more of it.

Sam: Oh, amazing! Well, I’ve loved talking to you, Emily. It’s been absolutely mind blowing. Thank you so much for joining me.

Dr. Manoogian: Thank you so much for having me. This is great.

Sam: Good luck with your flight.

Dr. Manoogian: Thank you. I know. I’ve been planning out my schedule.

Sam: Talk again soon when we can get some updates. I think that would be awesome.

Dr. Manoogian: Yeah. Absolutely. Sounds great. Have a great day.

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Weight Loss and FastingJason Fung, MD

Sam Asser: Hello, Dr. Jason Fung and welcome to The Fasting Summit. Thank you so much for joining me.

Dr. Jason Fung: Thank so much, thanks for having me.

Sam Asser: Now, I’m excited about this chat because this is going to be a very pressing topic that a lot of people bring up when it comes to fasting and when it comes to their health in general. And I know that you’re a big a believer when it comes to looking after your kidneys, when it comes to looking after diabetes, we need to start at the root cause which is often a lot weight issues that people are going through. And so, my first question for you today is why is fasting good for weight loss?

Dr. Jason Fung: Well, it seems kind of obvious that if you don’t eat, you’re going to lose weight. And that’s one of the things that is you really can’t deny it. What people try and say, of course, is that’s really unhealthy for you or it’s going to backfire in the long-term. But the fact that it works, you really can’t deny because it’s just no food coming in. Your body’s got to burn something. And it’s going to burn your stores of food energy, which is sort of glycogen in the liver and also body fat.

So, it’s interesting because many people have used it for thousands of years. It’s part of sort

of every major religion in the world. And people have always used it because it sort of makes a lot of sense. It’s only been in last about 30 or 40 years where people have started to say that, “Well, you can’t fast and that’s really bad for you.” And there’s sort of all of these myths that have come up around it that you’re going to go into starvation mode, and you’re going to burn all of your muscle, and all of these things.

And it’s like, well, what happened to the people 2,000 years ago who didn’t have anything to eat? Did their muscles just shrivel up? Like all of those Native Indians in the Americas or in the natives of Australia, for example, who had these feast/famine cycles where they wouldn’t eat for several days. Of course, they’re just little balls of fat, right? It’s like, no, they’re lean and muscled and all of this sort of stuff.

And it’s only been in the last sort of 30 years that there’s real turnaround where people would say, “Well, you can’t do it” even though we’ve been doing it for thousands of years and we tell people to do it. That is if you look at the Muslims for example, they’ll tell people there’s a holy month of fasting. During Lent for example in the Catholic religion, there’ll be days of fasting. Good Friday, and so on, and Greek Orthodox religion and Mormonism, Hinduism, Buddhism.

So, everybody has not only done it, because sometimes food wasn’t available, they’ve actually

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specifically told people to do it. That is literally billions of people throughout all of human history have been told, have been instructed to fast, and it’s not been in this sort of negative way. It’s been sort of this cleansing, this detoxification, this healthy practice of sort of getting rid of all of the excess sugar in your body.

And the real sort of conundrum is why we turned against it. And I think that it’s been because the agenda’s been pushed by sort of advertising and food companies. And they’ve been able to convince dietitians and doctors that this is something really, really unhealthy for you.

I mean, even the word itself, breakfast, is the meal that breaks your fast. That means you have to fast every day because if you’re not fasting you can’t break your fast.

So we went from the 70s from this idea that fasting was acceptable, it was good, it’s part of everyday life. And then okay, usually once a year, a couple times a year you do a longer fast and really cleanse your body, to this sort of idea 40 years down the line that everybody should be stuffing their faces every two hours with some crackers and muffins in order to stay healthy. And in that same time, obesity has sort of skyrocketed.

So obviously if you don’t eat, you’ll lose weight, but more than that you’re going to be able to lower your insulin, which is the main thing. Insulin, it goes up, whenever you eat, assuming that you eat sort of a balance meal of macronutrients.

Anything you eat will stimulate insulin, not to the same degree of course. Eggs for example are not going to stimulate insulin to the same degree that for example white bread does. But everything in general if it has a mix of stuff is going to stimulate insulin, so lowering insulin, because you’re not eating, is a way for you to access your stores of body fat.

And so, if you’re trying to burn body fat, there’s really nothing better, and there’s nothing harmful. And there’s where I go a lot into in my talks, and my lectures, and my books, and so on. I go into a lot of myths of fasting and why they’re not actually true, the physiology of fasting, what actually happens in the body and why it’s actually maybe actually quite beneficial for you.

Sam Asser: How can people know more about going into fat burning opposed to just burning glucose?

Dr. Jason Fung: So fat burning is mostly determined by insulin for the most part, which is a nutrient sensor. So, your body needs to know if there’s nutrients coming in. So, your body really only exists in one of two states, the fed state or the fasted state. And the fed state insulin is high. So, you eat, insulin goes up, and this is signal to the body to go into the fed state. Which means that you want to store food energy. You store it as glycogen which is glucose in the liver, and you store it as body fat.

If you eat a lot of protein, more than you need, your body really can’t store a lot of protein. So it does have a little bit of excess protein. But it doesn’t have a lot, so it will store the excess. It will change it into glucose and then store it as glucose. Or if there’s too much glucose, then it will turn it in a process called de novo lipogenesis, into fat.

So, if you want to get into fat burning, you can’t be stimulating insulin, because insulin puts you in the fed state. You’re trying to store food energy. This is a normal thing, remember. So, if you’re eating insulin goes up, you’re in the fed state.

You should be trying to store food energy. Because when you don’t eat, when you’re in the fasted stated insulin falls, which is the signal for the body to start burning some of that stored food energy. And that’s the reason you don’t die

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in your sleep every single night. It’s because you have this sort of ebb and flow of everything.

If you want to lose weight then you need to burn food energy, you can’t be storing it. Because that’s all body fat is, it’s a store of food energy. That’s what it’s used for. That’s what it’s designed for. So, if you keep eating, you’re not going to be able to burn your body fat because we say that insulin inhibits lipolysis, which a fancy word for saying fat burning. So, insulin, if it goes up, it blocks fat burning, because you want to be storing fat not burning it because you can only store it or burn it. You can’t do both at the same time.

So, this is the thing about fasting is that it’s a quick way to lower insulin. By lowering insulin, you allow your body to have access to the stores of body fat. And this is one of the reasons, for example, that people talk about starvation mode, and dropping their basal metabolic rate. And this is one of the reasons it doesn’t happen so much in fasting compared to calorie restriction. So, if you simply cut the fat, restrict your calories but eat ten times a day, you’re still stimulating insulin all the time and therefore, keeping your body in the fed state rather than the fasted state.

You need to be in the fasted state to burn that energy. So, if you can lower your insulin, then you allow your body to burn some of that food energy. So that’s fat burning. So that’s why low carbohydrate diets, and Ketogenic diets also have the main effect of lowering insulin. Because you restrict the food which is refined carbohydrates which is highest in insulin affect. Also, sugar and so on.

As opposed to the old fashion advice of cutting fat, which really doesn’t have much insulin affect. So, if you’re not affecting insulin, you’re not affecting whether the body is in the fed state or the fasted state. Therefore it really has not a great effect on weight loss.

The other issue you touched on was the autophagy, which is actually a way of the body has of breaking down protein. And this is more to do with wellness. So, when you eat protein, your body breaks it down into amino acids, which are these building blocks. And it uses them to build more protein. Any excess gets converted into glucose, which can then be stored and converted further into fat.

If you’re not malnourished, it’s estimated that 50 to 70 percent of the protein that you eat actually winds up turning into glucose. Okay, so if you’re very malnourished, if you’re sort of one of these prisoners of war in WWII Japan, like 100 percent of that protein is going to go towards building protein.

But if you’re sort of a regular person in the western world who is not particularly malnourished, if you’re not anorexic, if you’re not a cancer victim for example, then an average of 50 to 70 percent. But it kind of depends of course on your underlying muscle stores. A lot of that protein is just going to get turned into glucose.

Autophagy is a process which has just been recently sort of decoded, and it has to do with something called mTOR, which is another nutrient sensor. But it’s more specific for protein. If you don’t have enough protein then mTOR is going to go down, if you have a lot of protein, mTOR is going to go up. And when the body senses that it’s not getting enough protein it starts to break down some of these sub-cellular parts, and use it for energy and use it to rebuild other proteins.

So why it’s particularly interesting is because everybody thinks that growth is a good thing. In adults, growth is generally not a good thing. So, if you are a child, growth is good because you need to grow from sort of seven pounds at birth to 180 pounds or whatever you’re going to be at your adult weight. But as an adult your liver shouldn’t

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be growing, your lungs shouldn’t be growing, your brain shouldn’t be growing, nothing should be growing.

And any time you grow, it’s probably a bad thing. If you’re gaining weight, that’s excessive growth. If you have cancer, that’s a disease of excessive growth, if you have a lot of atherosclerosis—that’s sort of blockages of the arteries—that’s excessive growth, again. So, growth is not good.

And one way to turn down those growth signals is to really restrict these nutrient sensing pathways, because your body will not grow if there are not the available nutrients for it. So, insulin is sensitive for carbohydrates, but mTOR is sensitive for protein.

So, as you fast, as you don’t eat any sort of protein or carbohydrate for about 24 hours or so, 16 hours up to maybe 36 hours, your body’s actually going to start to breakdown protein. Which everybody thinks is a really bad thing.

And that’s where you get these myths, “Oh, you’re going to lose all of your muscle.” It’s not. First, you’re burning protein, not muscle. There’s a lot of excess protein in the body that needs to go. If you’re losing weight, you need to burn off all that connective tissue, the collagen, the skin, all of that needs to be burned off. So, there’s a lot of excessive protein.

Again, if you compare obese people to normal people, they have about 20 to 50 percent more protein than a lean person. So, there’s the excess skin, the excess connective tissue and so on. So, you don’t want more protein.

So, one way to really kind of break that all down is through this process of autophagy. And people think it may play a role in preventing Alzheimer’s disease, may help play a role in preventing cancer, for example, all of these sort of really interesting

effects that you can’t get simply with weight loss you can get with fasting.

So, there’s sort of these multiple pathways. As you don’t eat…So as your insulin falls, you get this counter-regulatory hormone surge, which means that growth hormone goes up. So, nothing turns off growth hormone as fast as eating. When you don’t, eat growth hormone goes up, which you think, “Well, that’s really strange. Why would you want to grow when there’s nothing to eat?”

And the reason is that it prepares you so that as you’re breaking down your protein, what you’re doing is you’re breaking down this old junky, old protein that you don’t really want. Then when you eat again, the growth hormone is high and you rebuild all of this protein.

But what you’ve done in essence is you’ve done a complete renovation cycle of your body’s proteins. So, you if you renovate your bathroom, the first thing you’ve got to do is rip out that avocado green sink that was from the 70s, right, that’s got to go. If you don’t replace that, if you don’t get rid of it you can’t put a new one in its place. So, the first thing is breaking down.

The body is the same way. The first thing you’ve got to do is break it down, then you rebuild. And that is much better than keeping the old stuff there. So, the autophagy is this sort of renewal cycle of protein that only happens once you get into that sort of protein burning stage and replacement of old protein with new protein, which can be very powerful, and maybe one of the reasons sort of everybody has always considered doing a longer fast.

Again, looking at religions, this sort of wisdom of ancient people. One of the things they did when they had enough food was say, “Hey, once a year we should not eat so much so just to cleanse our bodies.” And guess what, they were probably

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more correct than we know. Because they were actually getting rid of not just the excess glucose that’s making us diabetic, the excess fat that’s causing obesity, but they’re also getting rid of this excess protein that may be causing things like cancer and Alzheimer’s, and all of this other disease.

So, in fasting you have sort of this very, very powerful method, which is completely free and completely accessible, and anybody can do it, and it’s available. But it’s this very, very powerful method now of not only losing weight and also preventing type II diabetes, because again if you don’t eat your sugars will come down. But also, of maybe preventing all of this other chronic disease that we don’t even really know about yet. But has sort of intense potential, sort of more potential than any sort of known drug that’s out there.

Sam Asser: So incredible, isn’t it? And so, whilst we’re on the topic of that, does somebody need to extend fast or can they get this state by doing intermittent fasting daily? Or what’s the best kind of approach that someone needs to give that fasted state?

Dr. Jason Fung: So, the fasted stated really gets – so if you look at a fast it’s really just defined as any time you’re not eating. So, sort of that’s just the way it is. You’re still digesting food. So if you look at…Say you finished dinner at 7:00 p.m. for example. You’re still digesting your food. Your insulin is still high, it’s not going to drop the minute you stop eating. It’s going to take a couple of hours, two to three hours.

Insulin starts to fall because you stored the food in the stomach and it slowly gets partitioned out to the intestines. So, you’re still digesting the food three or four hours after that. But by about three or four hours then that has been digested, now your insulin starts to fall. And that’s where you’re starting to get into that fasted state.

So, it goes fairly quickly. So, if you can do sort of a 12 hour/14 hour fast overnight, which is what people used to do. They finished eating at sort of 6:00 p.m. they ate at around 8:00 a.m., so it’s like a 14 hour fast every single day. You’re going to balance sort of being in the fed state and fasted state. And therefore, you’re going to spend sort of ten hours, ten to twelve hours storing food energy, and 12 to 14 hours burning food energy, perfect.

We’ve gone from that, which is the 1970s’ sort of style and remember they’re eating white bread and jam, and they’re eating ice cream in the ‘50s and ‘60s, and there’s just not a lot of obesity. The difference is they’re only eating three times a day with no snacks.

Now if you go to 2004/2005, the average number of times people eat is closer to six. A couple of years ago they measured how often people were eating and they broke it into sort of deciles. So, the ten percent of people who ate the least frequently as 3.3 times. So, if you only ate three times a day, that was less than 90 percent of the population. And the top ten percent of people who at the most time, they averaged 10.3 times per day.

So, in essence what we’re doing is we’re staying in the fed state constantly from the minute we get up to the minute we go to bed. And we’re wondering, “Hey, why are we so fat?” It’s because you’re telling your body by eating ten times a day, you’re stimulating insulin ten times a day and you’re giving your body the instructions ten times a day to store fat. You can’t do that.

And what’s worse is that this is sort of generally accepted dietary wisdom. This isn’t something that people decided to do. This is something that medical professionals have told them is good for you. So, we’ve entrenched it in our schools. My kids are a bit older now. But a few years ago, you

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look at the schedule, they’d eat breakfast, and if you didn’t eat breakfast, boy, you were a bad parent.

So, you ate breakfast, then they had a little snack in the middle of the morning. Then they had lunch, and then after school they had a little snack, and then they had their dinner. And then when they’re playing soccer, parents thought it was a great idea to give some juice and cookies in the middle of soccer. I mean are you kidding me? That’s six times a day every single day. That’s just regular. That’s not including any snacks they take when they get home, and the Gatorade and all of this other stuff that they make take otherwise.

So, we entrenched this idea that you should eat all of the time, and it’s actually probably, I think, one of the biggest factors in causing the obesity epidemic. You need to eat less times. Because when you don’t eat, then your insulin is going to fall. You’re going to give your body the instruction to start burning that food energy. We used to call it just digest. Make sure you have time to digest you food. And it’s true. Like this is not like some newfangled stuff I’m coming up with.

I’m just trying to push people back to like the ‘60s when people weren’t eating all of the time. When eating at your desk was considered like horrible, just horrible. If you ate your computer or you ate your desk you were considered so wrong. Like you eat at a table, that’s when you eat. If you tried to eat after school, hey, you don’t get to eat because you’re going to ruin your dinner. If you tried to have a snack at bedtime, your mom would say, “No, you should have eaten more at dinner time.” You try to have a snack at 4:00 o’clock after school she said, “Too bad, you should have eaten more at lunch.” And that was just kind of it.

Because we recognized that you have to balance this sort of feeding and fed state, and we have totally lost that. And now we’re sort of paying the

price of that. And we don’t even know where we went wrong with the whole thing. We think it’s all about the foods we ate, not recognizing, we think, “Oh, it’s because we didn’t discover quinoa?”

It’s like they weren’t eating quinoa in the ‘60s, and they didn’t have any problems with obesity. They weren’t even counting anything. It’s like, “Oh, it’s because they’re counting calories.” Nobody in the ‘50s counted calories. They were fine. The key is don’t eat all the time. Don’t eat a lot of snacks. And that’s sort of the main message we have to get to people.

Sam Asser: Amazing. And Dr. Pompa talks about like don’t eat less, eat less often. So, it’s exactly kind of like what you’re saying, but I guess if somebody was looking at losing weight what do you suggest that they do in a day? Like how less do they need to eat and what do they need to eat? Because people get confused by this as well. Like, “If I’m going to start intermittent fasting then when do I eat and how much of that do, I eat?”

Dr. Jason Fung: Yeah, so there’s lots of different things. You can talk about how often to eat and when to eat is a very important question before we get into sort of fasting schedules to lose weight.

First of all, you’ve got to cut out snacks. Snacks are deadly. The reasons the snacks are really deadly is because they tend to be very convenient. So, they’re highly processed foods, they often have a lot of sugar in them. You’ve got to get rid of all the sort of sweetened beverages. I mean, they’re everywhere. The Frappuccino’s and stuff. So, it’s a coffee drink, it’s loaded with sugar. You’ve got to get rid of the added sugars, because again it’s just advice your grandmother would have given you.

The drinks have to really be monitored because it’s easy to get a Gatorade and think, “Oh, yeah, because I’m running today so I need Gatorade.”

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It’s really just a lot of sugar. So, you’ve got to get rid of that. You’ve got to get rid of all of the snacks because they’re all like crackers and stuff. If you’re having a snack of like grilled salmon and kale, it’s like sure, that’s not so bad, but who’s doing that? You’re grabbing a muffin or doughnut or something like that. So, the snacking really has to stop. That’s probably the most important thing.

Then you can talk about the when you should be eating sort of the circadian rhythm. And again, in my book I talk about the insulin hypothesis, so I go over this in the obesity code quite a bit. It’s really insulin that drives weight gain. There are other hormones, for most people it’s insulin. If you eat the same meal at breakfast versus dinner, you’re going to get a lot more insulin affect at dinner time. So that means that the same meal is actually is more fattening at dinner then it is at breakfast.

So, eating late at night is just not a very good thing to do. And again, not much different than your grandmother would have told you, don’t eat late at night. Because your body’s shutting down, it’s getting ready to go to bed so it’s just going to turn all of that energy into fat rather into energy.

So, eating in the morning can be okay. So, eating breakfast, it’s okay, the problem with breakfast food in general is that it tends to be very limited. That is most people are not eating sort of steak in the mornings, most people it’s this sort of very limited selection, most of which is very carbohydrate heavy. So, toast, and bread, and croissants, and so on. So, it’s very limited, and a lot of people aren’t hungry in the morning, so again, if you like breakfast and you can eat a breakfast that’s real unrefined foods it’s okay. But most people don’t, everybody’s in a hurry. In this case it’s just skip it.

So, it’s better to say just take a coffee than it is to eat a muffin and coffee. Just because you have

to have breakfast. And this is sort of one of the nuances that gets lost in a lot of hysteria around, “Oh, you’ve got to eat breakfast.” It’s like, sure I get it, if you eat breakfast you stay more full for the rest of the day. You’re actually getting less insulin affect for the same meal. But if you’re eating cereal, then you’re better off not eating. If you’re eating eggs and bacon, you may be better off taking that breakfast. It depends on the person.

So, the problem is everybody’s in a hurry in the morning. And there’s generally a very limited selection of food in the morning, so that’s why I’m not a big stickler on breakfast. But if you eat a big breakfast, it’s okay.

So, if you take away that, and then you say, “Well, you really want to concentrate your meal in sort of the middle of the day.” Sort of like 12:00 to 3:00, sort of time period. Because there’s a balance there of not being too late at night, and not in this sort of range where you’re in a hurry to get to work sort of thing, so therefore I’m just going to grab a muffin. So that’s probably the best time of the day is to concentrate your eating.

And then in terms of schedules, fasting schedules, so remember in the ‘50s you’re just talking about a balance of being in a fed state and the fast state, so you want to be sort of ten hours or sort of three meals a day, no snacks. And then that’s a 12 to 14 hour fast every day. That’s pretty weight neutral.

So, if you’re trying to lose weight you might not do very well on that. So, you need to extend it. So, you extend the fasting period to say 16 hours. So again, you try to keep your eating to eight hours, and then try and keep it to like the middle of the day. So, like 10:00 to 6:00 or something like that. So, the eight hours. You don’t want to be like 1:00 p.m. to 9:00 p.m. because then you’re going to get more problems.

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The problem with eating late at night too is that hunger tends to peak around 8:00 p.m. So, you’re getting this sort of double whammy, you’re more hungry, so you’re going to eat more and you’re getting more insulin affect for the food that you do eat. So, you want to concentrate those sort of eight hours in the middle of the day as much as can.

And then you can go further. You can go to 20 hours, you can go to one meal a day, which is about 23 hours. And then you can keep extending. So, sort of the most popular regimens would be sort of like a 16/8 sort of regimen. And that would be done about six days of week sort of thing. Twenty hours is popular.

And then one meal a day is sort of like a 23-hour regimen. And again, keeping that meal say either to a big breakfast, then breakfast to breakfast or lunch to lunch is optimal. But in the typical working schedule it doesn’t work a lot. Having a big lunch and then going to until the next day’s lunch.

It doesn’t work for me for example, so I rarely if ever do that. Because it’s weird for my work schedule. My work and family life schedule. So, we typically have dinner as a family, so therefore I wind up going to dinner recognizing that it’s probably not the optimal schedule. So that’s a 24 hour fast. And that’s usually done maybe three times a week or less. You can do it more if you like.

And then after that you start to get into the multiple days. We tend to avoid the two-day fast because if you look at multiple-day fasting, day two tends to be the hardest, and then after that it gets easier. Hunger starts to fall, and this is your body starts to shift over to burning your body fat, which takes 36 to 48 hours.

The longer you go in that, the more comfortable

your body is. Your body switches over to burning fat, and says, “Hey, there’s lots of this stuff. Let’s just burn it.” And then your hunger settles, and your metabolic rate goes up and so on because you’re not restricting your fuels, you’re simply switching your fuels from the food that you ate to the food that you stored.

So, two-day fasts are not great because you’re kind of hitting the worst time and then stopping. So, if you’re go long, we usually tell people to go four, five, six, seven days, because you’re getting the benefits all through. But you’re getting those easier days at the end as opposed to the two-day fasts.

Now everybody’s different, some people by day four it’s really tough so therefore we say go short. You can do well on any of the schedules and you don’t even need to fast. Obviously, there’s lots of ways to lose weight and fasting is not always part of it. But it’s an important thing to think about because if you’re eating ten times a day and doing whatever diet that you’re doing, you’re going to sabotage those efforts by doing the ten times a day. So at least stick to sort of three times a day as sort of the maximum you really ever want to eat.

Sam Asser: Interesting. Interesting. So, I have two questions that have come up, and the first one is if it takes 36 plus hours to get into fat burning mode then what about the people that are doing the 16/8 method for instance? Are they still getting into a fat burning state, is that still going to benefit them for losing weight? Or do they need to do a longer one?

Dr. Jason Fung: Yeah. You can still do very well with 16 and 24 hours, because the key is really the insulin. If the insulin falls then you’re going to start to burn your stored food energy. Now if you eat a very high carbohydrate meal then you’re going to have a lot of glycogen around if you don’t, you’re not.

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So, if your insulin is low and it starts to fall then you’re going to naturally liberate, you’re going to burn some glycogen but it’s going to make it easier for the body to access those fat stores. If you have sort of high insulin for a long time you can develop this thing called insulin resistance. And that can also keep your insulin levels high and that makes it more difficult for those who have had longstanding obesity to lose weight. In which case you have to use some of these more intensive sort of strategies.

But yeah, it’s not necessary to fast. You can lose weight without fasting. It’s about controlling that insulin. So, by keeping it low, remember even four hours after your meal when you finished sort of digestion, your insulin is already going to start falling. And if your insulin resistance is low and you can start to liberate those stores of fat, because that’s the signal to go into the sort of fasted mode. Even by sort of by three/four hours.

It’s just that if you have a lot of insulin resistance it may not get into that so much. Yeah, I mean it’s a different way to think about weight loss and weight gain for sure. But I think it’s a much more physiologic method of doing it. Counting calories is ridiculously stupid because, you really have, it doesn’t take into account sort of the body’s actual response.

Like you restrict calories, you could eat all artificial foods, sweeteners and all of that and get zero calories. It’s like, does anybody lose weight drinking diet Coke? Not really. I mean, if artificial sweeteners and cutting calories by putting all of these artificial foods in where it was important, then we would have an obesity crisis. We’d just drink diet Coke and we’d all be slim. It doesn’t make sense.

It really requires kind of thinking about weight loss in a different way, a more successful way than the calories. And that’s what we try to do

in our membership. So, we have a lot of free resources for people. So, on our website, which is idmprogram.com which stands for Intensive Dietary Management. It’s the program that we use for our patients. You can go there and there’s a weekly blog, and I talk a lot about the science of it. And there’s a lot of videos and lectures and stuff as well.

And then if people want a bit more guidance, they can do the sort of monthly membership, which is sort of group fast, doing fasts in a group is very useful because people are there to support you. People don’t always recognize this, but sort of having support of peers is super important when you’re trying to change behavior. And it’s very difficult to do stuff out there on your own. So that’s why we try and provide it. So, we try and answer questions and that sort of thing. And then if you want sort of more individualized help, then you can get that too.

Sam Asser: Amazing. Amazing. And thank you for sharing that because you do have some phenomenal information there for people that want to go deeper, and want to go further, and want to know more on this. Definitely check that out because you guys have such incredible information.

Now a couple of last questions just before we wrap things up today. What do you feel like is something that people don’t know about fasting that you believe they should know? Like if you have like one paragraph, or one-liner, or just one message that you wish everyone knew about fasting, what would it be?

Dr. Jason Fung: It would that it’s okay to not eat, and this is the message that I shouldn’t even have to say. But I do. As a physician I tell people to fast all of the time. So, if you need to do surgery you have to fast. If you need to do a colonoscopy you have to fast. If you have to do fasting bloodwork,

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you have to fast. So, physicians tell patients to fast all of the time. So, we know that nothing bad happens, it’s just a part of everyday life. Your body is okay, it’s going to know what to do when you don’t eat. You do not have to keep stuffing crackers into your mouth every two hours in order to be optimally healthy.

Our bodies have figured that out a long time ago. So, if you don’t eat, you’re going to lose weight. And guess what, it’s not going to be unhealthy for you, it’s okay. In fact, if you never fast, if you’re eating all of the time it may have significant, significant health benefits. The weight loss, the Type II Diabetes, and then the autophagy. So, it’s okay not to eat sometimes.

Sam Asser: We’re not going to die.

Dr. Jason Fung: Exactly.

Sam Asser: I like it. I like it. And then the other question I have is besides what we’ve spoken about already, so like besides the insulin levels, and stopping snacking, and stopping eating so much what would be your number one advice aside from that for someone who’s wanting to lose weight?

Dr. Jason Fung: I think for weight loss it comes down to two questions, really. It comes down what to eat and when to eat. So, we talk about the first question, sort of what you should be eating and what you should not be eating all of the time.

And it comes down insulin in the end, so what to eat you should eat foods that don’t stimulate a lot of insulin because if you do, you’re telling your body to store fat. That’s what insulin does, that’s what its supposed to do and that’s what it does.

So, you eat a lot of sort of white bread, which most people agree is not a great sort of slimming food, but if you eat a lot then insulin is going to go

really high and it’s going to tell you body to gain weight.

But the other question that people don’t always think about is the sort of when to eat question, and people think it doesn’t matter. You could eat from sun up to sun down is the same as long as the same number of calories. I don’t think that’s true. I think that the number of times you eat is actually as important or even more important than the foods that you are eating.

So again, it comes down to insulin, if you’re eating all of the time, you’re stimulating insulin all of the time and it’s going to give you insulin resistance. If you don’t eat all of the time you’re not stimulating your insulin all of the time, you’re going to let your body go into the sort of fasted mode, it’s going to be able to digest the food and prevent the development of this sort of insulin resistance which is very important sort of in the long-term.

So, to me it’s all about one, if you think about it from a physiologic end, it’s all about insulin. But from a practical standpoint it’s really about what to eat, and we recommend sort of unprocessed whole foods, low in refined carbohydrates, sort of moderate in protein, and high in natural fats.

And then the when to eat is don’t eat all of the time. But what specific sort of fasting regimen you want to do, and remember fasting is a part of every day life. It’s really just the balance of the feeding, so if you’re balancing your feeding, then you’re fasting. If you want to lose weight you want to do more fasting. But what specific regimen you do is sort of up to you. You could 16 hours, you could do 18 hours, you could do 24 hours, you could do five days. They all work, but it’s just a matter of keeping that balance.

Sam Asser: Awesome. I love it. And then the last question to follow on from that is once someone’s lost the weight how do they maintain it?

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Dr. Jason Fung: Again, it’s just applying the same principles. So, which is eat healthy foods and don’t eat all of the time. You can change things up. I don’t think that our bodies are actually supposed to be in this sort of, “Oh, you should eat exactly 2,000 calories, and have it the same every single day for your whole life.” I don’t think you do well that actually. Our bodies are not actually meant to deal with sort of the same thing every single day.

So, I think that you need to change things up sometimes which is sort of how life is supposed to go anyway. It’s sort of this, there are times that you should eat, and there’s times that you should fast. So even if you look at sort of how our lives arranged. There’s the holiday period where you know you’re going to eat a lot, then there’s sort of the post-holiday period where you have to balance that out. And that’s just the way it is.

A lot of religions are built along the same things, so you have sort of Christmas where you’re going to eat a lot. And then Easter and Good Friday where you’re not going to eat a lot. So, there’s these sort of built-in feast and fast, that’s the sort of natural cycle of things. On a daily basis it’s a natural cycle, but on a yearly basis it’s also a natural cycle. There are going to be times that you’re going to eat a lot, there are going to be times that you really shouldn’t be eating a lot to balance those times that you eat a lot.

You can’t eat the same thing for a month of Christmas sort of thing, eat a lot, and then go back to regular. It’s like you never made up for that month that you ate too much. So, for a month you have to eat a lot less, that’s just balance. But everybody thinks, “Oh, I’ll eat normal. I’ll eat a lot for Christmas, and New Year’s, and then I’ll go back to normal and my weight will go back to normal.”

It’s like what about that whole, all of that cake and stuff that you ate, when did you make up for

it? You didn’t. You put it in, but you never put the effort into taking it out. So, it’s really just cycle that’s – I call it the cycle of life. It’s a feast/famine cycle. It’s like you fed and you fast, it’s the same cycle, it’s the yin and the yang. It’s a balance that’s there that we’ve lost. We say, you eat all of the time and forget the cycle. Oh, and if you eat a lot then just go back to normal. And it’s like you didn’t complete the cycle.

Sam Asser: Amazing. That’s actually a really good way to put it, and I think it would have sunk in for a lot of people just then. So that’s perfect. I thank you for sharing where they can go to find you. We’ll link that up as well so everyone’s got it, so they can go and find out more about your program. And have access to your videos, but are there any last words that you want to share with everyone today?

Dr. Jason Fung: I think that the only thing is to sort of make sure you figure out what works for you. Because what works for one person is not always what works for another person. So, you always have to sort of experiment, just because your friend did well on a low carb diet doesn’t mean you’ll automatically do well on it.

So, don’t just sort of keep doing it if it’s not working. The most important is really to find out what is working for you and what is not working for you. The advantage of fasting for example is that it works for almost everybody. People don’t like it necessarily, but it almost always works. Because if you don’t eat you will lose weight.

Some people have a terrible time on it, and some people have a great time on it. So, you have to find out where it works and this is where having options is such a great thing. And that is one of things we always talk about in our program, is look at the options. You could do this or you could do that and if you do great on method A, then do it. But next person’s going to do terribly on

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method A, and we’ll say then try method B or C, or D, or E.

And then do what it is that works for you without worry about, oh, but method A worked so great on my friend. It’s like who cares? Who cares about that? I’m a clinician I deal with results, I don’t deal with theories and stuff. Like there are theories, there are things that I think that will work better than others, but in the end the only thing that matters is if you’re losing weight.

So, don’t be afraid of what this person says you have to do, or this person says you have to do. It might or might not be right with you, and that’s where we get into a lot of trouble. Is that a lot of sort of dietary people say, “Oh, it works so great for me, it must work for everybody.” That’s not the way it works. It worked great for you, that’s it, that’s all you can say, you can’t say it’ll work great for the next guy. It might, but it may not.

Sam Asser: Yeah. Absolutely amazing advice. And thank you so much for everything that you’ve shared today. It’s been very valuable for a lot of people, I know that, and a lot of little things would have sunk in because they did for me. So, thank you so much for sharing. And thanks for being here on The Fasting Summit.

Dr. Jason Fung: Okay. Thank you.