Episode 217: Bile & Gallbladder Stones, Longevity, Asthma, Steroids, Berberine, Hyperglycemia, Glucose Tolerance, And More!

Intermittent Fasting


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Jun 13

Welcome to Episode 217 of The Intermittent Fasting Podcast, hosted by Melanie Avalon, author of What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine and Gin Stephens, author of Delay, Don't Deny: Living An Intermittent Fasting Lifestyle

Today's episode of The Intermittent Fasting Podcast is brought to you by:

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Listener Feedback: Mario - Gallstones follow up

Gallstones (Johns Hopkins)

The Melanie Avalon Biohacking Podcast Episode #82 - Sergey Young

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Listener Q&A: Christine - Inhalers/Puffers'

Listener Q&A: Jen - Everything Is Terrible: Berberine Rebound Hyperglycemia/Glucose Tolerance, Microbiome Changes?

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The Melanie Avalon Biohacking Podcast Episode #93 - Shawn Wells


Melanie Avalon: Welcome to Episode 217 of The Intermittent Fasting Podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, author of What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. I'm here with my cohost, Gin Stephens, author of Delay, Don't Deny: Living an Intermittent Fasting Lifestyle. For more on us, check out ifpodcast.com, melanieavalon.com, and ginstephens.com. Please remember, the thoughts and opinions on this podcast do not constitute medical advice or treatment. So, pour yourself a cup of black coffee, a mug of tea, or even a glass of wine, if it's that time, and get ready for The Intermittent Fasting Podcast.

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Hi, everybody, and welcome. This is episode 217 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Gin Stephens.

Gin Stephens: Hi, everybody.

Melanie Avalon: How are you today, Gin?

Gin Stephens: I am great. I'm in this phase of in between when I sent off my book with the edits that my editor wanted me to make, and now it's in copy editing. So, I have a couple of weeks of downtime and [sighs] [laughs] copy editing is scary.

Melanie Avalon: So, then it'll come back and then--

Gin Stephens: Yeah, I’ve got all the dates, I can't remember them. Actually, here I have the printout of them beside me. I had them somewhere, but here they are. The copy editor, I'll get it back June 28 from the copy editor. Then, I have a week to get it all back to them. Then, I get another set of it a month later after they've done something else with it. then I have another week or so, maybe two weeks this time to give more feedback. This is the thing though that's so scary. Sometimes, things get changed up. Like I found out with Fast. Feast. Repeat., something got changed in the process that was right on one version, and then some paragraph got in there in the wrong place. So, you have to read it so carefully and make sure things didn't get moved around. There's a lot of hands on it. Let me just put it that way.

Melanie Avalon: Yeah, I remember when that happened with my book a few times.

Gin Stephens: Yeah. I'm just going to cross my fingers that I'm reading it for-- I don't know when I'm reading it for Audible, but I hope that I'm reading it for Audible before it's in line for the printer, because that's what happened last time. I was reading it for Audible, and I found the weird things. And they're like, “Too late. We're already in line at the printer.” I'm like, “What?”

Melanie Avalon: Okay, yeah.

Gin Stephens: Then, you can't apparently change something, get out of line. Seems like you should be able to do that, you should be able to change your file, but you can't. It's not how it works.

Melanie Avalon: Well, fingers crossed, it all manifests.

Gin Stephens: It's true. It's a lot more complicated than self-publishing, but so much worth it.

Melanie Avalon: Yeah, I went in Barnes & Noble this week. Every now and then, I just go in and I like to look at my book on the shelf. It was so surreal because since my last name is Avalon, A, I'm right by all the authors, so like Dave Asprey, I'm right by Dave. I took a picture and I put it on my Instagram, but I took a picture of just my book and the immediate surrounding books, and I knew so many people right next to me, and it's weird to think that that's just the As and Bs and Cs, authors. It was like, Dave Asprey, James Clement, Jonathan Bailor, Dr. Alan Christianson, I was like, “So many people.” It's exciting. I didn't sign it though. Do you sign it if you ever go in?

Gin Stephens: Well, I've done it a couple times. Yeah, I did. I did it one time in Augusta, and once at Myrtle Beach. The one at Myrtle Beach was funny. It was before I stopped doing as much drinking as I'm doing, not that I was like some crazy drinker, but we had been to brunch. I was there with my friends from college. We had been to brunch for a long time and had multiple drinks. They were like, “Let's go see if my book is there.” I was like, “I'm the author. Can I sign it?” They're probably like, “That girl, she's crazy,” [laughs] because I was in the happy phase of having had a few drinks. Let me just put it that way. I wasn't like sloppy wasted, no. [laughs] But that's not how I roll, you know what I'm saying.

Melanie Avalon: I wonder how long Barnes & Noble is open. If they're open late, I should do that sometime, like have a glass of wine and then--

Gin Stephens: Maybe don't go after a long, long boozy brunch. I'm sure they probably were like-- we were[?] lots of fun. Let's just call it that, but that might be like the last time I had that much to drink, because right after that, I was like it's really just not working for me.

Melanie Avalon: Yeah, I can't day drink.

Gin Stephens: Yeah, well, we did go have a nap after that. [laughs] But no day drinking is definitely not for me. Now, just one drink, two drinks max, and I'm just like, “All right, that's enough. It feels so much better.”

Melanie Avalon: I don't ever really drink that much. I drink my Dry Farm Wines. Actually, I'm continuing to read Dr. Breus’s book, The Power of When. He talks about the best time for each chronotype to drink their drink.

Gin Stephens: Well, now I really wonder what the best time for me to drink.

Melanie Avalon: Okay, because do we think you're a lion?

Gin Stephens: Yeah, I think I'm a lion.

Melanie Avalon: Okay, the lion, I can tell you really quick.

Gin Stephens: Is the answer never? [laughs]

Melanie Avalon: I think it's early in the day. Let me check. You would have dinner and one drink at 6 o’clockish. The lion’s metabolism best tolerates alcohol at 4 o’clock. He says, “In good conscience, I can't advise anyone to start happy hour at 4 o’clock, but that is when lion’s metabolism best tolerates alcohol. If you start drinking at dinnertime, you can handle one or two glasses without feeling flattened, but do not drink after 7:30 PM, or your body won't be able to metabolize the alcohol in your system before bed.”

Gin Stephens: Oh, my gosh, that is 100% true. He's right. Yes. When I have one glass of wine with an earlier kind of dinner, it's when I keep drinking it or have a second glass after dinner and nurse it for a while until maybe 8 or 9, that's when it starts to interfere with my sleep. He's right. That's hilarious.

Melanie Avalon: For me, I'm a dolphin. Okay, for the dolphin, if you meet a friend for a drink or have a glass of wine between 8:30 to 10:30, make sure you have your last swallow by 9 PM. Significantly later for the dolphin that I can have my wine. I usually have my last wine usually by 10.

Gin Stephens: I feel like if I had a glass of wine at 4, then I'd be asleep by 8. [laughs] That's not going to work.

Melanie Avalon: Is this what you experienced? He talks about how the lion, it's like once they hit their, like sleep time, the brain just shuts off. It's just bedtime.

Gin Stephens: Yeah, it's really, really hard to stay awake.

Melanie Avalon: I always saw my dad experienced that. I just don't understand that. I just can't comprehend that.

Gin Stephens: Yeah, I'm like, “I've got to go to bed right now.”

Melanie Avalon: That's what makes it sound like.

Gin Stephens: Even in college, I would be the one who be like, “I'm out.” [laughs] Not all the time, but sometimes.

Melanie Avalon: He talks about for each chronotype when they leave the party. He talks about how the lions are the first leave the party.

Gin Stephens: Uh-huh, I'm definitely a lion.

Melanie Avalon: The wolves are the last to leave. Yeah, so next week, I'm just doing a phone call just to talk to him, and then going to bring him on the show. So very exciting.

Gin Stephens: Very cool.

Melanie Avalon: Anyways, shall we jump into everything for today?

Gin Stephens: Yes.

Melanie Avalon: All right. To start things off, we have a follow-up email about a topic we've been discussing on the show, which was the role of fasting and gallstones. This comes from Mario. Mario says, “Gin and Melanie. It seems you have just answered a question on the gallbladder on a recent podcast, but you said you were only able to find limited evidence about this in journals. I'm hoping to shed a bit of light on this. I work in healthcare, and I have some anecdotal evidence with this but not much in terms of medical journals. Like Gin says, you'd hear more about it if it was a problem. My anecdotal evidence is not for people who practice fasting as a lifestyle, but those who fast for religious purposes. During Lent and Ramadan, more people come in for gallbladder complaints. The theory behind this is that the gallbladder is a wallet for unused bile in the body. When you eat a fatty meal, the liver secretes bile, but while it is busy making more, your body pulls out readymade bile that was stored in your gallbladder. Stones in general precipitate out of solution when there is increased concentrations, like crystallizing salts when you boil off the water, but it does not redissolve when the concentration goes down. Gallstones can have different types depending on the components, such as calcium stones from oxalates, and this can depend on your diet. If the gallbladder is constantly emptying out, there's less chance for the stones to form. If there are stones, they're usually small and will sink to the bottom of the gallbladder. Therefore, fasting allows for biliary stasis, which then leads to more time for stone formation. Unfortunately, stone formation is a lengthy process. Journal studies generally do not do studies that will give results in a few years, because of the funding issues to do long studies and the rate of patients getting lost to follow up. Also, when your study has no marketing potential, so no drug to sell or process to market, there is no reason to do studies for it.”

I have quick question, Gin, because I was thinking about this a lot, because I do think about that how the intention of studies is typically to sell drugs, but there are a lot of studies on fasting. There's not really drugs related to fasting. Have you thought about this before?

Gin Stephens: It really depends on who's funding the study. He's right when he says that a lot of studies are funded by drug companies, but not all of them are. Not all studies are funded by drug companies. You can get grants and things like that. My husband's a research chemist, and so he's not been funded by a drug company ever.

Melanie Avalon: True. The closest thing would be, if ever they try to develop fasting mimetic drugs or drugs that-- if they're setting fasting, to figure out how the health benefits happen, then try and create drugs that would mimic that.

Gin Stephens: There's a lot of stuff going on at universities, that is not funded by like Big Pharma.

Melanie Avalon: Yeah. Okay. That's good.

Gin Stephens: There's a lot that is.

Melanie Avalon: Okay, so he says, “The IF community is relatively young for the amount of time it takes for stones to develop. Maybe when the 20-year-olds in your community reach 50s to 60s after doing IF for 30 years, then we may get some data, and can do a retrospective study on the effects of intermittent fasting on gallstones. I first heard of IF about five years ago. I found out about the different plans but was unable to get started due to a lack of resolve and meal planning. The gallbladder issue was a factor back then too, but my friend was unable to address that question. My tip for looking up information about this topic will be to look up Abstracts and PubMed and Google Scholar, but use jargon like biliary stasis, which is delayed gallbladder emptying.” I don't even know how to say this. I feel bad for our transcript writers right now. Cholelithiasis, which is gallstones or cholecys--

Gin Stephens: Cholecystitis.

Melanie Avalon: Cholecystitis, which is gallbladder inflammation, due to gallbladder blocked by gallstones, which is the cause of the gallbladder-associated pain. He says, “You can also take a look at textbooks for the theory rather than in journals. I hope this clarifies a bit and helps you in your research. I'm still interested in continuing this on for now but wonder if more frequent cheat days is the solution for this. Kind regards, Mario.”

Gin Stephens: That was great info, Mario. Thank you for sending that in. It makes me think instead of “cheat days,” maybe ADF, alternate daily fasting.

Melanie Avalon: Oh, yeah, that would be--

Gin Stephens: Because every other day is an up day if you're doing alternate daily fasting.

Melanie Avalon: With the stasis that he talks about with things, I wonder how many hours it takes for that to--

Gin Stephens: Me, too. Yeah.

Melanie Avalon: The study we talked about the last time was the one that looked at the fasting. I feel there was an increased risk at-- wasn't it between like 12 and 16 hours or 12 hours, but then after that the risk actually went down?

Gin Stephens: Oh, I can't remember.

Melanie Avalon: Yeah. For listeners, we talked about this on a recent episode. One other thing I'd like to just draw attention to that he talked about, I do like how he pointed out that we don't really have long-term studies on a lot of the things in the IF community. It will be interesting to see over time how things manifest, but we have been doing fasting for a very long time as a species. At least there's that. It reminds me one of the things that Gary Taubes talks about in Case for Keto is, he questions the potential safety of foods and dietary protocols and things like that. He talks about how a lot of people debate health potential of dietary fat. I think he's quoting somebody else, but he calls them vintage fats. It's more likely that the fats we've been eating for thousands of years are likely much more safe for the human constitution than non-vintage fats, or just food in general.

Gin Stephens: I agree completely. Really, I think if we all just started eating real food that people have been eating for thousands of years, if you go back to what your great, great, great, great grandmother ate, and ate that, you'll probably be fine. You can't just say grandmother, because my grandmother was drinking Tab and putting saccharin in her tea. So, you have to go back farther than your grandmother [laughs] now, but the foods that are bought our bodies are adapted to eating those foods that are traditional foods.

Melanie Avalon: Like even saturated fats, for example, we've been eating for thousands of years compared to-- Well, obviously, like trans fats, but even refined polyunsaturated fats, we wouldn't really have been exposed to.

Gin Stephens: Well, think back in history, let's go back to Medieval England. The nobility that had the more refined foods and the more indulgent foods and the more processed foods, they had worse lifestyle diseases than the peasants. They were all healthy. I would have been a peasant. [laughs] My family, they were peasants. We're down there eating the brown bread, and I don't know what else we were eating. It was probably not something I would recognize as food right now. But we had different issues, obviously, with our health people were more likely to die of infections and viruses, the plague. But the lifestyle diseases with the food, the nobility did have those.

Melanie Avalon: Yeah, that's definitely been a trend. Affluence and the effect. Thank you, Mario. That was very insightful, everything that he said,

Gin Stephens: Thank you for sending it. In 30 years, we'll have a follow up on episode 10,942. I don't know. I just did that. That's probably not the right math, but-- [laughs]

Melanie Avalon: The other book I'm reading right now are one of the books. There's so many. I'm bringing back on-- I think I talked about Sergey Young before, he's the longevity investor. He finally has his book coming out. I'm reading it right now. It's blowing my mind. Okay, the stuff that he thinks is going to happen relatively soon with health advances, I'll be really, really curious to see if it manifests. It seems like so out there and so far removed, but you think about how far we've come just in a few years, I guess, it could be possible. I mean, it's all longevity stuff, but in reversing aging, but wearables and monitoring health conditions and computer artificial intelligence and health. We shall see.

Gin Stephens: That is so cool. By the way, I just actually did the math, it will not be Episode 10,000. It'll be Episode 1560 in 30 years, plus 217. The reason I thought it would be so big is because we already are on episode 217, and it feels like we just started.

Melanie Avalon: It does feel like that.

Gin Stephens: Yeah, but we did not just start.

 Melanie Avalon: We should go back and listen to our first episode. The elusive first episode that I don't think I even have it anymore. You should go listen to episode 2.

Gin Stephens: We've been doing this for four years.

Melanie Avalon: Four years? Wait, actually four years?

Gin Stephens: Yeah, just over four years. We started in 2017.

Melanie Avalon: If we make it to five years, it'll be half a decade.

Gin Stephens: Right.

Melanie Avalon: Isn't that crazy?

Gin Stephens: Yes. [laughs] Crazy. All right. Now my mind is blown. It just seemed like 30 years would be a lot more than that, but there's 52 weeks in a year. I multiply that by 30, and it was smaller than I was thinking. When I just randomly blurted out 10,000, but in 300 years when we get to episode 10,000. Yeah, we're not going to live that long, sorry.

Melanie Avalon: Sergey Young thinks that we might-- Yeah, he thinks immortality will be an option. Then, he thinks death will only occur from accidents, but those will be less common, because most of the accident things that we engage in today will have been taken care of like car crashes and stuff. Then, if you do die in an accident, you can be an avatar.

Gin Stephens: Now that's just gotten beyond me. I don't think I want to be an avatar and live forever. No, thank you.

Melanie Avalon: Well, you don't have to if you don't want to. [laughs] And you also don't have to live forever. Oh, wait, sorry, last thing. He asked this question, it's so funny, because he had the same approach to it that I did. I might have asked you this before. I thought everybody would want to live forever. We've talked about this, right?

Gin Stephens: I don't know if we have.

Melanie Avalon: I always just assumed everybody would want to live forever. When I ask people, I feel most people I asked don't want to live forever.

Gin Stephens: Well, also what age people are you asking? Because you're a lot younger than me. Are you asking people my age? We're like over it. No, we're not over it. That's-- [laughs] But we already know we don't want to live forever. That's all I'm saying.

Melanie Avalon: I probably mostly asking people your age. Yeah.

Gin Stephens: We love life. Life is fabulous. I love life.

Melanie Avalon: I feel I will perpetually-- I don't know, I guess we'll see.

Gin Stephens: I want to live for a long, long time, somewhere between a long time and forever, though, is the answer. [laughs] I do want to have a long, healthy life.

Melanie Avalon: Well, he talks about how three reasons people usually don't want to live forever. Then, when you dismantle them, maybe people do want to live forever. It's like people associate living forever with being decrepit, like being old and not being able to function, but that would not be the case. Then, people think that it's selfish or taxing to the environment if everybody lived forever. I haven't gotten to the chapter where he discusses that yet, but he says that's not a problem.

Gin Stephens: I have to admit, I did wonder about that, because if you live forever, then all the other generations grow up, and now they're all adults too. Now, we have all these adults, what do we do with all these adults? So many adults. Because everybody that's a child grows up, do you stop having children? And that would be sad because children are amazing. I love children. I think the answer is not a bunch of adults and never having children. Children are such a pleasure of life. I'm not just talking about your own children, but I'm loving watching my nieces grow up. One day, I'll have grandchildren and teaching children. All right, I'm thumbs down with immortality. No. [laughs]

Melanie Avalon: I'm curious, I’ll have to report back when I read that chapter. It's the only thing he said that he teased about it was he said that-- I didn't know this, did you know that--? Well, I don't know if I knew this. Our expansion rates are actually dropping.

Gin Stephens: I did know that. Yeah, I did know that.

Melanie Avalon: I think he said, like Japan and one other country are predicted to have, half of their population. I don't know what the timeline is on that.

Gin Stephens: I once read a statistic about that, that every man, woman, couple, whether you're married, whatever, needs to procreate at the rate of two point something-- clearly, we can't have point of a child, but that's the average. Two point something in order to continue to keep the species up because there's two of you, you have to reproduce by--

Melanie Avalon: Oh, so once you fall below that, will that species actually eventually--?

Gin Stephens: Well, if the average fell to less than two for all of humans, though, just think about that. You're not reproducing at the rate that's enough to replace you when you die.

Melanie Avalon: Doesn't get it exponential, though, again, because you have--?

Gin Stephens: I don't know, I can't remember. I just know that I read that.


Gin Stephens: Not if two people produce two people, that would not be exponential. Think about it. If every two people produced exactly two people, and then they die.

Melanie Avalon: But then those have two--

Gin Stephens: Well, those two people each have two people and then they die. You're not adding. All right, here's me and Chad, that's two of us. If we have two children, that's two more people, then we die, and we've made two people. Those two people marry somebody else that we did not create, but between them, no, it's not going to be exponential. It's only exponential if you create more people than you. Does that make sense?

Melanie Avalon: Yeah.

Gin Stephens: If every two people created three people, now it's starting to get exponential.

Melanie Avalon: Yes. Okay. I always spend too much time thinking about this.

Gin Stephens: I know it's like, “Ah.” [laughs] Well, anyway, my logic could be completely off, but it sounds perfectly reasonable to me right this minute.

Melanie Avalon: The other night I met with four friends. There were four combinations of a possibility of something that could happen. Each one of us was one of those combinations and the amount of time I spent later that night trying to figure out the odds of that, so if there were four possible options, and four people met, and each person is one of those four options-- I wish I'd still remembered math better, like permutations.

Gin Stephens: If you don't use it, you lose it.

Melanie Avalon: I know. Good times.

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We have a question from Christine. The subject is “Inhalers.” “I have been reading your book, Fast. Feast. Repeat. As I am reading, I started thinking about my puffers for asthma, wondering if they affect my weight. I looked it up, and it can because they're steroids. Wondering if you can expand on this at all, or if you have in the past. Also wondering, when I do take the puffer, it is in the nighttime before I go to bed, will this take me out of my fast? I'm just starting to listen to all of your podcasts. Thank you, Christine.”

Melanie Avalon: All right, this is a great question from Christine. In general, steroids are usually [sighs] linked to weight gain. I've always thought that it's usually because mostly electrolyte issues, like they cause you to retain water, but they can also just in general affect hormones. It's possible that they can increase your appetite and make you gain weight that way, or actually even change where your body stores fat. Which connects to what we're talking about last time with is a calorie a calorie and how there's so many factors that go into weight loss and weight gain and medication, I think, is a hugely underappreciated piece of the puzzle for many people in that. Medication doesn't have calories, but taking certain medication can 100% change how your body is using and storing calories if you're gaining or losing weight. So, yes, steroids can cause weight gain, that could be a thing. As far as it actually breaking your fast, we don't consider medications breaking the fast. Fasting is about if you're eating or not eating, it's not about if you're taking something that changes how you're metabolizing energy, that's not breaking your fast if it's not food. Gin, do you have thoughts?

Gin Stephens: Well, just you know, that's one of the things we know about steroids, like Melanie said, they are linked to weight gain. That is a well-publicized, well-understood side effect. You have to take what you need to breathe. If you've got asthma, and you've got to use your inhaler for medication in order to breathe, you have to do it. Weight gain may be the side effect, but it's important to take that medication that you need.

Now, here's a plus, with intermittent fasting, you may find your asthma gets a lot better. I've actually heard this a lot. People who were asthmatics who required inhalers a lot prior to intermittent fasting get to the point where they no longer need them. Inflammation goes down. So, you may find you don't need to use your inhaler-- of course, talk to your doctor, don't just stop using it, make a plan and use it when you need to. Fingers crossed, maybe you won't need it for long.

Melanie Avalon: A few different books that I've read recently have actually had chapters on asthma, and linked asthma to whatever the subject of the book was, but in general, the subject of the books, they've been things like metabolic issues regarding like insulin sensitivity, or dietary approaches or things like that. A lot of people, like Gin just said, with fasting, find a lot of health conditions that they might not suspect would be affected by fasting actually get better, or even go into remission. So, yeah.

Gin Stephens: Yep. Oh, and I have an update, I looked it up because I was curious. The number is 2.1. The fertility rate needs to be 2.1 in order for the size of the population to remain stable. My logic was right. And just for a little bit of info here, in 1950, the average-- I just want you to guess. I'll do what you always do. How many children--?

Melanie Avalon: Oh, I love the guessing game.

Gin Stephens: No, I knew you did. All right, in 1950, guess what the average rate of how many children a woman would have in her lifetime was?

Melanie Avalon: Four.

Gin Stephens: It was 4.7

Melanie Avalon: 4.7?

Gin Stephens: Yep. 4.7. Of course, that's an average no one's having point seven of a child, but one person had four, someone else had five. Yeah, in 1950. I guess it's probably a worldwide stat putting it all together. Of course, it depends country to country. What will it be by 2100?

Melanie Avalon: By 2100. Okay, wait. you said it needs to be 2.1 for us to-- do I think that they think by 2100 that we will be stable or not? That is the question. Hmm. So, I think 2.1?

Gin Stephens: No, it was already 2.4 by 2017. So, they're predicting it will fall to 1.7 by 2100. This article--

Melanie Avalon: Ooh.

Gin Stephens: Yeah, the researchers are predicting that the number of people on the planet will peak around 2064 and then begin to fall. Isn't that interesting?

Melanie Avalon: Unless Sergey Young is correct, in which case. [laughs]

Gin Stephens: Well, then we got a different problem. [laughs] Will you change careers a bunch of times? You don't want to do the same job for 500 years, probably. By that time, you're really tired of your husband’s BS. I'm just going to tell you. 500 years later, you're like, “I didn't sign up for eternity, for 500 years.” [laughs]

Melanie Avalon: I just won't get married, solve that problem.

Gin Stephens: That would change everything.

Melanie Avalon: Mm-hmm.

Gin Stephens: Yeah. Another reason I don't want to. Just forever. What are you going to do for the next 100 years? How many jobs do you want to have? I guess maybe it would be a plus, you could try a lot of jobs. I could be an interior designer, like I wanted to be, and then I could do something else.

Melanie Avalon: I've never wanted to do anything else besides the stuff that I do.

Gin Stephens: Really, I have so many things I would like to do.

Melanie Avalon: Yeah. Interesting. Got me thinking. All right. Shall we go on to our next question?

Gin Stephens: Yes.

Melanie Avalon: Okay. A little bit of a long email but has two good questions. This is from Jen. The subject is “Everything is terrible. Berberine rebound. Hyperglycemia/gut microbiome changes?” It's a very descriptive subject. Jen says, “Hi, ladies. Number one, I did the ZOE test after hearing Gin talk about it. And much to my dismay, everything came back as “bad.” Bad blood sugar clearance, bad blood fat clearance, bad gut microbiome. I'm so disappointed. I was surprised because my fasting glucose is typically in the 70s to 80s. I eat a lot of different vegetables and take P3-OM. I eat an omnivorous diet where my main meal is usually pretty healthy focusing on whole foods. I still enjoy a smallish amount of processed junky stuff for my snacks, which I know I need to minimize for my gut microbiome and overall dietary inflammation. I've started my ZOE program, and notice that if I eat the exact same amount of the exact same foods in a day, but portion/time them differently, I can get a vastly different ZOE score.

For example, entering a mealtime to my usual one meal a day lifestyle where I'll have a large amount of fat, we will arbitrarily say 60 grams, in a short period of time will significantly lower my score. But if I have that exact same amount of fat, with the exact same foods, but spread out over a meal and a snack, spaced at least a few hours apart, where I have 40 grams and then 20 grams of fat later, my day score will be much higher. I get that's because of the impact of dietary inflammation from too much fat, especially with my slow fat clearance. Does this mean one meal a day really is not the IF lifestyle for me? Do you think my one meal a day lifestyle is making this worse, since I eat one large meal a day, plus some smaller snacks that basically dump all my macronutrients in a short period of time? Should I do two really small meals spaced apart to give my sluggish blood sugar and fat clearance time to move things out? This will really cut down my daily fasting hours and I'd hate to miss out on all the health benefits of a longer fast. But if one meal a day creates too much of an inflammatory blood fat burden on me, I suppose that could negate the benefits of a longer fast and the first place?”

She tells us a little bit about her. She says she's been doing one meal a day with clean fasting for a little over a year, “Usually 20 to 24 hours fasting with around a three-hour eating window. Sometimes 18-hour fast on the weekends, I usually still do 40- to 44-hour fast once a week followed by an up day. My fasting glucose is usually 70s to 80s. HbA1c is in the low 5. My cholesterol and triglycerides are excellent, blood pressure is good, normal BMI.” Despite her garbage gut microbiome, she can eat anything comfortably, really loves doing one meal a day and feels great on it. When she did two smaller comparison meals, when she was doing the ZOE test, she felt hungry and unsatisfied. Maybe there's a lot of dietary inflammation going on inside. She says, “I don't know because my blood sugar and fat clearance.” This is a really good question.

Gin Stephens: It is, and keep in mind we are not ZOE researchers. [laughs] I'm a consumer of the ZOE program. I'm not involved in the science of it or running it. I'm just someone who used it and shared about it. I have talked to them, of course, because I'm such a fan, because it's such good cutting-edge science. We're actually part of the science here. They're using the information they're getting from us. They're continuing to add to the research and learn more about people. That's what's really exciting here. Jen, this is J-E-N, by the way, so I imagine you're Jennifer. Jen, I got the same as you, except my gut microbiome wasn't bad. It wasn't ideal. It wasn't perfect, but it wasn't bad. I did have slow blood sugar clearance. Instead of calling it bad, let's just call it slow.

Melanie Avalon: Can I ask a quick question?

Gin Stephens: Yeah.

Melanie Avalon: Do you take the muffins and then later do your food as well, and it determines your blood sugar clearance based on your CGM only?

Gin Stephens: No, I don't know what their algorithm is for calculating your blood sugar clearance. No. You enter when you eat the muffins, but you also take a blood sample afterwards. I don't know what they're used. I mean, I can't answer that, because I don't know. They do have your CGM data, obviously. You also have a blood sample that you send them within a period of time after having the muffins, so they might be using the blood sample, not the CGM. I don't know.

Melanie Avalon: My question is, I'm just trying to get a sense of the program. Is it like you do the muffins, do the blood sample, do the CGM, and then when you're starting the ZOE program-- because you get scores, is it still monitoring your CGM? Or do you just put them in?

Gin Stephens: No.

Melanie Avalon: Oh, you just put the meals in the app and it gives you a score. It's not like looking--

Gin Stephens: Yeah, later. Later, once you've sent everything in, you send the CGM back, and they take all of your data. They have these predictive algorithms that they use, and they put-- and so everyone has different numbers. Some of the moderators for my community have done it. We've compared back in discussions, like this is what chickpeas are for me, this is what happens to avocado. I mean, we all have different numbers. Legit, every person is going to have something different than the other people. But it's all based on everything put into this predictive algorithm based on your blood sugar clearance, your blood fat clearance, and what happens with your CGM, and what you have in your gut microbiome based on the species that they find in your gut microbiome and what makes the good guys thrive, or what would make the bad guys thrive. They want you to avoid things that would feed the negative inhabitants of your gut microbiome, and they encourage you to eat the things that are linked to nurturing the good gut microbiome and then, whether your body handles the fat well.

I have slow blood fat clearance, I also had slow blood sugar clearance. Jen, I think this is amazing data because, think about this, when I wrote Delay, Don't Deny, this research hadn't started yet, research they're doing now. 2017 was the first time I ever heard of people having a different blood glucose response, that science was just being reported in 2017 with that TED Talk with Eran Segal, and the whole idea of Personalized Nutrition. All of this is unfolding right now. We're learning that, “Hey, we don't all process the food the same way.” Actually, Jen, 100%, yes, if our bodies process this energy slowly, then maybe we do need a longer eating window because if you think about what we've talked about with Marty Kendall, he talks about energy toxicity. When we have too much energy building up in our bloodstream, that's not good. He talks about that with, he has blog posts about it, in any kind of energy, whether it's too much fat, too much blood glucose, or even too many ketones building up. Energy toxicity, according to Marty, and he explains this very well in his writing, is when you have too much energy in your blood, that is not what we want.

That being said, you may find that take that same exact amount of food just like ZOE is prompting you to spread it out, spread it out. ZOE didn't tell you what to eat. Specifically, you still get to decide what to eat, but think about how you're shifting it around. Also, alternatively, maybe you're talking about having 60 grams of fat, maybe your body would do better with less fat, you can also change what you're eating based on the fact that that might not be good for your body. Like for me, if I eat too much fat, it does feel inflammatory for me. When I did keto and I felt so bad. In order to feel my best, I do feel better when I add less fat to my meals, if I overdo it and have too much fat, I feel a little puffy, I really can tell the difference. Knowledge is power. We're learning things about our bodies that 10 years ago, no one could have told you. Instead of being like upset-- because I get it, I'm bummed that my body has bad blood fat clearance or slow-- Let's use the word slow, not bad. Slow blood fat clearance and slow blood sugar clearance, I wish that were not the case, but it's the body I have.

In order to have the best outcome for me, if I want to focus on what I'm eating, I can choose whole foods, slightly less fat. You don't have to have zero because you're talking about-- if you have 40 grams of fat, and then 20 grams of fat later, that's still a lot of fat. The low-fat people who are like strictly low fat would not be having 60 grams of fat in a day. So, 60 grams of fat is not destined to not have fat, you're still having fat and your food can still be delicious. But just spreading it out a little bit might be better for your body. That's what their science is telling them. That's why they're making these recommendations.

One thing about them that's interesting, a lot of people may not know this, I've got some friends that went through it way earlier than I did, like a whole year before I did. I didn't have time, I was working on Fast. Feast. Repeat. I didn't have time to fool with it at that time. I was like, “I'll just come back to it later,” and I did. But they changed the app recommendations right in the middle of while all my friends that did it before me were in the middle of trying to create their meals. They had rerun data, they had new data, and it changed the recommendations. They're like, “What? The recommendations are different.” They are genuinely responding to what they're learning. They are changing and making changes to the recommendations as they get more data. They didn't just get some data, and now they're just going on that old data. It's new and updated. Am I explaining this well, Melanie?

Melanie Avalon: Mm-hmm. Yes.

Gin Stephens: It's responding to what they're learning. As they gather more data from more participants, they're refining everything about the process. This is ongoing scientific research. I bet in three years, we'll know more than we know now. I know that's true. Don't be bummed about it. Even though I know that you asked a lot of questions about, does that mean I shouldn't fast as long? Well, you could still fast as long as if you tweaked what you were eating a little bit, or just have a slightly longer eating window. I really don't think there's a giant difference. Think about it, if you're having the exact same amount of food, you're calling it one meal a day, you're eating it in a short period of time, versus if you spread it out a few hours apart, I don't think you're going to have a vastly different fasting experience. Does that make sense, Melanie? Because that's really how I do it anyway. My one meal a day is not like an hour. What I eat is spaced out over a few hours. Don't feel you're not going to get in the health benefits of fasting if you have to eat for a five-hour window. That's okay.

Melanie Avalon: Quick side note question, because you mentioned it. You recorded with Marty Kendall yesterday, right?

Gin Stephens: He streamed it in his Facebook group.

Melanie Avalon: Did he ask you any questions from me?

Gin Stephens: Yes, he did.

Melanie Avalon: Because he messaged me and was like, “What questions do I ask Gin that the audience might like to hear?” What did he ask you?

Gin Stephens: I can't remember. We talked for about so many things, I can't remember which ones were you. Also, it was like 6 PM, and I hadn't eaten yet, so I was like, “I'm ready to have some food now.” [laughs] I had a 24-hour fast yesterday, I don't usually, but we had such a fun conversation. I love Marty Kendall. He's great. The whole idea of really what ZOE is telling us from the results of our clearance is the same thing Marty is saying. You don't want to have too much energy building up in your bloodstream. We're learning that.

Melanie Avalon: Question again about the muffins, and I would like to try this out. They never answered the email that you sent. Is there a low carb muffin test at all or no?

Gin Stephens: No. [laughs] You're not going to like these muffins. They're full of yucky stuff. They're not high quality, like artisanal muffins. [laughs] It's funky fat.

Melanie Avalon: So, you're eating fat in the context of carbs, and it's testing your fat clearance?

Gin Stephens: Yeah, these are not the muffins that you would eat. It's only just that one period of time and it's short, and then you're done with it.

Melanie Avalon: The thing I'm trying to focus on is, it doesn't test fat clearance in the context of a low carb situation, it sounds like. It only tests fat clearance in the context of carbs.

Gin Stephens: Of their experiment. It only tests what they are testing. It's based on just that one variable. They have one variable and here's the muffin. You're the variable, I guess. The muffin is not a variable, muffin is controlled. What your body does with it, is what they're trying to see. Same muffin for everybody.

Melanie Avalon: Again, I haven't done ZOE. So, I can't comment specifically, but just what I'm hearing, it sounds like it's testing the concern that I've had, that I talked about on the show for, I mean, maybe since day one, which is--

Gin Stephens: Fats and carbs together?

Melanie Avalon: Yeah. I haven't done ZOE, but that's why I personally eat to address that. I eat to address that in a way that actually allows liberal amounts of fat if I so desire. That's why I was asking about if they do a low carb thing, because it sounds like they're testing fat clearance in the context of carbs.

Gin Stephens: Well, there's two different kinds of muffins. Did you know that?

Melanie Avalon: That you get?

Gin Stephens: You do a high fat muffin, and then you do a higher sugar muffin.

Melanie Avalon: Does the high fat muffin have carbs in it, though?

Gin Stephens: Yes, neither is low of what you would consider-- Neither muffin would be what you would consider low fat or low sugar, but it's lower than the other one. Like the one that's high fat, obviously has a higher proportion of fat, but it still has the carbs. The one that is the higher sugary muffin still has fat in it. It's just a lower proportion. They change the proportion of the ingredients that you're having.

Melanie Avalon: My curiosity there is, for people that it brands as poor fat clearers, it sounds like we don't know if they are poor fat clearers in the context of a ketogenic diet. Just that they are in the context of carbs.

Gin Stephens: Well, that would be a different study.

Melanie Avalon: Right. The reason I'm drawing attention to that is, I'm a little bit concerned, if they get labeled as a bad fat clearer, it might just be that-- again, I'm speaking from a very uninformed position, and that I don't know of the technicalities of what they're testing and everything, but it sounds like people might be bad fat clearers in a carb context, which is what they're testing. I don't know if that always translates to bad fat clearers in the ketogenic state. I'm just thinking right now, like, I hadn't pre-thought about this, the ironic thing is those that are bad fat clearers, if they like fat, they might actually respond better to a low carb, higher fat diet, because that would make it easier to clear fat.

Gin Stephens: I'm not following that. I don't know. Okay, I felt awful on low carb. I felt inflamed and came back as a poor fat clearer, unsurprisingly. I don't feel like having a really high fat diet made me feel great. It didn't.

Melanie Avalon: A lot of people who do really well on low carb, it's often because they don't do well on carbs. One of the reasons they don't do well on carbs might be because they're poor fat clearers in the context of carbs.

Gin Stephens: Yeah, well, that's certainly a possibility, but that would be a whole different experiment, it would be interesting.

Melanie Avalon: What I'm trying to say is, I don't think that means that you can't have fats. I think a lot of people might extrapolate from that, that they need to be on a low-fat diet accordingly, or that they need to watch their fats because they're not good at clearing fats. An alternative that ZOE, I don't think is going to recommend, based on what I know about it. An alternative might actually be a low carb diet, and then you could have more fats. If you're a bad fat, clear, there are two ways you can go. It's the way that I actually live my life, which is not combining fats and carbs. I anticipate-- I don't know if I'm a bad fat clearer, but I feel like I am. That's why I eat my one meal a day, but I do either low fat, or low carb. I don't combine the two. Basically, just like if it says you're a bad fat clearer, I think there might actually be multiple ways that you could use that data. Like for Gin, if she does want to have a lot of fat, I love what she said and what Gin was saying about spreading it out over a long amount of time or maybe trying fat in the context of a low carb diet.

Gin Stephens: Yeah, I feel you just don't know that though. When you say that, someone who's a bad fat clearer because they're having the muffin, because it has carbs in it too, but it was the carbs that made them be a bad fat clearer, so just have a lot of fat, and not carbs and you'll be fine. I don't think that's what we can just jump to that, that that's the answer.

Melanie Avalon: Oh, 100%. We also can't make the other assumption that they're a bad fat clearer just by the fact. We don't know.

Gin Stephens: Well, I think most people, and I know that that might be hard for you, or maybe some people in the audience to realize, most people eat fats and carbs together all the time.

Melanie Avalon: Oh, I know. That's not hard for me to realize.

Gin Stephens: Right. Most people are not low carb or low fat. They're eating food together. ZOE is targeting people who are eating like the normal context of food. Most people eat things that are combined. They give us food that's combined and they're testing the combined foods, instead of isolating because they're not trying to limit macros. Even for me with my slower fat clearance, ZOE doesn't recommend that I go low fat. I just need to be a little more mindful with how I'm having it and not compressing it, because she's exactly right. If I have too much fat in a short window, my score goes down. Again, they're also not trying to make you keep your score to any certain thing. It's just we tend to gamify things like that. It's like, “Well, if I can get a score, I want to get 100. I don't want to get a 60.” It's just teaching you what pattern might be better for your body, and then you design your life accordingly. If that makes sense.

Melanie Avalon: 100%, I realize most people eat mixed macro situations with what they're testing-- and this is why I would love to interview them. I'm going to follow up on that email.

Gin Stephens: Yes, they are testing a mixed macro situation, because that is how the majority of people are eating.

Melanie Avalon: Which is why I was saying with the fasting, I think a solution for a lot of people, even though the majority of the population eats mix macros, a lot of people in the health sphere do play with macros, specifically. I think there are a lot of potential solutions if it says that you're a bad fat clearer. There's spreading it out and seeing how that makes you feel, then there's playing with the macros, so doing--

Gin Stephens: And that is what they recommend. They recommend spreading it out, because then you're clearing, you have time to clear it. That's the whole point of it because you put in your meal and the time that you eat it, so it predicts based on the data they have on you, how long it will take for you to clear it.

Melanie Avalon: I wish they would do a low carb muffin too. I wonder how that would change things.

Gin Stephens: That would be a whole different study, right?

Melanie Avalon: They could still. I wish they would do it as maybe a two-day thing where you do-- or just another arm of the study. It's like another part of the testing protocol that you do, because it would seem that you would want to know how you clear fat in the context of just fat. A lot of people have been talking about it in my Facebook group, their thoughts and everything. People seem to really, really like the gut microbiome findings because you tested-- don’t you do a stool sample as well?

Gin Stephens: Yes, you do.

Melanie Avalon: Yeah, so people who have sent in that, say that's great. I want to do it for that like are really, really do want to do it and figuring out your gut microbiome and all of that. Then, people love hearing about the fat clearance as well. People seem to say that, in general, it seems to recommend lower fat, regardless, perhaps it's based more on the foods that they think support the microbiome.

Gin Stephens: Probably so, you have to know that is his foundation. That is Tim Spector’s foundation. If you ask a plumber to come over, he's going to do plumbing stuff. If you ask a gut researcher to do something, he's going to spin it towards the gut, because he knows the health of the gut, and what nourishes your gut. That's what he's focusing on. It shouldn't surprise people. When people get those results back, you're getting gut researcher recommendations on what that gut researcher based on research believes will feed your gut the best and it might not be what a diet book that you read, recommending carnivore said to eat. I'm just throwing that out as an example. A gut researcher is looking at the gut, and what is going to make that thrive. Whereas somebody who's writing a book about keto maybe just focusing on what your blood sugar levels are doing or something, I don't know. People focus on different parts of what our bodies are doing. Of course, we're not doing anything in isolation. That's the thing. We're not just our gut. We're not just our blood sugar response. It's all of it together.

Melanie Avalon: Yep. 100%.

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Melanie Avalon: She has one more question. She says, “I've also been wearing a CGM since I finished the ZOE test because I love the data that it gave. I used Melanie’s discount for NutriSense.” Thank you. “Anyway, I've been experimenting with berberine, also after hearing Melanie talk about it. Melanie, you are an influencer, even though you don't think you are. Admittedly, sometimes to see what I can “get away” with during my eating window,” with a little like emoji, that's like, ugh, I don't know what you call that emoji. What would you call that emoji?

Gin Stephens: I don't know.

Melanie Avalon: Grimacing.

Gin Stephens: Yeah, I was thinking grimacing.

Melanie Avalon: Yeah. She says, “I take only 500 milligrams of Thorne Berberine 500 once a day, about 30 minutes before my meal, I take it only on days I eat a lot of carbs. It definitely blunts my glucose response, but sometimes I noticed around three to six hours later, I'll have a big spike or two up to 140s to 150s. Is this because the berberine can only suppress the spike for so long? It looks like the half-life is around five hours, but I would have already finished eating a couple hours prior. I don't want to take another dose because I don't want to risk hypoglycemia. How long should it be taken? I read it has antimicrobial properties, which I imagine would worsen my gut microbiome. Any thoughts on the new blood sugar breakthrough from BioOptimizers? Or pendulum probiotics? Thank you, ladies.”

Gin Stephens: Now that is totally a Melanie question. I'm going to defer to you.

Melanie Avalon: I was going to say, “Gin, do you want me to take this one?”

Gin Stephens: Well, yeah, I don't even want to answer that. I don't know what berberine is doing in your body.

Melanie Avalon: First of all, I'll put a link in the show notes to two things to the discount for NutriSense, if you'd like to get a CGM. I have a code for 15% off. I think it's melanieavalon.com/nutrisensecgm with the coupon, MELANIEAVALON, I think. Either way, we'll put it in the show notes. Second thing, I'll put a link to the interview that I did with Shawn Wells. He's really big in the supplement world. We had a very long conversation about berberine. I am a huge fan of berberine. It has been shown to basically rival the beneficial health effects of metformin, which is a pharmaceutical, and it lowers blood sugar pretty consistently. When I've worn a CGM, I've seen that it can do really great things for my blood sugar levels. It's debated about how it works, probably it reduces actual glucose absorption in the GI tract. Then also, it might be that it actually downregulates the liver’s production of glucose, so downregulating gluconeogenesis in the liver.

As far as she's taking it and she's seeing that it reduces, but then she has a big spike later. I don't know, it could be that the berberine is-- because she talks about the half-life, it could be that it is wanting that initial spike, but then there's still glucose absorbing later on. Could be that it only has an immediate effect for you in the liver. I don't know. But it sounds like it is “petering out” in a way. In any case, I would encourage you not to take it for-- because she said she basically takes it to see what she can “get away” with. I think it's a little bit of a dangerous path. I feel a lot of people do this with metformin and diabetic medications and insulin even, basically relying on those to mitigate the potential blood sugar issues from the diet. I would just encourage you to maybe occasionally but try not to make that a habit because we don't want to be relying on something like berberine to undo potentially dangerous blood sugar spikes. Also, because she said how long can it be taken? There's a lot of debate out there about taking it long term versus not. People have been talking about this a lot in my Facebook group. My Facebook group, by the way, is IF Biohackers, so I've been taking it for months now and I'm probably going to keep taking it and I know some people think-- like Shawn is a fan of taking it every day, basically for life, but I'm not a doctor. I don't know.

Gin Stephens: I don't know that we know. I mean, we don't have data of someone who takes berberine every day for years. We don't know.

Melanie Avalon: I guess we know people will take Metformin every day for years, and it seems like it has the benefits of Metformin without the potential negative side effects. But yeah, I can't really speak to it, but I feel like Gin is probably spot on with what is happening as far as it's blunting it in the beginning and then not so much later. I actually haven't tried Blood Sugar Breakthrough by BiOptimizers, people have posted in the group about it and love it, so I definitely need to try it. I have no idea what Pendulum probiotics are, so I can't comment.

Gin Stephens: What's Blood Sugar Breakthrough supposed to do? It's sort of like berberine?

Melanie Avalon: Yeah, it’s sort of berberine, it's supposed to lower blood sugar levels. I think it's like berberine, cinnamon, it's like all these different things. It has a few different ingredients. It has propolis, bitter melon, Tibetan holy fruit extract, gluco advantage. Okay, so this is actually dihydroberberine. Okay, if it contains glucose advantage, I think that's Shawn Wells’ is, I think he patented that. I could be incorrect. I think Shawn did that. It has dihydroberberine which is much more potent form of berberine has cinnulin, has ALA, alpha-lipoic acid, [unintelligible [01:06:19], benfotiamine, glucofit, which is a patented banaba leaf extract, has [unintelligible [01:06:27] I can't even pronounce, fucoxanthin. Yeah, okay. So, it's got a lot of stuff in it. Basically, it's stuff to lower resting blood sugar levels. You could try that, or you could just start with berberine. Okay, that was a lot.

Gin Stephens: That was a lot.

Melanie Avalon: This has been absolutely wonderful. A few things for listeners before we go, you'll definitely want to check out the show notes for today's show because we talked about a lot and there will be a full transcript there and show notes and links to everything that we talked about that will be at ifpodcast.com/episode217. If you would like to submit your own questions to the show, you can directly email questions@ifpodcast.com or you can go to ifpodcast.com and you can submit questions there. You can follow us on Instagram, we are @ifpodcast. I'm @melanieavalon, Gin is @ginstephens. I think that is everything. Anything from you, Gin, before we go?

Gin Stephens: No, I think that was it.

Melanie Avalon: All right. Well, this has been absolutely wonderful and I will talk to you next week.

Gin Stephens: All right. Bye-bye.

Melanie Avalon: Bye.

Thank you so much for listening to The Intermittent Fasting Podcast. Please remember that everything discussed on the show is not medical advice. We're not doctors. You can also check out our other podcasts, Intermittent Fasting Stories and the Melanie Avalon Biohacking Podcast. Theme music was composed by Leland Cox. See you next week.


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