Welcome to Episode 305 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:
BUTCHERBOX: Grass-Fed Beef, Organic Chicken, Heritage Pork, Wild-Caught Seafood: Nutrient-Rich, Raised Sustainably The Way Nature Intended, And Shipped Straight To Your Door! For A Limited Time Go To butcherbox.com/ifpodcast And Get Chuck Roast And A Whole Chicken Plus $10 Off!
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To submit your own questions, email questions@IFpodcast.com, or submit your questions here!!
1:10 - BUTCHERBOX: For A Limited Time Go To butcherbox.com/ifpodcast And Get Chuck Roast And A Whole Chicken Plus $10 Off!
3:30 - BEAUTYCOUNTER: Keep Your Fast Clean Inside And Out With Safe Skincare! Shop With Us At melanieavalon.com/beautycounter or beautycounter.com/cynthiathurlow And Use The Code CLEANFORALL30 For 30% Off PLUS Something Magical Might Happen After Your First Order! Find Your Perfect Beautycounter Products With Melanie's Quiz: Melanieavalon.Com/Beautycounterquiz
Join Melanie's Facebook Group Clean Beauty And Safe Skincare With Melanie Avalon To Discuss And Learn About All The Things Clean Beauty, Beautycounter And Safe Skincare!
The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture
How to Meet Your Self: The Workbook for Self-Discovery
NUTRISENSE: Get $30 Off A CGM Program And Get 1 Month Of
Free Dietitian Support At nutrisense.io/ifpodcast With The Code IFPODCAST
22:50 - LOMI: Get $50 Off Lomi At lomi.com/ifpodcast With The Code IFPODCAST!
26:00 - Listener Q&A: Laurie - I'm a foodie and an entertainer, and i'm fasting. Is there a happy medium?
39:25 - Listener Q&A: Tracy - Have you done an episode on BHRT and if not, would you address it?
39:30 - Listener Q&A: Stephanie - I'm on progesterone only HRT — Can you use estrogen even if you still have a period ? Will it cause weight gain?
Ep. 220 A Detailed Guide to Healthy Hormones with Dr. Lara Briden
Episode 4: Reboot Your Hormones Naturally with Dr. Tassone
Ep. 198 – Dispelling Myths About Hormone Replacement Therapy
#42 – Avrum Bluming, M.D. and Carol Tavris, Ph.D.: Controversial topic affecting all women—the role of hormone replacement therapy through menopause and beyond—the compelling case for long-term HRT and dispelling the myth that it causes breast cancer
45:30 - Listener Q&A: Stacy - Does THC inhibit weight loss while IF?
52:40 - ATHLETIC GREENS: Get A FREE 1 Year Supply Of Immune-Supporting Vitamin D AND 5 FREE Travel Packs With Your First Purchase At athleticgreens.com/ifpodcast
54:05 - listener Q&A: Katie - I love that the two of you are so positive. What would be interesting is to hear some of your biggest pet peeves.
Nicole - What are your pet peeves?
Theresa - Biggest turn-off?
Our content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and answers to personal health questions.
Melanie Avalon: Welcome to Episode 305 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 cohost, Cynthia Thurlow, Nurse Practitioner and author of Intermittent Fasting Transformation: A 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 if it's that time, and get ready for The Intermittent Fasting Podcast.
Hi friends. I'm about to tell you how you can get a grass-fed chuck roast and a whole free-range organic chicken plus $10 off. Yes, that is a free grass-fed chuck roast and a whole free-range organic chicken plus $10 off. So, we are a little bit obsessed with a company called ButcherBox. When you think high-quality meals, what do you think? For me, I think of the actual source ingredients. It's a little bit ironic because I do love eating out at restaurants, but I honestly think that I can get better high-quality meat and seafood right in my own home. That's because ButcherBox takes the guesswork out of finding high-quality meat and seafood and makes it so easy, so accessible, and so affordable.
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And 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? 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 a thousand 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 may be 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 percentage 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.
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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, so definitely check it out. 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.
And 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 CLEANFORALL20 to get 20% off your first order. And we'll put all this information in the show notes. All right, now, back to the show.
Hi everybody and welcome, this is episode number 305 of The Intermittent Fasting Podcast. I'm Melanie Avalon and I'm here with Cynthia Thurlow.
Cynthia Thurlow: Hey, Melanie, how are you?
Melanie Avalon: I am good. I did something that I haven't done in a long time that we've talked about a lot on this show, that listeners might be familiar with. I'm back on the CGM train.
Cynthia Thurlow: Oh, you are?
Melanie Avalon: Yeah, I haven't worn one. It's been a while. I go through periods, like, I put one on and I wear it for a while and then I take a breather. It's always really exciting to see where you are with everything with that. I'm curious because you said you wore one for months and months, right?
Cynthia Thurlow: I did for about 18 months and then I took a break. I felt like, especially with me doing a lot of travel, to me, it's just kind of one extra step to have to take. I do have a NutriSense CGM or a Freestyle Libre connected with NutriSense upstairs that I should put on at some point. But I've got, two trips in February and two in April, back-to-back, so I will definitely avoid having it on at that time.
Melanie Avalon: Yeah, it is because I don't want to dissuade people if they're traveling that they can't wear it. It is something were moving around and hustling and sleeping and then going out, it's a thing. For listeners who are not familiar, it's a continuous glucose monitor and you put it onto your arm and it constantly measures, actually, your interstitial fluid to measure your blood sugar levels 24/7. But my question for you was, in those 18 months did you see any significant changes? Did you make dietary or lifestyle or fasting changes to address your blood sugar levels or what was your experience like?
Cynthia Thurlow: I think it really validated the way that I eat and certainly for me it was insightful. There were certain types of carbohydrates, like plantains, I think I've talked about it on the podcast before. It doesn't matter how I consume them. They really spiked my blood sugar quite significantly. The other thing that I have really started paying attention to is just the stress of travel. I live in a city now where there are very few direct flights, so there's always a changeover either in Denver or Chicago or Atlanta. If anyone's traveled in those big airports, I think I chronicled that I sprinted in the Chicago airport to make my LA connection, that was about a mile and a quarter, and I kept saying, I don't know how people who are not healthy are able to do that. I would have missed my flight. To me, knowing the net impact of that stress, because with cortisol going up, blood sugar goes up in response to that.
To me, it's like, now I know what I need to be doing. It just validated good behavior. I haven't changed my diet all that much. I'm still very protein-centric, definitely cycle my carbohydrates. I do notice the net impact on my blood sugar and certainly my Oura Ring scores if I deviate from what I normally do. I'll give everyone an example although I'm not wearing a CGM right now, over the weekend, I just felt like having a clean brownie. So, I made brownies. Typically, if I'm going to do that, I don't do it at 8:00 or 09:00 o'clock at night and so what's interesting to me is how badly I felt after eating said brownies, even though I'd had a good dinner, like a good substantial dinner. I was telling my husband, I just think my body is less comfortable with me consuming things that are really sugary even if that's very sporadic, but for me that just reinforces good habits. I'm like, next time I definitely won't do that. I felt like the whole next day, like yesterday, I really didn't feel good. I think it was just the amount of sugar I consumed, which is not my normal. Yeah, I have one more CGM to use and I'm kind of holding off. I have a trip upcoming to London and then one to Denver, and I'll probably do it in March, which is in between all my trips.
Melanie Avalon: Very cool. For listeners, if they would like to get their own CGM, they can go to nutrisense.io/ifpodcast and use the coupon code IFPODCAST and that will get them a discount. But speaking to your story, I remember I was wearing a CGM once and I had something sugary. It scared me what I saw on my CGM. It's haunted me with PTSD. Ever since that time, I've been like, "Oh, okay." [laughs] This is what that is doing. And that's what I think the CGM can be so helpful because it literally is a mirror showing you what's actually happening. But I do want to clarify, I think people might be surprised, I eat, it's not ridiculously high carb. It is by, I think, low-carb keto world, paleo world standards. I eat a ton of fruit carbs, like pounds and pounds of fruit. It's really exciting because I watch my CGM and I do really well with that.
My blood sugar does not spike that high and it goes down pretty soon thereafter, which is, I don't know. It's interesting though because I can consume that really high amount of carbs from fruit and be fine, but comparing it to when I had a more processed form, I don't know how it actually compared in grams of carbs, but the spike was so different. So, it's really, really interesting to see. I'm also curious of your thoughts on something. I'm interviewing Ben Azadi next week, which I know, he's a mutual friend of ours. That's actually something really funny. I knew of him, and I knew him through you, and I knew you are friends with him and my publicist independently booked him for me. He connected us. We already knew who each other was. It was just really funny. I was like, "Oh, you're Cynthia's friend?"
But it was interesting. A big question I want to ask him is and this is something that I've seen a lot of people talk about in the fasting community. So, he talks about how he considers coffee or tea breaking a fast if it raises your blood sugar. He wants you to test your blood sugar, and if the coffee or tea raises your blood sugar, he considers that breaking the fast. My question about that, this is what I want to ask him and I'm curious of your thoughts. I don't see why raising your blood sugar from coffee or tea compared to, say cortisol, like, your experience or exercise, why would we qualify one as breaking the fast and not the other? I mean, I understand that it's coffee and tea, but presumably the mechanism would be similar. Do you think you break your fast if your blood sugar goes high?
Cynthia Thurlow: I think it depends on so many different variables. I'm a little more gray in this area. I think that as an example if someone is not sleeping well and they just keep throwing more gasoline on the fire, they've got really intense exercise, they're fasting, they're drinking a lot of coffee because their adrenals are completely tanked or they're really stressed, in that situation I think that the resultant rise in cortisol and rise in blood sugar and compensatory secretion of insulin is a mechanism related to stress. I think this is when I encourage people if they feel poorly. Like, as example, if you're fasting and you drink a cup of coffee or you drink bitter tea and you don't feel good, you really should with a degree of caffeine that's in both of those, it should give you a little bit of energy boost.
But for some people that feel really poorly understanding that it's this lumping together of multiple stressors all at once, like it could be the mold and the coffee, it could be the fact that you're fasting, it could be that you didn't sleep well, it could be that you worked out really hard and so, I prefer to look at it just from the concept and the mechanism of really thinking about each one of these things in and of themselves are a form of hormesis and are you doing too much? Again, this is when a CGM can be helpful. To me, it's very different, like having an intense amount of physical activity versus consuming something that potentially has the ability to secrete some insulin.
I think that I find for most individuals when they're concerned about these things, I generally encourage them to lean into it. If you think you probably are breaking your fast because your body just is not well adapted to be doing those types of stressors and you very likely are. I don't think, per se, that coffee in and of itself, in an otherwise well-adjusted, well-slept, not over-exercising, not over-fasting person, I don't think, per se, that's breaking the fast. I'm hoping that I made that really clear. I think that many of us in the health and wellness space have differing opinions on some of these things. And it's interesting, I was just on Gundry's podcast this past week and we were talking about some of the nuances of does this break my fast? Does this not break my fast? I think what it really comes down to is are you metabolically healthy? Are you at your ideal body weight? If you're not those two things, then you probably need to be more conscientious about what you're consuming and when you're consuming it. For most other people, they have a little bit of play with what they're consuming and when they're consuming it. Did that help?
Melanie Avalon: Yeah, no that really did. And I think a lot of it is just semantics and a paradigm around-- it's more like esoteric in a way. I guess the way I would phrase it is I wouldn't say that that's breaking the fast. I would say that it's not conducive to an easy fast. It's not conducive to making fasting easy for you or giving you the benefits that you want, but I wouldn't consider it actually breaking the fast. So, how was being on Gundry's podcast?
Cynthia Thurlow: It's funny. So, sometimes when you're on some of these bigger podcasts, they'll send questions ahead of time. And obviously, Dr. Gundry has been doing this for a long time. Sometimes smaller podcasts will do that because they just want the validation that they're asking questions you're comfortable with. I always say, like, I'm pretty comfortable with anything. There's nothing you're going to ask me that I'm going to feel unprepared for. Although it was interesting to see his kind of thought process and he really has a very thoughtful way of interacting with his guests, and it was really, really enjoyable. I think because we both come from these cardiology backgrounds, he was a surgeon, I worked in cardiology as an NP, and we have this mutual love for everything related to the heart. So, it was a really incredible experience. He was very gracious, very nice, very smart as you and I both know.
I love that we could talk about something that we both really fervently believe. By this, I'm talking about mitochondrial health, metabolic flexibility, intermittent fasting. We could talk about it and talk about it in a way that was very thoughtful. It was interesting. He had posted on Instagram not all that long ago, something around the fear-mongering about fasting and women. It's interesting to see there're some very polarizing opinions about this. It was just nice to have a conversation where it was very evident and clinically based. Like, this is my clinical experience, this is based on my research, this is based on your research, the things that we've read and did it in a way that made the information super accessible. So, it was really awesome. I always say when I had the opportunity to connect with interesting people it's always a blessing.
Melanie Avalon: That's amazing. You said he did send questions ahead of time.
Cynthia Thurlow: No, he didn't and what's interesting is most people don't ask me about stem cells and telomeres and so I was prepared to answer lots of questions. We didn't end up going down that path. I appreciated that there were very thoughtful questions and not like the normal, how do we say this, garden variety questions that I think most people ask, sometimes it's nice to deviate from what's expected.
Melanie Avalon: That's very exciting. Do you send questions to your guests?
Cynthia Thurlow: I do not. I always say I keep it. I always have several pages of notes, and I love that this is a Monday where I didn't have any of my own podcasts to record because my kids are off from school. From my perspective, I like being prepared. I like the guests knowing that I'm prepared, but I always allow the conversation to be very organic. If I think that someone has a lot that will resonate with listeners, I always say this is the first of two or we're definitely bringing this guest back because there's just so much to talk about and your guests know and your listeners know that you are super uber prepared.
Melanie Avalon: It's really interesting to think about, I was just thinking about why do I send the questions to the guests. Because honestly, I don't send it to them so that they will-- I think I send it to them so they will know-- I guess, I think it's about me honestly. I send it to them so they'll know that I read their book. [laughs] You know that I'm like taking the interview seriously.
Cynthia Thurlow: People really appreciate that. In fact, I'm trying to think about some of the more high-profile people I've interviewed in the last couple of months and Gabor Maté in particular was very appreciative that I had read the book, because a lot of those people, like, he's got a New York Times bestseller. I mean, he's just this prolific clinician and he's really changing the narrative for how we view trauma and addiction. I would imagine you get to a point where you got the same questions being asked every single day. At the end of the interview, he actually thanked me and said, thank you for reading my book. It's evident that you've read the book. I know now that I'm an author, I really appreciate it when people read the book and Gundry read the book because he was talking about different things throughout the book. I think it allows both the author and the podcast host to feel like we're in this together. We really want to ensure that there's this mutual admiration and appreciation for your craft and showing you in the best light, which I know you do with your guests as well. It's really an amazing opportunity as Melanie says, "Podcasting is the best form of networking."
Melanie Avalon: One of my favorite guests of all time is still David Sinclair and I did interview him when I was still relatively new to that other show. And I remember when I sent him the prep doc the first time and he actually answered via email and was like, wow, that's a deep dive. I was like, oh my goodness, I was so happy. [laughs] But thank you for the introduction by the way, I did book Dr. Gabor Maté. I'm so, so excited about interviewing him.
Cynthia Thurlow: It's funny, I've had a lot of people listen to that podcast, and if our listeners haven't listened to that podcast, it's the most personal podcast I've ever done. But you can't interview someone like that, not having invested in the work in yourself, because trauma and it's just hard stuff to talk about because there's no one out there that hasn't experienced some type of trauma in their life. It's just how we express it inwardly or outwardly. And for me, his book is amazing. It's one of my favorite books I read in the past several years. It's definitely a book like, you have to be ready to do the work, talk to yourself, the other person not to get off on a tangent, but do you know Dr. Nicole LePera?
Melanie Avalon: I do not.
Cynthia Thurlow: She's a holistic psychologist, and I don't know, it's like down a rabbit hole. I heard her on Lewis' podcast. I bought her book. I bought the workbook. I'm now in her healing group. It's just like I tell everyone, I talk about doing the work. I am always doing the work and how important it is to invest in yourself. If you're listening and you may never be in a position where you have the opportunity to connect with some of these people, but their books can be life changing. It can be very reflective. Gabor's book probably took me two or three weeks to get through because it's very heavy. There's a lot in that book that you have to kind of absorb it and okay. It's like I've read that chapter, I can take a break, I go back to it but it's an excellent resource.
Melanie Avalon: Well, I will have to check it out and we'll have to put links to it in the show notes.
Cynthia Thurlow: Absolutely.
Melanie Avalon: Friends, I am so excited to tell you about one of my new favoritest things ever. Okay, so you guys know I eat a lot of cucumbers. I don't think that this is any secret. I find myself throwing away pounds, yes, pounds of cucumber peels, every single night. I felt so awful just throwing it in the trash. It seemed like such a waste. I'd always wanted to try composting aka a sustainable approach to turning food waste into healthy dirt, but it seemed really intimidating and not very practical. It was on the to-do list for quite a while. You can imagine how thrilled I was when a company called Lomi by Pela reached out to me wanting to sponsor the show. Normally I have to think about all the brands that reach out to me. I was an immediate yes. I was so excited. I got my Lomi device, it is incredible. Lomi allows me to turn my food scraps into dirt with the push of a button. Lomi is a countertop electric composter that turns scraps to dirt in under 4 hours. By comparison, if you were to compost naturally, it would probably take at the shortest around six to eight weeks and maybe even up to a year. But nope with Lomi, I can literally do it in 4 hours. There is no smell when it runs and it is super quiet. I've been using Lomi for a few months now. It is substantially reducing my waste. I was taking out garbage bags all the time. It's probably cut that down by about 30% to 50%. In fact, I love it so much that I bought another Lomi for my parents for Christmas. Now with my Lomi, I throw out weightless garbage. That means that waste is not going to landfills and producing methane.
Instead, I turn my waste into nutrient-rich dirt that you can actually use to feed your plants. And Lomi is super cool. It has three different settings. It has the Eco Express setting, which is low energy consumption, provides the fastest results, and is good for your food waste. It has the Lomi Approved setting that's 5 to 8 hours. You can actually put in Lomi Approved bioplastics and other compostable commercial goods and packaging that are Lomi Approved. And then there's the Grow mode that's 24 hours, it's low heat with a longer duration and that actually preserves the microorganisms the most to help the soil and promote carbon storage in the soil. I am all about regenerative agriculture, so the fact that we can help put carbon back into the soil is so, so incredible.
Lomi is something I have instantly fallen in love with. If you guys are anything like me, I know you will as well. Turn your food waste into the dirt with the press of a button with Lomi. Use the code IFPODCAST to save $50 at lomi.com/ifpodcast. That's lomi.com/ifpodcast with the promo code IFPODCAST to save $50. We'll put all this information in the show notes.
So, shall we jump into everything for today?
Cynthia Thurlow: Yes.
Melanie Avalon: Okay. To start things off, we have a question from Laurie. This is actually kind of funny because I guess Laurie is listening to old episodes still, so she thought Gin was still on the show, and I don't think she realized that Cynthia is on the show, which is funny when you hear this question. So, I'm going to read her question. So, she says, "Hi, Gin, I've listened to more than a dozen episodes of Intermittent Fasting Stories over the past week in preparation for joining the IF train. You and your interviewees have motivated and inspired me. I am 100% in." For listeners who are not familiar, Intermittent Fasting Stories is Gin's other podcast where she interviews people who do intermittent fasting. If that is of interest to you, definitely check that show out. She says "I have only 20 pounds to lose and I'm very much looking forward to shedding unwanted pounds as I'm 61, and after 50 like so many others, the weight just creeped up. It is the health benefits I'm looking forward to, more stamina and energy, brain clarity, better sleep, and natural cravings for more nutritious food."
"I was introduced to IF in an episode of the Megyn Kelly Show Podcast, where she interviewed Cynthia Thurlow. I tried my first experience with IF about 18 months ago and was successful. So, Laurie, Cynthia Thurlow is now the host of the show. She says, "After the first challenge of deciding I didn't need cream in my coffee ha-ha, I was a believer in the IF methodology and the science behind it. Of course, after listening to many of your episodes, which go much deeper than the one episode on Megyn Kelly. I already know what I could have done better for better results and will be joining your groups for support." I do have a question/concern though and hopefully you can direct me to a specific episode of yours to help this concern of mine. So far, I haven't heard any topics of discussion on your podcast from people who consider themselves, "Foodies, who are able to square their love of entertaining, cooking, coffee dates, lunches, etc., because I have some concerns that this very thing that gives me so much joy in life, preparation of food, eating as part of my entertainment with people and serving people my delicious creations might fall away like they've described as their cravings for flavored coffees and salty snacks."
So, she's saying might fall away as their other cravings have fallen away. "Is there a happy medium?" Thank you for all you are doing for a huge population of women who have tried everything else, best, Laurie. I love this question. We actually haven't received the nuance of this specific question before, so I'm very curious. What are your thoughts on this Cynthia?
Cynthia Thurlow: Well, Laurie, thanks for your question and I'm glad that you were introduced to fasting during my podcast with Megyn Kelly, which we'll link up in the show notes as well. I think that any strategy that we are using to improve our quality of life needs to be something that's sustainable. So, when someone that is a foodie and I define foodie in different ways, sometimes people that are foodies just like really good food, but it sounds like Laurie enjoys the whole socialization piece, the cooking, the prepping, the gathering together around food. I don't think it's an all-or-nothing phenomenon. I do think that you can intermittent fast and also enjoy those things in your lifestyle. I think it has to be a reframe in terms of, if you choose to go, like to have a coffee date or go out to lunch with a girlfriend, or maybe you break your fast earlier or later.
Maybe if you have a big party on a Saturday night, maybe you fast longer on Sunday. I mean, there're a lot of different ways to work around that. The other thing is, as a menopausal woman and wanting to lose about 20 pounds, it's not just fasting that's going to help get you there. There are other things. We know that women, especially in the second half of their lives, we have less muscle mass, which also impacts insulin sensitivity. So, in most of my menopausal patients and clients, I'm really encouraging them to strength train, make sure they're sleep styled in. If HRT or hormone replacement therapy is appropriate for you, estrogen in particular is an insulin-sensitizing hormone, to really think about that in conjunction with intermittent fasting. But I don't think it's all or nothing. I think you can enjoy food and intermittent fast. In fact I'm married to a foodie and by being married to him, I've kind of been like a quasi-foodie for the last 20 years.
And he navigates really beautifully. I think it's always with the context in the lens of I moderate what I enjoy eating and I just adjust my fasting and feeding windows around my lifestyle. If I go on vacation, maybe I'm having three meals a day and a wider feeding window. It is certainly a sustainable strategy, but it's not all-or-nothing. Unfortunately, I think some people feel like you have to be gluten free, dairy free, all these things. It does not have to be that way. But what I do think needs to be entertained is that you're still doing activities that you enjoy. Because if intermittent fasting has left you with the impression that you can't do those things, then we need to find a reframe because you absolutely can enjoy entertaining and going out to dinner and having parties and lunch dates and coffee dates and you can absolutely do that and integrate that into this lifestyle. Melanie, what are your thoughts?
Melanie Avalon: Yeah, I agree with what you said snd it's funny. I'm actually reading a book right now called The Fun Habit: How the Pursuit of Joy and Wonder Can Change Your Life by Mike Rucker, I'm really enjoying it, but I just started it. I'm only like sixth of the way through, but he talks all about the importance of having fun. But in any case, I'm so intrigued by this question for a few different reasons. It's really interesting to me and this is just something to contemplate how? Well, first of all, let me start by saying I agree with Cynthia that I actually think assuming this continues to be something that brings you joy in life, you can maintain it 100%. I'll talk a little bit more about that. Before that, it's interesting to think about how if we have joy for something or something brings us pleasure and then it's an activity that no longer does, for whatever reason, if it's no longer bringing you joy, it's not like it hurts you or that you-- how do I say this? I'm not articulating this well.
I find it interesting that we would have a secondary emotion about something no longer giving us joy and presumably something else does give you joy. It's not like you lost something really. So, for example, with the coffee and snacks, people get sad at the idea of thinking they will lose their cravings for these foods that they once loved. But the thing is, if you no longer crave it anymore, you no longer crave it anymore. Really what you're sad about is the loss of something that you once enjoyed. But the ironic thing is, if it's literally not bringing you joy anymore, I just think it's funny to step back and be like, "Why am I feeling this about this experience?" Because also, presumably if you no longer have a craving for something, you likely are enjoying something else food wise, so you could focus on what you are enjoying rather than what you no longer enjoy.
I think it's important that we are okay with change and realizing that what we find joy in right now can be anything and that's where the joy comes from. It doesn't really matter if it was something we used to have joy in or if we'll have joy in the future. I don't want to say it's not important that things that really meant something to us for a long time if we no longer find joy in them, that that's just something we should brush off. It's an interesting thing to contemplate. Like, I can contemplate this for a long time, especially with the food because presumably when your cravings change, they really do shift to something else. Especially when people do fasting, or adopt a paleo diet, or whole foods diet, or cut out processed foods, they tend to really enjoy new foods that tend to be healthier for them.
Maybe it's like a loss of identity honestly because you identified with liking something before and now you no longer do. Like, for me for example, well I still really love the idea of funfetti cake, but I'm actually not sad not eating it. To get more specific to your question, Laurie, because I feel like that was very esoteric. I actually don't see and Cynthia covered this very well, it's really not that hard, I don't think to maintain all of this. Also, coffee dates. Coffee dates, if you're drinking black coffee, you can still do those the way you've been doing them. I understand like lunches, depending on what your window is. If you have a window, you could make your window something that includes lunches and dinners, or you could change your window around, or you could break it-- open it early like Cynthia was saying. You can make it work around meals.
Most people with intermittent fasting, not everybody, but a lot, do have an eating window that covers the evening in some capacity. That's when the majority of entertaining-type stuff, especially parties often happen. So, then there's no issue there. You can still keep doing all of that. It's really interesting too, even on the foodie side of things. I eat so plain as people know when I go to restaurants, I just get like completely plain steak or completely plain fish and plain vegetables. But what's funny is, I think I'm not a foodie just because I don't fit the definition, because I don't engage in the way meals are prepared when they often have a lot of ingredients that I personally wouldn't consume, but from all appearances, I probably look like a foodie.
I hardcore research the restaurants not to see if they have something I can eat, more because I'm curious about the experience in the actual meals and the food that they have. I get really into it. I get really into multi courses. I'm all about it. It's funny because I was with a friend and he was saying that-- we're picking out a restaurant to go to and he was saying well-- he commented on how I was such a foodie. I was like, well, I'm really not because I literally eat the exact same thing at every restaurant I go to pretty much. But I am very much into the experience of it, which is what I think Laurie is getting at here. The point of all of that meandering long answer was, you can definitely maintain it. Although in the end, it seems like your concern isn't even if you could, your concern is that you're going to lose that desire. I don't see any reason that you would lose that desire if that's something that is bringing you joy.
People lose the desire often with the cravings with intermittent fasting, because it's literally changing how their body interprets food and processes food because they're no longer eating. It's putting people more in touch with what their body needs and their cravings tend to naturally change to something less processed. But the joy of entertaining and cooking and being with others and all of that, I don't see how fasting would change that. If anything, I think it might enhance it. Actually. I really do think it might enhance it because it's enhanced it for me, because the meal experience is more concentrated to like this sacred time window where I really experience it more because I'm not eating 24/7. Have you found that Cynthia that you enjoy meals more now?
Cynthia Thurlow: Well, I mean I'm at a different stage of life, so I would say the past nearly three years when we had a whole year when the boys were home and not in school, and we had four different people eating at four different times because of work schedules, book writing schedules, school schedules. I definitely really savor my meal time especially when I'm not eating by myself, when I'm with my family that's a very sacred time on the weekend when we're all together, all eating at the same time. I think it just makes you more appreciative of the process of eating. It's not this mechanical, it's breakfast time so I eat breakfast. It's lunchtime, so I eat. I'm much more attuned to what my body needs at that given point in time, as opposed to when I was probably eating three meals a day and snacks and many meals because that's what I was telling my patients. It just felt like I was constantly eating whereas now it's a much more thoughtful way to honor my body.
Melanie Avalon: I think the take-home message, Laurie, based on all of that is that, yes, your experience with eating and food might change, but I think if your underlying joy for these activities is still there in being a foodie, I don't think that's going to change. You can definitely pair it with intermittent fasting. So, any other thoughts for that one?
Cynthia Thurlow: No. I appreciate that she's putting so much thought behind it, but it's really that reframe of not what you can't have, but what you can have and then adopting, if you're having a party at your home, maybe you're going to have a wider feeding window and maybe you're going to have a shorter feeding window the following day. I think there are a lot of different ways to navigate fasting and having a lifestyle that embraces a lot of entertaining.
Melanie Avalon: Yeah, definitely. Now we still have some great questions from the AMAs that we asked for. We actually got two questions related to bioidentical hormones. So, I'm going to read those. So, Tracy sent, "Have you done an episode on bioidentical hormone replacement therapy? And if not, would you address it? And Stephanie said, I'm on progesterone only HRT, can you use estrogen even if you still have a period? Will it cause weight gain?" I will just say this is Cynthia's forte. [laughs]
Cynthia Thurlow: Let me be sure, I definitely told Melanie we needed to definitely answer these questions. So, Tracy, no, we have not done a dedicated bioidentical hormone episode, but I think we should definitely do one. Maybe we'll bring in one of my favorite colleagues to bolster that, a GYN friend, so that they can provide additional input. And then Stephanie said, I'm on progesterone only and let me be clear, a lot of women in perimenopause, the 10 to 15 years preceding menopause, and yes if the average age is 51, late 30s, you're there. One of the first hormonal shifts that starts to happen is that our ovaries stop producing as much progesterone. It's not at all uncommon to take just progesterone and still be in perimenopause. I do see several women who are also on estrogen, although interestingly enough and I learned this while writing my book that in perimenopause, women can have wild fluctuations in estrogen.
It's because of these fluctuations in progesterone we're making less progesterone, our ovaries, we're starting this early ovarian failure. Our adrenal glands are trying to pick up the slack with progesterone. Well, we get this relative estrogen dominance internally, but we can also have higher levels of estrogen because of exogenous exposure. So, it can be multiple things. But Dr. Lara Briden does a particularly great explanation of this in the Hormone Repair Manual and we'll link up the podcast I did with her, but you see these wild fluctuations in estradiol throughout perimenopause right before menopause when those estrogen levels are starting to falter. It's interesting because I've seen several women who've been on estradiol patches or they've been on different types of testosterone therapy or other types of therapies in perimenopause, but typically if you have a uterus and you are in menopause, you should be on both estrogen and progesterone to protect the lining of the uterus.
I know this question will probably come up, so I'm just going to address it. But testosterone therapy, interestingly enough, there's no FDA-approved testosterone option for women. You will see women using pellets. I am not a fan of pellets. They are wildly unpredictable. I've seen a lot of women that have had a lot of problems because they've been on pellets. Of course, there's always an exception. Every time we do a post about pellets, we get 10 people who tell us they have a great experience. They're the minority. I also did a podcast with Dr. Shawn Tassone talking specifically about pellets, which we'll also link up, but to reassure women that you can actually have testosterone replacement in perimenopause and menopause, but you want to fix the upstream issue. Interestingly enough, stress has a large impact on our libido and also our testosterone levels as well as insulin resistance. So, you want to make sure both of those are addressed before you consider testosterone cream.
Some people even prescribe subcutaneous testosterone administration, but you absolutely positively want to work with a practitioner who's familiar with all of your options and there's not just one size fits all, someone who does the testing. So, not just blood testing, but also the Dutch, which I use in my practice and I'm a huge proponent of, because it gives you information like how well your body breaks down and detoxifies estrogen. So, yes, you can just be on progesterone. More often than not, you're probably in perimenopause, which it sounds like Stephanie is, and then estrogen sometimes is added as people are getting closer to menopause. You don't have to just be in menopause to be getting bioidentical hormones and we could have a whole episode just on that, but I'll just leave it at that. We'll give you guys some resources and I will work with Melanie to find an appropriate person to bring on that is a GYN that will be able to answer all the things about HRT and bioidentical HRT.
Melanie Avalon: I really have nothing to add.
Cynthia Thurlow: And that's totally okay.
Melanie Avalon: [laughs] Historically, for so long, people ask me questions all the time and I'm like, I don't know. [laughs] This is not my area of expertise.
Cynthia Thurlow: That's totally okay. If we have a podcast episode like that, I'm happy to tell everyone what I've done, what I haven't done, what's worked, what has not worked, what I would recommend, what I would not recommend. I think most women have to go through several practitioners to get the care they want in middle age. I don't think it's a one size fits all, unfortunately.
Melanie Avalon: Yeah. I'm just happy that there are so many changes happening, I think, progressively in the medical system with all of this because especially with the role of women in the medical system and how there's not really been that much attention to them and studies and things like that. So, I will not go on that soapbox tangent.
Cynthia Thurlow: Well, and it's interesting. There's a really good book if you're interested in learning more about the Women's Health Initiative and what has come out of that. We have a whole generation of clinicians and patients who are fearful to prescribe and take hormones. There's a really excellent resource called Why Estrogen Matters by Drs. Avrum Bluming and Carol Tavris, he is an oncologist, she is a researcher. They're an amazing, amazing duo and I had them on the podcast last year and we really unpacked the Women's Health Initiative. So that's a really good starting point. Why Estrogen Matters is a really great book to get you up to speed and if you want to spend 3 hours listening to a podcast, you can listen to Peter Attia's podcast with them. That's how I got acquainted with their work. My podcast with them, I think, is under an hour and 15 minutes. If you want a shorter one, [laughs] there's definitely my podcast with them but that's a really great resource.
Melanie Avalon: Well, you had me at Peter Attia, so sign me up. Okay, so we have a really fun question next.
Cynthia Thurlow: So, our next question is from Stacy. Subject is AMA question, "Does THC inhibit weight loss while intermittent fasting? Before Melanie answers, Melanie and I have been talking about the research around THC and it's really been very interesting. So, Melanie, what are your thoughts?
Melanie Avalon: It's really interesting because there're a lot of studies on both CBD and THC. I think when people think THC, they associate it with CBD especially with all of the CBD oils on the market because there are not THC oils on the market, and that's because of THC-- So, when you're engaging in something like cannabis or hemp and like CBD oil from that, if there's any THC in it as well, the THC is actually the part of cannabis that has the psychoactive properties to it. So, when people get CBD oils, they usually won't have THC or they'll have very minimal amounts. I know her question was specifically about THC, but for all intents and purposes, I researched both THC and CBD. It's really interesting because the studies are all over the board. So, for CBD specifically, some studies have found no effects, some have found that CBD can actually decrease body weight, others have found that CBD can actually increase body weight.
What's really interesting is one of the studies that I was looking at was proposing that maybe CBD was increasing body weight, but THC was counter to that. Another study I found was basically saying the opposite that THC might be responsible for the weight gain. Basically, it's really hard to say something either way and also it might have to do with the patient population. Sometimes they'll do studies in patients with weight loss issues or anorexia or something like that, and they will see how it affects weight gain or weight loss. That's important information to know, but it might not necessarily apply to the general public. It's really hard to say something either way. I know her question is actually about THC in relation to fasting. What I would say to that is that if it's having that effect either way, I don't know that the effect would be that strong that you wouldn't lose weight while fasting. But I think it's going to be very, very individual. What did you find in your research, Cynthia?
Cynthia Thurlow: Yeah, I think you did a really nice job explaining that. It's interesting because the studies I was looking at were comparing short versus long-term use. In individuals that have cancer and we call it cachexia, but they're very very thin and very frail individuals with HIV and AIDS that it can be helpful for appetite stimulation iin low-weight individuals. What I found from my research was that individuals that are at a healthier, "Normal weight" that's dependent on many many variables, but they are less likely to gain weight while utilizing cannabis. From my perspective, I didn't say anything that was specific to inhibition of weight loss while fasting, but more often than not, it's in my clinical experience, so again, this is different, that people who are still smoking a lot of marijuana or using CBD-type products are just more prone to snacking and eating outside of a feeding window.
I think it's highly individual and based on the research that I looked at, the utilization of these types of substances can be beneficial for people who are underweight, if they want to gain weight, but is really limited to the population I looked at in the research was cancer patients, chronically ill people that are underweight, and those that have HIV and AIDS, where they get this kind of starvation cachexia syndromes where their bodies are chronically malnourished. They're having trouble utilizing the food that they do consume, and then they're on medications that are probably impacting their desire to eat.
Melanie Avalon: Yeah, and to that point, that reminded me of one of the things I had read, which was pointing out the paradox that users of CBD, I think specifically marijuana, I'd have to find it again, but it was talking about how that's associated with increased appetite and eating more and all of that, but that the users don't tend to weigh more. It's a bit of a paradox, and I think it speaks to that long-term piece of the overall habits. But I think that was the one where it said that maybe THC was responsible for mitigating that, but it's really hard to know. This is a 2021 study, so relatively recent. The title is Cannabinoid Use for Appetite Stimulation and Weight Gain in Cancer Care. I wonder if this was maybe related to what you had read, Cynthia, but like a quote from this, this is really interesting. They said, "Over the past 20 years, six randomized controlled trials have evaluated the impact of cannabinoids on appetite-related outcomes in oncology patients in comparison with the control group or placebo." Based on that literature, cannabinoids do not appear to improve appetite, oral intake, weight, chemosensory function, or appetite-related quality of life. But limitations are small sample sizes, lack of adjustment for compounding variables, difficulties in conducting the trials. Yeah, we need more research for sure. It seems to be all over the place.
Cynthia Thurlow: Well, and it's interesting, 20 plus years ago there was a drug called Marinol. It's probably still in existence, but it was THC. When I use the term street legal, like, people could prescribe it legally. This is way before the advent of all this legalization of marijuana and their byproducts and it was something that they're really pushing clinicians to use for the same patients I was talking about. The people who've got these wasting syndromes, cancer patients, HIV/AIDS, etc., as being beneficial, but I agree with you and hopefully with the legalization in many parts of the United States that there'll be more research that we'll be able to determine the net impact on many different variables.
Melanie Avalon: I agree and I do want to backtrack a little bit, I'm just thinking more about something I said earlier because I was saying that I thought that even if it was having an effect that you could still lose the weight with the fasting. I do want to emphasize if it's having an hormonal effect on you, I don't think we can overstate the role that hormonal changes can have as being a barrier to weight loss or weight gain. So, that could go either way. For people who are having this in their life, they're just going to have to look at themselves and see how it's affecting them. But I think it definitely could play a factor either way. I feel like this answer is not that helpful. Basically, you have to just figure it out for yourself if it's affecting you that way.
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Melanie Avalon: Now we'll answer another one of our AMA questions. This is a personal one. I'm really excited to answer this one. Nicole wants to know a few people ask this, which is interesting. Katie said, "The two of you are so positive. What would be interesting is to hear some of your biggest pet peeves. Nicole said, "What are your pet peeves?" and then Teresa said, "What is your biggest turn-off?" So, pet peeves and turn-offs?
Cynthia Thurlow: Yeah, I would say my personal pet peeve that drives me absolutely crazy are wet socks. In my house, we don't wear shoes. Every morning when my kids go off to school, I open up all their plantation shutters and I go through rooms and gather laundry and things like that and my kids are absolute water like hogs. There's water everywhere, it's on the floor, it's never on the bathmat and so If I have socks on and I walk into their bathroom and my socks get wet, there's something about wet socks that makes me crazy, and so I have to then change my socks. I would say, just from a personal perspective, that's my own quirky thing, but I would say things that bother me a lot like you travel, I travel, people that chew their gum really loudly and pop it in public and individuals talk on their cell phones as if no one is around in an enclosed space. I'm not talking about, like, if you're outside. I'm talking about you're in an enclosed environment and you are pretending as if no one is around you and you're speaking at full volume and yelling, and it's not a brief conversation, it's an extensive one. Those are probably my three that bother me the most. I generally with the exception of the socks, I just have to pray that someone walks away from me. It's like please go somewhere else and chew your gum and talk loudly into your cell phone. How about you?
Melanie Avalon: That's so funny. I'm having flashbacks too. Remember when people first started wearing Bluetooth headsets? Like earpods and they weren't a thing yet, so people would be like talking to themselves out loud. I just remember that first started happening and I was like, "What are they doing?" I realized it was the earpods. Yes, so I have quite a few. Okay, when people-- this one kills me. When you send a text to somebody that has multiple questions and then they only answer the last question, they don't address the entire text, drives me up the wall. Did you not read the whole text? There are multiple questions in there. People who can't really plan, although it can work if I can plan for us, but I need plans. People who really wear being busy like a badge of honor, that's their thing in life. That really bothers me. That probably bothers me too much because it bothers me to the point where I don't like to tell people I'm busy as the reason because I have this own concern around it. Last night, I was having a phone call or-- I was texting a friend and she was trying to schedule a time to catch up and I was so busy, I didn't want to tell her I was busy because I didn't want her to think I was just saying I was busy to wear busy like a badge of honor. Then finally I had to tell her, I was like, "Listen, it's just because I'm busy, I'm so sorry." So, that one gets to me.
Oh, this one, because growing up, my mom, she has a lot of autoimmune conditions and she would always say that it's in her genes, like, my grandmother had it. It's just the way it is. I think when people-- and I don't like to ascribe pet peeve to it because I don't want to-- When people say this, I really feel for them and I understand that they do feel like it's in their genes certain health conditions and that's their destiny and that makes me really sad, and I want to empower people to feel differently. I think when people blame genetics, I guess the pet peeve of it would come in when people are living a lifestyle that is not conducive to a healthy state, and then they just blame their health conditions on genetics, that bothers me. Typos, typos really, really get to me.
Cynthia Thurlow: Melanie has a fastidious editing like I, so when I do my next book, Melanie, I'm going to have you help me make sure there's nothing that should be edited.
Melanie Avalon: I feel so bad, if I'm ever hiring which, by the way, I really want to get an intern. I'm probably going to post-- need to post on one of those job-hiring sites. I've got to get an intern. Just so you know though, if anybody applies for an internship with me and there's a typo in your application no. [Laughs] Just because if that's your first impression, I don't see any excuse to have a typo. If it's something that you're really putting time into, after you get the job, that's different. If it's like your first impression or if somebody's hitting on me and sends a text with a typo, I'm like, "Nope, nope." And then just in general, probably my biggest pet peeve of all pet peeves is people getting offended by things. I really just don't think there's any reason-- Yes, people get offended but let me clarify getting offended and blaming other people for feeling offended.
My biggest thing is that if you're offended, there's something in you that's offended. Don't blame other people. I don't even care if it's something that is straight-up wrong that somebody else did. That feeling of being offended is something I think-- This is just my opinion, but I think it's a fear or anxiety or something that you're uncomfortable with in you. If anything, those actions that people do are just providing a mirror or a spotlight to figure out what bothers you and your psyche. I just can't handle today's culture of blaming everybody for everything. Just personal responsibility [laughs] is what I'm all about.
Yeah, the only reason I didn't want to answer this question and I don't know if this is true, but how you read these things about psychology and they stick with you? I read at one point that when you talk negatively-- This actually is good to know, when you talk negatively about somebody else, people ascribe that whatever you're saying and those negative characteristics subconsciously to you. So, ever since I read that, I was like, "Oh, I should not talk negatively about people because people might subconsciously ascribe that to me, which is a selfish reason to not want to do that. It's nice because it kind of curtails talking negatively about people as well." So, hopefully, people do not ascribe those attributes to us.
Cynthia Thurlow: No, but I think it's just a lot of what bothers me in general beyond the wet socks, which obviously is my own weird-- and I've been that way my whole life, has a lot to do with just being courteous of one another as a society just being thoughtful. The concept of treat others as you would like to be treated and I think in many ways we're so disconnected from one another that we don't even perceive the behavior that we're embracing wherever we are. I try to be a very thoughtful person. My pet peeves are definitely things where I'm just like that's that person is not being thoughtful of people around them, they're just off in their own little-- We used to call it our Own Private Idaho, that movie from many years ago when I was back in Maryland, there were a couple of people that would just say they were off in their Own Private Idaho, I was like, "Yes, they are." Not even aware. But I couldn't agree with you more. We choose to be positive, right?
Melanie Avalon: Yes. Quick plug, everybody now go buy-- If any of these interests you, go buy The Science of Positivity by Loretta Breuning. It is fascinating. It's a lot about cynicism and how we naturally engage in cynicism to like protect ourselves or it's a really, really, really good book and how you can actually be more positive. So, okie dokie. Well, this has been absolutely wonderful. A few things for listeners before we go.
So, if listeners would like to submit their own questions for the podcast, they can directly email email@example.com or they can go to ifpodcast.com and they can submit questions there. The show notes for today's show where we will put links to everything that we talked about. I know we talked about quite a few studies, so we will put those in the show notes. Those will be at ifpodcast.com/episode305 and then you can get all the stuff that we like at ifpodcast.com/stuffwelike and you can follow us on Instagram. We are @ifpodcast, I am @melanieavalon, Cynthia is @cynthia_thurlow_ and I think that is all things. Anything from you, Cynthia, before we go?
Cynthia Thurlow: No. I look forward to our next episode where we can dive into the rest of these listeners' questions along with our regular questions.
Melanie Avalon: Awesome. Well, this has been absolutely amazing and I will talk to you next week.
Cynthia Thurlow: Sounds good.
Melanie Avalon: 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 re-composed by Steve Saunders. See you next week.
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STUFF WE LIKE
Check out the Stuff We Like page for links to any of the books/supplements/products etc. mentioned on the podcast that we like!
Melanie's What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine
Cynthia's Intermittent Fasting Transformation: The 45-Day Program for Women to Lose Stubborn Weight, Improve Hormonal Health, and Slow Aging
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