Welcome to Episode 399 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 Vanessa Spina, author of Keto Essentials: 150 Ketogenic Recipes to Revitalize, Heal, and Shed Weight.
SHOW NOTES
SPECIAL GUEST:
Megan Ramos is a Canadian clinical educator and expert on therapeutic fasting and low-carbohydrate diets, having guided more than 14,000 people worldwide. She is the co-author of the New York Times Bestseller Life in the Fasting Lane and The Essential Guide to Intermittent Fasting for Women.
Website | IG (Fasting Method) | IG (Megan Ramos)
SPONSORS & DISCOUNTS:
SEED: Seed's DS-01 Daily Synbiotic is a 2-in-1 prebiotic and probiotic formulated to support gut health, skin health, and overall well-being. With clinically and scientifically studied strains, Seed's Daily Synbiotic promotes digestive health, boosts immune function, and enhances your body's nutrient absorption. Start your journey to a healthier you with Seed's innovative and effective synbiotic formula. Get 25% off your first month of DS-01® with code 25IFPODCAST at seed.com/ifpodcast.
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 2 lbs of grass-fed and finished ground beef in every box for life! Plus, get $20 off your first order!
STUFF WE LIKE:
Visit ifpodcast.com/stuffwelike for all the stuff we like!
OTHER LINKS:
Vanessa's Tone Device: The Tone Device Breath Ketone Analyzer
Melanie's podcast: The Melanie Avalon Biohacking Podcast
Vanessa's podcast: The Optimal Protein Podcast
More on Melanie: MelanieAvalon.com
More on Vanessa: ketogenicgirl.com
If you enjoyed this episode, please consider leaving us a review in Apple Podcasts!
Original theme composed by Leland Cox, and recomposed by Steve Saunders.
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.
TRANSCRIPT
(Note: This is generated by AI with 98% accuracy. However, any errors may cause unintended changes in meaning.)
Melanie Avalon
Welcome to Episode 399 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, author of What, When, Wine, and creator of the supplement line, AvalonX. And I'm here with my co-host, Vanessa Spina, sports nutrition specialist, author of Keto Essentials, and creator of the Tone Breath Ketone Analyzer and Tone Luxe Red Light Therapy Panels. For more on us, check out ifpodcast.com, melanieavalon.com, and ketogenicgirl.com. Please remember, the thoughts and opinions on this show do not constitute medical advice or treatment. To be featured on the show, email us your questions to questions at ifpodcast.com. We would love to hear from you. 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. Welcome back to the show. I am so incredibly excited about the conversation I am about to have. It is with a very, very popular guest. So I've had today's guest on the show before. And I often ask for questions in my Facebook group for guests. And whenever I even remotely mention this beautiful person, I'm here with Megan Ramos, I get inundated with optimism and excitement and enthusiasm because people love what you're doing, Megan. And so many people say that, you know, they're the reason that they found fasting and, you know, change their lives and things like that. So I get so much gratitude. And then I also get so many questions for you. And I had you on the show before. And that was before you had released or yeah, I'm pretty sure that was before you had released your newest book, which is The Essential Guide to Intermittent Fasting for Women, Balance Your Hormones to Lose Weight, Lower Stress and Optimize Health. That book honestly is absolutely incredible when it comes to just being a I mean, it's in the title, An Essential Guide to Intermittent Fasting. And what I also loved, there's an endorsement on it by Cynthia Thurlow, who my audience will be very, very familiar with since she was a former co host as well. Megan has a lot of her background working with Dr. Jason Fung, who is a legend in the fasting world. And she wrote the New York Times bestseller book with him life in the fasting lane. So Megan, thank you so much in advance for being here. And also I know it's been a while, but last time we had you on that was pre pregnancy and baby and this is post pregnancy and baby. So congrats on that. How old now is your who's it a boy or girl?
Megan Ramos
I have a son. His name is Marcus, and he's just about 13 months old. So it's pretty wild. I don't think I've slept since I was last on your podcast. It's all been kind of a blur. Pregnancy was a bit rough. And then this last year has been crazy. I appreciate your very kind intro though, Melanie, I feel like for the last year, I've just been known as my son's cow and the lady who doesn't sleep at the end of the street. So it's good to hear that makes me feel a little bit more like myself, and like all these long hours are worthwhile and hopefully we're helping a lot of people out there.
Melanie Avalon
No, I literally have so much gratitude. And I talk about this on the show a lot. I personally don't anticipate having kids. I just don't really see it as part of my life. And so I am, I am so I don't know how you guys do it. And I am so grateful to moms like you for, you know, taking one for the team. They're like, I could not, I could not, not do it. And I'm going to ask a listener question right off the bat because something relates to this. Teresa, she said she wanted to know, she said, I know pregnant women aren't supposed to fast. So I'm curious what Megan's eating patterns were when she was pregnant. What times and what types of food did she have? So yeah, I'm curious about that as well. Did you get create? Well, first of all, did you get weird cravings during pregnancy?
Megan Ramos
I did not have any weird cravings at all during pregnancy. I didn't really change my diet. The weird thing about my pregnancy was that I ended up having two placentas. And I didn't know this. And it kind of explained why my pregnancy was so awful at the very end. But I had these two placentas, the one my son's main placenta, and then I had this accessory placenta. And they caught it at the last minute, which is great, because we both got to live. And it was actually a pretty serious condition called type two of azaprivia. It got caught by a real fluke. So I mean, all the stars align there to keep us alive and healthy. But I was super sick. And I had all these dreams and plans of eating and how I was going to structure everything and make everything as nutrient dense as humanly possible going into pregnancy. And I was barely alive for the eight months that I was pregnant before I was born. He ended up having to come early because of the placenta issue. And I was amazed that I like he was growing and that I didn't end up in the hospital. But I'll say like during my pregnancy, whatever food I could tolerate, I just like ate and ate and ate. And that changed as my symptoms change. But I stuck very true to like a real whole food kind of principle, I guess, sort of paleo. But I did do things like drinking raw goat milk from a farmer that I knew was very comfortable with. And you know, eating a two sheep yogurt. So I did have some, you know, type of dairy sources as well. But yeah, just kind of stuck to my regular I really prioritize protein. Fortunately, I could eat beef, but I couldn't like tolerate like a New York strip for some reason. But I could tolerate fillets like wrapped in bacon. So I think like for like two months, like that's all I ate for like dinner. And my vegetables, I just try to cycle through and I did eat some carbs, you know, I usually would have some berries at lunchtime. And then I would have like some sweet potato or some root vegetable at dinner time as well. And you know, I did gain 26 pounds by the time he was born. And he was born at five pounds, eight ounces a month early. So you know, it was enough, at least to keep him going and thriving. But all of my plans for like a real, you know, like ultra nutrient dense pregnancy kind of went out the window. And I just had to go with what my body let me eat. But I know I didn't have fast food, I didn't have junk food once, you know, I we ate at home, pretty much we did take a trip early on in our pregnancy to lanai. And we were fortunate they had like things like grass said beef and avocados actually really helped with my early nausea. And they're high in B6, which I kind of knew but then really became aware of once I was pregnant. So I pretty much ate grass said beef and avocados the entire time we were in lanai. And I could eat eggs, eggs didn't seem to bother me. So just yeah, just trying to get in when I could tolerate within my own dietary principles. But I didn't shift anything. Prior to pregnancy, I you know, I did eat some carbs, I ate berries, I did eat root vegetables and smaller portions.
Megan Ramos
They're not things I ate when I was struggling with insulin resistance. But they were things that I strategically added into my diet afterwards. And I continued to consume those throughout pregnancy to tolerance.
Melanie Avalon
Wow. Okay. So many questions. Well, I love how you were saying that you had these dreams of eating nutrient rich and then it sounds like what you ate was really nutrient rich to me. Sounds like you did pretty good.
Megan Ramos
I think I thought I was going to eat like liver like a few times a week.
Melanie Avalon
the organ meats and all the things. Okay, I hear you. Did you change your eating windows?
Megan Ramos
Yeah, I did. And I actually banked embryos, I went into mommyhood, actually a little bit late in life. So a lot of your listeners know, and for those of you who don't, I was diagnosed with PCOS when I was 14. I was actually kind of amnoxiously skinny preteen. And I had PCOS and it was kind of weird, like I didn't have acne, I actually had regular periods. But I started cycling, you know, just before my 10th birthday, like really kind of abnormal PCOS stuff. You know, I have been able to correct that later on in life, but it didn't undo some of the damage that happened earlier. So when a woman has PCOS, they burn through a lot of follicles early on in life. And we're only born with so many eggs. Like we don't have an infinite supply of eggs that we can generate over time and genetics, you know, plays a big role in dictating how many eggs we have at the start. And then things like PCOS, you know, plays a role kind of in the life, like the longevity, like how often, you know, or how long we have those eggs for. If you have PCOS, she'll burn through a lot earlier on. So when I was older, and we decided it was time to start a family, I wasn't that old. I mean, I just turned 40 and my sons one, I had low ovarian reserves because of my past. So I we decided to bank embryos, because we would like to have a second kid. So I did the whole IVF thing. I was very fortunate, though, because of my lifestyle, I had really high quality eggs. So even though I didn't have like a ton, because of my history of PCOS, I had some really good raw materials to work with. And that gave us an amazing baby boy very easily from IVF. So we were very fortunate in that respect.
Melanie Avalon
Well, I didn't know that about PCOS and the eggs and IVF. That's amazing. And the high quality eggs with the fasting, how did you change it?
Megan Ramos
Yeah, my mommy brain here. I'm so sorry. Yeah, so pretty much like my maintenance plan, because you know, I've, I've improved a lot of health markers, like reversing type two diabetes, and my PCOS and fatty liver, and I lost a lot of weight and kept it off for a long time. And pretty much since I hit my goals, I've really like eaten two meals a day. And then as my schedules just kind of dictated it, I've done fasting. So like, prior to pregnancy, I had a class every Wednesday evening. So I just ended up doing 24s, a 24 hour fast every Wednesday, I had a long flight, which I often did, you know, I would cycle in some even longer fasts. And then I would strategically plan a few extended fasts a year just for longevity, health improved health span reasons. But you know, going into pregnancy, sorry, going into my IVF journey is where I got lost my tangent there. I started doing 14 hour window only, and having three smaller meals throughout the day. And I'll say like with all my symptoms, it was the only way I was able to get in I think enough food at the end of the day to keep a healthy pregnancy without having to go into the hospital or something like TPO and just I wouldn't want that for my son's development. And I could avoid it. So having the three smaller meals throughout the day did help quell a lot of my side effects and enable me to get in a good I guess a good low love like low diet of nutrient density throughout the day enough to have an optimal healthy baby at the end.
Melanie Avalon
So you were still, because I think people get really nervous with pregnancy and everything, and we get lots of questions about breastfeeding as well, but you were still eating in a slightly restricted window.
Megan Ramos
Yeah, you know, I still got in 14 hours a day. It was pretty easy. I never snacked unless like, I really felt kind of like I needed to. During pregnancy, my whole thing was like, if I if I felt hungry, like I wasn't going to say, Okay, you know, have some sparkling water and just try to suck it up. Pregnancy is a time for growth. And it's not a time for for fasting. So I just made sure to listen to my cues. I think I was so fortunate. By the time I did get pregnant, I'm like incredibly in tuned to my body and its needs. I know when I'm thirsty versus hungry, and vice versa. So I never really withheld but I found like I was able to maintain, you know, three smaller meals a day, and sort of a 14 hour window pretty easily, you know, throughout my journey.
Melanie Avalon
Okay, awesome. Yeah, so I have more questions about the windows and fasting and everything, but while we were talking about PCOS, I did have a good question about that. It was from Leah, and she wanted to know if someone is a type 2 diabetic and has PCOS, did one lead to another? Are they both just caused by high insulin or is there some other component that influences which way this insulin resistance manifests? Would you treat the two the same with diet and fasting or should one thing be taken into consideration with PCOS?
Megan Ramos
Yeah, lots of really good questions. PCOS is essentially like diabetes of the ovaries. So PCOS and type 2 diabetes are both caused by insulin resistance. Genetics sort of can play a role too as to what of these expressions of insulin resistance, like which of these diseases you're likely to develop to over time, although I think I was actually like the first person in my family to have PCOS. There's a whole bunch of them, like I had fatty liver, PCOS, and then eventually type 2 diabetes. As the insulin resistance becomes more severe, the more expressions and diseases related to it, you're going to accumulate over time. And unfortunately, due to all of the dietary crazy changes that happened in the late 70s, a lot of women in my age group and younger women are struggling with multiple metabolic diseases as they've gotten older. So it's really common to see PCOS and type 2 diabetes come hand in hand. I had actually a lot of women that come to us with PCOS that was established when they were younger. When we do look at their diabetes markers, sure, they're not classically abnormal by like tradition Western medical standards, but by functional integrative standards, like they're not good. And the person is usually on the cusp of being diagnosed with type 2 diabetes as well. You know, it's sort of a bit controversial, I think, and even in the fasting space, how we treat this, a lot of my colleagues outside of the fasting method and Jason, who work with women with PCOS, they always kind of like try to treat the PCOS and the sex hormones and get those balance first, and then, you know, sort of tackle the diabetes. What Jason and I have always done at the fasting method is treat the insulin first, we end up sort of, you know, knocking down two birds with one stone. But really that the insulin resistance is what's causing the sex hormone issues that's leading to the PCOS. And it's just it's a perpetual cycle. And, you know, sometimes I think just treating the hormones, especially in severe cases where someone also has something like type 2 diabetes, we know the insulin resistance is on really bad. So really trying to target the sex hormones is just kind of, it's frustrating, it's a long lengthy process. And when there's type 2 diabetes parallel, it doesn't always work. So in if we have a woman, say a 27 year old woman came to me, she's a newly diagnosed type 2 diabetes, she's known since her teen years, she had PCOS, she's looking, you know, to maybe want to have the possibility of conceiving down the road, she just wants it to be an option. So she does want to tackle the PCOS. And she's struggling with the symptoms of PCOS, like acne, facial hair, but we don't want those symptoms if you know, we can avoid it. So what do we do? And I would treat them like a diabetic first and foremost, in the sense like, you know, we're treating the insulin resistance. And that's kind of what we say. But I mean, the if you you just rephrase the PCOS is that's diabetes of the ovaries, we're treating the insulin resistance, the diabetes of everything kind of first.
Megan Ramos
And then once we have regained insulin sensitivity in the body, then we really focus on trying to optimize the sex hormones, like, you know, where they're still in balances, where they're still, you know, low levels of progesterone, or the issues with androgens, like, how do we optimize those down the road? And we found it to be, you know, very, very effective. You know, fortunately, we've helped a lot of women, you know, with PCOS, who wanted to be moms become moms, which has been really great, you know, they told me at 14 that I would probably never be a mom. And here I was, you know, like, I, I got pregnant, first embryo transfer, no issues right off the bat, you know, and, and had a lot of luck. And there's just there's so many opportunities for these these women. So it's been grateful to be part of these journeys. But even if motherhood is not something of interest, like we still want to treat the PCOS because it is like type two diabetes, but of the ovaries. So we want to fix that get rid of the potential side effects that someone might be experiencing as well, and just improve their overall health outcomes. And we treat everybody like a diabetic in terms of fasting protocols at the start.
Melanie Avalon
That's incredible. And so when you say doing that first and then potentially treating the sex hormone issues, is that with like bioidentical hormones or HRT?
Megan Ramos
We don't do that at the FASTA method, but if there's things that we can do, we would recommend it in certain cases if needed. Or if there's just things that we can do nutritionally to boost things like progesterone levels. You know, when someone's a type two diabetic and it's causing these other issues, and there's like PCOS and insulin resistance is causing the imbalances, we will, for example, you know, in a cycling woman, fast them fairly aggressively throughout the duration of their cycle. But once we've tackled the insulin resistance, then we want to optimize the hormones in each part of the cycle. So once we've sort of tackled the insulin resistance, something that we would do to help optimize the hormones then is sort of more fasting. And the beginning of the cycle, less fasting in the second half of the cycle, more structured carbohydrate intake in the second half of the cycle to support progesterone production, for example. So there's hacks that we would do nutritionally to see if we can optimize things first. We're fortunate, like for certain age demographics, we've had a lot of great benefits doing that. Generally, as women get older, like taking bioidentical hormones does have a lot of longevity benefits. I chose my own will and accord as a 38, 39 year old woman pregnant to take bioidentical progesterone throughout my pregnancy. And then to take it after I knew my breast milk was established with my son to just kind of optimize my hormones, because that just declines naturally with age. And I will gladly take estradiol as from the time comes. So we are a big fan of bioidentical hormones for the right demographic who does need it. But for younger women, we can often optimize a lot of things nutritionally and perhaps postpone the need for those hormones a little bit down the road.
Melanie Avalon
Is there a reason the progesterone is after the breast milk is established?
Megan Ramos
Taking progesterone might interfere with prolactin levels. So they're kind of contradictory to one another. So elevated prolactin suppresses progesterone levels and elevated progesterone will suppress prolactin levels. So I just wanted to make sure. I unfortunately, due to my weird placenta situation, had to have a C-section. That was not the dream. And my son was born early. So it was really important to, I worked really hard to establish my milk. Just wanted to make sure that was solid. And once that was solid and my son was growing like a weed, then I was happy to take the progesterone. And it was such a great thing to add in because of all the postpartum anxiety and all that stuff. And the progesterone really, it's amazing how much hormonal support helps with things like that.
Melanie Avalon
Awesome, okay. By the way, how rare is that double placenta situation?
Megan Ramos
Oh, it's super rare. And it's like 2% of the population. It is more common in women who have done IVF just because of the embryos are like implanted kind of artificially, right? Like it's not just something that spontaneously happens in the uterus. So I guess you're just a little bit more prone to some placenta issues. And of course, I didn't know that. And then they don't tell you that till after the fact.
Melanie Avalon
man, crazy, crazy, crazy. And also at your clinic, how many patients have you guys treated or how many do you deal with ongoing? Like how many I'm just curious, like trying to get like an idea of like the numbers.
Megan Ramos
Yeah, so we're now entirely online. I was actually just asking for this data for email that I was working on. I think in the last 12 years, we have worked with either between our Toronto Clinic and law online. We've worked with close to 100,000 individuals worldwide.
Melanie Avalon
That's amazing. That explains a lot why you can have so much knowledge, you know, especially when writing your book and a question about your book, there's a lot of debate out there with fasting definitions. I don't know if you saw the study that came out a couple months ago where they tried to have an official like establishment of what the different fasting definitions mean. I've found it really interesting. So what do you consider intermittent fasting in your book? I found it really interesting that I think what you were calling intermittent fasting may not be what a lot of people refer to it as basically what constitutes a fast, an intermittent fast.
Megan Ramos
We at the fasting method classify things like 12, 14, 16, 18 hours of fasting, especially when done daily. We consider that to be just good time restricted eating. Why? Well, following these strategies, you know, we don't often see things like PCOS or type 2 diabetes reverse like at all, maybe very mild issues of insulin resistance are resolved. Maybe, you know, if you're early on in your journey and you it's been just a few years of you carrying that freshman 15 still, it can easily be lost with those journeys. But unfortunately, we have a very sick North American and sort of, you know, global population, severe type 2 diabetes, severe insulin resistance and metabolic health problems. And those just don't cut it for fasting strategies. So we classify those as just good eating days, how you should eat in between fasts to maintain the progress that you've made with your fasting, and how you should just eat for optimal health and longevity and just sort of good daily shorter fasting practices that we do know have disease preventing benefits down the road. So like something like 14 hours of fasting has some really great benefits of preventing metabolic related breast cancer and woman. These are great things that we should be doing all of the time to sort of maintain good health and free disease prevention. But for actual disease reversal, and especially when we've got a lot of that body fat that's super stubborn, and there's a lot of insulin resistance, they're keeping it on, we don't find those to be effective strategies. So those are those time restricted eating protocols, you know, they're daily fasting protocols for for maintaining health and for disease prevention, once you are healthy. Now, what we focus on is fasting protocols that really target the insulin resistance. And in an insulin resistant individual, we really don't see those insulin levels fall enough for healing and some sensitivity to begin to develop until we approach the 24 hour mark. So people that we work with and how we define fasting is we call it therapeutic fasting, we're fasting to treat condition we're fasting to treat insulin resistance. So we do combinations of 24, 36, 42, 48 hours of fasting, and then occasionally some extended fast. So sometimes, you know, it's funny, because like I see all of the same stuff as you and your listeners, and like an extended fast is 24 hours, I actually just had someone the other day tell me they did an extended fast or 24 hours. By definition, though, an extended fast, you know, for us is 72 hours or longer. And these are the therapeutic strategies we help to reverse disease. Now when someone's disease is reversed, we don't keep up with therapeutic strategies. I mean, you do a therapy to treat a condition and hopefully you can alleviate that condition and go to maintenance. And then we switch to time restricted eating protocols to maintain after that.
Melanie Avalon
It's definitely a slightly different view than I think a lot of people have. We had a question about the 72-hour fasting. Sherry said, I heard her say on one podcast that 72-hour fasting is easier for menopausal women. Can you ask her about it and what that looks like? For example, is that three fasting days and then four days with two meals? I will say for listeners, get the book because it will go through, it goes through all the protocols and what this actually looks like. Just to briefly answer, when people are doing those extended fasts, are they fasting completely for 72 hours and then eating regularly the other days or what does it look like?
Megan Ramos
Yeah, for individuals who want to do 72 hour fast. So for like cycling woman, we would do it in the first half of the cycle in that follicular phase before ovulation. And then in menopausal, post-menopausal woman, there's a lot more flexibility. You can do it any time. That feels good. We would have people do three days consecutively, like say from Sunday dinner to Wednesday dinner. And then that ends up with four consecutive days of eating, usually two to three meals a day, often though people will break it up with a 24 hour fast somewhere in the middle. So we commonly see people fasting, say from Sunday dinner to Wednesday dinner, and then maybe doing a 24 hour fast on Friday until from Thursday dinner to Friday dinner, just to kind of break up those four days of eating. I know this sounds really intensive, and it has been a common comment since my book came out, is that I'm the crazy fasting lady. And these are intensive strategies. And they're really only meant for short term treating a condition and then moving on from it. And I'm all about the minimal effective dosage. For those of you who are listening, you might be a little bit scared of these things. We always start someone off slowly and work our way up. And we always see what is the minimal effective dosage of fasting required for them. And I hate to say it, but unfortunately, in cases of severe metabolic disease, severe insulin resistance, we often do need to do some of these therapeutic fasts. Now, I would say there's never really a need to do a 72 hour fast. You can do one if you want to do one. Sometimes people really like packing all their three days of fasting back to back. You know, we used to have women do a Monday, Wednesday, Friday fast in our clinic. And they would come in and say, can we please just do them all in one day, because or sorry, an all in one stretch, because once we get into a fastest state, it's easier to stay there than to have to bounce back and forth throughout the week. Whatever is most sustainable, sure. But we do these therapeutic strategies, hopefully, you know, not longer for than six months. If someone's able to be consistent with them, you know, before we start to turn down the fasting dial. And if someone's making great progress, you know, doing 24s, then like, hey, if it's not broken, don't fix it. And we definitely work to keep them there. But there are people who do need to do longer fast, there is definitely a time and a place, you know, for doing something like 248 hour fast, and maybe occasionally, you know, doing a 72 if that's easier for you. And there's a time and a place for that. And I feel like there's not a ton of resources out there. So I think sometimes I get labeled the crazy fasting lady, with these long protocols, but there is a time and a place. And I wanted to make sure we could provide a voice for all women, we a woman who have great success with 24s, but for the woman that just find it easier to do some little longer fast to get to their goals as well.
Melanie Avalon
A question about the mechanisms of action there with the longer fasting. How much of it is just due to the low insulin versus other things that are happening with fasting? And my follow-up question would be, can you sort of hack it by doing like a 36-hour fast and then a super low insulin meal, you know, and like, so sort of like maintaining that low insulin but not fasting as long, or is it really about the fasting hours?
Megan Ramos
A bit of both. Someone's looking for weight loss. Jason actually just interviewed me. It was the funniest thing. We spent 20 years just talking, and it was just weird to be talking on camera with him, interviewing me. I know that interview's not going to air well into next year, but he shared on the interview that he recently... It was just going to work out in his schedule to do a three-day fast. He wanted to do one before seven, the holiday hoopla. He took a very tiny, next-to-no insulin-producing meal every single day during that fast. You can absolutely do that. For women, if I was someone who wants to do a five-day fast and I need something like a slice of avocado in the middle of that fast to be successful, then do it. If they're really looking to knock down the insulin and suppress it for a long period of time and to try to burn as much fat, do it. Absolutely. Go for it. There are some other health benefits. In certain cases, like if someone was a cancer patient, we would probably want to do three days to focus on water and electrolytes because we would really want to optimize the cellular recycling process called autophagy. Autophagy is this physiological cellular recycling process that can be activated by nutrient suppression in the body. That is beneficial. A lot of cancer patients seek it out as just one of the tools in their toolbox of therapies that they're using in conjunction with regular medicine. We tend to really try to optimize that autophagy process. We would try to minimize nutrients being added to that particular time and just stick close to water and salts and some Epsom salt baths. Sometimes people feel too like when they are losing weight, they're starting to get a little bit excess skin accumulation and they want to try to minimize that. That's another instance where we'd see someone really want to optimize autophagy happening in the body so we can get that breakdown of the connective tissue happening there. If that was the goal, then we would say, okay, autophagy really peaks at the 72-hour marker into a fast. We would want to do a three-day fast then if that was someone's goal and we would try to minimize nutrient intake during that particular time. There's really no black or white answer. There's really no wrong or right way. It just depends on what that particular goal is of that specific fast. Sometimes there's a time and a place. I think Jason's like he had some broccoli and green vegetables. Nothing that sounded appealing for me even on an eating day, but I don't like broccoli, but I'm pretty sure that's what he ate. That's fine. People have avocado slices here or dill pickle there. That's also fine if they're just trying to lose weight, but otherwise it depends on what their goals are, how we would guide them on that.
Melanie Avalon
Yeah, so actually the second part of Sherry's question, she was the one asking about the 72-hour fast. She said, can a salad with oil and vinegar be a fasting aid? And she also said, I'm so glad you were interviewing her.
Megan Ramos
So Jason, yeah, but it can be but it is it is a fasting aid. So, you know, I'm not going to say that you're in the fastest state for that entire duration, you are going to be removed from the fastest state for a period of time. But if it's something small, if it's something that you know, if you're having something like leafy greens, and it's there's not going to be that insulin response is just so minimal. And you add a little bit of olive oil, for example, but not a lot, just like a little bit. It's not a ton of fat, you know, it's really not any different than adding a little bit of something like heavy whipping cream to your coffee during a fast. So it is fairly equivalent in that sense of someone needed something.
Melanie Avalon
And so, to clarify, we're talking about people using this to do those longer fasts, not like their daily fasting window, just for super clarity there. Speaking of daily fasting, you mentioned this in the book, but how do you feel about people doing one meal a day every day?
Megan Ramos
No, I hate it with a fiery, fierce passion. And I'm fortunate that there's a lot of wonderful female fasting advocates out there who also feel the same. It is just such a detriment we've seen to women's metabolism over time. We run into nutrient issues over time, and then women are feeling like garbage, they're starting to gain weight. So with one meal a day, these are kind of the big issues. So you're doing the same thing day in and day out. There's really not that much intermittent with it, and the body does begin to adapt versus doing three 24-hour fasts a week. So if you're doing just one meal on Monday, Wednesdays, and Fridays, it's intermittent. One day is one meal, the next day is two meals. You know, then one meal, two meals, one meal, two meals. So there's change, there's variety there. Your metabolism is getting fed different amounts of metabolic energy every other day, and it keeps it guessing, and it keeps your metabolism running well. But when you do the same thing every single day, your body adapts, and it slows down your metabolic rate. So I always talk about, you know, you have a house, we all have household incomes, right? So if your household income is reduced by 40 percent for whatever reason, at first you would overspend, likely. If it was abruptly reduced by 40 percent, I mean, you would still maybe have expensive car bills and other luxuries, like gym memberships and things that you might not be able to afford afterwards. And so you might go into a bit of debt. And then over time, you learn how to avoid accumulating debt month in and month out. And you cut back, you know, you might cut back on groceries. You might sell one of your two cars and get a public transport pass. You might get a Netflix subscription instead of going to the movies. You might just stream stuff versus paying for cable, like that type of thing. Like you figure out how to cut corners and avoid going into debt every month because your monthly income has been reduced and you learn to adapt over time. And so our bodies are we feed our bodies and we give it, you know, metabolic dollars every day in those meals. And when you reduce it every day, just to sort of one meal and say you you're still eating a very colorically dense meal at that one meal, but you're still reducing it, say, by about 40 percent day in and day out. And your body over time will overspend metabolic dollars and you will see some weight loss happening. But then it says, OK, you know, this is becoming consistent now. And I know how to plan and I'm going to cut costs and reproductive function. And you're going to cut costs from cognitive function, cardiovascular function. And I'm going to adapt to this new budget and then your body adapts to that new budget by slowing down your metabolic rate to match your new metabolic intake.
Megan Ramos
And that's what we see happening when people do one meal a day. Also, it's just not enough protein. It's pretty much the bottom line. And, you know, too, is that a woman, especially as we get older, our protein demands increase and it's so important, you know, to have good protein intake because it plays a huge role in maintaining really good hormonal health, not just, you know, when I talk a lot about insulin hormone, but sex hormones and we need the protein. The protein is really an important building block along with dietary fat as well for good hormonal health as we get older. So our demand for it actually increases, decreases as we age.
Melanie Avalon
I'm a huge fan of protein. It's ironic. I'm airing the week that we're recording, not that this is coming out. An episode with Dr. Michael Greger, who's very, very big in the vegan sphere. And he was talking about how the one thing correlated to longevity consistently is a low protein diet. And I think it's really confusing to people when they get completely different perspectives on that. It's interesting. I feel like I'm a unique unicorn in a one experiment with this because I have been doing one meal a day for, man, over a decade. I eat super high protein though, like pounds and pounds of meat and fish and seafood at night. And then I tend to alternate between higher carb days versus low carb days. I don't know if maybe that is enough to keep my body guessing or keep my metabolism going. I mean, it's worked for me so far, but I also realized that I'm very unique in that. Like the amount of protein I eat in my window is like a shocking amount. So I don't know if you've worked with any unicorns like that.
Megan Ramos
No, there are definitely unicorns out there. I'd say it's not like the bulk of individuals, though. But I love your strategy of changing up your macros. Often, you know, there are times where people cannot fast for whatever reasons. You know, like we won't necessarily fast somebody that's going under evaluation for an unknown medical condition, because then they always just kind of like blame the fasting, even if it would be helpful. If there's these instances that pop up or someone just, you know, they're going through a stressful time and, you know, they haven't combated stress eating yet. But, you know, they can make the commitment to eat healthier. And we'll change up their macros. So weeks of higher protein, then weeks of higher carb, weeks of higher fat, and more moderate protein and carbohydrates, which is mixing up those macros. And it's been incredibly beneficial in their health journeys. And it has made an improvement in their insulin resistance levels as well, in sort of the absence of doing longer fast. I don't necessarily know if it would take like an insulin dependent diabetic off of insulin. I don't believe so. But, you know, there's always going to be a unicorn in every case. But it is a it is a great strategy. We are big believers in our program of just kind of rolling with the seasons. And some seasons will be higher carbs, some will be higher protein, some, you know, will be higher fat, and just kind of really making sure that you're prioritizing what you're eating locally, because it's going to be more nutrient dense, and just kind of embracing those changes in macros as the seasons change as well. So there's a lot of, you know, Davis and Claire, I know he can be controversial too, like Michael Greger and these other guys, but he's got some interesting data on the benefits of changing sort of macro ratios for a longevity. And when we've put that into clinical practice, we've seen some really interesting outcomes and improving health span as well.
Melanie Avalon
I've had them on the show twice so I'll put links to that for listeners. How do you feel about and have you seen a change in your patient population either by numbers or by just their condition they're coming in with due to JLP ones?
Megan Ramos
We usually, it's very common for someone on our team to tell me that they had a consultation with someone and they said, I must be the only person that this didn't work for. And if I had like a quarter for every time I heard that, all of us pastors would be like living up on a Hawaiian Island. So there's that. So one thing, you know, it goes to show that we've got to really sort of fix our relationship, our food choices, the frequency that we eat, our behavioral aspects around food. There isn't a magic bullet, especially that one that will work for everybody. So some people can continue to snack all day long on process, they refine foods and they might get some weight loss from these GLP ones. But we do see a substantial number of individuals that say, Hey, you know, this doesn't work for me. I must be the only one because that's kind of what the media has a believing right now. It's just like, no, like welcome to like 10,000 people who are just just like you. The other thing we see is nice people that have taken them have had some positive experiences with fat loss, but then have developed some side of effects, have had to stop taking it and then have regained the weight because they didn't change how they ate the frequency that they ate or their behaviors around food. So it's definitely not a miracle bullet. There's a time and a place for them though, you know, when they did come out, I know Jason would put people on them short term, that would be the goal just to help get kind of appetite under control, but we would never want them to be on them long term where they might experience some problems down the road. We again, don't think it's a magic bullet. I will never forget it was the start of COVID lockdown in Toronto at the time Toronto was really kind of crazy with it. My dad is a very social outgoing lawyer and he was then just home alone and isolated and he was eating his feelings. Sorry, dad, I'm sharing this with everyone and he had made such great progress with his diabetes through fasting. He had lost tons of weight. He was off all his medications and A1C was like moving in the great direction, but this COVID just kind of sent him like so many other people into like a loop of poor habits and eating and his numbers all slid and Jason called me and he's like, I'm seeing your dad this afternoon and he's like in a telehealth appointment and he's like, what do you want me to do? These are his numbers and he's like, I imagine, you know, you're aware of what's going on with his eating as well. And I said, just put him on a was epic for three months, like just give him three months to get it together, to get him to acclimate to what's going on, give him a little bit more control over his appetite at this particular time. And Jason said he agreed, but he wanted to make sure that I was on the same page and that's exactly what it did. You know, it helps suppress things a bit, you know, for him to kind of, you know, get used to what was going on, make a new health plan to get back into action.
Megan Ramos
And after that three months, he didn't need it anymore. And he was rolling along and doing just fine and was able to maintain, you know, good habits and eating and fasting afterwards and get back his numbers. So, you know, we don't say never, you know, in our program, there is a time and a place. I know clinically when we're working with someone in the clinic, you know, we try to make it not as long term as possible. It's not a magic bullet. That's for sure what we've seen as well.
Melanie Avalon
I really love and appreciate that perspective. And yeah, I think they're clearly there can be very powerful and potentially therapeutic if used correctly. I feel like they're just a severe lack of education and correct implementation. And yeah, so that that's fascinating. Another question. So with the holidays and everything, do you have tips or tricks for people? Should they consciously try to be more restrictive? Should they use that as a time where it's seasonal and that's a time to boost their metabolism? And we've mentioned avocados a lot in this interview. And I keep getting flashbacks to something that you share in your book, which is your 90 minute hack where you can determine if you're actually hungry and then you think about an avocado or something. Yeah. So what are some tips and tricks for holidays and approaching them? And what is this 90 minute hack thing that you have?
Megan Ramos
Yeah, so you know, when it comes to the holiday season, there's there's all different kinds of things like, you know, trying to be the one that hosts it so you can play on the menu or offer to bring like charcuterie or different side dishes so you do know that there's something that you can have. I know here in the I live in the Bay Area now and we always go to our friends on Thanksgiving. And I just know now to offer to bring my own side dishes and I make amazing brussel sprouts with pancetta and they love it. So everybody's excited. And then I'm mostly excited because I know there's a side dish there that I can really lean into. And I'm not stuck with bad options. So and most people who are hosting don't mind if you offer to help because it is a lot. So I mean, there's things like that. In general, I do recommend eating and prioritizing, you know, some good fatty protein or fatty fiber source depending on where you lean more plant based and more animal based fatty protein or fatty plant or fiber source before you go. So you're nice and satiated before you show up to the party. We do have a 90 minute hack to help you reach satiation at the start of your journey. But we have a 90 minute holiday hack is that when you show up, I know I'm unfortunately won't be home for Christmas this year. But when we are, you know, we show up at my mom's super early. So you can do like the presents, the old school presents, they get to be kids again, even like the age of 40 and 37. And then we're just there for the whole day. And there's like food being put out after food being put out. But like the real main meals, not, you know, coming to like five o'clock, you know, you get there early, and there's all these appetizers and hors d'oeuvres. And I encourage people, you know, treat them like a mini meal. So you're showing up, you know, dinner is still going to be a few hours away. Eat for 90 minutes, but cut it off. So like you're not grazing, you know, for three hours, you get to participate, you can focus on the foods that align with your sister or with your principles and food values. And then everybody thinks you're participating, and then you cut it off. And then you wait until mealtime. And during that time, you know, enjoy different herbal teas, like mint tea that might suppress your appetite carbonated waters, flavored carbonated waters, just to help what we often see so much as people say, no, I'm going to fast to dinner, I'm going to show up at my sister's house at noon, and dinner is not going to be to six. And I'm going to avoid all of the pastries. And I'm going to do a 24 hour fast. Don't do that. Please don't do that. Like wake up that day, have breakfast, prioritize the foods that make you feel satiated for that meal.
Megan Ramos
You know, so for like my family, we might have like bacon, eggs and avocado, you know, for for that meal. And then we show up and we do enjoy some appetizers and dessert orders, like we don't shoot ourselves in the foot, and then spend, you know, six hours debating with people that you know, why we're fasting, and why we need to fast and why they should be fasting, like no one wants to get into that over the holidays. And so we show up, you know, we give by giving ourselves permission. So this whole concept of food freedom that Melissa urban sort of coined, to a certain extent, you know, you're giving yourself permission to have something that way, you don't go overboard with it, right? When we show up with the attitude, we're not going to eat anything. And we're going to fast into dinner, almost every single time, you know, the patient or client would come back and say, Well, I ended up eating everything. But when you show up and say, No, I'm going to eat the foods that align with my values, and I'm going to eat them for 90 minutes, and then cut off the timer. At that point, people then do stick to the foods that resonate with their values. And they do cut off the timer, and then they avoid all of this family conflict. They are feeling satiated then because they stuck with the foods with their values. So that's a sort of the 90 minute recommendation. And a lot of our communities found that to be helpful. And then if you are going to have, you know, something a little bit special at your at your meals, I do know, like whenever we're in Florida for Thanksgiving, my husband loves his godmother's like sweet potato casserole, and he will have it. But he will eat everything else first, all of the other protein, fiber and fat sources that he's going to have, he will eat all of those first, and already feel pretty satiated before having any of that sweet potato. And then he's able to control his portion size. What we found was on, you know, all the days like that. And this happened to me, I remember it was like my first Christmas, and I was going to eat my mom's roasted potatoes. And I was like a little four year old, I put all the food on my plate, and they went for the roasted potatoes first. But I ate roasted potatoes on a mostly empty stomach, my insulin spiked, my glucose was spiked, my appetite was spiked. And then I was like a bottomless pit and like people stared at me. And then I knew for the next holiday, wait, no, the great fatty protein and fiber. And I went to have some of her special roasted potatoes, I could only eat a small portion of them because I was full. My appetite was suppressed, meaning all the other good foods. So save any indulgent items that you have for last, fill up on the good fatty fiber protein sources first. And if you can use something like vinegar, so if you can appropriately add it to a particular carb dish, like if you are having potatoes, for example, maybe not sweet potato, casserole, but something else add some vinegar can make a big difference as well.
Melanie Avalon
Wow, that's so cool that you intuitively figured that out as a kid. You know, that's amazing with the potatoes.
Megan Ramos
I was like 27 at the time, but I felt like a kid the first time. I'm like, oh, I'm going to eat all of this. This is my Christmas present, potatoes. And it just went horribly wrong very quickly. I didn't have any self-restraint. And the next time, I'm like, no, I'm going to treat them like dessert on my plate, and I'm going to eat them last. And I had a lot more control that way.
Melanie Avalon
I love that. A final question about your book. So you were mentioning earlier how some people interpreted the book a certain way with what you're prescribing when it comes to fasting. So I'm curious, since releasing the book, also since having your pregnancy and everything, is there anything that you would go back and change or adjust with what you wrote, or do you want to write another book? Have your thoughts evolved.
Megan Ramos
I would love to write a book on perimenopause and strategies. I think the essential guide to intermittent fasting for women, there was some information there for perimenopausal women, but I think it's such a unique time in a woman's life where there's so many hormonal changes going on. And there's a whole different game set of strategies. And we gave some of the basic ones, the common ones in the book for effectiveness, but perimenopausal women trying to lose weight and treat or prevent insulin resistance from developing, they deserve their own book. There's a lot there. Of course, I would also love to write one for women who are struggling with PCOS geared towards fertility and positive fertility outcomes as well. So we tried to make the essential guide to intermittent fasting for women with key pieces of information for women across the whole adult hormonal landscape and spectrum there. So there's definitely something for everyone, but I feel like those were two demographics where there could be whole books just dedicated to those particular things. And then of course, the post-menopausal women, I think, have so much freedom and liberty with fasting and even some nutritional choices to a certain extent. And I wish if there was a second version, I could have highlighted that a little bit more. So I know when we do our book club at the fasting method and we go through the book, we really try to highlight that so that the post-menopausal women really feel heard and seen. So those are some reflections now that it's been over a year. Those are some of my hopeful goals for the future, once I've slept for a few consecutive nights at some point, things that I'd like to work on.
Melanie Avalon
And to clarify with the perimenopausal woman, is that the category of woman that needs to be more, I guess, concerned about overfasting? It's interesting because a Megan, another Megan, she said that she really appreciates you. She said she heard you. She said hearing her on a podcast changed the way I think about my health and has helped me enormously. And then she wanted to know, for a woman approaching perimenopause, how can they make sure they're not fasting excessively? So my question there is just, is perimenopause where that is more of an issue?
Megan Ramos
It can be, absolutely. Sometimes less fasting is definitely more in terms of results. And when we work with a perimenopausal woman, we need to see the labs and we really customize it. We really want to make sure we're being ultra sensitive to thyroid. When you're younger or even a bit older, you can beat up your thyroid a little bit, but we don't want that to happen during that time. We really want to make sure we're loving and nurturing our thyroid. I know at adrenal glands, there's so many that's so important for just overall sex hormone balance. Taking a look at the different sex hormone balance, taking a look at their cortisol, and really planning their particular fasting and eating strategies around that. Even from when we would work, have someone do an intensive workout, changes if they're having cortisol issues, especially going through perimenopause. There's a lot of stuff that we, I think it's the most time in a person's life where fasting really needs to be personalized based on a whole handful of hormones. Often less fasting is more and being really creative about how you structure it. I think maybe millions of people have heard both Jason and I say, breakfast. But a lot of the times, we make breakfast one of the staple meals for the perimenopausal women. Especially when cortisol is high, we want to optimize the conversion of Friti 4 to Friti 3 in the morning rather than reverse C3. We see all these reverse C3 issues. We want to optimize that. We don't want to make it worse throughout the day or in general. We often will implement breakfast, whether we're doing some shorter fast or are still doing some longer therapeutic fast. It's very personalized and we do tend to turn the fasting pile down a bit during this particular stage in life.
Melanie Avalon
I, and I'm sure others will eagerly await hopefully that book when you get some more sleep in you. Thank you so much, Megan. I really cannot express enough my gratitude I have for everything that you're doing. And literally, you are so wildly popular with my audience. It's insane. And even having co-hosted the Intermittent Fasting Podcast with both Cynthia Thurlow and Vanessa Spina, they both say the same thing that just, you know, whenever they have you on their shows, it's just everybody is obsessed. So, um, thank you so much for what you're doing, friends, definitely get the essential guide to intermittent fasting for women. I will hopefully can have you back in the future when you have a new book and some sleep in you and all the things.
Megan Ramos
Yes. Thank you, Melanie. And thanks to all of your listeners for everyone's support. And I will keep putting information out there, sleepless or not so sleepless. We will keep getting stuff out there, helping just real practical strategies, you know, because fasting is super doable for everybody, but it is a little bit nuanced, especially for us ladies. So just keep getting the information out there so women know that it is safe for them, but I feel confident that the strategies that they're doing are safe for them. So thanks everyone for listening to my rambles and happy fasting and we'll see you soon.
Melanie Avalon
Yes, no, thank you. And I almost forgot last question. It's so easy. What is something you're grateful for?
Megan Ramos
Right now, I'm so grateful for everything I've learned about nutrition, because my my son was born early, and he was 1.6 percentile for weight. And it has been a journey, but he is absolutely thriving. And if I hadn't been through all of this, like he's going to have such a completely different life than I have. So grateful. Sorry. Anyways, he's a cool guy. So he's not going to be part of the puffs generation. That is for sure. And I'm happy for for it. So we can make we can start making changes for the kids to come.
Melanie Avalon
Thank you so much. That is so powerful. I am overwhelmingly grateful. Congratulations to you and your beautiful boy, and have a wonderful year. We'll talk again soon. Thanks, Melanie. Thanks, everyone. Thank you. 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 a review on iTunes. We couldn't do this without our amazing team. Editing by podcast doctors, show notes and artwork by Brianna Joyner, and original theme composed by Leland Cox and recomposed by Steve Saunders. See you next week.