Welcome to Episode 275 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 Cynthia Thurlow, author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging.
Today's episode of The Intermittent Fasting Podcast is brought to you by:
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23:10 - BON CHARGE: Go To boncharge.com And Use Coupon Code IFPODCAST To Save 15%.
25:40 - Listener Q&A: celeste - Medications
40:45 - Listener Q&A: tina - Protein for vegetarians
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Our content does not constitute an attempt to practice medicine, and does not establish a doctor-patient relationship. Please consult a qualified health care provider for medical advice and answers to personal health questions.
Melanie Avalon: Welcome to Episode 275 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, Biohacker and author of, What When Wine: Lose Weight and Feel Great with Paleo-Style Meals, Intermittent Fasting, and Wine. And I'm here with my co-host, Cynthia Thurlow, nurse practitioner and author of Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging. For more on us check out ifpodcast.com, melanieavalon.com and cynthiathurlow.com. Please remember, the thoughts and opinions on this show do not constitute medical advice or treatment and no doctor-patient relationship is formed. So, pour yourself a mug of black coffee, a cup of tea, or even a glass of wine and fix that time and get ready for the Intermittent Fasting Podcast.
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I am so grateful for all of the information that I learned about their company. All of their beef is 100% grass fed and grass finished that's really hard to find. And they work personally with all the farmers to truly support the regenerative agriculture system. I also did an interview with Robb Wolf on my show, The Melanie Avalon Biohacking Podcast, all about the massive importance of supporting regenerative agriculture for the sustainability of not only ourselves with the planet. This is so important to me, I'll put a link to that in the show notes. If you recently saw a documentary on Netflix called Seaspiracy. You might be a little bit nervous about eating seafood. Now, I understand why ButcherBox makes it so so clear and important about how they work with the seafood industry. Everything is checked for transparency, for quality, and for sustainable raising practices. You want their seafood; the value is incredible. The average cost is actually less than $6 per meal and it's so easy. Everything shifts directly to your door. I am a huge steak lover. Every time I go to a restaurant, I usually order the steak, "Oh my goodness, the ButcherBox steaks are amazing." I remember the first time I had one and I just thought this is honestly one of the best steaks I've ever had in my entire life. On top of that, "Did you know that the fatty acid profile of grass fed, grass finished steaks is much healthier for you than conventional steaks." And their bacon, for example is from pastured pork and sugar and nitrate free. How hard is that to find and I'm super excited, because ButcherBox’ bacon for life is back and it's even better because you get $10 off as well. Yep, right now new members will get one pack of free bacon in every box for the life of your membership plus $10 off. When you sign up at butcherbox.com/ifpodcast. That's one pack of free bacon in every box for the rest of your life plus $10 off. Just go to butcherbox.com/ifpodcast and we'll put all this information in the show notes. One more thing before we jump in are you fasting clean inside and out?
When it comes to weight loss, we focus a lot on what and when we eat? It makes sense because these foods affect our hormones and how our bodies store and burn fat. But do you know what is possibly, one of the most influential factors in weight gain and it's not your food and it's not fasting, it's actually our skincare and makeup. As it turns out, Europe has banned over 1000 compounds found in conventional skincare and makeup in the US due to their toxicity. These include endocrine disrupters, which mess with your hormones, carcinogens linked to cancer and obesogens which literally can cause your body to store and gain weight. Basically, when we're using conventional skincare and makeup, we are giving these obesogenic compounds direct access to our bloodstream and then in our bodies studies have shown they do things like reduce our satiety hormones, increase our hunger hormones, make fat cells more likely to store fat and more resistant to burning fat, and so much more. If you have stubborn fat, friends, your skincare and makeup maybe playing a role in that, beyond weight gain and weight loss these compounds have very detrimental effects on our health and they affect the health of our future generations. That's because ladies when we have babies, a huge percent of those toxic compounds go through the placenta into the newborn. It is so so shocking and the effects last for years. Conventional lipstick for example, often tests high in lead and the half-life of lead is up to 30 years. That means when you put on some conventional lipstick 30 years later, maybe half of that lead has left your bones, on top of that there is essentially no regulation of these products on the shelves. That's why it's up to us to choose brands that are changing this.
The brand that is working the hardest to do this is Beautycounter. They were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin so you can truly feel good about what you put on. And friends, these products really really work, they are incredible. They have counter time for anti-aging, counter match for normal skin, counter control for acne and oily prone, and counter start for sensitive. I use their overnight resurfacing peel and vitamin C serum every single night of my life. Their makeup is amazing, check out my Instagram to see what it looks like. Tina Fey, even wore all Beautycounter makeup when she hosted the Golden Globes. So yes, it is high-definition camera ready. They have so many other products, deodorant, shampoo and conditioner that I love, products for babies and so much more. You can shop with us at beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow. Use the coupon code CLEAN for all 20, to get 20% off your first order. Also make sure to get on my clean beauty email list that's at melanieavalon.com/cleanbeauty. I give away a lot of free things on that list. Definitely check it out, and you can join me in my Facebook Group Clean Beauty and Safe Skincare with Melanie Avalon. People share their experiences, ask questions, give product reviews, and I do a giveaway every single week in that group as well. Lastly, if you're thinking of making Clean Beauty and Safe Skincare a part of your future, like we have, we definitely recommend becoming a band of beauty member. It’s sort of like the Amazon Prime for Clean Beauty. You get 10% back in product credit, free shipping on qualifying orders, and a welcome gift that is worth way more than the price of the yearlong membership. It is totally completely worth it. So again, to shop with us go to beautycounter.com/melanieavalon or beautycounter.com/cynthiathurlow and use the coupon code CLEAN for all 20 to get 20% off your first order. We'll put all this information in the show notes. All right, now back to the show.
Melanie Avalon: Hi, everybody and welcome. This is Episode number 275 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.
Cynthia Thurlow: Hey, how are you today?
Melanie Avalon: I'm doing really great, how about you?
Cynthia Thurlow: I'm doing well. It's amazing how therapeutic a vacation can be? I'm ready and raring to go back to work. [laughs]
Melanie Avalon: It's an amazing feeling to take time off.
Cynthia Thurlow: It's really important. That was one of the things I can tell you when I was traveling, people saying Americans don't seem to do a good job of disconnecting. I was like I have to agree with you and I don't want to be one of those people.
Melanie Avalon: Yeah. In my daily life even, you and I talk about this a lot via text, I'm so intense with my boundaries surrounding what I know I can do and not do, because you and I both, we're doing so many things, now we have two shows, other projects, presentations, product lines, there's so much. I know for me; I have no shame. People, they kind of wear not sleeping as a badge of honor. I'm like, nope, I need my nine hours and I make that sacred and I really prioritize self-care, because I know in the long run that's what’s sustainable.
Cynthia Thurlow: It's important for people not to feel guilty for creating healthy boundaries. This is something that I value and appreciate a lot about you and our friendship is that we're both very respectful of one another. For me, I have a tendency as a reformed people pleaser to not want to disappoint people. I now understand this really what happens to me when I do things that are not aligned with my true purpose and not aligned with honoring what's best and most important for me. I try to really lean into that and to stop saying yes to things that aren't a hell yes. I jokingly always say that when Melanie asked me to potentially consider coming on as a co-host, it was a hell yes. And if it had been any other thing, if I had a different reaction, it would have been, thank you so much for this opportunity, but I'm really not interested. Because if it's not a hell yes, it's a hell no, there's nothing gray in my life. It's either yes or it's no. I think that's very important for all of us.
What's interesting fun fact, as women are getting older. Obviously, we're at two different life stages, you're still at peak fertile years, I'm in menopause. As women start losing estrogen in perimenopause, guess what starts to happen, many of us stopped being people pleasers. Because estrogen is the hormone that generally encourages us to be people pleasing and as wonderful as estrogen is when we have less of it circulating. All of a sudden, I'm like, "Oh, well that explains why I speak my mind now, that explains why I'm no longer as accommodating." So really kind of reflecting on the fact that physiologically this starts to happen. And for the way that I was raised and I'm sure you were probably raised similarly. As a woman, we were expected to behave a certain way and present ourselves a certain way and all those things are fine and good. Ultimately, we have to honor who we are as individuals and healthy boundaries are so important. My mom's generation, they just served, served, served, served, served. My mom had a very high-profile demanding job and when she retired, she lost 20 pounds because she was so stressed all the time, she didn't even realize it. Now, she's finally at this healthy weight she wanted to be at for years. I said, "Well, it's the lack of stress." In your life as a retiree, but we don't want to wait till we're in retirement to be in that methodology and mindset. I just wanted to reaffirm how important I think that is to for all of us. Everyone listening, finding ways to honor who we are and to say no more often, and not apologize for it.
Melanie Avalon: I love hearing that. Something I as well, I'm probably not quite reformed with people pleasing. It can be draining actually. Especially, interacting with so many different people all the time and new people and I do I want everybody to just be happy. Normally, I feel like everything kind of pans out the way I would like, but I definitely could work on understanding more. The role of saying no and not having to make everybody happy and it's a struggle. I do think women-- not to make a generalization, but I do think women struggle with this made me more than men.
Cynthia Thurlow: Oh, absolutely. I think it's part of our social conditioning. I know that there were definitely expectations that I was expected to behave a certain way and look a certain way. As much as I love my parents, some of that set into motion that desire to be a people pleaser, and as a nurse and a nurse practitioner, oh my gosh, you're expected to be exactly that. When I reflect back on my career, why was I so successful at what I did? Oh, because there was a lot of people pleasing going on, at whose expense, oftentimes my own. We're all a work in progress, I think part of it's just acknowledging. I never would have described-- I would have never thought I was a people pleaser. Retrospectively, I'm like, oh my gosh, I've been this way my whole life. I always wanted things to be good and didn't want anyone to have a lot of argumentations, or arguing or dissent. Now I'm like oh I understand why I created that environment for myself. We all work in progress and I'm sure I will be working on that for the rest of my existence, I'm in a better position now. For people that are listening, just understand Melanie and I are real people and we go through that too. And just try to find small ways to make sure that you're articulating what needs to happen for you and your lifestyle. And having people that are in your life honoring and respecting the need for you to create boundaries. I think that's the most important thing.
Melanie Avalon: Yeah. You touched on the subtle nuance of it all. Which is you're saying how it did relate to your success and I don't know if that's part of the issue, but that's part of the complexity of it which is that it does benefit you like if you're a workaholic that works. It manifests with career success and such, but at what cost? Yes, just prioritizing self-care like I said. It's kind of the cliche airplane thing about putting on your own mask before others.
Cynthia Thurlow: Exactly. Yeah, I'm going to give you one really good example that will be relevant to listeners as well. I'm getting ready to speak at KetoCon and I'm the first speaker the first day. Just like every time I prepare, I like my talk to be run a certain way, be perceived a certain way. I want it to really be valuable. There was one graphic that I'm using in my slide deck that I shared on Insta Stories this morning. 99.9% positive reaction except for the one triggered person, who then vomited in my DMs. The old me would have wanted to explain myself and identify that her perception was wrong and then I just decided, I screenshotted it, sent to my team, I said, "No one's responding to this, there's no need to, this person was triggered, she has to take ownership of that. This is not a representation of me or our brand, or us and that's how I have to perceive it." The old me would have felt a need to explain myself and win her over. Now I'm like this person doesn't understand the context that this was shared in. I'm talking about metabolic health is wealth that's the context. That person didn't hear that or see it and just reacted. This is a good example of old me behavior versus new me behavior. And me feeling very comfortable saying, "Okay, that person may decide they want to unfollow they didn't like the whatever it is. That's okay. I'm not for everybody and that's totally okay." I'm coming from a place of education, inspiration, empowerment. I want, every person who listens to be educated to take the right steps for their health, to feel inspired, to feel empowered., that's the platform we come from. Well, occasionally people miss the mark absolutely. But I can't take ownership of that.
Melanie Avalon: I think that's so wonderful and it's interesting. This is a concept that prior to social media would not even be a concept. Prior to social media, you wouldn't have random people coming up to you and expressing their opinion and expecting an answer. Everything would have been context driven because you'd be talking to people first. [chuckles] People don't understand that if they are reaching out with their opinion, and especially if it's something that doesn't quite align with what you're doing, we get a lot of people reaching out. It's not-- there's necessarily the time to engage with every single argument brought to us.
Cynthia Thurlow: That's like bless and release, bless and release. That's my mindset, I’m like bless and release.
Melanie Avalon: [chuckles] I love it. Which speaking of sleep, I mentioned last episode, I would talk about something I have been I think is causing the massive increase on my Oura score. Okay, it's something where I feel it's what it is? But I'm skeptical. I got connected to this company called Leela Quantum Tech, it's L-E-E-L-A. I got connected through a fellow “biohacker" in the sphere and I did a call with the founder. It's interesting. It's supposed to be dealing with quantum energy and stuff like that. Which sounds very woo-woo. I talked to the founder on the phone for a long time and he said, they've been doing studies on it, and they'll be releasing it. And he said, "You'll see differences if you actually track and monitor blood tests or Oura ring or whatever." Since using this, it's great, my Oura ring scores have just been really boosted so much. Are you familiar with this type of stuff, Cynthia?
Cynthia Thurlow: I'm not. That's why, I'm like listening intently. Tell me more.
Melanie Avalon: Okay, the main device that he gave me is this-- and if you go to their website, you can see what it looks like. But It's this, you put it together, it's kind of like a box, a metal looking box thing. It's really hard to describe. If you look at the website, you'll see it. You're supposed to just set it down and it does stuff. It's similar to-- I've been using the Somavedic, which was my first experience with something that was supposed to do stuff like this and that's more for EMF mitigation and it can structure water, and they sent me a unit and I noticed an increase in my Oura scores. I was very impressed and I ordered a second unit completely on my own, because I felt like it was doing something, but this is next level. One night where I was not set up to have a good night's sleep based on the activities I had done and going out and drinking and all of that and using this and I was fine. They also have necklaces and they have these cards. I'm excited to interview him and ask him a lot of questions. But if listeners would like to give me feedback, if they've used something like that before. I did ask him for a coupon code. He said, "They never rarely ever give coupon codes" But he said, "I guess since we gave a coupon code to Dave Asprey and Luke Storey, we’ll give one to you. [chuckles] I was so happy about that. So the link and code for that is, you can go to melanieavalon.com/leela. That's L-E-E-L-A and you can use the the code MELANIE10 will get you 10% off. I don’t know, it's just funny because I'm so skeptical because I can't see why it would be doing what it's doing, but the Oura scores are just very impressive.
Cynthia Thurlow: Well. I've to check it out. It's interesting on vacation consistently my deep sleep was almost two hours and my REM was no less than 90 minutes. And as a 50-year-old that's pretty darn good. I was kept saying to my husband, it is possible. [chuckles] Because sometimes my deep sleep will be the area that I'm constantly tweaking and fine tuning and definitely with my post vacation viral illness, non-COVID, non-flu went down the toilet was my deep sleep. That was the first thing, I noticed that in my temperature and my readiness. It actually didn't give me the option of putting the rest mode on, [chuckles] it just put me into rest mode which I appreciated because I had a couple days where I could not pay attention to what my readiness score was. I was like this is stressing me out. So, anything that we can do to improve our sleep quality, I'm all for it.
Melanie Avalon: Yeah. The actual numbers difference I've seen on Oura. I feel prior to Somavedic which was the first thing I feel I was usually the low 70s for things and then I felt when I got Somavedic, I’d started creeping up to higher 70s. And then with this, it's very comfortably in the 80s and even so it's up to the point where it'll hit 89. I'm pretty sure the algorithm of Oura, I know for the sleep, I'm not sure about for the readiness score, but I think they probably relate because if the sleep is affected, it would affect the readiness, because of how late I go to bed. Even if I have a perfect sleep cycle, everything could be perfect. It basically detracts points because I go to bed so late. The only time I ever get in the 90s for sleep is if I had to go to bed early for something then I will get in the 90s. Basically, I approach the limit of what I think Oura will give me ever since using this. I don’t know, I would love to hear listeners thoughts if they've used something like this before.
Cynthia Thurlow: Do you want to know something I realized when I was six hours ahead of the world from you is that we were awake at the same time. [laughs] I was literally texting you. I was like she's awake right now and it’s like oh it's because it's a godly--
Melanie Avalon: It's 3 am here.
Cynthia Thurlow: I’m away, it’s like morning here and Melanie is still awake.
Melanie Avalon: Yep. I did ask when I had Harpreet on the show, I asked him that about the score. Is it impossible for me to get basically a perfect sleep score? And he's like, yep, because of how I go to bed.
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Cynthia Thurlow: Absolutely.
Melanie Avalon: To start things off, we have a question from Celeste and the subject is: Medications. Celeste says, please help me, how can I find out which medications can interact with fasting? I'm specifically wondering about gabapentin. I heard it raises your insulin. I've conducted research, but I can't find anything that addresses it. Again, please help me I've hit a plateau and I'm clean fasting for 20 hours a day and I have a three to four max eating window, Thank you. I will say before you jump into this, Cynthia, I'm excited to hear-- we haven't answered a question about gabapentin on the show before, but we've answered questions a lot about medications and fasting, but it's exciting to have you on now because we get to revisit all these questions and hear a potentially new perspective. I would love to hear your perspective on medications in general while fasting. I know you did some research on gabapentin.
Cynthia Thurlow: Yeah. First and foremost, most of the questions that I receive across social media and even in my groups are relevant to hormones. By this I mean thyroid medication, maybe someone takes progesterone, maybe someone is taking oral contraceptive, etc. Now, I'm the first person to say that if you've been prescribed either a synthetic or non-synthetic hormone and you've been directed take it on an empty stomach like thyroid medicine, I do not believe that breaks your fast. I don't want anyone to get so focused or fixated on minutiae or little details that are not going to really impact your fasting in a negative way. I take thyroid medication every single morning, I take it on an empty stomach, because that is where how you have it prescribed. For that reason, I tell everyone do not let this be of concern specifically to gabapentin as one example. I did some research on this and there is an observed causal relationship between the use of gabapentin and the potentiality of some degree of insulin resistance, although they don't understand the mechanism of action, meaning there's been a little bit of research, there have been anecdotal, meaning there are clinicians who have reported they suspect, there's this interrelationship between the utilization of gabapentin which is used for neuropathic pain and people that had developed insulin resistance.
Now, there are so many things that impact insulin resistance. When they talk about correlation is not causation. We talk about this causal relationship. It's because they can't necessarily say it's directly attributable to the gabapentin use. I think when someone is dealing with chronic pain, what we're really talking about is. If you have a heightened pain response, you are dealing with a heightened level of cortisol. What does cortisol do chronically over time, it's going to raise blood sugar, which could potentially lead to blood sugar dysregulation, which could reduce the sensitivity of insulin sensitizing cells on the cell receptors, excuse me. And in lieu of that, we could then make poor quality choices, when it comes to food, we don't crave broccoli and chicken when we're stressed or when our blood sugar is dysregulated. We're going to crave things that are not going to serve our blood sugar regulation really in the best-- the best way. There are a couple things that could be going on here. I did read that there's a clinical trial that was done prior to bringing this drug on to market, which reported there was some degree of insulin resistance, but there's not a lot of research demonstrating that there is this interrelationship, so what I'm trying to say here is there's enough information reported that is suggestive that there may be this relationship.
Obviously, the N of 1, the power of you as an individual bio-individuality is critically important. Now, I don't know your age. I don't know how physically active you are. I don't know what your macros are during your feeding window. There's a lot that could be at play. If you are a perimenopausal or menopausal female, you are more prone to insulin resistance already. As you were having these fluctuations in estradiol, progesterone, etc., you are going to be more at risk for insulin resistance, just by virtue of a hormonal dysregulation. If you're dealing with chronic stress, if your sleep is in the toilet, if you're doing the wrong types of exercise, if you're not consuming an anti-inflammatory diet, you are going to be at greater risk for insulin resistance. If you can hear from what I'm saying, it may not just be the gabapentin, if you are dealing with chronic neuropathic pain that could be contributing as well. I was prescribed gabapentin after my hip surgery, I only took it for a couple days. Thankfully, I didn't need the narcotics and the gabapentin for very long. I didn't see any changes in my glucometer anything, but that's not to suggest that this was something I needed to take every day, that could potentially impact my blood sugar in negative ways. We need more information. What's your blood sugar like. Are you seeing differing trends. What's your fasting insulin like? What is your A1c? What are your inflammatory markers showing? There's a lot here that you may be able to discuss with your prescribing provider, may be able to do on your own so that you have information. Have you seen weight changes, are you seeing non-scale victories that are changing? The other thing that I always think about when someone has a very short eating window, are you getting enough food in your eating window, does your body perceive that you are not getting enough food in and that is why you are starting to see some degree of insulin resistance.
There's a lot that could be going on here, but I think the big takeaway is, if you've been prescribed a medication that you need to take, I don't want anyone worrying that it's going to break your fast. That's number one. Number two, there's enough anecdotal and observational data about gabapentin, we also need to be thinking about what else can be contributing to insulin resistance. It has been my clinical experience that when people have chronic pain, they don't move as much. They're not as active because they are in pain. Just the heightened cortisol impact and the dysregulation of your blood sugar could also make you more likely to become insulin resistant. So just some things to think about. Obviously, when listeners are sending in questions, please don't feel like you can't share a little bit more about your personal circumstances, not enough so that you feel you're disclosing things you're uncomfortable with. But give us age ranges, let us know what stage of life you're in. It allows me to have some context so that I can answer these questions a little bit better.
Here's my other big takeaway about medications in response to feeding and fasting windows. Some medicines you have to take with food, eat it in your feeding-- or consume it during your feeding window. Sometimes, you need to have the food to buffer what you're taking. I was on a medication last week that I had to take with food and I waited till I opened up my feeding window. I took the medication with my food, which helped slow the absorption and allowed me not to get nauseous or have any side effects. Melanie, I'm curious, what is your take? Did you find anything out about gabapentin that I didn't already mention?
Melanie Avalon: Not about gabapentin. I do want to say, thank you so much. I really appreciate you researching that. That was fascinating, I did not know any of that. My thoughts are, you kind of touched on this, but people get really wrapped in their head about this idea of something like medication potentially “breaking fast.” What's interesting is, unless it's with a food which would be a different situation, but a medication, so a signaling molecule for your body. Even if that does raise insulin or have hormonal effects, which wouldn't be ideal. Raising the insulin in my opinion and this would be a little bit complicated, but that's not technically breaking your fast. What I mean by that is you could do exercise and increase cortisol or increase blood sugar levels completely independent of food. The insulin levels in your body which are fluctuating, the blood sugar levels of your body which are fluctuating, a lot of factors can affect that including medication. That doesn't mean you're not fasting. Even if your insulin level goes sky high, you're just fasting with an insulin level that went sky high, which again, not ideal, but it's just a reframe of the “breaking the fast.” I know she didn't use the terminology breaking the fast, she said interact with fasting which would be what's going on. I just wanted to speak to that and actually I was thinking a lot about this because listening to Peter Attia's most recent episode with Stephan Guyenet, have you listened to that one?
Cynthia Thurlow: So good. I'm almost done. It's really long.
Melanie Avalon: I really want to interview him.
Cynthia Thurlow: He sounds young.
Melanie Avalon: I'm so confused by him. I've been following him for a long time. It's Stephan I think Stephan not Steven, Stephan, he seems-- what you just said. He seems so young, but he's friends with all the people. He was on Joe Rogan with Gary Taubes. There's an interview with Gary Taubes and Stephan Guyenet. Yes, so I just confirmed it. And this was a while ago on Joe Rogan and I just remember because Gary says at one point because they have a thing between them now, Stephan Guyenet and Gary Taubes.
Cynthia Thurlow: I think as in like a negative thing.
Melanie Avalon: A negative thing. Yes, they have some sort of thing that happened between them. The interview I've listened to it twice which has a lot, because Joe Rogan's interviews are long. It's just interesting because Gary says at one point, it is so funny the way he says it, they're talking and then Gary's like, what happened with us? We used to be buddies and [laughs] it's so precious. What's interesting about it is he makes it sound like they go way back. I'm like, wow, and that was a while ago, even. I don't understand how Stephan Guyenet has-- he must be way older than he looks and sounds.
Cynthia Thurlow: He sounds very young, but then I have to understand that this is for anyone who's listening who's middle aged. You don't think of yourself as old as you are. In my mind, when I hear someone sounds really young. I'm like are they really young or do they just have a youthful voice. [laughs] When I heard him, I was God, he sounds like he's a post-doc. Maybe he's 30 but clearly, if he's on Rogan and he's hanging out with Gary.
Melanie Avalon: He's on Rogen, a while ago with Gary talking about how way back in the day, they used to be buddies, so he's been around. [laughs]
Cynthia Thurlow: You should Google how old he is?
Melanie Avalon: I'm trying to figure it out. The recent episode on Peter Attia is Stephen Guyenet and did you get to the part yet where they talk about semaglutide?
Cynthia Thurlow: Yes, because I get so many questions about that drug.
Melanie Avalon: That really got me thinking because they actually addressed this in the show. I had not gotten to the point yet where they address this, but they had brought it up, semaglutide, which is a weight loss drug. Then I was googling it and it talks about how-- what it does is it raises your insulin; I was like that's interesting. Peter says that when people are on it long term, it goes down and that's probably not the actual main mechanism of action. What were you going to say?
Cynthia Thurlow: No. It's interesting, because I've had patients who have been prescribed it by other providers. The two big takeaways are number one they stopped eating as much because they're horribly nauseous and then they get horribly constipated because it slows gut motility.
Melanie Avalon: I saw that.
Cynthia Thurlow: I always think to myself, my gosh, if you're trying to lose weight, I can think of a lot of other ways that won't make you constipated, nauseous as a side effect. People are losing weight and they're so fixated on that as opposed to the side effects on a lot of levels, I think it's kind of the traditional. This is what western medicine does, they create a drug to treat a problem, that lifestyle could probably fix more effectively and long term.
Melanie Avalon: Yeah. I looked it up and I was like this sounds miserable, but what's interesting and what we can think about-- thinking about this drug is that's a drug that literally raises insulin, apparently, it also increases insulin sensitivity. You're just using, it seems like a little bit more complicated than it just raises insulin. That would be a situation were looking at it from the outside, you'd be like, oh this is something that really breaks the fast and yet it has the effect of actually expediting weight loss. Point of all that, is that I wouldn't stress as much about medications breaking fast. But have the understanding that the medication you're having might like Celeste says, "Interact with your fasting, and may make it easier or harder accordingly depending on what it's doing."
Cynthia Thurlow: Yeah, but don’t, I think the biggest takeaway because people can get fixated-- I've had people send me DMs like if I brush my teeth does it break my fast and in a lot of levels, I appreciate the attention to detail. It also shows me that there are people out there who are stressing about everything. That's not the place I want people to come from, I want them to feel that fasting is something they could do that supports a healthy lifestyle as opposed to making them feel like they have to be fearful about everything that they come in contact with. That's my big takeaway.
Melanie Avalon: I'm glad you brought up the brushing the teeth thing, because I think something important to keep in mind is that there are different phases of insulin release and so there's the cephalic phase insulin response and basically if you're exposed to a queue that would have been the beginning of a meal, now today we might get that by like brushing our teeth with something that has a flavor or walking by a store that has smells. The body can release a small amount of insulin that it basically has primed and ready and it's in that first phase of your insulin response. What's nice is that it's kind of there's a cap, it only has a little bit ready and waiting and that's separate from the insulin that would be released when you actually eat. It's not you have this exposure and then your body just goes into the main action of releasing insulin. It's probably that cephalic phase insulin response, which is temporary and doesn't necessarily speak to elongated insulin response. Shall we go on to our next question, and thank you again for researching gabapentin.
Cynthia Thurlow: Yeah, absolutely. I was happy to do that.
Melanie Avalon: We have a question from Tina. The subject is: “Protein for vegetarians.” Tina says, "Hello, Melanie. I've been listening to your podcasts and I have enjoyed the down to earth and common-sense advice given on the show. I'm very excited to have Cynthia onboard. I've been looking her up on Insta and listening to her podcast and it's prompted me to write in with a question I've been wanting to ask for ages. I'm a vegetarian who also increasingly does not eat eggs. This is a lifestyle and personal choice for me and I would never go back to eating meat or fish again. I do eat eggs on very rare occasions, but they are definitely not a daily or even weekly food source for me. I do consume dairy but not a huge amount. I'll drink oat milk, but this is also not part of my general diet. I do consume Skyr yogurt quite regularly, you could say I'm almost vegan apart from the Skyr and sometimes Greek yogurt or even Indian homemade yogurt, which we call and I've never known how to say this, this is a Dahi.
Cynthia Thurlow: I think it's Dahi.
Melanie Avalon: My question is, where do I get my mass and take a protein that you and Cynthia advocate. Everything's protein-esque also has quite high carb content like lentils and quinoa and nuts have high fat and none of these have anywhere near the same protein composition as animal sources. Do you have any recommendations or anything that I am not thinking of, do I just have to live with having a probably lower protein intake than a meat eater and should I just focus on getting as much as I can through the yogurt and the lentils? I feel that I'm not able to implement your advice around macros being a vegetarian. I'm 42 years old, 5 foot 2, live in the UK, have been IFing for a while, lost a huge amount of weight in a short amount of time through Dr. Michael Mosley's fast 800 regimen in the summer of 2020. Then faced the holiday seasons and work stress and emotionally late-night binge, ate my way back up to a higher weight by spring 2022. Now, that the latest period of work stress is over. I'm focused again on my healthy eating choices and I'm doing it slow and steady and focusing on clean fasting, healthy food choices, whole real very unlimited ultra-processed foods, eating to satiety and focusing on mindset rather than the calorie counting fast weight loss method advocated by Dr. Mosley. I've only lost around two pounds in around six to seven weeks, but I'm not focused on the weight loss and rather want to achieve a sustainable lifestyle. I feel that increasing protein consumption will help and after any advice that you're able to please offer. Many thanks in advance. My origins are Northwest India where the majority of people are non-egg eating vegetarians definitely, dairy consuming. I remember you used to talk about eating the same foods as your ancestors. I wonder if this is also relevant information. Thanks so much in advance if you do get around to answering my question. Either way, I listen every week, so I definitely won't miss it even if you answer in a year's time. All right, Tina. Cynthia, what are your thoughts?
Cynthia Thurlow: Yeah. Tina, thank you for your thoughtfully and carefully worded question. I thought about this a great length. I want to respect and honor your desire to do a primarily plant-based diet. I think the challenge that I always have when young women and you're a young woman, when young women are wanting to eat a predominantly a plant-based diet. You're now 42 so perimenopause years and this is a time when we tend to be becoming more prone to insulin resistance and so when we're talking about plant-based protein, we're really looking at things you mentioned nuts and seeds, which can be a little bit calorically dense. I think about things like nutritional yeast, which when you look at the macros on that about 16 grams work out to be eight grams of protein, beans and lentils, as you mentioned, some of the ancient grains, hemp seeds, which two tablespoons of those will give you about eight grams of protein and that tends to be a complete plant-based protein. Then I think also about things like spirulina. But always my greatest concern for my plant-based females is, how are they going to be able to get enough protein in and not completely create a circumstance where they're going to be consuming so many carbohydrates that it's going to put them at a disadvantage metabolically.
I did a podcast with Dr. Ritamarie Loscalzo. I did that last year, we'll include that in the show notes and she's actually a physician that is plant-based keto, and has been for a long time. We have had a lot of really good vibrant discussions. She's actually in her 60s and looks amazing and she's usually my go to resource. If I have someone who really wants to be dedicated either ketogenic low carb and plant based. She eats a lot of seeds and nuts, has created a lot of like delicious recipes and she probably is not hitting the protein macros that Melanie and I embrace, but that is what works for her and her methodology. We definitely want that to be available as a resource. I'm not a huge fan of soy. I don't know what Melanie's position is on this but for me, I'm not a fan of soy, genetically modified, etc. I'm not sure how different that is in the UK if it's any different here than it is in the United States. My other thing that I get concerned about is just the issue with sarcopenia. You're in perimenopause, this 10 to 15 years preceding menopause and after the age of 40, we start to lose muscle mass. It's not a question of if but when and the way that we help maintain muscle mass is eating enough protein, lifting heavy weights, lifting, doing strength training, and getting enough sleep. If you're not able to get your protein macros where we have ideally kind of identified them, I would really encourage you to make sure that you're really leaning into doing some type of weight training even if it's weight bearing exercise to start because the more muscle mass you have, the more insulin sensitive you will be. Let me say that again, the more muscle mass you have, the more insulin sensitive you will be. This is critically important. There is not a woman listening to this that doesn't need to understand, we need to maintain muscle mass as we get older, what starts to happen after the age of 40 as we start replacing adipose tissue with that muscle mass, so we start losing more insulin sensitivity.
The other thing that I get concerned about, during my cardiology experience which most of my nurse practitioner years were working in cardiology clinic both in hospital-based medicine and clinical cardiology, and I had the experience of working in Washington DC where it is a very multicultural city. I had the opportunity to work with a lot of different ethnicities, races, etc. I had many south Asian physicians I worked with and so I feel very confident saying one thing that's interesting if you look at the research that south Asians are prone to insulin resistance. And they think some of this is epigenetic, meaning some of it is genetic based, genetic mediated, things that we inherit. If it gets turned on in expression to things we're exposed to our environment, or in our food, etc. They talk a lot about this thrifty genotype and it might be why some south Asians are more prone to insulin resistance, because their bodies have gone through periods of-- generationally have gone through periods where there's been a lack of access to food, and then there is access to food. So, there's a higher prevalence of diabetes and insulin resistance. This is something that they anticipate, will continue, will link some research articles that I was looking at in anticipation of this question.
I just think you do the best with what you have, so you know that you have a desire to no longer consume animal-based protein and you occasionally eat eggs. You have to really lean into eating as much protein as you can plant-based without disrupting your blood sugar without becoming insulin resistant. That podcast that I mentioned, we'll make sure is linked in the show notes so that you can listen to that. Dr. Ritamarie is an excellent option. You're probably going to have to do a little bit of experimentation. I think it'll be very unrealistic to think that you can hit 100 grams of protein a day with just plant-based protein, you'd either have to be eating constantly or you would really be detrimentally impacting your macros by way too many carbs and way too much fat. So, I think it's going to be a very delicate balance. It's not in possible to try to find the right balance for you, but I think given your origin story that you so graciously shared, just really being very mindful of the fact that you are going to be more prone to insulin resistance just based on your country of origin and the research that's being done in that area and how many thin south Asian patients I took care of that were insulin resistant. They always talk about TOFI, thin on the outside fat on the inside and a lot of the Indian physicians I worked with used to talk about this that we had to always be anticipatorily assuming, don't assume because you have a thin patient that they don't have insulin resistance. I would make sure you have a conversation with your internist, your primary care provider about markers to be looking for inflammation and insulin resistance. We've talked about these in a lot of the podcasts trying to be as proactive as possible. Hopefully that was a helpful bit of information. Melanie, I'm sure you probably have some insights as well that you probably will want to add.
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Melanie Avalon: I find it so fascinating the different body types, and especially how they might relate to ethnicity and the potential implications on metabolic health. Like you said, "It's really ironic because a phenotype that is naturally thin and maintains a thin body." On the one hand, it may be a person that's very metabolically healthy but then on the other hand, and this is what you're talking about, especially with the Asian population. Basically, they don't easily make fat cells like new fat cells. If they're consuming a diet that is an excess of energy, rather than creating new fat cells which would be protective in the short term, because that would allow an absorption of that extra energy, they just don't. It leads to elevated blood sugar levels and metabolic issues and it can create this like you said, "You don't see it on the outside, but they can have metabolic syndrome on the inside." It's really, really interesting. It's interesting to think how obesity in a way is protective against metabolic syndrome until it's not anymore and it's not when you hit that point where you hit that limit of the body can no longer absorb the extra energy. People who are metabolically that phenotype where they just don't do that, they hit that at a very thin body weight potentially. It's so fascinating to me.
Cynthia Thurlow: You did a great explanation of a very complicated concept.
Melanie Avalon: There's this one I always mention it, Peter Attia has one episode with-- I don't want to say the wrong person, I think it's Dr. [unintelligible [00:54:21] but I'm not sure. It's basically a two-hour episode just about this concept, but basically that's what it boils down to is that concept.
Cynthia Thurlow: I need a whole year of my life to catch up on Peter Attia. It's now, I get 30 minutes here and there I'm like okay, I got 30 minutes down. I got I need an hour and a half more to get through this podcast.
Melanie Avalon: Actually, my daily-- because I listen to certain podcasts during the day and certain ones at night and so I always listen to his new episodes, but then when I run out of new episodes of five or so consistent shows, I listen to you. Then I go and I'm working my way back through his Q&A episodes. I'm halfway back. I'm going backwards in time. It's kind of fun. Yeah, he's amazing. But yes, so appropriately enough I already mentioned this episode that Rhonda Patrick episode with Stuart Phillips, although we were talking about that last week, I think. Last week I mentioned an episode that Rhonda Patrick did with Stuart Phillips. It's all about protein intake, and muscle and all of that. He actually talks about this because she asked him, "What does he think about protein intake on a vegetarian or vegan diet, and he said that his thoughts surrounding it have actually changed because he used to think that it was not really possible or sustainable but now with the evolution of food products, now it is more possible for vegans and vegetarians to get higher protein intakes because we have food processing. Now, we have protein powders and basically there are options that can work.
Cynthia, was mentioning some, but I was just thinking you can get rice protein powder and for all of these, I would really look up the source and make sure it's organic. Something that you feel confident is tested for toxins and things like that. There's rice protein powder, there's pea protein powder, you mentioned that's being fatty, there's actually defatted almond protein powder. Since you're doing eggs, you could do egg white protein powder that might be a good option for you. There's pumpkin seed protein powder, I actually have one of those that I really like, I'll put a link to it in the show notes. I've done two episodes with people who also had their own protein powder, which was a complete protein powder, all nine essential amino acids and vegan. One was with John Jaquish and then one was with David Minkoff. David Minkoff’s episode was all about this that might be a good episode to listen to. His is called PerfectAmino. If you go to melanieavalon.com/perfectamino, you can use the coupon code MELANIEAVALON to get a discount on that. So that might be something to try and just a thought I have surrounding all of it. And this is something that I interviewed Simon Hill recently, who's big in the vegan world, and we had a really good nuanced discussion about this concept, which is that people like to think that in order for a diet to be an ideal diet that it wouldn't require supplementation or wouldn't require kind of finessing it to actually work. So, we see that with veganism or vegetarianism or potentially even something like carnivore to me and this is just my opinion. I'd be curious of your opinion, Cynthia. To me, I don't have any issue with, say you're following a vegan diet and in order to make it give you adequate protein intake, you eat these protein powders or you do something to reach what you need. I don't have any problem with that. People think that it has to necessarily work as whole foods only, I am more fan of whole foods but people may think that it's a wrong diet because you can't get it all from foods. But just in general, it's hard to get all of our nutrition today especially with our nutrient depleted soil. The point of that is I don't have an issue with people being super aware of this issue and making sure they hit what they need with their diet, especially if it's like they're doing it out of culture or ethics or personal reasons. So, I do think it's a possibility now but you'll have to focus on it.
Cynthia Thurlow: That's correct. I'm a realist. I tell everyone that I have whey protein powder in my house because three out of four of us tolerate dairy, I not being one of them. I have protein powder that I use on occasion, I don't use it every day. Sometimes that's how I choose to break a fast, sometimes that's how I get my macros in. I am a fan and a proponent of a less processed, nutrient dense Whole Foods diet but I'm also a realist. The only concern I have about a lot of the vegetarian plant-based protein options. Just making sure you get it from a really high-quality source because I think even pea protein can be highly contaminated even if it's organic and same thing with rice, with arsenic and those are the things I would just say are my concerns. But beyond that there's no judgement and I respect and honor where people are in time and space.
Melanie Avalon: I'm glad you said that because that made me think of two other things. I did want to focus on she was talking about yogurt and Greek yogurt, because I know one of her concerns is getting protein without necessarily high carb or high fat as well. I'm sure if she probably knows this but you can get basically fat free yogurt, well, I guess it would have carbs too. But you can get very high protein, not too high carb yogurt, especially with the Greek yogurt. Then you would ask me about my thoughts on soy, my opinions have been evolving a little bit. I used to be very much in the camp of being very concerned with soy and I am still very concerned with soy, I believe it's the most genetically modified crop that there is. I'm suspicious on a lot of the literature showing the beneficial effects across the board on soy. A lot of it probably has to do with-- a lot of benefits of soy are attributed to something called I think it’s Equol production. It's this compound that's created when your gut bacteria digest soy, you actually have to have the gut bacteria that create that compound. That's one of the reasons, so Asian populations, for example, are high in these bacteria and so that might be one of the reasons they benefit so much from soy compared to us, Americans.
If you don't have that gut bacteria, you're not going to get that beneficial effect from soy, so I think that's something huge to keep in mind. Also, like traditionally fermented soy and things like Tempeh. Tempeh might be something to try Tina because you can find some good fermented non-GMO Tempeh that would be high in protein. The way my thoughts have been evolving as I did interview, Dr. Neal Barnard on the Melanie Avalon Biohacking Podcast, and he is very big in the vegan world. He actually specifically wanted to come on just for his study about soy, a soy inclusive vegetarian diet and its vegan diet and its effects on menopausal symptoms. His study has a very big flaw, which I asked him about, which is that he had no control group to compare a vegan diet without soy. He just compared a vegan diet with soy to a Standard American Diet. So, I don't know how you can attribute anything to the soy specifically and not just the vegan diet with soy. But in any case, and prepping for that show. I really tried to go through the literature on soy, and I walked away feeling less apprehensive than I was because there is a lot of good literature on beneficial effects from soy. But I think context is so key and I think a lot of it today is genetically modified and processed and possibly might be more estrogenic than the way it's advocated which is as a phytoestrogen, which would modulate your estrogen levels and I feel like I'm getting very long winded. Basically, I'm on the fence about soy.
Cynthia Thurlow: I don't love soy but having said that, the really cool thing about having our other podcasts is it gives us opportunities to connect with individuals that can change our perspectives. We're both open minded enough to be able to facilitate that, yeah. There's a lot that can be said here and hopefully we were able to answer her question in a very thoughtful way that will be really, really helpful. But we'll make sure all those links are included to podcasts. I've done and Melanie has done and products that we've talked about. Gosh, we have so many great questions, we have not yet answered, we rest assured that we're trying to make sure that we are answering these as thoughtfully and as deliberately and as helpfully as possible. We really do put a lot of love and effort into this podcast and we hope that it shows.
Melanie Avalon: I just want to say thank you, Cynthia, because it does really show. I'm just so happy. It's been really exciting to have the evolution of this show. And I'm really, really enjoying our conversations, and I so appreciate all of the research that you've been putting in and I really feel like—I hope I feel like we're really benefiting listeners. Thank you. Thank you for being here.
Cynthia Thurlow: Yeah, absolutely. I'm excited for us to do our next call together so that we can dive into some other topics that I was super prepared. You know what it is? I think we go into such depth in our explanations that we're averaging probably two questions for each episode. Maybe we'll be able to squeak a third in.
Melanie Avalon: I think it's all amazing content. All right, well, this has been absolutely wonderful. A few things for listeners before we go. The show notes will be at ifpodcast.com/episode275. They will have a full transcript as well as links to everything we talked about which was a lot of stuff. So definitely, check that out. If you would like to submit your own questions for the show, you can directly email email@example.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 and Cynthia is @cynthia_thurlow_. Okay. That is everything. Anything from you, Cynthia, before we go.
Cynthia Thurlow: No. Just excited to dive into more questions next time.
Melanie Avalon: I know and to have fun in Austin.
Cynthia Thurlow: Yeah. This is the biggest group of people I've spoken in front of in real life, ever.
Melanie Avalon: Oh, really? Yeah.
Cynthia Thurlow: It's like 2,500 are at KetoCon. It's kind of cool.
Melanie Avalon: Oh, that's very exciting. How many people when you did your TED Talk? How many people?
Cynthia Thurlow: 500 I think and I think about that now and I can't even watch that.
Melanie Avalon: Really.
Cynthia Thurlow: Now, because I had been so sick, it was only 27 days after I left the hospital I got up on that stage. When I think about it's a little overwhelming. Okay, my brain had not caught up with my body, clearly. When I watch it now, I'm just oh, yikes. [laughs]
Melanie Avalon: Well. Clearly, it panned out fine. Nobody picked up on it. Because you have what 11 million views?
Cynthia Thurlow: Yeah. It's funny. My 14-year-old likes to pay attention. I he said, It's 11.5. It's just, yeah, it's not slowing down.
Melanie Avalon: It's amazing. So cool. Well, congrats.
Cynthia Thurlow: Thank you.
Melanie Avalon: Well, happy travels and I will talk to you next week.
Cynthia Thurlow: Sounds good.
Melanie Avalon: Bye.
Thank you so much for listening. To the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice, and no patient-doctor relationship is formed. If you enjoyed the show, please consider writing your review on iTunes. We couldn't do this without our amazing team. Administration by Sharon Merriman, editing by Podcast Doctors, show notes and artwork by Brianna Joyner, transcripts by SpeechDocs and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.
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STUFF WE LIKE
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Melanie's What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine
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