Episode 100: Intermittent Fasting Part 1
This episode is a deep dive into metabolic health and why it’s so important. Can intermittent fasting be a therapeutic tool? What are the different ways to approach intermittent fasting? What are the pros & cons of a fat fast?
In this episode:
Time restricted eating
Different ways to approach intermittent fasting
Pros & Cons of a fat fast
Benefits of intermittent fasting
Fasting and the gut
What does circadian rhythm have to do with it?
Conditions where fasting can be helpful
What you need to know about insulin
Signs and symptoms of insulin resistance and high blood sugars
Lab markers of metabolic syndrome
Brain health in menopause
PCOS
How to reverse insulin resistance
Resources mentioned:
Carb Compatibility Project (Available for free within the Funk’tional Nutrition Collective)
CCP weekly workouts provided by:
Learn More About Metabolic Health
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Erin Holt [00:00:05]:
Welcome to the Funk'tional Nutrition Podcast. I'm your host, Erin Holt, and I'm a board certified integrative and functional nutritionist. I live on the seacoast of New Hampshire and work with clients in my virtual practice all over the world through private consultations and online nutrition and functional medicine programs. Functional medicine nutrition is all about diving deep with people to get to the root cause of their health issues. And that's exactly what I tackle in this podcast. All things health, food, and nutrition, unpacking current research, and almost a decade of clinical experience. I love to bring experts and thought leaders to the table so we can all learn together. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment.
Erin Holt [00:00:55]:
Thanks for joining me. Now, let's dive in. What's up, everybody? This is the episode that I've been sitting on for a while, the intermittent fasting episode. I know you want to know about it. We're gonna talk about it all today. I had this cued up for a couple of, maybe like a month ago. I don't even know. Time doesn't matter anymore.
Erin Holt [00:01:21]:
It's all mush. But, you know, then COVID happened, so it didn't seem super relevant. I just felt there was more pressing things to address on the show. And now we're finally coming out with it, which actually seems pretty timely because there's been so much stuff coming out showing the comorbidities with COVID-19 complications and deaths. And what we're really seeing is that there's this underlying metabolic dysfunction in those who are suffering the most. A recent peer reviewed observational study, which was published in the Journal of Diabetics Science and Technology, showed that diabetics and those with hyperglycemia, so that's high blood sugar, had a four times higher in hospital mortality rate and increased length of stay. So diabetes, uncontrolled high blood sugars, insulin resistance, a lot of the stuff we're going to get into today would be considered metabolic dysfunction. And so, you know, this is.
Erin Holt [00:02:26]:
I'm not talking about this as a way to undercut the severity of the virus or. Or any, or downplay any of that. What I'm saying is that we do have to pay attention to what makes people more susceptible. It's something that I talk about all the time on this show, that inner terrain. What does your inner terrain look like? How. What is your ability to fend yourself off against pathogens? Because again, I will say it time and time again, and we're never going to win the war on microbes or on viruses. It's really up to us to make sure that we have a robust inner terrain and so metabolic dysfunction and how your metabolism runs and all of this super duper plays into it. And so we have to.
Erin Holt [00:03:15]:
We can't always just deal with exactly what's in front of us. Right. We have to think more preventatively. Okay, well, what do we do marching forward? How do we take care of ourselves? So we're going to get into a little bit about. About that kind of stuff today. I know I talk a lot about low blood sugar. A lot, a lot, a lot about low blood sugar.
Erin Holt [00:03:33]:
But the other side of the spectrum, the high blood sugar, the insulin resistance picture is not to be ignored. And quite frankly, I'm seeing more and more of it. The more people I work with, the more I see that side of the coin. And this is especially true for my menopausal woman. Perimenopausal, postmenopausal. We're going to get into that a little bit later on. So we got to pay attention to this. This is important stuff.
Erin Holt [00:03:59]:
Whether or not you choose to intermittent fast, this is. This is still really good stuff. And hey, guess what? It's my hundredth episode. Can you believe it? I've pumped out over a hundred hours of content. That is crazy. I think I've been doing this for two and a half years. I should do. I would love to do a little, like, throwback show with Kyle, who was my original co host.
Erin Holt [00:04:24]:
That would be a fun episode. Maybe we'll do that. Anyway, hundredth episode. Another big important change is that I changed my instagram handle, which sounds wicked dumb to say, I will fully admit that. And big, important changed instagram. But because I interface with so many of you guys on that platform, it's, you know, it's a big part of my business. So I changed my name from Erin Holt Health, which is still the name of my business and still my actual name, but I change it over to the.funktional.nutritionist, the period functional, spelt like it's spelled in the show, period nutritionist. And I did that just so people from the podcast could more easily find me and recognize me, and so people have a better understanding what I do.
Erin Holt [00:05:15]:
Erin Holt's health doesn't really convey exactly what I do. So that's that. Just a heads up that happened just this week, so don't get confused if you see a new handle marching around. What else? The Carb Compatibility Project starts May 11. I got a lot of awesome bonuses this round. I'm adding a brand new module that's going to address and go into way more depth about all the stuff we're going to talk about on today's show. I'm going to include labs that you can ask your doctor for that will be covered by insurance. I want you to understand the difference between optimal and normal levels.
Erin Holt [00:05:58]:
So if you get blood work done at the doctors and they're like, it's normal, we might wanna do a little bit of a deeper dive on that. We're gonna talk about the link between blood sugars, cortisol and that visceral belly fat, the link between insulin resistance and your gut. And because it's so important, this gut health, I even threw in my entire What the Gut? Two and a half hour gut health workshop. So that's another bonus. We'll talk about functional medicine, approaches to high blood sugars and insulin resistance, and then specific dietary approaches to focus on. So that's all going to be a bonus module for all of you guys. And one more bonus. I'm just hitting you from every angle.
Erin Holt [00:06:39]:
We have weekly workouts now, so that's provided for my good friends at Blaze yoga and pilates, and Steamhouse yoga and pilates online workouts. We're going to do the interval training, weight training, yoga, pilates. It's going to be awesome. This May group is going to be en fuego, so I hope you join us. All right, I'm going to encourage you to share this episode with any of your friends who are fasting curious. Anyone that's interested in intermittent fasting or is currently trying intermittent fasting, or people that are talking to you about intermittent fasting. This is going to be like a really extensive deep dive.
Erin Holt [00:07:23]:
And in fact, I might break it up into two episodes. I have 30 pages of notes to pick through today. A lot of that is resources, but a lot of it isn't. So if I get to the 45 minutes mark and I still have a long way to go, I'm going to break it up into two episodes just so it's just a little bit easier to digest. But do feel free to share this episode. Share, share, share. Anybody that you know that has type two diabetes, who has high insulin, pre diabetes, insulin resistance, metabolic syndrome, high blood sugars, anyone going through menopause or post menopause. Share this episode. It's going to be rich with content and resources for your friends, for your family. Okay, so when I do talk about intermittent fasting, because no doubt you've heard me talk about it before on instagram, here on the show, it's usually to highlight the downsides of it.
Erin Holt [00:08:25]:
And it's not because I have anything inherently against fasting or because I believe that nobody should do fasting. It's because it's such a popular thing right now. And when something gets so popular and when everybody's talking about something, what happens is that everyone thinks that they should be doing it. All nuance, all context, all reason and common sense goes flying out the window. I try to be the voice of reason to counteract the nonsensical stuff we hear, which is why, while everybody is talking about why intermittent fasting is so great, you'll hear me say, yeah, but. Because the truth is, fasting is not appropriate for all. It is not the panacea that everyone wants it to be. Sorry to be the bearer of bad news. I've used actual lab examples on Instagram of the negative hormonal effects of fasting for some women.
Erin Holt [00:09:34]:
So I can't podcast. It's all audio. I can't show you visuals. So that's what I use Instagram for, is to show you like, hey, see this lab? Here's what's going on. This woman was fasting. Here's her hormones responding negatively to the fasting. And there's. There you might kind of, depending on what channel you follow or channels you might be hearing even more talk about intermittent fasting for immune health.
Erin Holt [00:10:04]:
So people are really promoting fasting as a way to sort of fend yourself off against the virus. And it's like, okay, maybe, maybe, maybe that's true for some people, but it's definitely not true for all people. In fact, you could push yourself even into a more of a stress response, which is going to impair your immune system. So it's not, again, it's not going to be black and white. In the field of nutrition, we have to make specific space for all truths. It is true that intermittent fasting is detrimental. And. And.
Erin Holt [00:10:42]:
And it is true that intermittent fasting is beneficial. Oh, my dear God, what do we do with that information? Both truths can coexist here. It's not an either or situation. It's an and also. And what's kind of crazy is that both truths can coexist within the same human being. There might be times, depending on your stress levels or your exercise routines or your hormonal fluctuations, where intermittent fasting works really well for you. And then there might be some times when intermittent fasting is a really horrible fit. So that's kind of the name of the game today. Talking about, how can you assess if there's.
Erin Holt [00:11:32]:
If it's. If it's appropriate for you or not, given your unique context? I posted on social media. Oh, goodness. It was while Your Hormone Revival was running. And this is the last week. So probably a month or so ago, I had analyzed two sets of hormone labs for two different ladies in my program. And for one person, I was recommending intermittent fasting. I was saying, you should try it.
Erin Holt [00:12:00]:
And for another person, I was specifically telling them to stop intermittent fasting. Right. So, of course, when I shared that, everybody had lots of questions, and I started stockpiling those questions into one place so I could answer them here on this podcast in one place. So the big questions that really came through were, who was it for? Like, who should try it? When is it therapeutic? Why is it therapeutic? What are the benefits or potential benefits of intermittent fasting? Does it work for women's bodies? I love that question. And then somebody else said, is it just another diet culture tool? Ooh, that's a good one, right? It's that last question that really has prevented me from addressing the benefits of intermittent fasting on the show. As somebody who struggled with eating disorders for 13 years and went through hell, absolute hell, to recover, I'm hyper sensitive to restriction recommendations, and I'm still seeing a massive amount of restriction in my clinical practice. I know that I have a lot of people that listen to the show who have recovered from eating disorders or who might be going through the process of recovery, that that whole dance, two steps forward, maybe a step back, that whole struggle. And so I know that talking about fasting might be a trigger for somebody, and I never want to perpetuate the starvation model.
Erin Holt [00:13:33]:
Obviously, if you've been here through all 99 episodes up until this point, you guys get that, you know, that that's not my jam, that's not my jump off. But I also don't want to restrict myself from putting out information. I want to always showcase all sides of the information where it's appropriate. And ultimately, it's not my responsibility to micromanage how people consume and perceive my content in material. It's like me saying, well, I can't give this information because they can't handle it. And that's not true. I trust that you can handle this information, and I'm going to trust that you can determine whether or not it applies to you. Is this for you, or is this not for you? That's your responsibility to self audit, use the information, and run it through your own body.
Erin Holt [00:14:24]:
Hey, I know we are absolutely inundated with information, and so we all have to build up some sort of internal checks and balances to run this information through ourselves and to have the ability to assess. Does this apply to me? Is this right for me? Is this information that I should take or leave? Because not everything you hear is going to be for you. You know, just take what you need, leave the rest. And there's a massive difference between doing these practices because they are therapy for a health condition, and doing these practices because we've fallen victim to diet culture. And that's what I want you to determine for yourself today. Based on the information I provide does intermittent fasting sound like appropriate therapy for your body, or is it just more of the same diet bandwagon? So let's go. Let's start with the basics. What the hell is it? What is it? True fasting is where you limit the ingestion of all food, all forms of calories and all metabolites.
Erin Holt [00:15:37]:
So this is any xenobiotic, anything foreign to the body that the body has to metabolize. So hey, guess what? This includes black coffee, herbal tea, electrolyte powders, vitamins and supplements. Doctor Satchin Panda is really a leading expert in the field of circadian rhythm research, and he says that any xenobiotic will start the digestive circadian clock, even if those things don't contain calories. So we're talking about true fasting here. And I think I probably just bummed a lot of people out, right out of the gate who thought they were fasting, but maybe actually weren't fasting, because this is certainly different than the way many people are practicing fasting. And the experts are kind of mixed on this. Some say as long as there's no calories, it's fine. And then some say that if you're keeping it under 50 calories, it's fine.
Erin Holt [00:16:38]:
You're still going to get the effects of fasting. And to be clear, when I say effects, I'm talking about the therapeutic health benefits. I'm not necessarily referring to just weight loss. As Cathy Biase said on the cancer episode that we did a couple of months ago, fasting is not a weight loss thing. Weight loss can be a byproduct of fasting, but it's not really the primary driver when we're talking about it from a health intervention standpoint. I will talk about a study in a little bit that showed big improvements in health biomarkers regardless of weight loss. Right? So weight loss is not always the thing that we're chasing from a health perspective. So there is a difference between intermittent fasting and time restricted feeding or time restricted eating.
Erin Holt [00:17:33]:
Intermittent fasting is complete fasting for 24 hours, whereas time restricted feeding is limiting the daily period of food intake. You're basically shortening your eating window. So what many of us are talking about when we refer to intermittent fasting is actually time restricted feeding. For the sake of today's show, I'm going to continue to call it intermittent fasting. But I just wanted to point out that distinction there. And what most people are talking about when they say intermittent fasting is really a compressed eating window where you limit your food and caloric intake to a window of 12 hours or 10 hours or 8 hours. And the research is kind of all over the place in terms of methods, because there's so many different ways to utilize fasting. You can do alternate day fasting.
Erin Holt [00:18:30]:
You can fast for two days every week. You can restrict your calories two days every week. Even with time restricted eating, there's different studies on different times of the day. So there's early time restricted feeding, which means that you start eating early in the day, like, say, 07:00 a.m. And then you would stop eating around 03:00 p.m. So you don't put anything into your system beyond 03:00 p.m. And I'll share research that in a little bit. I think what most people are doing when they practice intermittent fasting is they skip breakfast or they start to eat later in the day, like 11:00 a.m.
Erin Holt [00:19:10]:
Or noon, maybe they start eating. So I guess my point here is that there's a lot of different ways to approach this, really, like with anything in health and nutrition. And you can argue that there's benefits for all the different ways. So I think if this is a practice that you want to try out, you need to think about what really makes the most sense for you and what feels the best in your body. And I'm going to talk about very specific ways to approach this towards the end of the show, or maybe in part two, depending on how long this runs. So we have the fasting mimicking diet. This is one way to go about it, which you might have heard of.
Erin Holt [00:19:49]:
It's gained a lot of momentum and popularity in the past couple of years. And then they. I'm pretty sure they highlighted it on the Goop Netflix show. I think that Gwyneth and her, and her pals did it. So that's going to even, you know, increase the popularity there. It's called the ProLon Fasting Mimicking Diet. It's a five day meal program available for purchase. So you do purchase specific foods to eat.
Erin Holt [00:20:16]:
Kind of like Jenny Craig back in the day. Right. And it mimics the effects of fasting, but without having to completely abstain for food for five days, it's extremely restricted calories for a five day period. Okay. So that's what the fasting mimicking diet is all about. And a lot of really great research to support that. If you go to their website, there's a lot of research there that you can check out. Then there's actual fasting again, going 24 hours or longer without food.
Erin Holt [00:20:49]:
This can be extremely therapeutic. It goes beyond the scope of my expertise. It's nothing that I would do clinically with a client. I'm not going to get into it here just because I don't like to talk about things that I don't know about, because I think that's irresponsible and inappropriate. But Doctor Jason Fung is a canadian nephrologist and he's the leading expert, or a leading expert on fasting. So you can check out his information. He really pumps out a lot of info. As a kidney doctor.
Erin Holt [00:21:19]:
He obviously saw a lot of type two diabetes, metabolic syndrome, and obesity. So that's his whole jam. You can check him out if that fits your picture. But please, if you're listening to this show and you have a history of eating disorders, or you're just one of those people that have convinced yourself that you have like five extra pounds to lose, I'm not sending you to Jason Fung to do like a long, long term fast to, you know, to fix your metabolic dysfunction. That's, that's for a very specific segment of the population. So again, self audit. Run the information through yourself. Does this apply to me or not? And then we have a fat fast, which is, this was really made popular by the bulletproof coffee trend where you're, I mean, there's other ways to fat fast.
Erin Holt [00:22:09]:
It doesn't have to be with coffee, but I would say this is the most popular one, where you're adding fat to your coffee and that instead of eating breakfast, you're doing, you're doing more of a fat fast. So you would add anywhere between one to four tablespoons of fat. You could also add some protein. So a lot of people like to add collagen to this. This seems to be really from a stress perspective, which we'll talk about in a bit how, how fasting can trigger stress in women and really kind of play around with their thyroid health and hormones, adding some protein in seems to mitigate some of those negative side effects. Fat fasting works because it doesn't raise blood sugar or insulin. So insulin really responds.
Erin Holt [00:23:05]:
Mostly it responds to anything you put in your pie hole, but mostly to carbohydrate. So if you're getting no carbohydrate when you're doing coffee and fat and maybe some protein. Right. And so this can often pair well with somebody who really wants to be in ketosis. They want to be in ketosis. They want to reap the rewards of a ketogenic diet, in nutritional ketosis, because this will keep you in ketosis. Despite the calories, you're not getting a blood sugar spike, you're not getting an insulin spike. So this would be a good approach for that category of people.
Erin Holt [00:23:44]:
It can keep leptin from being depleted. So leptin, we'll talk about later. It's our satiety hormone. It does a lot of other things and big interplay with mood and hormones, which again, we'll talk about. But we know it as our satiety hormone and it's triggered by having our own body fat, so it's released if we have body fat stores or when we consume dietary fat in the diet. So the pros of doing a fat fast, like a bulletproof coffee, is that it can keep things more stable than just a plain fast. It can keep leptin from being depleted. When leptin gets low, when leptin is depleted, it tells the brain that your body is in an under fed state. And this is what has the impacts on thyroid, on sex hormones.
Erin Holt [00:24:40]:
And with the fat fast, some degree of autophagy can still happen without ringing the alarm bells in the body. And when I'm talking about, well, you'll, you'll learn what autophagy means in a little bit. I will still say, though, that I've seen hormone reports from women who are using a fat fast as a practice and it did still have negative consequences. So keep that in mind. It's not a, it's not a sure, you know, a surefire fit for everybody. There are some cons, there are some draw drawbacks of a fat fast. And I will, I'll say this now, we're going to get into who should avoid fasting altogether. But there is, because the bulletproof coffee thing is, is such a popular approach.
Erin Holt [00:25:34]:
And in case you don't make it to the end of this episode or part two. Doing this can easily put you into an undercarbed, underfed, over caffeinated and over stressed state. Even if you're getting ample calories through the fat, you might be missing out on some micronutrients and phytochemicals and antioxidants. And just leaning on caffeine instead of eating a full meal can really tweak some things in the body. Okay. So it's a good fit for some, not a great fit for everybody. And then there's a protein fast, which is limiting your. It sounds like you just fast on protein, but you actually restrict protein.
Erin Holt [00:26:16]:
You limit your protein consumption to 15 to 25 grams a day. This gives your body a full day to recycle proteins, which will help reduce inflammation and, um, uh, and it prevents any muscle loss while you're doing it. It's hard to do. It's really, really hard to do. I'm not going to have any pro tips because it's just a very challenging thing to do, but you could look into whether or not that's appropriate for you. Now those are the different ways to attempt or different styles of fasting that you might hear about. But why, why would you do it? What is it good for? Um, taking a break from eating essentially mimics a more ancestral pattern of eating where food scarcity was a big thing. I mean, you have to think about historically, what were the biggest threats to survival.
Erin Holt [00:27:09]:
Not having enough food was the big one. It was one of the biggest. So we did. Again, our genetics are sort of used to going longer stretches without food. So that's kind of one of the arguments for fasting, is that, well, our bodies, you know, have always been equipped to do this. When I hear that, when I hear that as a, as a reason to try something while our ancestors did it, we also have to take into account that modern day looks very different than it did 100 years ago, a thousand years ago, 5000 years ago, right? We had big, major stressors running away from a lion, a tiger, a bear. Oh my, right, finding food, those are big stressors. Shelter, right now, we don't have those big, massive stressors.
Erin Holt [00:28:04]:
We have little like micro bursts of stress all throughout the day. Consistent, chronic low grade stress all the time. Traffic, you know, blue lights from screens, having a screen in your face all day, not being outside, financial stress, too much on our plate, you know, being a caretaker, all of these things are just, we're just inundated with these, these low grade stressors. So to say, well, we just need to look to what our ancestors, did, you know, a few thousand years back? Well, okay, maybe. But also different lifestyle, too. So it's not comparing apples and apples. What I think is really interesting there is. There's a doctor, Doctor Wilson, who does a lot with thyroid, and he sort of coined the term Wilson's temperatures syndrome, which is basically low T3. And as we've talked about on the show before, T3 is our active thyroid hormone.
Erin Holt [00:29:05]:
It's the hormone that does most of the things in our body. And so if we have low T3, your lab work could look perfectly normal. Your tsh could be perfectly fine, T4 perfectly fine. But if you have low T3, you're going to experience symptoms of hypothyroidism, low thyroid function. And what he found is that it seems to be more common in patients whose ancestors survived famine, like Irish, American, Indian, Scottish, Welsh, Russian, which is very interesting. And I'm gonna circle back around to this idea in a little bit, but I guess my point in teasing this out is saying, okay, so maybe our ancestors survived famine, but did that do us any favors? Right? Is starving ourselves the answer? Is restricting food the answer? I don't know. It's something to really think about. But we do know that there are very clear cut benefits to intermittent fasting, including improving insulin sensitivity, reducing glucose levels in the body blood sugar.
Erin Holt [00:30:11]:
Reducing insulin levels in the body, can lower blood pressure, it can improve lipid profiles, and it can reduce the markers of inflammation and oxidative stress. So these are like, big things that contribute to cardiovascular disease, right? They contribute to metabolic dysfunction, or it is metabolic dysfunction. It can lead to diabetes. It can lead to stroke. It can lead to a great many things. I mean, we were talking at the start of the show the implications that it has in COVID-19 mortalities and complications. Right. This is big stuff. So the fact that intermittent fasting could potentially be a tool for this is.
Erin Holt [00:30:56]:
Is pretty eye opening. Now, I'm not gonna. Anybody that's struggling with this, I'm not gonna say, hey, like, jump right in, you know, come in, the water's warm. I want you to really listen to the, you know, everything I have to say in these. These two episodes and assess, is this right for you? There is some cool stuff as it relates to gut health as well. Intermittent fasting in the gut. Some animal studies, there's no human studies yet, but some animal studies showed that intermittent fasting could increase bacteria richness.
Erin Holt [00:31:36]:
And that's a good thing, since the microbiome plays such a large role in metabolic health. This is a good thing. Intermittent fasting induce changes to the gut microbiome, increased ketone formation and glutathione metabolism, the body's main antioxidant, and it enhanced antioxidant pathways. Furthermore, intermittent fasting increased the number of regulatory t cells. So basically it's going to lower oxidative stress, it's going to enhance antioxidants, it's going to support the immune system through the function of Treg cells. So that's kind of, that's a, that's a cool study in my eyes. Um, really what we need to do, because the, our microbiome works on its own rhythm. I mean, we have circadian rhythm. Our microbiome does, does, too.
Erin Holt [00:32:34]:
And so if we can eat and sleep at the same time, that really leads to a more healthy, rich, robust microbiome. So the timing of eating really impacts the microbiome's ability to control insulin. It determines how it produces energy. So does this mean, okay, well, I have to do intermittent fasting in order to get better gut health and therefore better metabolic health. Well, maybe not. Maybe you just need to eat at the same time, exercise at the same time, don't over train. Overtraining is a big stressor. Try to get to bed at the same time every night, get enough sleep.
Erin Holt [00:33:12]:
All of those things can also contribute to a healthy microbiome as well. Right? So we're not overlooking the basics. We're not skipping steps. We're not skipping the basics and jumping right to intermittent fasting. Hey, I'm not going to sleep. I'm going to eat a trash diet. I'm going to over train or not move my body at all, and then I'm just going to sprinkle some intermittent fasting onto the situation, and all is, well, not how it works. Okay, yes, fasting has benefits, but you still have to be doing the fundamental building blocks.
Erin Holt [00:33:46]:
The basics. Another pro of intermittent fasting is autophagy, which I mentioned earlier. Autophagy essentially means self eating. It's our natural detoxification system of our cells.. So cell material is recycled, it's repaired, or it's destroyed. And this is autophagy is the body's mechanism of getting rid of all the broken down old cell machinery, organelles, proteins, cell membranes. It's a regulated, orderly process to break down and recycle cellular components. We want to get rid of the garbage, right? So this autophagy is one of the ways that we get rid of the garbage. Because if we continue to accumulate old, faulty, broken down, crummy proteins, we can see this play out as disease states, Alzheimer's disease, cancer.
Erin Holt [00:34:46]:
Right. So we need to have this, this, this detox system, this clearing out system in the body. Now, autophagy, normally and naturally happens when we're sleeping. So you don't have to intermittent fast to get autophagy, but it happens when we're sleeping because that's when we're fasting. Right. Most of us aren't eating in the middle of the night. Most of us are. We go to bed, we don't eat, and so we're fasting.
Erin Holt [00:35:15]:
Now, if insulin goes up, glucagon goes down. If insulin goes down, glucagon goes up. Okay, so it's an inverse relationship between these two hormones. As we eat, insulin goes up, glucagon goes down, and then when we fast, when we don't eat, insulin goes down and glucagon goes up. And it's this increase in glucagon that stimulates the process of autophagy. Might be too many details for some of you guys, but I also know I have, like, a lot of nutrition geeks that listen to the show, so I'm always trying to sprinkle in the mechanism of action where I can. It can also promote autophagy in the brain, which is very protective against cognitive decline and neurodegenerative disease. That's something that really should be on just about all of our radars because it's something that is rising.
Erin Holt [00:36:15]:
Now, again, Satchin Panda is that leading expert in the field of circadian rhythm research. And he says that we have a circadian rhythm for calorie consumption and metabolism the same as that we do for sleeping and waking. Right. Meal timing can optimize liver function. It can optimize the microbiome, like we talked about a little bit ago. And it can also optimize digestion. It's good for fat metabolism, insulin sensitivity, mitochondria function, that's energy, immune function, microbiome diversity, and it can lower cancer risk. And Panda says that it's best to keep calories in an eight to twelve hour window every day.
Erin Holt [00:37:07]:
And it's this circadian system, this internal biological clock, that might explain why the benefits of time restricted eating appear to depend on the time of day. Because all of those things glucose, fats, energy, metabolism, they're all regulated by this circadian system. So it upregulates them at some times of day and it down regulates them at others. So in humans, insulin sensitivity, beta cell responsiveness. So insulin is produced by the beta cells in your pancreas. So beta cell responsiveness and the thermic effect of food are all higher in the morning than in the afternoon or evening. So this suggests that human metabolism is optimized for food intake in the morning.
Erin Holt [00:38:00]:
It's kind of different than a lot of the things that we hear and a lot of the different approaches to intermittent fasting. Right. Studies in humans show not so, not animals. Now we've. We've moved to humans. Studies in humans show that eating got in alignment with circadian rhythm in metabolism by increasing food intake at breakfast time and reducing it at dinner time, improves glycemic control, weight loss and lipid levels, and can also reduce hunger. So, wow, that just flipped a lot of things on its head. Right.
Erin Holt [00:38:36]:
I think the point, or not the point, but a point to think about here is you can find evidence of whatever you're looking to find evidence for. You really, really can. We still need that ability to run this information through our bodies, maybe try some different things on for size and say what works best for me? Because there's definitely data to support waking up, eating a full meal, and then letting your eating taper off throughout the course of the day. Right. There's definitely data to support that. And yet a lot of people do intermittent fasting by skipping breakfast. And maybe they feel really great, too. So what works? What approach works for your body? And ultimately the one that makes you feel the best and the one where it's not impacting health in a negative way is going to be the best approach for you.
Erin Holt [00:39:37]:
But something that doctor Stacy Sims says is that I kind of get a chuckle out of this. Not eating for 12 hours between dinner and breakfast is not intermittent fasting. This is normal. We've just become so accustomed in our culture to eating around the clock. Food is everywhere. Many of us are overfed and we're undernourished because even though we're eating around the clock, it's low nutrition food. Right. It's a lot of the processed sugars, it's a lot of the refined carbohydrates.
Erin Holt [00:40:12]:
I did a, I did a poll on instagram this week. Maybe you answered my questions. Thank you so much if you did. And I was wicked surprised to see how many people, and this wasn't like, this wasn't a poll, like, asking, is sugar a problem for you? Like, this wasn't a leading question, people. I was like, what's your biggest health struggle? And people were like, sugar, sugar. I have a hard time giving up sugar. It's everywhere. It's everywhere.
Erin Holt [00:40:38]:
So, and it's hard when we're eating a high sugar, high refined, highly refined carbohydrate diet, it's hard to walk away from it because it's spikes our blood sugar, and then we get a subsequent crash. So then we feel really hangry, we feel very hungry, we feel very low energy, and we're reaching for the next thing. And, hey, guess what's there? It's the sugar, right? So this is one of the reasons that I created the Carb Compatibility Project to put a stop to this kind of interrupt that process to replace the low nutrient food with high nutrient dense food and help to regulate your blood sugar so we can stop this, this vicious cycle of up, down, up, down. Whoops, one of my crystals just got. Just fell over. I wonder if that's a sign. Maybe that's a sign to wrap it up. I can't. I'm gonna keep pushing through.
Erin Holt [00:41:31]:
We're only at 40 minutes. So let's talk about some conditions where fasting can be helpful. So, specific conditions where fasting might be something to consider. Fasting and cancer. I am not a cancer expert, but there's some research to indicate that this could be helpful. I please, please, please pursue this under the care of a doctor. I'm just reporting research. I have exactly zero clinical experience with this.
Erin Holt [00:42:06]:
So this is not a. Well, Erin Holt told me to do this situation. It's just presenting data. You need to take this little nugget that I'm about to give you and do your own research, and also speak with your oncologist and speak with your own physicians about whether or not this approach makes sense for you. It's been determined that fasting can play an important role during cancer treatment and progression through the regulation of insulin like growth factor one, as well as other growth factors. It's also been shown that fasting would enhance the chemotherapy effect in cancer patients, selectively protects normal cells in organisms from chemotherapy toxicity, while simultaneously sensitizing tumors. Fasting can theoretically inhibit several critical pathways in the development and progression of cancer while simultaneously causing malignancies more sensitive to treatments. For instance, chemotherapy and radiotherapy.
Erin Holt [00:43:07]:
I'm going to link to a couple of resources where I got that information, but I just didn't feel. I wanted to at least mention that on the show. So this is a more comprehensive deep dive. Right. Another. Another place where this can be helpful, where intermittent fasting can be helpful is if you have significant weight loss. Significant weight loss. We're going to talk about what that means in part two. Okay.
Erin Holt [00:43:43]:
Significant weight loss, plus unhealthy biomarkers. And what I mean by this are markers of metabolic issues. So let's do a spotlight on insulin right now. I posted about insulin this week, and some people are like, what the hell's insulin? So, like, okay, let's back up a couple steps. Let's talk about insulin. Insulin is a hormone produced and secreted by the beta cells in the pancreas. It directs blood sugar into the cells to create energy in the form of ATP. That's so important to note.
Erin Holt [00:44:15]:
Blood sugar doesn't just, like, do. It is not just, like, hanging out in the bloodstream, like, what's up? What's up? What's up? I'm gonna do some jobs. Uh uh. It has to get inside the cell in order to generate energy, in order to generate that sweet, sweet ATP. And the only way it can get inside the cell is by insulin. Insulin plays this massive role. It takes sugar out of the blood, and it directs it into the cell, puts it inside the cell.
Erin Holt [00:44:45]:
Now, insulin resistance is when glucose, blood sugar cannot get into the cell because insulin receptor sites are no longer responding to insulin. It kind of becomes, like, white noise. Insulin is being pumped out, but that it's not able to dock to receptor sites. So the blood glucose stays in the blood. It's just cranking around in the blood, and it can't get inside the cell. Can't get inside the cell to make ATP and do its job. Insulin resistance is usually due to chronic overuse of sugar and refined carbs. Right.
Erin Holt [00:45:24]:
What we were just talking about. So much of this metabolic dysfunction is. Comes back to diet and lifestyle. Diet and lifestyle, diet and lifestyle. Right? How do you live your life? Do you sleep? What's your stress like? Do you meditate? Do you move your body? Do you eat good food? All of this is so gosh darn important and cannot be overlooked. So, how it. How it usually goes is that we eat a diet high in sugar, high in refined carbohydrates, insulin levels. So when we do this, this increases blood sugar.
Erin Holt [00:46:01]:
Right. And insulin levels also increase. Because insulin responds to blood sugar. Blood sugar spikes. Insulin spikes. So insulin levels increase in the bloodstream. And sometimes. Sometimes we can overshoot insulin, which can then lead to low blood sugar.
Erin Holt [00:46:20]:
So this might happen before you get to insulin resistance. What might happen is you. You know, like, I eat a bagel for breakfast. High blood sugar, insulin spikes. It spikes a little too high, so it grabs too much of the blood sugar, puts it into the cells. So now we have a low blood sugar picture. So now we feel kind of, like, weird and shaky and a little irritable, and, like, wacky, maybe headache, maybe a little dizzy.
Erin Holt [00:46:45]:
And then we get hungry a couple of hours later, right, because we need more blood sugar. And so then we reach for the next high carbohydrate snack or meal. So this can go on for years. It's not an either or. It's not either you have low blood sugar or you have high blood sugar. You can have fluctuations throughout the course of the day. And this can go on for years and years before you hit an insulin resistant picture.
Erin Holt [00:47:11]:
So that's one of the reasons that I take low blood sugar so seriously. Like, we gotta get. We gotta address that. We can't just let that run rampant. So over time, cells can become resistant to insulin. Receptor sites on cells are blunted from that constant exposure to high insulin release. Glucose can't get into the cell. So glucose stays high in the blood.
Erin Holt [00:47:32]:
Insulin might stay high in the blood. And so if insulin's high, the pancreas. Pancreas is going to be like, well, we don't. We don't need to make anymore. So if the pancreas is going to decrease insulin production, then blood sugar cannot be cleared out of the bloodstream. And this is. This leads to type two diabetes. When glucose is just hanging out, cruising around the bloodstream, it has to go somewhere.
Erin Holt [00:48:00]:
It can't just stay in the bloodstream indefinitely. So it goes to. Usually goes to one of two places. It's oxidized into free radicals. This is not good. This is accelerated aging. This is damage to DNA, which can lead to disease and cancer. And glucose can also be shunted into triglycerides.
Erin Holt [00:48:21]:
Right? So this is why triglycerides will go up with insulin resistance. This is one of the things to look at if you're wondering if you're part of this picture. How are your triglycerides? Are they high? Yeah. This might be part of your picture in doing this. Putting glucose into triglycerides is a very energy demanding step. And this is why you feel fatigued after you eat a meal. When you have insulin resistance, you eat a meal and you're like, I'm really tired. I could take a nap.
Erin Holt [00:48:53]:
I need a cup of coffee. I gotta, like, give me some giddy up. So insulin resistance is a very pro inflammatory state. It creates oxidative stress. These chronic insulin surges turn on inflammatory pathways and reactions in the body. This inflammation leads to even more insulin resistance. So it's a very constant state of chronic systemic inflammation.
Erin Holt [00:49:20]:
Once you get to this point. Now, I'm just going to kind of go through some, going to go through some, seeing how much time we have here. So much more to talk about. Some signs and symptoms of having high blood sugars and insulin resistance, because I think it's really important. Feeling fatigued and drowsy after meals. I just said that one. Intense cravings for sweets, especially after meals, you're like, I need something sweet. And then eating the sweets doesn't relieve your sugar cravings.
Erin Holt [00:49:59]:
And in fact, eating sugar can actually make you crave more sugar craving breads and other high carb foods. Constantly hungry. Just really can't feel satiated, getting hangry or lightheaded if you skip meals. General fatigue. Just kind of feeling like low grade fatigue all the time. Maybe some migrating aches and pains, needing caffeine to make it through the day because you have that fatigue. Visceral fat, abdominal fat. If your waist girth is equal to or larger than your hip girth, that's a big one.
Erin Holt [00:50:36]:
Frequent urination. If you're peeing a lot. If you have increased thirst. These are signs, big, big signs that you're looking at a pre diabetic or even diabetic picture. If you have difficulty losing weight. Okay, so if, you know, if you have one of those things, I'm not saying you have insulin resistance. If you have a lot of those things, it's something to look into. So how would you know? There's certain things to look for on your labs. We're going to look for a high hemoglobin A1C, a high fasting glucose, a high fasting insulin, and then a homa ir score. That is the marker of insulin resistance that's emerging. If it's over two, it means that you're using a lot of insulin to try to regulate glucose.
Erin Holt [00:51:31]:
Now, insulin levels are not something that are routinely checked, but insulin is a key player before someone develops impaired fasting glucose or impaired glucose tolerance. So we really should be measuring insulin because it gives us a lot more information. If we're just relying on fasting glucose alone, it will under diagnose insulin resistance. So I'm going to talk about more of this concept and specific labs and markers to ask your own doctor for. That's part of what we're going to do in the Carb Compatibility Project in that module. A little bit of a deeper dive on this stuff. And what levels are normal and what levels are optimal. What are we shooting for all of that? All of that kind of stuff. I am just seeing, as I mentioned earlier, more and more of this with my perimenopausal and postmenopausal ladies.
Erin Holt [00:52:32]:
I do, in Your Hormone Revival, check all of these markers. Because glucose metabolism and blood sugar go hand in hand with hormones. There's no separation here. Give someone a protocol in Your Hormone Revival for their hormones. We're always addressing blood sugar. We're always taking into account issues with blood sugar. We have to. There's, again, I can't.
Erin Holt [00:52:59]:
I can't fix your hormones for you if blood sugar is unstable. And when I. When I realized this, when I truly understood how important this was in clinical practice, that's when I developed the Carb Compatibility Project, I was like, oh, dear. We need. We need to. We need to do this. Like, we all really need to be working on this insulin. One small example that I'll give you, because so many people talk about cortisol.
Erin Holt [00:53:29]:
Insulin and glucose problems can drive up metabolized cortisol. So if you've done a DUCTH test and you've seen that your metabolized cortisol dial is high, we have to question, and hopefully, whoever ran the DUTCH test on you was willing to. To question. They're not just saying you have high cortisol. They're also saying, okay, let's figure out why, what's driving up that metabolized cortisol, what's making your body make more? And so when we. When we have all the data, we can start to really put together different pieces of the puzzle here. Okay? Some other biomarkers that I want you to be aware of.
Erin Holt [00:54:16]:
This might be the time to, like, you know, go look at your old labs or think about what your doctor has talked to you about, because here's the deal. The prequel to severe metabolic disease, severe metabolic disease being type two diabetes, metabolic syndrome is really this insulin resistance picture and elevated lipid. So if you have insulin resistance, if you've been told you have high triglycerides, the time to act on it is right now. It's not when it becomes a problem. There's a diagnosis called pre diabetes, and a lot of doctors will say, there's no pre anything. You got to get that in check right now.
Erin Holt [00:54:57]:
You don't wait till you have a diagnosed disease. You. You do work now. So, in order to be diagnosed with metabolic syndrome, you have to meet three out of the following five criteria. So if you have a waste circumference of over 35 inches for women or 40 inches for men because that visceral fat is its own endocrine organ. Low hdl cholesterol, less than 40 for men, less than 50 for women, high triglycerides, anything over 150, high blood pressure, anything over 130, over 85, and a high fasting glucose, anything over 100. This is a lot of people. This is 35% of US adults.
Erin Holt [00:55:46]:
That's over a third of the adults in the US. And 50% of those older than 60 meet this criteria. So half of Smericans over 60 meet this criteria. So, you guys, metabolic syndrome is no joke. It's a massive problem. It's a very common problem, okay? By the, some time somebody is diagnosed with this, they're five times more likely to get type two diabetes, two times more likely for cardiovascular disease, the number one killer, two to four times more likely to have a stroke, and three to four times more likely to have a heart attack. So I'm not playing around with this stuff, like, right, we, this is something that we all have to really pay attention to. And then really, there's any other situation where there's metabolic dysfunction.
Erin Holt [00:56:37]:
These are all good candidates for thinking about not only cleaning up your diet through something like a Carb Compatibility Project, but also maybe peppering in some insulin resistance. Post menopause is a big one. Doctor Kerry Jones calls perimenopause reverse puberty because your hormones are so up and down, up and down, up and down. Right. That's why you feel so junky. There's dramatic changes in estrogen and progesterone and testosterone, and that really is what causes the hot flashes, the night sweats, the sleep problems. Estrogen and progesterone affect how your cells respond to insulin. So after menopause, changes in your hormones can trigger fluctuations in your blood sugar levels.
Erin Holt [00:57:26]:
It affects insulin, blood sugar regulation, hunger, satiety hormones, and you become more insulin resistant. And this is, this was a really big aha moment for me, honestly, in this round of Your Hormone Revival, because I had a lot of women who were either going through the change or after the change, and I just keeps, kept seeing the same thing consistently on labs. Higher insulin, high blood glucose, high A1C, and high metabolized cortisol. And this is exactly what's going on. So I had a listener write in, Diane Lamprey. Hello, Diane. She wrote, I would love to hear more about nutrition to support your brain health in menopause. Would you consider doing a podcast on this? Love the information you share.
Erin Holt [00:58:19]:
Really. What I have to say is that brain health has everything to do with blood sugar regulation and inflammation. So you got to get those two things in check. Menopause. If we're talking about being more insulin resistant in menopause, this means that we have to be more hyper aware of our blood sugar, of our metabolic control. This is going to have everything. This is going to make a massive, dramatic impact on your brain. So I would recommend doing a program like the Carb Compatibility Project and maybe looking into whether or not intermittent fasting feels right for you, because that can be very neuroprotective during this time.
Erin Holt [00:59:08]:
Some types of PCOS. Now, I say some types because PCOS falls on a spectrum. Sometimes it involves insulin, sometimes it doesn't. Sometimes it's an adrenal problem. Insulin resistant PCOS is the most common driver because chronic insulin surges activate an enzyme in the ovaries that cause them to produce testosterone, which then throws off follicle stimulating hormone and luteinizing hormone. And this can lead to dysfunctional menstrual cycles. You can miss your periods.
Erin Holt [00:59:40]:
You could have anovulatory cycles. This can all lead to infertility. But I will say how you treat PCOS is going to be very different based on what kind you have. So you have to make sure that you're doing the appropriate testing. It really infuriates me when people narrow down PCOS to a weight issue, like, you just need to lose weight. It's actually not the case in many, many cases. So if you have more of an adrenal PCOS picture or if it's really more of a thyroid thing, then intermittent fasting wouldn't be a good approach for you. But if you do have insulin resistant PCOS with that higher androgen picture, then it does make sense to follow some of this advice.
Erin Holt [01:00:22]:
Doing a more low carb approach may be peppered in with a little bit of intermittent fasting. Okay, so what do we do for these conditions? How do we reverse insulin resistance? We're already at an hour here, so I'm gonna. This is gonna be the last part. This is gonna be part one. I'm gonna close it out, come back next episode with part two. So let's close it out here, because I do want to leave you guys with some tangible things to implement if this sounds like your situation. You need to lower sugar. You have to lower refined carbohydrates.
Erin Holt [01:01:01]:
I know I'm the bad guy for saying this, but it's the truth. And I know this will piss some people off, but I mean, if you could do it while still eating your lollipops, more power to you, but chances are you probably can't. So no cakes, cookies, granola bars, fruit juice, dried fruit, maple syrup, honey, anything with added sugars or sweeteners, just going to get you more of the same. The Carb Compatibility Project is literally my prescription for people with the insulin resistant picture with a high blood sugar picture. I don't just create programs based on what I feel like teaching. I've tried it before, it's a failure. I create programs based on the areas where there's a massive need for them in the CCP is actually written into all of my hormone protocols for people with high blood sugar.
Erin Holt [01:01:53]:
That's how, how much this program works. If you do it, if you actually follow the plan, it's a very, very good plan for high blood sugars. It can also really help anchor low blood sugars. Remember that fluctuation, that rollercoaster thing? It's a plan that's developed for just good metabolic control. Magnesium is something to consider. Magnesium deficiency has been associated with insulin resistance and increased risk for type two diabetes. Magnesium also plays a role in adrenal health. The whole HPA axis picture, it supports progesterone, it lowers inflammation, it can improve sleep.
Erin Holt [01:02:36]:
I love magnesium. There's really so much more supplemental help that I use in my practice that I use in Your Hormone Revival. I do reserve that stuff for clinical practice rather than just kind of throwing out like, well, try this Internet stranger. I'm not really a huge fan of that. Magnesium is one that I think that everybody could be on. I don't think it's a problem, but we're going to get into a little bit more detail of the nutraceuticals and the botanicals and the vitamins and the specific nutrients in my Carb Compatibility Project this round. So if that's something that you're looking to do, that more functional medicine approach, food as medicine approach, then join the CCP. You also have to sleep.
Erin Holt [01:03:22]:
Circadian rhythm, your body clock has a profound effect on glucose metabolism and insulin sensitivity. Sleep deprivation creates metabolic changes. Stress hormones go up. Glucose goes up. Insulin goes up. Hunger hormones go up. The calorie equivalent of sleep deprivation is between 385 to 549 calories a day. Yo, yo, yo.
Erin Holt [01:03:53]:
You don't need to go on a restrictive calorie diet. You just need to go to sleep, okay? That's a massive amount of calories. Sleep deprivation. So nuts. Get some sleep. A small study showed a sleep deprived group. They slept for 1 hour and 20 minutes less than the control group each day. Consumed an average of 549 additional calories each day.
Erin Holt [01:04:19]:
So that's just an hour and 20 minutes less. Another larger study, the sleep deprived participants had a net energy gain of 385 calories a day, which is equivalent to the calories about four and a half slices of bread. Right. So you got to get your sleep on. Exercise is a big one. Exercise can improve insulin sensitivity. Weight training is really, if you have insulin sensitivity or, excuse me, insulin resistance, you got to start weight training. And if your energy allows for it, you got to work in high intensity interval training.
Erin Holt [01:04:56]:
HIIT training because it increases glucose demands, which is really good news if you have high blood sugar. Interval training also activates something called the AMPK pathway. This is the central pathway for managing blood sugar issues, for managing insulin, for managing a healthy metabolism. It also determines whether we burn fat or store fat. The more intense the exercise, the faster you clear insulin and glucose from the blood and the longer the effects last. So both intensity and frequency matters. You got to really work hard for that. And so that is why I was really thinking about how to, during this time, I really want to get across to people how important this stuff is, and I really want to help people get this under control.
Erin Holt [01:05:47]:
So what other resources could I throw at people? And that's why we included the weight training in the interval training into the CCP this round is so you have this one stop shop to, like, reset your metabolism. I'm so grateful to Blaze Yoga into Steamhouse yoga. They really came through with some online content for you guys. It's going to be awesome. So you have to check it out. So we're doing it, you know, we're doing diet, we're doing lifestyle, we're doing exercise. We got it all in one package for you.
Erin Holt [01:06:21]:
Now we're going to come back next week with part two just because, I mean, I'm already way over an hour for this one. And in part two, I'm going to talk about contraindications. Who shouldn't try intermittent fasting, who should stay away from intermittent fasting. Hormones, talk about the thyroid, talk about leptin, how to start intermittent fasting. If you're like, hmm, okay, so, like, I'm doing a lot of this stuff already. I think that I could work in some fasting. How do I start? What is the way to approach it? We're gonna get all into that goodness next week, so come back and check it out then. Thanks for joining us for this episode of the Funk'tional Nutrition Podcast. If you'd like to submit a question to the show, fill out the contact form@erinholthealth.com.
Erin Holt [01:07:16]:
If you like what you hear, don't forget to subscribe and leave a review in iTunes. Take care of you.
