342: How to Properly Fast: Women vs. Men

Today's guest is Cynthia Thurlow, and s he is here today to talk about intermittent fasting for women, especially regarding weight loss – and we’ll uncover reasons why we need to consider hormones, sleep and self-care to optimize results.

Cynthia is a globally recognized expert in nutrition & intermittent fasting, and her TedX talk on intermittent fasting has been viewed nearly 6 million times – you are about to learn why.

More about Cynthia Thurlow:

Cynthia Thurlow is a globally recognized expert in nutrition & intermittent fasting, highly sought after speaker, CEO and founder of Everyday Wellness Project. She's been a nurse practitioner for 20+ years, is a 2x TEDx speaker: her 2nd talk on intermittent fasting has been viewed nearly 6 million views. She has been featured on ABC, FOX5, KTLA, CW and in Medium and Entrepreneur. She's also the host of Everyday Wellness podcast, which was listed as “20 Podcasts That Will Help You Grow in 2020” by Entrepreneur magazine.

On April 14, 2020, Dr. Danenberg was appointed the Chair of the Periodontal Committee for the IABDM. He also created the Certification Program for Biological Nutritional Dental Professionals offered by the IABDM.

Show notes:

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Transcript:

Dr. Pompa:
The question is is do women struggle with intermittent fasting, fasting, or low-carb diets more so than men? The answer might surprise you. What to do in and around these topics that I just mentioned I think will surprise you as well. This expert has six million views on her TED Talk, and after this interview, you’re going to see why.

Ashley:
Hello, everyone. Welcome to Cellular Healing TV. I am Ashley Smith, and today we welcome nurse practitioner Cynthia Thurlow. She is here today to talk about intermittent fasting in women, especially regarding weight loss, and we’ll uncover reasons why we need to consider hormones, sleep, and self-care to optimize results. Cynthia is a globally recognized expert in nutrition and intermittent fasting, and her Tedx Talk on intermittent fasting has been viewed nearly six million times, which is incredible. I cannot wait for this. Let’s get started and welcome Cynthia Thurlow and, of course, Dr. Pompa to the show. Welcome, both of you.

Cynthia:
Thanks for having me.

Dr. Pompa:
Yeah, this is going to be such a great conversation, one of my favorite topics, right? Let’s go right after it. I mean, let’s face it. Women, if we would really—and I’ve polled audiences I’m sure like you have, right?

Cynthia:
Mm-hmm.

Dr. Pompa:
It’s this unspoken thing, especially in the world of ketosis and low carb and fasting. It’s like how many women struggle more so than you feel your husbands, or boyfriends, or men in your life? The hands go up. Cynthia, obviously, there’s something real here, but yet, people don’t talk about it. Why is it more challenging for women than men?

Cynthia:
I mean, I would say that when I’m speaking in groups or even within my own programs the one thing that’s consistent is women have cycling hormones. We are not consistent day to day, hour to hour, and we’re much more sensitive to the stressors that we experience in our personal lives. Whereas men can jump into the intermittent fasting pond, if you will, like a duck to water, women, it’s not always that easy. Now, I do find there are definitely women that as soon as they clean up their diets and they are mindful of the quality of foods that they’re eating and they’re sleeping well, then they can easily do it, but more often than not, there’s a lot of flexibility that needs to be stressed. I have to remind people that there’s no one-size-fits-all philosophy, that they may need to change their strategy around the time of their cycle. If they’re postmenopausal or they’re perimenopausal, goodness, things get much more interesting at that stage of life. I find that the women that have the easiest transition are the ones that are little less hard on themselves. I think rigidity as it applies to intermittent fasting as a strategy is often times a recipe for disaster.

Dr. Pompa:
Couldn’t agree more.

Cynthia:
I’m sure you probably have patients like this, the people who over exercise. They’re super restrictive with their diet, and then they’re really rigid about their dogma as it pertains to intermittent fasting are the ones that—particular personality type that I feel like they are the ones that really—they’re so focused on whatever that goal is, generally weight loss, that they almost undo all the good that they’re doing by being so rigid.

Dr. Pompa:
Yeah, no, I find the same thing. Obviously, I talk about it in my book. You had sent me a text saying, gosh, why don’t—many people talking about this? I was talking about weekly diet variation, monthly, changing it around your cycle and how that’s more needed for women. You resonated right to it because you see the same problem I see, obviously. Let’s be clear. We’re both saying that fasting, intermittent fasting, low carb is possible for women. However, there needs to be changes made. We’ll discuss more of those in a minute.

I almost want to back up a second. We have new viewers often times that are like intermittent what? Just give a brief explanation. I couldn’t help but jump right in because of your TED Talk and your knowledge around intermittent fasting. What is it intermittent fasting and even why does—why are people, so many people attracted to it?

Cynthia:
I mean, intermittent fasting is not something that’s new or novel. I mean, it’s been around since Plato, Hippocrates, and biblical times, so I like to remind people that it’s the way our bodies are designed to work. We spend more time in a fasted state when we’re not eating, it’s that simple, than we do when we’re eating. In our overconsumption culture that we live in, I think the average American—I read a statistic the other day. They’re consuming either a sugar sweetened beverage or food 16 to 17 times a day, and that’s not the way our bodies are designed to thrive. Really, intermittent fasting is periods of time when you’re not eating and periods of time when you’re eating and the emphasis on more fasting and less feasting, and it’s really that simple.

I think people are attracted to it because now it seems novel. It seems new. Over the last I would say five or ten years, you’re seeing more and more people in the media and healthcare providers as well that are utilizing it as a strategy, and I would argue that it is one of the most important strategies that we should be using with our patients. We don’t need more pills. We don’t need more procedures. What we need are strategies that people can embrace throughout their lifetime and be able to do that and feel empowered. I think that’s really critical as well. We don’t want to feel like everything that we’re doing with our bodies needs to have an ICD-10 code on it in order to…

Dr. Pompa:
I mean, you said hormones play a big role in why women might have more difficulty adapting to this way of eating. It doesn’t make it wrong for them. It just makes it—maybe perhaps they need some different strategies, so let’s discuss those. One of the big ones that I know you discuss a lot about is sleep, right? It’s like, obviously, sleep impacts our hormones. How does this impact a woman in low-carb or intermittent fasting, and what can they do about it, more importantly?

Cynthia:
Yeah, I often times will remind women, if I can’t get you to sleep, I can’t get you to lose weight, so sleep is absolutely, positively one of the first things we will discuss. If a woman is sleeping well and she starts doing intermittent fasting and is low carbing—it’s now a verb in my mind, low carbing, and she suddenly starts to struggle with sleep. That’s a reminder that we need to dial in. What are the macros like? Are you eating enough calories, protein, and healthy fats during the day? Are you being mindful of where you are in your menstrual cycle? Are you dialing in on stress?

We know that people can wake up either in the middle of the night because their adrenals are stressed. Maybe their blood sugar’s low. It could be for so many reasons, or people are so engaged in electronics before they go to bed. They don’t have good sleep hygiene, and that can be really challenging for women throughout their lifetime. I see, cycling women, that can often times be the reason. Then perimenopause and menopause is a whole other situation where sometimes we’ll find, as women are having more fluctuating levels of progesterone relative to estrogen, they can start to struggle with sleep. It could be from insulin resistance. There’s so many issues that can drive that.

I always look at it as are you sleeping before you start intermittent fasting? If the answer is yes, then intermittent fasting is a go. If you’re not sleeping before you start intermittent fasting, then we have to dial in on that first. Intermittent fasting is considered to be a hormetic stressor, a healthy stressor, but if you’ve already got too much stress, adding more gasoline to the fire is not beneficial so really looking at those things. Again, I want to emphasize, if you aren’t sleeping, you can’t lose weight, and that can be related to a variety of things. A lot of it can be blood sugar, insulin resistance. It can also be relevant to that balance of ghrelin and leptin, which is the appetite satiety cues, which I know—I always remind people, when I had babies and I was breastfeeding and I was up all night long or it seemed like I was up all night long, what did I crave in the morning? It wasn’t broccoli. I craved sugar, and so I remind people that, if you’re not sleeping well, you’re not going to crave high quality foods.

Dr. Pompa:
I mean, you said something that’s so true. There’s a lot of different reasons why you’re not sleeping well, whether you can’t get to sleep or wake up in the middle of the night, can’t get back to sleep, blood glucose to certain hormones, cortisol, stress survival mechanism. With all that said, all my viewer wants to know is what can I do about it? You’re going to say, well, it depends on the cause. Go through some of the cause-solution relationships.

Cynthia:
Yeah, so first and foremost, I always start with the food piece. If you’re not getting enough calories in within your feeding window, maybe you’re not getting two good sized meals during your feeding window. The other piece with that is your dinner. I mean, sometimes you have to adjust your macros, meaning your protein, fat, and carbohydrates. Now, if you’re low carb, I know for myself, I can tell when I’m too low carb. I mean, I’m very attuned to how my body feels when I exercise. Maybe I’ve gone a little too low carb, and I need to liberalize things a little bit.

Being very mindful of how you’re structuring your meals. Sometimes people need to have—at the end of their fasting-feeding window, they need to have a little bit of a—I don’t want to call it a fat bomb because it gives a connotation that it’s dessert, but sometimes maybe you need to have a scoop of almond butter. Maybe you need to have a handful of nuts. Maybe you need to have some—something that’s a little bit of protein before you get to bed so that you’re ensuring that your body has plenty of fuel to be able to get through the night. That can sometimes be an issue when people are first utilizing intermittent fasting as a strategy, and they’re not fully fat adapted so using fat for fuel as opposed to sugar. That’s number one.

Dr. Pompa:
Yeah, let me just say something on that. You’re right; when people aren’t fully fat adapted, they’re—a healthy fat adapted person has the ability to burn fat through the night, and therefore, their brain gets plenty of energy. Their cells are getting plenty of energy. If that’s not the case, your brain needs glucose, freaks out, throws cortisol up to get the glucose up. Then, of course, you wake up, but your body survived itself. To your point, often times, doing something a little fattier before bed or protein sometimes can get you through that night until you get healthier. Toxins play a lot of role in that too, why someone can’t get really good fat adaption, and they can’t make it through a night. To your point, that is an issue.

Cynthia:
Yeah, absolutely. Sometimes I find that people are over exercising. They’re not allowing themselves to have some down time. I mean, those rest days when you’re working out in a strenuous program are critical. Sometimes people are just—their bodies are so worn out that they’re not going to be able to sleep properly. They’ve really just overtaxed their bodies. I think it’s important that people differentiate. They’re honest with themselves. What’s my food like? How much activity did I do? How is my stress dialed in?

I’m going to use a really perfect example. Given COVID and social distancing over the past five plus months, I’ve seen people who normally have no issues with sleep that all of a sudden start to struggle with sleep. A lot of it’s cortisol. It’s that survivalistic mechanism that you mentioned. People are fearful. They’re fearful am I going to be able to get to the grocery store? What’s going to go on with my kids? What’s going on with my job? I mean, just baseline survivalistic mechanism.

That stress piece has to be managed. Sometimes it can be as easy as do you get off of electronics? Are you meditating before bed? I used to think that was really woo-woo and silly, but there’s real sound reasoning how important that is. Making sure that in the morning you’re getting light exposure. Making sure that you’re not on electronics before bed. Making sure your room is cold and dark. If it gets really sexy and you have to wear a sleep mask like I do—I’m of that stage of life. I wear a sleep mask to keep all the light out. That could be beneficial.

Then I just say—we start to layer things in. There are specific adaptogenic herbs that could be helpful with helping to decompress before bed or having herbal tea or things that aren’t going to mess up your fasting window but can be beneficial. I think it really dials into sleep, the self-care piece, which I know you’re a fan of that terminology. We’re really looking at that in the food piece. That’s usually where I start. That’s typically where I start. Then I want to lastly just add in the hormone piece. Depending where someone is in their cycle, that can absolutely influence how well their sleep quality is, as upsetting as that can be. People say I sleep really well until the week before I get my period, and then all things are—things are completely different.

Dr. Pompa:
That’s one of the things in my book I talk about, the need for changing the diet often times right before your cycle. Whether it’s high carbs or high protein, there’s a lot of different hormone conversions and transitions that are being made and, therefore, different needs. Often times, five days of either high healthy carbs or protein depending on the person is the magic. Then the rest of the month it can really change you, and sleep’s one of the things that we know is a big game changer for people. You found similar things.

Cynthia:
Absolutely, and I think it’s also important for people to understand that we take sleep for granted until it’s not working properly. No, I’m serious. I never thought about sleep while I was in my 40s.

Dr. Pompa:
It’s true.

Cynthia:
Then, all of a sudden, I’m like what is this? Why all of a sudden is it—I feel like it’s a dog and pony show to make sure that my sleep’s ratcheted in. I use sleep as a barometer to really determine what’s going on? How well are we doing? It’s not related to a celebration where you’re excited, but the day-to-day sleeping and sleep hygiene is really critical. I think that one of the things that I’ve come to find out is that the influence of radiation and EMF is certainly something that’s not talked about enough.

We had a house evaluation, and it turned out that the amount of radiation coming from one appliance in my house was so much that we shut the Wi-Fi off at night. We removed the microwave. We did all these extraneous things to ensure that we were doing as much as we can. Sometimes you have to dig a little bit deeper if it persists. What could be driving cortisol to be waking you up at night, which, obviously, none of us want to have? For anyone that’s doing intermittent fasting, to just reassure everyone that you can successfully intermittent fast and sleep, but if you’re not sleeping, you need to figure out why.

Dr. Pompa:
Yeah, we mentioned toxins. We mentioned blood glucose, not being fully fat adapted. You mentioned light, getting good morning light, cutting off light before bed, screens and that source, which we know has an effect on melatonin, deep sleep period. You mentioned EMF. I’m just reviewing because you said a lot of things and really important things, turning off your Wi-Fi. Really, I mean, it’s a simple solution going down and just hitting the breaker. Obviously, you can mitigate the issues in your room. There’s a little bit more knowledge there, but if you hit the breaker, you’ve got it. The problem with that, maybe people would say, well, my clock doesn’t work. You shouldn’t need the clock anyway. That’s a whole ‘nother topic.

Anyways, you can put your phone on airplane mode next to your bed. This is with an iPhone. You can set this up to actually go red screen. When you turn your phone on, if you hit it three times, one, two, three, the screen goes red. How about that? Yeah, isn’t that cool.

Cynthia:
Oh, look at that.

Dr. Pompa:
Yeah, so don’t ask me now how to do that, Cynthia. My son did this. If you have a teenager in your house…

Cynthia:
Yes, I do.

Dr. Pompa:
He could go into your settings and go, oh—I’m sure it’s under screen. Who knows, brightness maybe? You can actually do that so pretty cool.

Cynthia:
They’re so amazing with technology.

Dr. Pompa:
Yeah, they are.

Cynthia:
My kids are always embarrassed. They’re like, “Mom, how do you not know that?” I’m like, “Well.”

Dr. Pompa:
I get it. If you have to get up in the middle of the night for something, you might—a light, that red light still works rather than a nightlight. You could check the time, whatever. Those are all great. Okay, did I miss any of those sleep tips? I just reviewed them.

Cynthia:
I don’t think so. I mean, I think the next level is looking at things like Muse or a BrainTap or looking at adaptogenic herbs. Then I start layering other things to really help people, but from a very basic perspective, I think we hit the big ones. I do find that if you work through most of those that will generally get through most of the ideologies for why people are struggling, and then the next level up is looking a little bit more deeply. Doing testing if that’s indicated and pulling out appliances. I laugh. I had my BrainTap sitting on my desk for the hope that I will use it before I go to bed tonight. It’s a visual cue to remind me to utilize it, but there’s all sorts of technologies.

Dr. Pompa:
For BrainTap, there’s a couple products like that out there. It’s like the blinking lights, right?

Cynthia:
Yes.

Dr. Pompa:
The auditory component, light has that big of an effect on the brain. I mean, it does and, therefore, sleep.

Cynthia:
It’s amazing.

Dr. Pompa:
A couple products that I could just throw out there for people, there’s a product that saved my life when I was sick, Seriphos.

Cynthia:
Oh, Seriphos is amazing.

Dr. Pompa:
Yeah, and it’s S-E-R-I-P-H-O-S, for people listening. It tapered down my cortisol, and again, I had high cortisol from toxins and different things. It’s not like you can remove the toxins in a day, right? Fact is is I needed something to help deal with that cortisol. I would take two, three before bed. If I woke up, I would take a couple more, and it would help. Then BIND is another great one just because—a lot of that cortisol rise in the middle of the night the Chinese call liver time between 2 and 4 a.m. Your body dumps bile at that time through the liver, and it’s a very toxic dump if you’re toxic. Then, phoom, your cortisol just goes through the roof, so you have something in there to catch it. It’s another little trick.

Some of the herbs that you mentioned—there’s a product on here called [Dream], or DRAM is how they say it, and it has some of the adaptogenic herbs. I know people will ask what the products are, and Ashley can put some of those in. Do you have any that you would recommend?

Cynthia:
I do. I like L-theanine, which is an amino acid. A lot of people that are struggling with that, they—it’s the anxiety piece, L-theanine. Relora is one of the adaptogens that I’ve gotten really very happy with, good results. I would say products like Ashwagandha has a good profile in terms of safety.

Dr. Pompa:
Yeah, that’s good.

Cynthia:
A lot of these are plant-based compounds that are designed to be very nourishing. Relora is derived from magnolia bark, so it can’t get much more natural than that. That seems to be where I’m tapering. I would say a couple people I’ve had some success with GABA. There’s a product by Designs for Health called PharmaGABA that I’ve been happy with. Again, you want to take that at the very end of your feeding window because it does have stevia. Sometimes, when we’re talking about supplements, you just want to be mindful of what’s in them to ensure that it’s not a sugar alcohol or stevia or something that could potentially impact your fasting window.

Dr. Pompa:
Yeah, so what does your intermittent fasting window look like? How do you vary it, change it being a woman?

Cynthia:
That’s a great question. I think, once people are fat adapted, I really encourage them to change things up. The average day, I probably do two or three 18:6s during the week.

Dr. Pompa:
Explain what that is for new people.

Cynthia:
Yeah, so it would be an 18 hours fasted with a 6-hour feeding window. However, I always have 1 day a week where I’ll just do a 24-hour fast, and I always ensure that it’s plugged on a day when maybe my eating window has been a little wider than it is normally. Maybe I got in three meals. Normally, if it weren’t social distancing, maybe I went out to dinner with my family or with girlfriends, and so I really want to just reset my body. Then, occasionally, I’ll do one meal a day. Again, it could be a 24-hour fast or 1 meal a day around a day that I’ve eaten more than I would normally, and I feel like that just gets me back on track. The point I want to make is that, when someone is fat adapted, I like to see things not being consistently and being rigid.

Dr. Pompa:
Yeah, me too.

Cynthia:
I think that’s really important. I think the flexibility piece needs to be stressed. Some people, they want to do a couple months of 16 hours fasted with an 8-hour feeding window or some variation like that, and that’s completely fine. I’ve been doing this for a long time, and my body just knows. Okay, I ate too much the day before, doesn’t happen very often these days. The following day I’m going to do something different. Our bodies are designed to have a little bit of variety. Just like we wouldn’t do the same exercise program every day, we want to make sure that we’re giving our bodies opportunities to adjust. It’s like you got to take an extra step. Okay, we’ll work with that.

Dr. Pompa:
Yeah, no, and I’m the same as you. I just take it as I feel it. In my book, I talk about starting with a 5-1-1, meaning 5 days of low carb, and then you have 1 day where you fast for 24 hours and 1 feast day. You almost have to plan them. Like you, I just go with them. There’s days where I’m not hungry. There’s days I’m hungrier, and I can just roll with it. We’ve been fat adapted for a much longer time than most people, so we can trust our innate intelligence on that.

Cynthia:
Absolutely, and I think it also gets you connected with what true intrinsic hunger really feels like. That’s something that a lot of people have never experienced, or it’s been so long since they experienced what it’s like to be really hungry that it frightened them. I just remind them. I’m like, “It’s very cyclical. You may get a hunger grumble at 7 a.m., but you might not get another one ‘til 9.” I said, “That’s the beautiful thing about green tea, or black tea, or coffee is that it’ll help suppress those cues, so you can just keep going.” I just remind myself, if I’m doing a longer fast and I’m getting hungry, I’m like I must need some green tea. It’s time for some green tea, and that’s just the way that I roll.

Dr. Pompa:
Yeah, no, exactly, I mean, that is a great strategy and even anything warm, actually. The Chinese used to do just warm water. It’s like that would curb appetite. Of course, add a little bit of salt, and it curbs it as well. Then green tea and other teas can be a great thing as well. I always say that, if something that raises your glucose, that can break your fasting window, right? You can test it. You can test it simply by testing your glucose ahead of it and then 30 minutes after just to see. Some teas, for example, caffeine related, may raise your glucose, and it could be for other reasons as well. It’s always a good idea to test.

Cynthia:
That’s a great point. I keep trying to decide if I’m going to get a CGM, a continuous glucose monitor, just really for data collection. I’m starting to see a lot of the low-carb crowd that are getting them, and they’re enjoying tracking their information because bio-individuality rules. For a lot of people, coffee works really well for them, and for someone else, it may not. It may bump up their cortisol and raise their glucose. I think that there’s value in getting that validation.

I think most of us, once we’ve been doing this long enough, everyone once in a while—I’ll give you an example. Last week I had a higher carb day. There were some rice noodles, which I don’t normally eat. I haven’t really done grains for several years because it just doesn’t agree with me, and it actually spikes my blood sugar. I had them, and then I went for a walk a couple hours later. About halfway through my walk, which is normal that I walk in the hilly part of my neighborhood, I was telling my husband—I was like I just didn’t feel good and so, sure enough, went home, tested my blood sugar. The reason why I felt so terrible after eating these noodles, even after the walk, was it spiked my blood sugar, which is not normally what happens to me, but I felt so poorly. I was so attuned to how I felt.

I think it’s important. If anyone’s curious to know, there’s a—Robb Wolf is one of those individuals that has a book called Wired to Eat that I sometimes will recommend to people if they’re interested in trying to determine what their carb tolerance is, if they’re trying to figure out if grains work for them or other types of carbohydrates. That can sometimes be very illuminating about figuring out your N of 1. What works for me may be very different for each one of us.

Dr. Pompa:
I mean, look, no matter what you eat, you’re glucose is going to rise. The question is is how high? If it’s going far above 120, that can be an issue and how long it takes to come back down. If it takes more than two hours to come back down, you’ve got a problem.

Cynthia:
Right, exactly.

Dr. Pompa:
A problem with what you actually ate, to your point, right? Glucose is simple. When people always say does my coffee work in my fasting window, my question always—I don’t know. Test it. Test your glucose right before and right after. If it rises up consistently after, then you probably should change something.

Cynthia:
That’s a great tip.

Dr. Pompa:
The hormone connection really is—when people would ask me, well, should women fast, I would say, well—I was in a culture in Africa, and the women were fasting. Obviously, this is not just that culture. This is something that women are able to do. What’s the difference of women in the US and women in other countries that fast? The answer has to be around hormones, but then let me ask you a more specific question. What is it that’s creating so many hormone problems in this country?

Cynthia:
Oh, that’s a treasure trove of answers. I think there’s many things. I mean, our Westernized culture, it’s the food, our highly processed stupid American diet, a little nod to Ben for that, stupid American diet so highly processed diet, exposure to toxins in our personal care products, environment, and food, the stress. Even if you have indigenous cultures that are fasting, I’m fairly confident that they rise when the sun comes up, and they go to bed when it gets dark. They’re not eating all day long, and they tend to really ascribe to a philosophy of what our ancestors did, whereas we live in a culture where we’re attached to devices 24/7. We’re accessible. We’ve got stress that is unmanageable for most people.

I think it becomes a combination of many, many things that create these hormonal disrupters. Like I mentioned, it’s things that we’re exposed to every day. It’s the stress of our environment, and I think that many, many things contribute to this. I think, when you think about highly processed food that we’re eating and we’re spiking insulin all day long, that’s making us fat. It’s this very toxic—it’s like a toxic stew that we are experiencing. If you’re eating all day long and you’re not getting enough sleep and your hormones aren’t properly balanced because of those two reasons alone, I mean, that’s contributory. Then you’re infertile because of the toxins you’re exposed to and because you’re insulin resistant. I mean, it’s this very kind of circuitous toxic stew that we exist in.

Dr. Pompa:
I agree, yeah. Do you think that women today carry a different burden, perhaps more burden than in the past, meaning that it seems to me—I’m not a woman. That’s why I’m asking you the question. The idea women have unique stresses today, some of which are sending their stress bucket over the edge just with their duties, their roles, things, is that true, and what would be some of the changes that would have created this?

Cynthia:
Yeah, I think there’s a lot of—actually, I talked to my grandmother about this when she was in her 80s, which was a long time ago. One of the things that she said was that she was the World War II generation, and in her generation, they did work, even though they had children. That was during the war, and that was part of the war effort. She said the difference was they weren’t attached to a computer, and they weren’t attached to a cellphone. Kids ran around outside. When they were cooking dinner, kids were out of the house, and they would make these meals. Women still had these more traditional roles.

I think what has evolved in our society is that women are expected to have it all. They’re expected to get pregnant effortlessly. They are expected to get back to their pre-pregnancy weight seemingly overnight. They’re expected to cook these nutritious meals, and they’re expected to have these career/be a stay-at-home mom. I think there’s a lot of intrinsic pressure on each one of us wanting to be the kind of perfect…

Dr. Pompa:
I was going to joke and say and the problem with that is what? I’m kidding. I’m kidding. That’s a lot. You’re right. I agree with you on that, though. I mean, it is true.

Cynthia:
There’s a lot. I mean, when I look at friends of mine that whether they’re stay-at-home moms or they have jobs outside the home, it’s impossible to get everything done and also take care of yourself. I think there’s guilt about advocating for self-care, and there’s guilt about saying I’m going to go to bed early because that’s what serves me best. There’s guilt if you’re not making the perfect Instagram worthy birthday party for your kid or the Pinterest worthy invitations for something. I just think there’s a lot of—there’s just a lot of extra pressure on women that is unique and through no fault of our own. I don’t think it was intentionally.

My mom’s generation was part of that first wave of feminism, and so those women went out there and did a lot for trying to deal with some gender disparities, if you will. Not trying to be political, but I think there’s just a lot of expectations both societal. Then, also, social media I think is making things very hard for women. Women think what they see is normal, and it’s been Photoshopped or…

Dr. Pompa:
I agree, yeah, exactly. Yeah, I mean, in many ways, this—that could go on a whole ‘nother direction. One of the things I saw when I was in Africa was the community was so different, meaning that the women—the men would go off hunting. The women were there, and you could tell they all support each other. It wasn’t like this one woman raising her three, four kids. It was her with this person, with that person, and there was a community that supported the raising of all the kids.

Cynthia:
Yeah, it takes a village.

Dr. Pompa:
There is a saying that it takes a community to raise a child, but yet, that’s not what’s happening today, right? We’re very individualized in our life. We don’t have that community. Some women do.

Cynthia:
Yes, you grow up in one area, and then you move away. Unless you have a strong sense of family support, that can make things so much harder. It’s interesting. I was telling someone the other day that—I have all boys, and so we’ve had a lot of ER visits. My youngest when he was 2 had a fall out of a second story window. In the middle of the night with a husband who’s out of the country, having to call girlfriends to come get my oldest so that I could be in the hospital with the little guy and trying to explain to people, I said it really does take a village, remarking about your strong sense of community for women. When women do have that support from other women, that makes the difference. It really, really does, and then they don’t feel quite so alone, or sequestered, or unsupported.

Much like men, men need guy time, and women need girl time. It’s hard for other—as wonderful as spouses can be, sometimes it really does take another woman to understand what—the pressures that certain women may be experiencing, so I agree with that. That’s a great observation.

Dr. Pompa:
Yeah, I mean, men often times have their work scenario. They get away too, and that’s hard. Yeah, I mean, I just see that women do have unique stresses today that carry on. To bring this whole conversation full circle, that affects cortisol. That affects sleep ultimately. That affects hormones, ultimately.

Cynthia:
Oh, yeah.

Dr. Pompa:
Again, I always say hormones is the real reason why people struggle to lose weight or have weight loss resistance, right? You look upstream, and you see all these factors that we were just discussing.

Cynthia:
It really can be hugely problematic, and I always say weight gain is a symptom of an issue. It’s not the weight gain is the issue. Weight gain is the side effect to what’s going on, whether it’s inflammation, toxins, etc., and that’s really what requires the digging, the detective work.

Dr. Pompa:
Despite our efforts, not just you and I, Cynthia, but almost everyone in our community, we talked about calories being not the way to lose weight, low-fat diets but yet, still our government, social media, media in general—I mean, you could turn on any morning show, and there’s going to be a—something, a recipe for low calories, low fat, and exercising more. The message is still we’re gluttonous. We don’t exercise enough, and we are absolutely—or I should say we’re gluttonous. We eat too much. We’re lazy. We don’t exercise enough. How do we change that, I mean, honestly? I would even lump low fat into that to where it’s still a low-fat, low-calorie recipe if you watch any morning show, and yet, it’s not the reality. Have we even impacted this at all?

Cynthia:
I think the tide is changing. I do believe that there are more and more healthcare providers like ourselves that are using—this is a platform to really help change the narrative. That’s really what it’s about. This dogma, I think we’re at least 20 years behind the dogma. Every time I do a post talking about CICO, calories in, calories out being dead, I have trolls that come from every direction because it really challenges people’s belief system. I just remind people. I’m like, “Listen, I haven’t counted a calorie in five years, and I only did five years ago as an experiment. I don’t believe in doing that.” I said, “If once you have gotten to a point where you are comfortable enough with your feeding-fasting window and you respond appropriately, your body intrinsically will let you know I’ve had enough.”

This emotional eating piece, which I think is unfortunately exacerbated by this whole misnomer that breakfast is the most important meal of the day—that it’s all about over exercising. You have to over exercise every time you eat too many calories. It just meets this notion that—this repetitive, pedantic kind of notion and mindset that we have to worry about—our bodies are not keeping score per se. It’s time for us to get back to eating the way that our ancestors did. I’m quite confident that 200 years ago there wasn’t a Hostess Twinkie that people got out of the vending machine, and they looked at it and said, okay, this is 450 calories. Therefore, I know what I need to do to burn this off. I mean, that just isn’t the way that our bodies are designed to function.

Dr. Pompa:
Yeah, but it’s still the message.

Cynthia:
It is, and so yes, there needs to be more open-minded individuals that are doing government regulations. I mean, unfortunately, I don’t see the USDA making any significant changes in the near future, but I did actually read recently—was it the AHA? One of the American Heart Association—one of the major associations was saying, okay, maybe saturated fat isn’t that bad. I was like, okay, that’s a start.

Dr. Pompa:
That is a start, mm-hmm.

Cynthia:
Granted, it’s 20 years plus, 30, 40 years that they’ve been propagating that fat is bad but slowly but surely. I think it really—it requires people to think outside the box. I use the term I don’t like to be sheeple. It’s like I ask a lot of questions. I probably irritate people because I ask a lot of questions, but if I still believed in the prevailing old antiquated dogma, I wouldn’t be here today. I just got tired of writing prescriptions. Some of us just have to get fed up enough that we just say there has to be a better way, and it all starts with food. I always say that’s my standard mantra. It all starts with the food that we’re eating.

Dr. Pompa:
Unfortunate, the guilt that that message lays on us as we—so many people, it’s like they failed because they couldn’t control their appetite. The reason they thought they couldn’t control their appetite is because the message is eat less, so none of us could eat half of our meal and push it away. Bad things happen, right? Eventually, we fail no matter what because our body wants to survive, or we start eating our own muscle because our body wants to survive. Either way, it’s a lose when you try to caloric restrict, and you know this from my book. My message is don’t eat less. Eat less often. That’s the key is, when I eat, I eat to full, but I just do it less often.

At the end of the day, I promise you, Cynthia, we do eat less. We’re not pushing calories away. It’s a completely different hormone shift, one for survival and one that’s just easy.

Cynthia:
I think the big thing is when you’re satiated, and that’s something that I teach my patients. When you’re satiated, it’s a completely different connection with your food. I was jokingly telling someone the other day—my father, who’s in his 70s was horrified that—he’s like, “I can’t believe how many eggs you eat a week and how much bacon.” I said, “Dad, here’s the thing. I’m so satiated. I don’t even think about eating again until four or five hours later.” I said, “That’s the distinction. If you get up in the morning”—and he’s a frail 70-plus-year-old guy. I would say, “If the first thing you eat is—you’re eating fruit, and you’re eating a muffin. You’re eating an English muffin.” I said, “All you’re doing all day long is your blood sugar is going up and down like this.”

He was trying to figure out why he was having energy issues. I reminded him. I said, “If you got up, even if you had a piece of bacon or you had an egg, you would be so much better off keeping your insulin from spiking throughout the day that you wouldn’t deal with those energy slumps. You would have plenty of energy.”

Dr. Pompa:
I agree. By the way, when your body’s burning its own fat, you don’t have insulin and glucose spikes. It knows exactly what it’s doing. What’s your thought on this? There’s different takes to eating first thing in the morning or waiting it out a little bit, right? Are you an early day person eater or a later day person? What’s your thoughts?

Cynthia:
I would say a midday person. I just find I’m not hungry when I get up for the first several hours.

Dr. Pompa:
Me neither.

Cynthia:
Actually, my 12-year-old, since we’ve been socially distanced and he’s been home, he doesn’t eat breakfast until 10 or 11 o’clock. He was concerned because he had heard me say children shouldn’t intermittent fast. I said, “You’re not intermittent fasting. You’re just listening to your body. You probably ate at 8 o’clock at night. You probably had your second dinner, and you’re really not going that long.” To respond to the question, for me, personally, I’m not even hungry until 10 or 11 o’clock in the morning.

Dr. Pompa:
I love Dr. Fung, but he talks about people eating earlier, even Valter Longo talks about people eating earlier. Myself, I’m not hungry. I’m healthy. My children, they don’t eat. I don’t have a child that gets up in the morning and eats, right? There is the cortisol effect in the morning, meaning your cortisol rises. They call it the dawn effect, and your glucose rises. Isn’t that glucose rise just—that’s part of why we’re not hungry, right? I’m not sure that I agree with the morning eating, even for diabetics. I don’t know.

Cynthia:
Yeah, I mean, if we think physiologically why that happened is because we were—well, maybe the men were going out to hunt or look for food. It physiologically made sense. I find that, most of the people that I’m working with that are intermittent fasting, they prefer not eating. They like to push it ‘til later in the morning.

Dr. Pompa:
By the way, the tribe that I saw, they got up, and they went out all day. They didn’t eat in the morning. They did not eat. They got up, went before dawn, and then they came back late afternoon. They weren’t eating. They came back and ate one—well, probably like a three-hour meal, very long meals, but it was still one meal. It just lasted a long time.

Cynthia:
That’s amazing.

Dr. Pompa:
I mean, yeah, I think that there’s different thoughts about that, whether you skip breakfast or skip dinner. I guess it really depends on what time your dinner is and what time your breakfast is. Eating first thing, I just—I think the body’s meant to survive on that glucose that rises up with cortisol.

Cynthia:
It makes me laugh. For so many years, I would get up. I would go to this hardcore conditioning class at my gym. I would drink a protein shake going there, and I’d drink a protein shake coming home. Then I’d have a meal before I got to the hospital. I was still thin, but it’s unbelievable when I think about—I mean, I was just eating these small little meals all day long.

Dr. Pompa:
That’s what we thought was best, honestly.

Cynthia:
Right, yeah.

Dr. Pompa:
Until I went and spent time with the tribe in Africa, I really didn’t see anything different than that until then. I was like, boy—that just started me questioning it. It got me to research it further to realize, gosh, maybe this is bad. When you look at studies, really, the people who eat less live longer, but it’s not just eating less. It’s eating less by eating less often, right?

Cynthia:
Right.

Dr. Pompa:
That’s it. If you’re eating all the time, the energy that it takes to deal with that food constantly and we’re not allowing our body to burn its own stored fat. Although you were skinny, fact was is you probably had a lot of organ fat and visceral fat, and like I said, we’re actually creating health problems.

Cynthia:
Yeah, absolutely. The perfect storm and for women that are listening is those perimenopause years. Five to seven years before women go through menopause the game changes. We’re much more prone to insulin resistance, even if you’re thin. I tell people that’s when women sometimes will get stuck, and that’s when we really have to dial in on all the things that we’ve alluded to, the sleep, the self-care, or the nutritional choices. That’s when I find people start becoming a little more receptive to making those changes.

Dr. Pompa:
Yeah, no, I agree. That was going to be my last question is perimenopause, menopause, just advice for women who are going through that right now. As we pointed out, hormones are really the answer and the problem. I mean, the healthiest women no matter what are going to go through a hormone change. It’s normal; advice.

Cynthia:
I would start with the food piece. If you are not already really focusing on protein and healthy fats, that’s critical. I just remind women that, in perimenopause and menopause, all of a sudden the game shifts. You can’t just eat copious amounts of carbs. You can’t just eat all the wine and the chocolate cake that you want. If you focus on protein and healthy fats to keep your blood sugar stable, that’s critical. That’s number one. I would say that this is not the time to be over exercising. All of a sudden, people go from wanting to do really strenuous exercise like they had been doing to all of a sudden realizing they just feel burned out.

Dr. Pompa:
Yeah, burned out, that’s true.

Cynthia:
I remind women that this is a time to do—make sure you’re doing some strength training. Making sure you’re doing some restorative practices like yoga, walking, really critical. This is when sleep becomes absolutely paramount, as well as looking—dialing in on the stress piece like I’ve alluded to and a time to think about intermittent fasting. I know that scares a lot of people to consider doing it, but I really do believe that, if women are able to capture that strategy in perimenopause, then their transition into menopause will be that much easier. The women that really struggle with perimenopause and go into menopause just being miserable, they’re having hot flashes. They can’t sleep. They’ve gained 50 pounds. They crave sugar because their bodies are just looking for a quick source of fuel. They’re the ones that could use that advice the most, so sometimes bad habits from our 20s and 30s need to be rectified.

The other thing that I always like to remind people is the most inflammatory foods are things like gluten, grains, dairy, processed sugars, and this is the time to clean it up. It may not be that everyone that’s listening is sensitive to all of those foods, but I find it can really be instrumental. I know, for myself, I kicked out gluten at 40, grains and dairy a few years later, made a huge difference.

Dr. Pompa:
By the way, the no grain is a way big step better than just gluten free. Number one, so many gluten-free products are super sugars and even worse. Number two, there is a lot of proteins that people react to beyond gluten. What I find is taking grains out period seem to have the most anti-inflammatory effect.

Cynthia:
I think it’s those subtle changes that really have a lot to do with it. I do find that alcohol—if people have been really leaning on alcohol as a stress reduction strategy, all of a sudden it really dysregulates their blood sugar. They just don’t tolerate. They can’t have more than a glass of wine or more than one drink, and all of a sudden, they’re having the hot flashes and not sleeping. That’s where I would probably start. Those are the things that, if you can master that, you will definitely have a much easier transition into menopause.

Dr. Pompa:
I couldn’t agree more. I want to highlight something that you just brushed over, and that’s resistive training. I think resistive training around that time is more important because bones are remodeling. Really, you get a hormone optimization that occurs with resistive training, so shift more from cardio to resistive. I think it plays better, especially in that time.

Cynthia:
If you look at the data on muscle being the organ of longevity, I mean, the more muscle mass we have, both men and women, the less likely we are to be obese, have diabetes, have all these metabolic disorders, so I remind people. Sometimes they freak out. They’re like I don’t want to get big. Women cannot get as big as men. It’s physiologically impossible, but I remind people the muscle that you keep on your body is going to help you burn—have more thermogenic burn. You’re going to burn more calories, and you’re going to do it when you’re not even doing anything. There’s a lot of bang for the buck.

Dr. Pompa:
It creates a hormone optimization when you’re not doing anything, right? When you resistive train, you may not burn fat while you’re doing it, but for 36 hours, your body’s actually burning more fat and hormonally optimizing. Yeah, I couldn’t agree more. The problem is social media, once again. They see these women, and they’re like I don’t want to look like that. Okay, they didn’t just lift weights to get that way. There’s a lot of hormones in getting that way. Even today, even the—not the bodybuilder women but the bathing suit women—I don’t even know what you call it. They too are taking hormones. You’re not going to look that way, but you are going to help regulate your hormones by adding some resistive training in.

Cynthia, great talk, I mean, I think every woman needs to share this one with every woman and friend they have. These are the topics of the day. I mean, this is the advice that if you just did half of what Cynthia just said, I’m telling you, your life’s going to change so do it. Thank you, wealth and knowledge on the subject. I loved it.

Cynthia:
Thank you so much. It was really a pleasure to connect with you.

Dr. Pompa:
Yeah, absolutely, we’ll have you on again. Thanks.

Cynthia:
Sounds good.

Ashley:
That’s it for this week. I hope you enjoyed today’s episode, which was brought to you by Fastonic Molecular Hydrogen. Please check it out at getfastonic.com. We’ll be back next week and every Friday at 10 a.m. Eastern. We truly appreciate your support. You can always find us at cellularhealing.tv, and please remember to spread the love by liking, subscribing, giving an iTunes review, or sharing the show with anyone who may benefit from the information heard here. As always, thanks for listening.