Why Intermittent Fasting Works with Dr Jason Fung #285

I need to think, you know, weight loss is just about calories and minus calories. The energy balance equation is always true, but people always misinterpret it to mean that just eating fewer calories leads to body fat loss. It does not. Hi, my name is Rongan Chasjee. Welcome to Feel Better Live More. Time is the last time you had something to eat. Was the food consumed at a meal time or just because? What today's guest on my podcast has a simple but powerful message that I believe could revolutionize your health. Dr Jason Fung is one of the world's foremost experts on intermittent fasting. He practices in Canada as a kidney specialist and in 2012 he co-founded America's first intermittent fasting clinic. He's published multiple international bestsellers including the obesity codes, the diabetes code and the cancer codes and he runs a global online coaching program called intensive dietary management and he's someone who works tirelessly to communicate simple messages with the public on his YouTube channel. We begin our conversation by discussing how many unscheduled opportunities to eat there are in modern life. Why these days is it okay to eat at your desk? In meetings while walking down the streets on public transports or even on the sofa at home. Just a few decades ago such habits would have seemed very out of place. Jason explains at the idea that it's good to graze all day. It's unscientific and damaging our bodies can only draw on our fat stores for energy when we're not in a fed state. Jason says our default should be not eating. With two or three meals planned in short windows over 24 hours. Instead these days, schools, workplaces and places of leisure are designed around opportunities to snack and for many of us it's causing a host of problems. Now Jason explains how many of us actually eat more and more often than we should not because we lack self control but because we feel hungry and we feel hungry because we're eating the wrong foods. Jason also covers why in his opinion calorie counting is not the answer when it comes to getting your weight and health in check and why some foods are more fattening than others even if they're equal in calories. Now Jason's approach is to encourage all of us to switch to what he calls the right foods. Whole unprocessed foods, low in sugar and refined carbohydrates which will not stimulate large amounts of a hormone called insulin. As a result, Jason says you'll be less hungry, less inclined to eat constantly and return your hormones to the way they're designed to work. Jason is also a big fan of intermittent fasting for the right person and explains easy ways to practice it, the common mistakes and misconceptions and reveals why the rules are not as strict as you think. Whether you're already a fan of intermittent fasting, whether you're in the dark or whether you are someone who is yet to be convinced, I'd urge you to give this conversation a listen. Jason is a fantastic communicator who's helped countless people all around the world improve their health and wellbeing. I really enjoyed my conversation with him. I hope you enjoy listening. Now before we get started, I think it is really important for me to say that this episode may not be suitable for everyone. In particular, people who have recovered from or are currently suffering from eating disorders may find themselves getting triggered by some of the content. In fact, Jason and I actually discussed this very topic towards the end of our conversation. Please also note that if you are on medication for conditions such as type 2 diabetes, it is advised you speak to a healthcare professional before fasting for prolonged periods. And now, my conversation with Dr. Jason van. You have been sharing health information with your patients, with people all over the world. For coming up to a decade now, you've helped so many people improve their lives and improve their health. With all that experience, with all that knowledge, I wanted to start by asking you, what are some of the daily things that people can think about doing that's going to help them feel better, improve their health, reduce weight if they need to, but also reduce the risk of getting sick in the future. Yeah, I think there's a few things. I mean, one is to stop a lot of the sort of snacking that goes on. For a long time, people said, "Oh, you should eat 10 times a day." Right, don't make sure you get your snacks and stuff. And I think it really sort of drives us in the wrong direction based on the people who need to lose weight. Because unfortunately, that's the majority of people these days. And this idea that you should sort of eat all the time and it being healthy is probably one of the most sort of damaging things that we've done to people. It's not natural. It's not what we used to do. It's what we haven't done that for most of our history. It's only been in the last 30 years that people thought, "Well, you should eat 6 to 8 times a day." Most of the time, it was sort of 2 to 3 times a day maximum with stipulations that you really shouldn't eat more than that. And then now all of a sudden, people are like, "Oh, yeah, you should eat all the time to lose weight." And then all of a sudden, it's not even worth it. Like from a physiologic standpoint, when you eat, you're not losing weight. You cannot be. It's impossible. So this idea that, "Oh, you have to do that." It's sort of a very, very modern idea that's been presented as scientific and all that sort of stuff. I think it's really damaging because then people don't get the right idea that, "Hey, you can leave your body and you don't figure out where it's going to get its energy from without completely screwing up the system sort of thing." So I think that's one of the things I've sort of focused on mostly is trying to increase that sort of fasting period or if you're trying to lose weight using intermittent fasting, that kind of thing. It's one of the things that I think makes no sense to me whatsoever. The next thing I think it's important to do is sort of put it on the schedule that is even things like eating. It should be sort of scheduled. So all that unscheduled snacking and stuff that really derails people. So you're walking by and you say, "Hey, there's a coffee shop. I'm going to get a coffee." Then you see that go in the coffee and then you smell the donuts and then like before you know, you've got the donuts, right? So the problem is that you've got all these periods of time where you've got unscheduled sort of opportunities to eat and they're never really good for you. You're walking, you're in the office, somebody has a bowl of candy out so you go and get some candy, you go to the, you know, there's never on the schedule. You have a meeting, all of a sudden somebody's ordered a plate of cookies and before you know it, you eat cookies, right? So there's all this sort of scheduled stuff, like unscheduled stuff. So you really want to just put it, make sure, you know, when you're eating, you make sure you're sort of like mindful of this, right? You're deliberately scheduling a time to eat and every other time don't eat, right? And it sort of goes hand in hand with this idea that we should eat all the time to lose weight. We think that there's no cost to it or, you know, maybe you were the ones ordering the state of cookies for the afternoon meeting, right? And it's like, it's not necessary. It never was necessary. It's not doing anybody any favors. So, you know, make sure that when you're eating, you know, it's sort of, it's sort of on the schedule. Like if it's not on the schedule, they shouldn't be eating. And it's the same idea as mindfulness behavior. I love that idea of scheduling when you're going to eat. It almost feels like a revolution to react in the 21st century because there's such, food availability all the time, you know, we're always surrounded by food, tempted by food. And just this very simple idea that put when you're going to eat on the schedule, I think for many people, it may be the first time they've ever heard that before. Yeah, it's sort of, it's what your default is, right? So most of the time up until, say, the 90s, the default was not eating. So therefore, you schedule going, you ate breakfast, lunch, and dinner. All of a sudden, based on no science, really, we thought we should eat constantly. From the minute you get up to the minute you go to bed, you hear constant refrains. Well, you know, always eat breakfast, never skip breakfast, start eating immediately, and then have bedtime snacks and have snacks. And you think about, and I don't know in the UK, but in Canada, for example, if you send your kids to school, they get like morning snacks, they get after school snacks, they get snacks when they go on the bus, you know, they've done, they play, you know, sports and somebody wants to go and snacks in between, you know, to give them energy. like, you know, they have plenty of energy, whether you give them sugar or not. And so the default all of a sudden became eating. So, you know, it was strange because we went from a default of not eating, you have to decide when you're gonna eat to eating all the time and to send deciding when you're not going to eat, which is bizarre. So, you know, and not healthy because if your baseline is to eat, then you can be in wait. It's unfortunately, there's no way around it. You are a big proponent of fasting, intermittent fasting, and you've done a lot to spread knowledge of that throughout the world over the past few years. Many people these days are trying to experiment with some form of fasting. In your experience, and I know you've got, you know, years of practical experience doing this with real-life patients, with busy lives, you know, busy jobs, kids to look after, all those kind of things. What are some of the common mistakes that people often make when they try and do some form of intermittent fasting? - Probably the biggest one is sort of overeating when you fast, like thinking that just because you didn't eat for a period of time, that gives you sort of card-blosh to eat whatever you want afterwards. Sort of, there's two important factors in weight losses. One is the foods that you eat, when we talk about this all the time, that's your diet, right? What you eat, when you decide you want to eat. So, you know, people are paleo and keto and vegan and whatever, there's plenty of different diets. We argue about that all the time. But what a lot of people don't talk about is sort of the time you spend not eating, right? And that's your period of fasting. How long should it be? How often should you eat? Those are just as important questions 'cause it's more than half of your day is should be spent not eating. So, you know, if you get that part right, that is you spend a period of the day not eating 16 hours or 24 hours or whatever you decide, it still doesn't mean that you can just eat whatever you want. And there's been several studies doing this exact sort of sort of overfeeding strategy that is, well, we'll fast for 16 hours and then let people eat whatever they want. Well, it's a very unsuccessful strategy. You want to eat still healthy, still sort of good, nutritious whole foods and combine the fasting. It's not sort of like, they're sort of like two levers, right? You want them both going in the right direction. You don't want to go one up and one down. That's just gonna make it ineffective. So, you know, and that's one of the things that people don't understand because there are some rats studies, for example, that said, well rats, you let them eat whatever they want and as long as they fast for a period of time, they stay under way. So therefore, that should apply to humans too. You can eat whatever you want. That is, if you fast 16 hours, you can eat junk food and fast food and McDonald's and all this sort of stuff. It's like, no, you can't. Fine is, when you're fasting, all you're trying to do is let your body use the calories that you've stored away as body fat. That's all it is. Body fat is nothing more or less than a storage form of calories, right? You take in food energy in the form of calories and your body stores some of that away. That's when you eat. When you don't eat or when you're fasting, then your body is going to use the store of calories that you've put away, right? That's why you don't die in your sleep every single night because your body has the ability to store some of those calories away. So, that's all it is. So, it always boggles my mind that people experts are saying, oh, you know, intermittent fat is bad for you and it's not natural. It's like, it's the most natural thing in the world. You're supposed to be cycling. That's why you have this word break fast, breakfast. You're supposed to fast. Otherwise, you can't break your fast, but you're supposed to feed in your fast. And then if you ask your grandmother, she would say something like, well, you just got to give your body some time to digest the food that you've eaten. Yeah. It's funny how culture has changed so much. Just in the last 30, 40, 50 years where this idea of eating all the time has become just so prevalent. And it's really interesting what people actually do. You know, Professor Sachin Panda from the Salt Institute. I know when I last spoke to him, he was sharing information with me from his app that people are tracking how often they're eating for and he said 50% of non-shift workers in the US are eating pretty much over a 15-hour period each day. Now, technically it was 14 hours, 45 minutes, but basically 50% are eating over 15 hours. And he said, under 10% of people that they were tracking were eating in under a 12-hour window. Now, if we compare that to 100 years ago, this is so abnormal, isn't it? This is so not how we have lived for most of our revolution. And I guess the question then is, why is this problematic? And when we say fasting or when you use it to him fasting, what do you mean by it? Yeah, and it's really just fasting is just any period of time that you're not eating. And if you think about the 14 hours, 45 minutes, if you wake up at 8 a.m. and you start eating immediately, you're eating until 10, 45 p.m. That's basically your entire waking day, minus brushing your teeth or something. It's a ridiculous amount of time to be eating and that's the average. So when you talk about this, how did this happen and why is it so bad? Well, I think I have my theories about why it happened, but the reason that's so bad is that your body really exists in one of two states. It's either in the fed state, which is, you're eating insulin is high, which is telling your body, please store some of these calories that are coming into your body because you're gonna need them when you're not eating. Or it's in the fast state, which is insulin is low, you're not eating and your body says, hey, I need calories, please take them from my storage, right? So it's not different than a refrigerator, for example. You go to the grocery store, you have too much food, you put it in the fridge, right? So now think about it this way. If you now go to the store five or six times a day and all the time you're putting food in your fridge, putting food in your fridge pretty soon, your fridge is gonna be full. Then somebody says, well, in order to empty your fridge, you need to go to the store more often. It's like, does that make any sense? When you're eating, you're telling your body, like you're literally telling your body, please store some of these excess calories into storage, put it into storage, because that's what the insulin does. It's not even good in our bad, it's just its job. So because you're stimulating it all the time, you're telling your body all the time to do it for 14 hours and 45 minutes of every day, you're telling your body to do that. And it's actually more because of course, your stomach actually holds some of the food and slowly sort of pushes it out. So it's not 14, 45, that your body is in the fed state. It's actually hours longer than that. So the point is simply this, like if we try and complicate things so much all the time, but it's very simple, when you're eating your storing calories, when you're not eating, you're using calories. That's all it is and that's natural and it's normal. And you can handle it. Like people think it's so, you need to eat 2000 calories in a day, you shouldn't cut your calories, for example. Like what, you know, if you're fast the entire day. Well, if you're worried about those 2000 calories, well, what about the 100 or 200 or 300,000 calories that you have stored currently on your body? Like why would you worry about the 2000, just like the refrigerator? If you don't go to the store one day, are you going to be really badly off? Well, your fridge is unverfilled. You have way too much stuff in the fridge. Just eat something from the fridge. That's the same thing. If you don't eat, your body has a 300,000 calories of body fat. Your body's going to use it. Or your diabetic, you have blood sugar sort of just filling out from everywhere. Your body's going to use some of that sugar because it's a source of energy. So what's wrong with that? How is that bad in any sense of the word? You're simply letting your body use it for what it was designed for. And that's the whole point of fasting, which is why it always boggles my mind that you see experts saying, oh, you know, I attribute fasting so bad for you. But you have, and there's certain circumstances, of course, if you're malnourished, if you're underway, you know, sure. Absolutely. But if you're overweight, if you're type 2 diabetic, that's actually exactly what you want your body to do. Yeah. Let's expand this beyond weight loss because one of the things that pulls all of your work together, for me, at least, is that we have overly focused on calories and not focused enough on hormones. And it's easy to talk about fasting and burning body fat in the context of someone who might have type 2 diabetes or someone who is carrying excess fat and considers themselves to be overweight. But this goes beyond weight, doesn't it? This is actually a very helpful practice for people He wants to. to be an optimal health, have more energy, yes, have a good body weight, but also reduce the risk of getting sick in the future. - Yeah, absolutely, because if you think about it, like it's a balance here, right? You eat, you store calories, you don't eat, you use those calories, right? And you wanna keep those in balance, so 12 hours, 12 hours is perfect. If you think about a typical sort of 1960s, 1970s, 'cause, and I choose that time because it's before the obesity epidemic, when people aren't really watching their diet, particularly people are eating white bread and jam, and stuff like that, right? But if you think about it, you know, your breakfast maybe eight o'clock before school, and then you had dinner maybe around six o'clock, that's a 10 hour eating window, and 14 hours of fasting. And literally everybody did that every single day without even thinking about it. So was it hard? No, because that was sort of your baseline. And the point is that it's not, it's not neither difficult, it's just about your habits, and then all of a sudden people switched and changed. But before that, you would hear things like, if you wanted an after school snack, your mom would say, no, you're gonna ruin your dinner. If you wanted bedtime snacks, she'd say, no, you should ate more at dinner, right? So there wasn't not this tolerance of snacking. It was sort of this occasional thing that you did once in a while, but rarely. It's an indulgence, right? And then it became every day. So you know, my kids, when they went to school on a trip, for example, a bus trip, right? So they'd go on the bus and you'd get this note from the school, which would say, please send two snacks with your child. And I'd be like, why are they not eating lunch? Or am I not feeding them dinner? Is that why they eat a snack? Is that why you're good at it? And then we, so we teach them that you have to snack all the time and then we blame them for gaining all this weight. And then tell them that, hey, it's your diet, it's your lack of willpower. And it's like, well, you know, we focus on the wrong things. And you might say, it was all very inadvertent, I think. It wasn't that anybody deliberately meant to do that. It all came back to sort of the dietary guidelines, which was in the '70s, people said, you should eat ultra, ultra, ultra, ultra, ultra fat. And in order to do that, the government, the United States government encouraged people to eat processed food because you could process the fat out of it and put other things mostly carbs because fat and protein tend to go together. And so instead of eating, say, a typical breakfast of eggs and bacon, which would keep you full until lunch, they'd eat two slices of white bread and jam and some sugary cereal. The problem with that, and we know this, of course, is that insulin spikes up very high, glucose spikes up very high, because they're all very highly refined carbohydrates. Then it crashes. So by 10.30, you're just starving. So then you go get yourself a low fat muffin. And then the same thing happens, right? You're, you're, you're, you're, you're, insulin spikes up very high, your insulin spikes up very high, and then, and then it's gone. So people started eating more frequently because they're basically just eating a whole bunch of refined carbohydrates. Then they said, well, I'm eating six times a day when I used to eat three times a day. But since I'm eating super low fat, this must be a good thing. It never was a good thing, of course. It was just a byproduct. Now, of course, we know we shouldn't be eating a whole pile of refined carbs, like right away. But back then, two slices of white bread and strawberry jam was perfectly acceptable, very low fat, almost zero fat. In fact, all sugar, all refined carbs. So I think that's sort of how it came about because of this sort of insistence that we eat low fat, low fat, low fat, which unfortunately wasn't like more beans. It was refined, highly refined carbs is what replaced the fat in our diet. But then the inadvertent thing was that even as we moved away from those refined carbohydrates, so we started acknowledging, hey, there's healthy fats. Say you should eat nuts, hey, you should eat whole grains. Even as we moved away from those refined carbs, we never moved away from the fact that we're just eating constipation. And of course, our institutions have changed to allow all that, so our habits of change, you have, it's acceptable to eat at your desk. It's acceptable to eat in the movie theaters. It's acceptable to eat in front of the TV. It's acceptable to eat while you're walking. All of those things would have been super frowned upon. If you went to the office and you were eating at your desk in the 70s, people would be like, what the heck are you doing? There's a place to eat and it's not at your desk. Go eat somewhere else. But because everybody was hungry all the time, you got this 230 cent, I mean, you've been to meetings, like medical meetings, right? Like, my god, it's like, okay, so you'd have a full breakfast. Then at 1030, they roll out the granola bars and stuff. And that's at 1030 AM, you just ate a huge breakfast at 8 AM. And then you have lunch. And then you know, at 230, there's a nutrition break, right? Or they roll out muffins and cookies and stuff, right? And then you go eat dinner. It's like, these are for doctors, like you and me. And this is at every single meeting you go to, American Heart Association, diabetes association, like you'll go to the diabetes association meetings. And they're rolling out snacks and snacks and snacks. It's like, okay, well, what's the message here? Eat all the time. It always is. And I think that just speaks to culturally, how much this has changed. As you say, it's just acceptable now to do this. In fact, if you were hosting a meeting, it would probably be considered rude. If you didn't provide cookies and biscuits and those sort of things, do you know what I mean? It's very few of us are able to resist societal, environmental pressures, which is why what happens at school saddens me so much because it literally is conditioning kids from a young age to, you know, think, oh, I need to snack. I'm not eating for two hours. I need to eat something. Whereas, you know, the truth is, we know we don't need to do that. And culturally, there's countries. So I think France, it's still there in France where, you know, snacking is just not that common air, except will type thing to do. You eat when it's meal times and you don't sort of eat in between. And when I spoke to Professor Tim Spets, he was on the podcast. He was saying very similar to you, the impacts of constant snacking, what it does for the gut microbiome, all kinds of things that we just don't need to be eating all the time. Now, Jason, one of the central ideas in your work is that chronically elevated insulin is problematic for a variety of different reasons. When was the first time you started to become aware of this as a doctor? And then maybe you could go from there and explain what causes insulin to go up and what happens to us? Why should someone listening to this right now who doesn't have type 2 diabetes? Think some are in pretty good health. Maybe they've got a little bit of extra fat that they don't want but they can live with it. Why should they care about chronically elevated insulin? It actually impacts a huge number of medical conditions. It actually, so if you look at insulin resistance, which is really the same as chronically elevated insulin. There's two sides of the same coin. It's called hyperinsulinemia, which is basically a word hyper-meant-high insulin. And then emia means in the blood. So hyperinsulinemia just means high blood levels. But insulin resistance people have heard of is the same really as hyperinsulinemia. They do the same thing. And it really impacts a huge number of conditions, such as heart disease, type 2 diabetes, which can cause kidney disease, nerve problems, amputations, cancer is related to insulin levels. So there's just all of these chronic conditions that are really the main focus of today's medicine that are made worse by chronically elevated insulin levels. And the point is that you're really not supposed to be in that state. So when you look at hormones, and this applies to almost all hormones, you're really supposed to have a spike of hormone and then go to low level. So whether it's thyroid hormone or growth hormone or cortisol or parathyroid hormone, all of these hormones, they spike and then they go down. So growth hormone, for example, will spike in the morning and then it'll go down to very low levels. And that's why you have to measure these hormones at certain times of the day and not other times. So you do an A and cortisol and the blood work, for example. Well, insulin's really supposed to be the same. You're supposed to have high levels when you eat, then it's supposed to go down and then high levels and it goes down. So you're always supposed to have this sort of balance between the two. What's really bad is when you have high levels all the time. And it's true for cortisol as well. Cortisol, again, it's not bad for you. It's just the natural hormone, but you're supposed to have it spike up and then go down. When you have it chronically high, it's actually super, super bad for you. This idea that eating all that you should eat all the time, of course, leads to insulin levels being up all the time. And the other problem is that as you move away from fatty foods and stuff, then you're choosing foods that typically spike insulin much higher. So if you're choosing white bread over eggs in the morning, eggs that have very little insulin effect and white bread has very high insulin effects. So you're, you know, it's sort of a double whammy. You're choosing foods that are very high in insulin. And if you think about it, so insulin its job is to tell you, it's a nutrient sensor. So it tells you food is coming in and can sort away. So you choose white bread. So even if it's the same number of calories, they choose a white bread versus in the egg. When you eat that white bread, glucose spikes up, insulin spikes up, when insulin spikes up, it says put all those calories into storage because that's, that's its job. That's what it's telling you to do. So when you eat that bread, it contains two things. It contains the energy, which is the calories, but it also contains instructions as to what to do with those calories. So you eat the white bread and insulin goes up, all of that energy goes immediately into your storage. Well, now at 1030, you have no energy left. Your blood sugars are starting to go very low. So what happens? Your body says, I need to get more food. Why? Because you put it all away. It's just like you go to the grocery store and you take the food instead of eating some of it, you put all of it into the freezer or the fridge. Well, you have nothing to eat. So then you go out and buy more food, right? It makes no sense. Whereas the egg, insulin is not going to go up as high. The energy is now available for you to use all day and you're not hungry at 1030 because you still have energy to do your activities with daily living, right? But it was the hormones really that made the difference. And this is the thing that I think is really important. When you have two foods, white bread and eggs, which are the same number of calories, their bodies response to those calories are completely and utterly different. Okay? So one of them spikes insulin, one of them doesn't. So in order to say that they are equal and you hear this all the time, calories of calories, just calorie calories, right? That's how you get stupid ideas like, oh, you could eat ice cream for dinner. Just don't eat your broccoli because years, there's a hundred calories of broccoli you didn't eat. So you can eat a hundred calories of ice cream. Well, that's stupid. It's really, really bad advice that a lot of experts gave out because they're like, it's the same number of calories. But the hormonal effect is so different. And it's the hormones that tell your body what to do. You take a hundred calories in. You can either store it away or you can use it as energy, right? One of that makes you fat. And one of them makes you full gives you energy. Which one do you want to do? Well, you have to choose the hundred calories that don't go straight to fat, which is, you know, the ice cream and the white bread and so on, right? And that's the point that everybody misses when they're so focused on calories. And there's so many people out there that are like, you're saying, calories aren't important. Like, I'm saying that there's way more important things than the calories because it's what you do with that energy, not just the total amount of energy. Yeah. There's a couple of things there for me. One of the problems with saying, whether you're eating ice cream or eggs or salmon or whatever it might be. It's the same as long as the same amount of calories. Problem number one with that for me is that food is so much more than calories. Food is information. Food has an impact on inflammation. That has an impact on genetic expression. It does so much. It's it's signals so many things in the body, which we really undervalue when we just say how many calories is in that? Firstly, secondly, I think this idea of calories is worth just exploring in a little bit more depth because as you say, a lot of people talk about calories, inverse calories out, simple. If you want to lose weight or maintain a healthy weight, you just need to get in a deficit with calories. We have to be burning off more than we're taking in, technically, scientifically. Do you have any insight on that? Yeah. So the energy balance equation is basically, they say body fat equals calories and minus calories out. That's sort of what we all think about. So therefore, people say, oh, you must be in a caloric deficit. You actually can never be in a caloric deficit because it's a balance equation. There's three variables, body fat, calories in, calories out, and they must balance. So the point is that if you change one of those variables, and everybody forget, I always think there's only two variables, calories in calories out. No, there's three variables, body fat, calories in calories out. If you change one of those variables, calories in, it does not mean there's two other variables. It does not mean that your body fat will decrease because if you decrease calories in, you could also decrease your calories out. That is your metabolic rate will go down. And your body fat will be unchanged. Right? So the energy balance equation is always true, but people always misinterpret it to mean that just eating fewer calories leads to body fat loss. It does not. In fact, almost every study we've done over the last sort of 50, 60 years says that when you simply reduce calories and don't change the sort of composition of your calories, then what happens is that body fat goes down a little bit, but what happens is your metabolic rate goes down more. So if you go from 2000 calories, for example, you're burning 2000, you're eating 2000, you're, you're, you're, you're, you know, in balance. You want to lose weight now. So you go down to 1500 calories. That's what everybody says, right? 500 calories less per day. So you cut out the salmon and you cut out the eggs, but you love bread and ice cream. So you keep your bread and ice cream. You go down to 1500 calories. There's two possible things that happen. One is that you lose body fat. But two, the other possibility is your body simply burns 1500 calories. And your body fat stays relatively unchanged. That does not break the energy balance equation. Neither does it break the laws of thermodynamics. In fact, when you look at studies, every study we've done practically over the last 50 years shows that is precisely what happens. You eat 1500 calories. Your body then actually goes down and burns 1400 calories and you start to gain weight back. And then when you start to gain weight back because you did the diet all wrong by focusing on calories, people say, oh, you know, you weren't trying very hard. You didn't have willpower and all this kind of stuff, right? And that's the whole problem with weight loss is that when you focus on calories, you're, you're losing the sort of thread of the energy balance equation. You think that eating fewer calories guarantees you body fat loss. It does not. You can just as easily balance that equation by reducing your energy expenditure, just like if you are working and you get fired, you lower your expenses. That's just what you do so that you protect your bank account, right? You don't want to take money out of your bank. So you lower your expenses. So you reduce your income, you reduce your expenditures. So same thing with calories. You reduce your income. How much you eat calories in your body reduces calories out. You don't control that. You can't decide to burn our calories, but your body does. Now all of a sudden, you're in a situation where you're still overweight, but you're eating 1500 calories and your body's burning 1500. So you're cold, you're tired, you're hungry, you feel terrible, but you're not losing any body weight. That is actually precisely what has happened and everybody who's done a diet knows this, every single person, the failure rate of sort of counting calories for weight loss. The failure rate is somewhere around 95 to 99%. And yet we think that this is a scientifically proven way to do thing. It's actually proven to fail. It's guaranteed. It's practically guaranteed to fail if you don't adjust the foods that you're eating. Because as you say, we think it's all about willpower, but really it's all about eating the right foods because the hormonal response to those foods, which is telling our body to either gain weight or not gain weight, right? That's what tells our body. It's just monstriply different. Like you eat bread, you eat an egg, we can measure the difference in the hormones that you've stimulated, right? It's not just a very very, we know it 100% for sure that there is a difference. And yet we have to pretend that those hormonal differences make no, doesn't matter, right? Which is ridiculous. Yeah, it really isn't. You know, the other thing I think people miss when they're focusing too much on that equation is that when we talk about calories out, everyone assumes it's just one thing. You know, it's like how much did I exercise for example that day? They forget that actually calories out could well be four different things, the basal metabolic rate as you've mentioned. So, you know, how much energy does it take to keep the lights on in your body, lungs, kidneys, whatever it might be? There's also the thermogenic effects of foods in the whole context of things. It's relatively small, but still that's part of that calories out, part of the equation. There's purposeful movement and exercise, which has can burn some calories, although potentially not as much as people think. And then there's also neat, you know, non-exercise, activated thermogenesis, a kind of non-purpose or movement. All these kind of subtleties, people are not thinking about when they're thinking about that equation. So I think for many reasons, while scientifically that equation may be true, in terms of practical application for most people that has very little value, and I think this is a wider point, Jason, for me, which is there's a lot of technical scientific debate around these kind of topics, insulin, calories in, calories out. You know, for me, like you as a practicing clinician, it's like, well, you know what, yeah, we can debate these little nuances in this science. Or we can simplify things and just help people do what we know, and we see repeatedly work. Do you know what I mean? And I feel that's one of the reasons I, I've very much liked your approach. You have seen tens of thousands of patients. You've helped probably millions of people through the internet now and through your books across the world. A lot of people are gaining huge value from this. And I think we sometimes miss that when we're trying to dot all the eyes and cross the seas with the science, it's important. But it's not everything. Yeah, absolutely. And in this whole idea that, you know, a certain number of calories, 100 calories of bread versus 100 calories of egg are going to have different effects on the body. They have different hormonal effects. It boils down practically to a simple idea. That is, some foods are more fattening than other foods, which is of course an idea that your grandmother would have thought blindly obvious. Right? Like who gets fat eating broccoli? Like zero people in the whole world who gets fat eating cookies, many, many, many people. Right? And she didn't understand the difference between, you know, the hormonal responses of broccoli versus cookies. But she understood that you eat these foods, you know, and this goes back hundreds of years because the first low carb diet was sort of like what, banting in the 1800s, right? So you're talking about at least 150 years. People have said, hey, certain things really make people gain weight. And even if you go back to Ansel Keys, for example, so he did a very interesting study in the 40s, the Minnesota's Servation Study. Interestingly, it wasn't a sort of starvation study at all. It was a 1500 calorie a day diet, 1500 and 70 calories, which is actually not far off of what people advise for weight loss. Very high starch foods because that was what was available in post-war Europe at the time. So when he measured metabolic rate, it dropped by like 40%. When you dropped calories by about 40%, metabolic rate dropped by about 40%. And what happened? He actually measured other things, so heart volume, shrink, stroke volume, like the amount of blood that you pump out went down. People were cold through the generating less body heat because they're burning 40% less calories. You're sort of these sort of metabolic housekeeping things, like how much blood to, you're not pumping blood, you're more tired. You get, you know, you're not generating body heat, you're cold, right? So the whole point is that yeah, all of these things are important. This calories out is not just exercised. The majority of it is, you know, basal metabolic rate and you don't control that through your mind, right? You control that through your hormones. It's your hormones that control everything. That's just the way it works in the human body. Everything is controlled by hormones. You don't control how strong your bones are. That's controlled by growth hormone and other hormones, parathyroid hormones, right? You don't control how active your thyroid is. So this idea that it's all about willpower, you know, because people look at this thing, they go body fat equals calories and minus calories out. So therefore calories and is what you eat calories out is exercised. It's all willpower. It's like that's nonsense. It actually doesn't work for anybody because you have to actually, it's an extremely simplistic way of looking at things. When you go one level deeper and say, okay, so, okay, calories and minus calories out is what you eat and what you exercise. Let's go one level deeper. Why is it that you're eating more or eating the wrong foods? Well, it's because you're hungry. So that comes back to your hormones. And then you look at calories out. Well, it's exercise. It's actually mostly basal metabolic rate. So you can control what you eat, but you can't control how hungry you are. You can't decide to be that hungry. You can't decide that you're going to burn more calories. So it's all down to your hormones. It wasn't due to willpower at all. So you can take a drug such as somagletide, which is a weight loss drug now. When you completely whack that appetite, you know, in half people lose weight and never was willpower. It was that you controlled the hunger as opposed to the calorie, right? It all comes down to hormones. The human body is run by hormones. That is, that is the chemical messengers that tell our body what to do. And this idea that it comes down to something so simplistic like calories. Calories is such a terrible notion because it's not terrible. It's just misused because it's the unit from physics, not physiology, right? So it's the amount of heat energy that is contained in a certain amount of food. It doesn't tell anything about how our body is going to use it. A block of wood may have 100 calories. If you eat that block of wood, you will get none of it, right? So it's like, well, you know, that's it, right? I mean, there's lots of calories in a block of wood, but you won't absorb any of it. It's just the unit of physics. Physiology is what happens in the human body, right? Where are the calorie receptors? Do we have calorie counters within our body? They're saying, you took this many calories there for this, right? And you look at the failure of that sort of academic notion that we can be so precise that we are now physicists, not physicians, right? Like we're physicians. That sort of stuff from physics doesn't work because it doesn't jive with how the human body works. We don't have calorie counters. We don't have calorie receptors. Like there is nothing in our body that senses how many calories you eat. And it doesn't account for the realities of modern life where people are sleep deprived, right? And therefore, their hunger in society hormones are completely off work. It doesn't account for chronic stress, which raises that hormone you mentioned earlier, cortisol, which again has a huge effects on our hunger and all kinds of things and where we might store that body fats. You know, the human body is just much more complex. And I think I think a lot of people have a certain bias, right? So if you're a personal trainer, I guess your bias is probably the subset of people you've seen, people who are coming to see you who believe that actually working out regularly exercising hard is really, really important to lose weight. And of course, it can form part of the overall strategy of things. But therefore, your view as a personal trainer is going to be hugely impacted by what you see. Of course, my view is hugely impacted. But what I've seen over 20 years, tens of thousands of patients, but as a general practitioner, I guess one thing I would say is that you see everything. You literally see everything. You see people who've got all kinds of issues. And therefore, I feel that gives you insight into a whole variety of different people, different lifestyles, people who are shift workers. And you, you know, you're a practicing clinician as well. I guess as a nephrologist, you will also see a huge amount of different people, right? Yeah, exactly. And that's one of the things that you see a lot of in this sort of fitness world. And there's this sort of pro science. Because, you know, you're so invested in this idea that it's all about effort, right? You know, that all of weight loss is just due to effort and willpower, right? As opposed to, you know, eating the right foods and all these other things that are so important, we know, like sleep and stress and so on. I used to, you know, and I think we all did, of course, we all used to believe that, right? And I always thought in medical school and above I used to think, you know, weight loss is just about willpower. It's about controlling what you eat, right? And I always thought it's strange that there are a lot of medical conditions that cause weight gain and weight loss, but weight gain in particular. And I always thought it's strange because how can a medical condition cause weight gain? It's all about willpower, 100% about willpower. It's about calories in, calories out. I used, and then I thought, how is that possible that you have a medical condition that has nothing to do with willpower, right? So if you're, if you have prey to willy or any of these other conditions that cause obesity, you know, addisins, sorry, cushing disease, how can that cause weight gain? Because we know that it's caused by sort of effort, right? So it's very strange, but as you go on, then you realize, no, it's all about, it's all about the hormones. Like you give somebody insulin and I don't really care how much will power you have, you gain weight. Why? Because you're literally telling your body to gain that weight. So therefore, if that's the important thing, then how are you going to minimize those instructions to gain weight? Well, you eat natural foods. Does natural foods, even carbohydrate-containing foods, natural ones have far less insulin effect than others. And intermittent fasting, when you don't eat, you know, your your body is going, your insulin levels are going to go low. Your body is going to start using calories instead of storing calories, right? So it's all about those hormonal effects that we have to understand that we said were unimportant because we sort of elevated calories to be the one and only thing. And I think a lot of fitness people and a lot of scientists, in fact, love the sort of simplicity of that idea. But unfortunately, it wasn't really true. And you see it all the time. Like there's so many people, like doctors, for example. There are a lot of doctors who are overweight. And I know a lot of doctors, most of my friends are doctors, right? And would I say that they have no willpower? Absolutely not. I've seen these people work sort of 36 hours at a time, right? When they put their mind to something, they will absolutely go out and do it. Nothing will stop them. You know, these people are overweight. Some of them are obese. Some of them are my friends. I don't think they have no willpower. I don't think they have a lack of willpower as the reason that they are overweight. I think they're eating the wrong foods because they are either getting the wrong advice to eat constantly and so on. And so many doctors have come back to me. So when I started talking to intermittent fasting, probably about eight years ago, I honestly, people thought I was insane. Like it was, you know, common knowledge that you had to eat all the time, even to lose weight, right? And when I came out and said, well, you can fast. I mean, and most of the doctors that I spoke to, you know, because they knew me and they would listen to me, they said, this actually makes a lot of sense. And they're all like, you know, I remember when I was in residency in training, I'd go like 24 hours without eating. Nothing bad ever happened. I was so busy in the emergency, I was so busy in the operating room at so many patients, I just didn't eat and nothing really happened other than I was a hungry for a little while but I was too busy, I ignored it. And I'm thinking, yeah, because when you don't eat, your body is just gonna take whatever calories it needs from your body fat and that's it. And everybody's like, yeah, I was like 30 pounds lighter at that time, right? When I didn't eat, tons. So a lot of the physicians would always come back and say, you know what, this makes a lot of sense from a physiologic standpoint, this idea that you should eat all the time is wrong. So one, you know, fasting is a way to eat fewer calories because you're taking it from your stores and you're feeling full because you've taken it from your stores, right? Just like you take food from the fridge, it doesn't mean you're less full. You're just as full as if you went to the store. Just so you took it, you took those calories from a different place, you took it from storage. Same thing with body fat, you took those calories from storage as opposed to from food. No difference in terms of physiology. So yeah, it's interesting because a lot of doctors themselves, even these sort of highly, highly educated people, would say, and that's one of the things that, you know, I think has started to sort of resonate through. There was an interesting study where they looked at, they did a Facebook poll of physicians and how they used weight. And what was interesting was that 75% of people used intermittent fasting in this poll for weight loss, physicians, yet they only counseled it for about 30%. So the huge gap was that the doctors wanted to lose weight and wanted to do something effective, which was fasting, but with their patients, they had to give sort of sanctioned advice, which didn't include the fast. I want to get into some practical information for people. I think one of the really beautiful things you said so far is that it's not a lack of willpower. And unfortunately, this over focus on the calorie has led to a lot of people feel really bad so that they think, you know, I'm really trying. Like I'm restricting my calorie intake. I'm not eating that much, but I can't lose weight. And they feel like failures, I feel guilt, they feel ashamed of themselves, which is really, really toxic to try and make long-term behavior change when you feel like that. So I want to go into some really practical things before we do just to finish off the calories and calories out model for a moment. My approach has always been with patients and when I like you when I write books, I say, look, if you find that counting calories works for you and you can fit it into your life and your lifestyle and you're getting the health outcome you desire, I'm not trying to change your mind. I'm not saying stop doing it. If that works for you, go for your life. I'm just saying in my experience, I haven't found it to be that helpful, certainly for most people that come to see me. What would you say to someone who is watching this and says, Jason, listen, I actually have no problem counts in calories. I like counting them three times a day and I can maintain my weight and maintain my health doing this. What would you say to that person? I agree with you. I mean, if something's working for you, then go ahead and do it. Like there's no reason to stop. And it really goes for anything. It's if you're eating 10 times a day and you're doing well with it, then go ahead. Be my guest. And we know everybody reacts differently. So I'm okay with that. But if you want to make a change, then you could probably go out of that's where to start, right? Here's a good place to start. And then you decide what to do with it. And I think the other thing, you know, I think you said that was very good was that this idea of sort of people who aren't losing weight, what happens, of course, is that when you focus on calories and say it's all about willpower, what you're saying to these people is that they don't have the willpower, which I think is absolutely not true because it's one of these embedded assumptions in the calories and calories outmodel. That is that nobody acknowledges, which is that calories out can go down. You're basal metabolic rate can go down when you die it. So therefore, if you are not losing weight, even as you eat fewer calories, you could still not lose weight because your metabolic rate is going down along with it. So why are you blaming these people? And that's where you get a lot of people sort of just have made that assumption that calories out is going to stay stable at 2000 calories a day. Right? This is the whole thing when you read these people who are like, oh, just cut 500 calories a day, you'll lose a pound a week that actually never happens because that assumes that your calories out, your metabolic rate stays at 2000 calories. Every physiologic study we've ever done says it goes down. And you know it must go down. So for example, if you take somebody who's 200 pounds, you say, cut 500 calories a day, you lose a pound a week, does that mean in 200 weeks they'll lose the way zero pounds? Like no, absolutely not. That will never happen, even if you stick to 1500 calories. So therefore, your metabolic rate must go down at some point, turns out it goes down almost immediately and persists. So therefore, this idea that it was all because they skipped on their diets, right? That's not true. It might have just been a very purely constructed diet. That is not taking into account just the foods, but also the sort of eating duration, the fasting, the hormones, what hormones you're stimulating with the foods that you're eating, what information you're giving your body, what instructions you're giving them by. There's so much of that other things that are important. Yeah, and I think it's time to take that sort of guilt and shame away from those people. We're all sort of working together. Yeah, it's a great point. Let's get to the sort of practicalities you've mentioned in your books, you mentioned this conversation that chronically elevated insulin is problematic for a whole variety of different reasons. Yes, for the developments of Tarts Udo Abities of putting on weights. Also, a lot of people aren't aware that it increases blood pressure, increases fluid retention, increases a type of cholesterol called VLDL, very low density lipoprosis, which can be problematic. So for a variety of reasons, we want to lower that. So there's two broad ways I'm getting that we can do that. One is through a diet that does not constantly push up insulin. And the other way is with a form of intermittent fasting. Or bringing in some type. So if we start off with food and diet, you mentioned low carb early on in this conversation. Of course, we know how divisive the diet landscape currently is. In your experience, if we're thinking about a diet, food choices that don't spike insulin too much, what are the kind of principles you like your patients to follow? [MUSIC PLAYING] This is where there's always a lot of different subpoignant or low carb versus high carb. And I actually think that there's a huge difference, even within carbohydrates. So the problem is not generally the carbohydrates, but the processing that makes the biggest difference. So if you look at the glycemic index, which looks at carbohydrate, containing foods sees how much insulin tends to go up and glucose tends to go up, they tend to go up together of certain foods. What you see is that unprocessed carbohydrates tend to cause a lot lower spike in insulin than processed foods. So you take cereals like cereals and stuff, they're really, really high. You take a very refined product like white bread, just very, very high. Then you look at something like boiled potatoes and it's just extremely low. They're both carbohydrate containing foods. So there's a big difference even within carbohydrates, beans, beans are carbohydrates. They have a different type of amelopectin. They have amelopectin C versus amelopectin A. Their digestion is completely different. They're still carbs. So trying to simplify it to just carbs is difficult because you could eat a lot of beans and who gets fat eating beans like very few people. Are you so okay? Like black beans, kidney beans, these sort of things. Yeah. The type of carbohydrate to contain is amelopectin C, which is harder to digest and therefore leads to much lower blood glucose levels, much lower insulin levels. But insulin is sort of that key. So even within carbohydrates, so people think, well, one of the things is to cut carbs, which is a reasonable thing. But cutting the refined carbs does a lot better because you have to understand that a lot of countries, a lot of cultures have had high carbohydrate intakes and in the past, have never had a big problem. So China, for example, was classic in the 80s. It was eating 300 grams a day of carbohydrates, almost all white rice. And there was almost no obesity. This is 1980. Then of course, recently they started eating a lot more processed foods, a lot more sugary foods. Now their obesity is just exploding. But it was not just the car. Why do you, this is really interesting for me. So white rice is a refined carbohydrates. Why do we have societies with high volumes of carbohydrates who are not putting on weights and who are not getting toxic diabetes? And that example, you use of China, there's really interesting 300 grams of white rice a day. You would think would spike insulin and would cause people to get sick, but it wasn't. And what if, you know, one of the theories I put forward in my first, what was this idea that maybe in the West, in the modern world, in which we now live where people are chronically stressed, they're chronically under slept, they're chronically under active and they're eating a lot of high-degrees all together. That's creating the perfect conditions for high levels of insulin resistance. And I thought, well, maybe the low carb diet has a particular utility in modern stressed out cultures. I don't know, if you got any comments on that, and how do you explain that in the 1970s, they were eating this in China and not getting sick? I think there's a few things. One is that the amount of sugar they were eating was just almost zero. So sugar, which is fructose, is metabolized quite differently than glucose. So when you metabolize glucose, all your cells in the body can use glucose. When you metabolize fructose, only the liver can use fructose. So the fructose goes straight to your liver and there it gets converted and causes fatty liver, causes all kinds of things when you're eating too much fructose. So it can get converted back into glucose, but for a lot of reasons, it just gets turned into fat through denobolipogenesis. You get fatty liver, you get insulin resistance, which causes hyperinsulinemia. So the fructose is actually much worse for you than the glucose, in my opinion, because if you are 150 pounds, you have 150 pounds of body that's using glucose versus sort of five pounds of liver that can metabolize fructose. So the fructose is much, much more obesogenic, I think, than the glucose. So therefore, the practical side is that sugar and sweet things like that are just much more fattening than starchy foods. So maybe you're saying then in China, back then, because they're not having much fructose. Yeah, I'm on zero. But therefore, the bodies can handle the 300 grams of white rice each day, whereas on the background, there's a lot of fructose, which is of course how many of us live these days, too much sugar, too much fruit juice, all these kinds of things, maybe with a background of that, suddenly the white rice starts to become problematic. Yeah, I think so. I think the fructose really makes that much worse. But the other thing is that there's different reasons why and two, they weren't eating all the time, right? They weren't eating constantly. It's not like they're eating eight times a day of white rice. And the third thing, I think, that's sort of always overlooked because it doesn't fit into this neat little square, is that there's different reasons why we eat. Like there's the hunger, the nutrition part of things, which we think is important, but in this day and age, it's probably the least important of the reasons that we eat. There's the habits, right? You eat because it's time to eat. That's really the only reason. And you eat because it's delicious. So if you take any diet that is monotonous, so no matter what diet it is, so you can eat, say, say you love pizza, but I give you pizza, breakfast, lunch, and dinner. Okay, very soon, much sooner than you think, you are going to be so sick of pizza that if I continue to feed you pizza, you're just going to say, okay, I'm going to eat as little of this pizza as I possibly can until I'm no longer hungry because I just don't like to eat it. That's the same thing with white rice. If you eat white rice in vegetables every single day, three meals a day, which is what they're eating in China, like different types of vegetables with white rice. Pretty soon, you're going to be like, I will eat the rice because I'm hungry. As soon as I stop being hungry, I am stopping eating because I know the hedonic effect of food, the pleasure giving sense of food goes away when it's completely monotonous. So you can eat all that, and you're not going to overeat it because you don't want to. You just want to make sure you're not hungry. And therefore, any monotonous diet always works because you've just very quickly run out of things that you want to eat. So what we've done, of course, in the modern age is we've introduced all kinds of varieties of food, which keeps us eating beyond these, we're full sort of stage. I've got my nutrition undone. I don't want to eat anymore. We never get that state because we're always like, well, we want to keep eating. And then you get around it by snacking because even if there's lots of good things to eat, so you go to buffet, all you can eat restaurant. After a certain point, you have to stop. You can't keep going. If you've eaten everything, and somebody says, hey, why don't you have a bit more of this pork chop? You'd be like, that's going to make me throw up. It's the same pork chop as you ate 20 minutes ago, but you're now full. So the point is that if you take away the sort of pleasure giving part of food, then you're going to be able to control a lot of overweight obesity, which is what the right rice was. It was monotonous. It was just every single day was the same thing. I can tell you, I ate rice a lot growing up because my parents were immigrants. They came from Hong Kong. We ate rice probably every single day. So yeah, I like rice all right, but until you're full, then that's it. I don't want to eat more than I can do because I've eaten too much of it already. So that's why it's always, people say, therefore, carbs are good or you have to camp in a rice diet from the forties. Hey, that proves that carbs aren't the enemy. It's like, no, no, no, it's very complicated. You can't just simplify things into like, this food is good and this food is bad, right? So there's a lot that goes into sort of understanding it. And satiety plays a big role in that. That is why the things that are most successful at controlling weight are hormonal agents that control your appetite. So nicotine is a classic example. It actually suppresses your appetite. People notice this when they stop smoking that their appetite goes up. And it's probably because it was chronic. We suppress same thing, the semaglutide, the drugs that some of the drugs that are used now. But anyway, so it means that the carbohydrates are not the only thing that matters. It matters the type of carbohydrates. So is it animal-type DNA, animal-type and see how often you're eating it because it's not just how high you spike it and how refined it is going to affect how high it spikes. The foods you eat it with are also going to make a difference. And this is always very interesting to me because you can take the same foods. And you're, that's not what's important. The hormonal response is what's important. If you take this same food at breakfast versus dinner, you're going to have a different insulin response to it. So you're going to actually have a much higher insulin response at nighttime versus breakfast. Same thing with something like vinegar. And this is very interesting actually, I think. So when you take sushi rice, for example, which is vinegar rice, when you take an acid or lemon juice with bread or vinegar with bread, for example, you can take say 100 grams of bread and you can measure how much your glycemic index goes up. And when you take it with the acid, it's like 50% 60% of what it was without the acid. It's just fascinating because of the same 100 grams of carbohydrate. So say you take white rice versus vinegar rice. The glucose level on the insulin level goes up to about 65, 69, something like that versus 100. So you have much less effect. And there's an interesting reason why that is. And it's because there's in terms of the gestion of starch is suggested by a hormone called amylase. There's salivary amylase and there's pancreatic amylase. So the assumption, so you eat bread, the saliva contains amylase, starts breaking down that starch. You remember starch is a chain of glucose. You need to break it into little pieces so that you can absorb it. The saliva contains amylase that immediately starts to work it. And we had assumed always that most of the digestion is through the pancreas. That turns out that up to 80%, 60% to 80% of the digestion can be salivary amylase because salivary amylase is deactivated by low stomach pH. So we assumed you chew it, boom, it goes into the stomach and all of a sudden salivary amylase stops. It stops breaking down the starch. But in fact, because of the bolus of food, the pH of the stomach actually never gets down there. And that doesn't get low enough to deactivate salivary amylase. So if you take something like bread with vinegar, like they do, you know, olive oil and vinegar, for example, turns out that you're, you don't break down the same amount of starch. And therefore your glycemic index goes much lower, your insulin spice will much lower. And it's because of the acid in the food. Lemon juice does that, fermented food does that, which is like the acid vinegar, which is a cedar acid does that. So there are things that you can take with the carbs that will also affect it. If you take carbs first versus last in the meal, you take it with protein or with fat, it's going to make a difference. And there's so many things that make a difference, other than just adding the total number. Yeah, I love that. And I think that officially qualifies as a hack, you know, the term hack is, you know, thrown around a lot of these days. But that seems like a really practical thing that people can do within the context of their own diet, just to lower that glucose and lower that insulin response in the body. The other thing, of course, I can do is think about the food order. And I know you released a video recently on your YouTube channel about this. Why is the order in which we eat foods important when we're thinking about glucose and insulin? Yeah, and it's again, it was the same sort of thing where they did a study where they had people, they ate carbs first and then wait a 10 minutes, then had their fat and protein versus taking the fat and protein, then waiting 10 minutes and then eating the carbs. And again, same number of carbs, same type of carbs, right? Same food, same amount of food in the carbs. Exactly. Yet the rise in the insulin was like 50% of what it was. And remember, the insulin is what's telling your body to, hey, store this energy, store these calories away. So at the less of this insulin, you have trying to store it away. The more you're going to leave out in the body for you to use this energy and it's going to keep you fuller longer. So that's the food order. So basically, the whole hack would be just shift your carbohydrate intake to the last part of the meal instead of the first part of the meal. And that's going to do two things. One, it's going to make you less wanting to eat the carbs because you're already full from the fat and protein. And two, the amount of carbs that you take, even if it's the same, is going to have less of an effect on you. So it's, it's, it's, so, so, you know, this is what I mean when I say it's a complicated topic and people who try and simplify it to total calories or total carbs, always wind up missing a few things because there are ways to get around it because, you know, we have eaten carbs in the past without without growth, you know, worldwide obesity up at that point, right? Yeah. This is something I've done for a good couple of years now and more recently with the kids, my kids are 12 and nine at the moment. And I will, if it if I'm cooking dinner, I will serve them the protein sauce and their vegetables first. And when that's finished or almost finished, then I'll put on, I don't know, the sweet potato mash or whatever else, you know, whatever whole food carb we're serving with it. And, you know, because it's very hard for me as a parent knowing the science, knowing the impact, not to try and implement it because it's pretty straightforward to do actually. And it's something that I think anyone listening to this or watching this right now can can experiment with themselves, you know, eat the carbs last. And you know, there's a really good video on your YouTube channel that I think will help people understand the science of that as well. Jason moving to fasting, intermittent fasting. Right, if someone's kind of heard what you've had to say so far and saying, okay, all right, I'm interested in trying intermittent fasting. Where would you encourage them to start? And before you answer, I also want to say, one of the things I think is so great about the practice of intermittent fasting is that it doesn't really matter what diet to try, be belonged to. You can still practice this and get benefits, right? So I think it cuts through straight away through all that noise. So yeah, maybe maybe some tips for people on where they might want to start. Yeah, I think that the first place to start really is just to go back to sort of, you know, eight hours, 10 hours of eating sort of thing. If you want to eat sort of breakfast at eight, nine o'clock in the morning and finish by like six o'clock in the evening, then let the rest of the time be fasting. You know, you're talking about a eight, nine, 10 hour eating window, there may be 14 to 16 hours and that's relatively easy to do. And of course, it's something that people have done for many, many years. So cutting out the snacks, cutting out the late night eating, and then, you know, so if you cut out the eating after dinner and push your breakfast a little bit later, then then you're automatically going to get that that period of time and that's a great place to start. And then you can experiment, you can go longer or shorter depending on what you like. But I think that's probably a good place to start off with. That's going to be safe for everybody. You know, there's no, there's no problems with anything. You're still going to be eating a relatively normal, you know, meal schedule and so on. But you know, there's so many, or there used to be at least so many sort of myths about fasting, about how it was so damaging to you and all this. I think, you know, it's important to get that right information as well. People used to think, oh, well, you know, it's it's going to burn muscle. It's like, you hear this all the time. And I'm always like, okay, if you're an ABD athlete, sure, maybe that's something you have to be mindful of. But for most people who are not elite athletes, you're just sort of regular people, you know, this idea that it's going to burn muscle is still very much in grain. You see it out there. Lots of people talk about it. And it's like, do you really think that our body is just so stupid that we would store calories as glucose and body fat, like the minute that you don't eat anything, you're going to burn muscle. Like do you think that we survived as a species to become the dominant species on our because our body is so intrinsically stupid, like it's sort of like storing firewood, you know, for the winter. And then as soon as it gets a little cold, you chop up your sofa and throw it in the fire. Like what? Like why are you storing body fat? If you plan to use that muscle, it's like ridiculous. And I think it's a huge misunderstanding of the physiology. So I have a video about the five stages of fasting. And there's a period of time in there that actually is called gluconeogenesis. So when you think about the physiology of fasting, there's a lot of good things that happen. But essentially your body goes from eating food, then it starts using glycogen, which is sugar. It's basically chains of glucose that are stored in your liver. And then after glycogen, then there's a short period of gluconeogenesis, which is protein. And that's where people say, wow, that's your that's where you're breaking down muscle. And I have to say, no, protein is not the same as muscle. Protein is a lot of things. There's lots of excess protein on our bodies. Skin, for example, is protein, connective tissue. The thing that binds it all together is protein. When you break down proteins, your body is going to break it down and then rebuild whatever it is that you need. So if you need muscle, you will build it. If you don't need it, it won't build it. Like the only thing that builds muscle, what builds muscle and loses muscle is not how much or how little you eat or protein you eat. It's the exercise that you do. Like I'd love it if I could eat and build muscle, but I don't. Like, it doesn't happen ever as much as I wanted to. And it's the same thing. When you're breaking down protein, it's not necessarily muscle. If you're using the muscle, it's not going to get broken down. But what you are going to do is break down the skin, the connective tissue, the stuff that you don't need. And this is this process called a topology where your body is actually going to break down organelles in the body because it's not necessary. And it's a process of cleaning out the unnecessary stuff so people who did intermittent fasting, we have people who lose, you know, 150 pounds. They haven't sent anybody for skin removal surgery because that was protein that was removed, not fat. And that's all anecdotal. I know it's not sort of proof. But we have a lot of people who say, "Well, my skin has tightened up too." It's like, you don't get that with just body fat loss. That's protein loss. If you look at the amount of protein on the human body, in somebody who's overweight, it's far an excess. They have more protein than somebody who weighs less. It's not just the fat. It's all the stuff that helps to support the fat, the blood vessels, the skin, the connective tissue, right? And that all also has to go with that. So yes, there is a period of breaking down proteins during the period of fasting, sort of around 18 to 24 to 30 hours, something like that. But it's not necessarily a bad thing. It doesn't mean your body is breaking down muscle. You will lose muscle when you don't use muscle. So you're saying start off for people, maybe a 10 hour eating window, as you say, let's say 8 a.m. until 6 p.m. is your eating window. Out with that, what in your view, because you take a lot of people through these fasting programs, I know, in your clinic, what are they? Committed to do outside that eating window in terms of drinks and other things. That's the first question. And then going beyond that, it's like, what benefits then might people, once they start there and go, okay, this is pretty easy. I can do that. I'm feeling better, lost a bit of weight, I'm sleeping better for your lighter. What are the benefits? Or why should some people consider going further? Because I think in your clinic, am I right in saying that sometimes you take people into 36 hour fast, 48 hour fast, those sort of things. So maybe just walk us through that, if you will. Yeah, so classic fast is water only, but really you don't have to be that strict. There's no rules. When you're talking about fast, and there's two main variables. One is length of fast, and two is what is allowed during that fast. And there's lots of things. So tea, for example, is something that I recommend for a lot of people. You can drink coffee. And then those really don't have too much effect on your body. There's no calories and green tea. And it really doesn't have much effect. On the other hand, the coffee and stuff, it's going to have the coffee and tea. They both have things like stimulants, like caffeine. And that may keep your sort of energy, your metabolic rate a little bit higher. So yeah, maybe there's a little benefit from those, although the effect is relatively small. So teas, coffees, herbal teas, those are all great to do. Then you get into things that are more clearly sued. So things like bone broth, for example. And then people even take small salads and stuff within that fasting window. If they get very hungry, for example. And people think, well, I just broke my fast. I have to start all over. That's not what happens. What happens is that when you're fasting, you're trying to force that insulin level down. So if your insulin level is going down, your body is going to switch towards using your stored calories, not the food. If you break that fast with say, oh, I had some bone broth. Yeah, your insulin is going to blip up for a little bit. But it's a very small amount. And then it's just going to start going back down again. It's not going to have a huge effect. But even if you take something during that fasting, it doesn't mean that all of your progress has been lost and you have to start from scratch again. So you don't have to worry so much. But generally, I tend to tell people, just stick with teas, coffee. If you put a little bit of cream in the coffee because that's what you're used to, go ahead. It's not going to make a huge difference. But don't put the whole carton of cream in it. Then you're talking about food more than anything else. And then the other thing is in terms of the benefits of fast and why continue with it. There's a lot of reasons. Like if you think about the physiology of what happens during fasting, there's a lot of good things that happen. People always assume that they're going to be tired during fasting, but that's not actually what happens. So if you don't eat, there's a very sort of stereotype to response. That is, insulin is going to go down. Certain other hormones are going to go up. And one of those hormones is the sympathetic nervous system and growth hormone. So both of those go up as you fast. Sympathetic nervous system is part of this sort of parasympathetic, sort of relaxing. Sympathetic is sort of stimulating and so sort of fight or flight response. So it's the hormones involved are mostly nor adrenaline and adrenaline. So you actually activate the sympathetic nervous system when you don't eat. And this is sort of basic first year medical school stuff. It's a number of hormones called the counter regulatory hormones. You get a spike of this counter regulatory hormone in the morning, around 5 a.m. 4 a.m. 5 a.m. And it sets you up for the day. It's pushing the calories, the energy into the system so that you have energy for the day ahead. So that's why you don't necessarily have to eat the minute that you get up because your body's already started fueling yourself from its stores. And because you're having higher levels of sympathetic nervous system, you're going to be able to concentrate better. You're going to have more energy as you fast, not less energy. Like think about it. You know, if you have a lion who just ate, it's sort of sleepy, just wants to lie there and digest, but you have a hungry wolf. Is it sort of like falling over because you can't concentrate? No. The hunger is what makes it dangerous because it's dialed in. It's concentrated and it's got energy to burn. It's just getting its energy from its stores, not from its food. And that's because you've, you know, again, it's not some rudy magic psychology. It's just physiology. Your body is ramping up at the time that you're fasting. Well, that's great. You're going to have more energy. I've had people come in, you know, women and their husbands would be like, I can't keep up with her anymore. Like she walks so fast. I can't even, I have to tell her to slow down. It's just, it's like, it's because I have so much energy. It's like, yeah, because now you're releasing that energy. You've now finally allowed your body to access the stores of energy by allowing instant to fall by fasting. You're allowing your body to access this huge store of calories. There's 100,000 calories that you've had stored away that you've never been able to access before because insulin is always blocking you. Now you have access to this energy. They're like, well, okay, let's use it. Let's use it. Your body's pumping up the sympathetic tone. Some people actually can't sleep because they're so pumped up when they're fasting. But then they can focus better. We know that people, you know, in terms of their mental abilities are do better with fasting. It's a fascinating process, but a lot of good stuff there. It's just crazy how many people have never, ever experienced anything like that because of what we were talking about, right? They started this conversation where, you know, over 50% of the US population who don't work in shifts are consuming foods over 15 hours a day. So they're nowhere near able to actually experience these things that you're talking about. And I think another thing which I often think about with fasting is that humans have been fasting for donkeys years, right? If it was dangerous, how would we possibly have survived this far? Now, on that, I think a couple of caveats, and I know you deal with a lot of patients with type two diabetes, do people, in your opinion, need to be careful if they are taking blood sugar, lowering medications or injecting insulin? I think we should just sort of briefly mention that in case people jump straight in. Yeah, absolutely. So remember that when you're fasting and your body is going to be using glucose, stored glucose, whether it's in your blood or whether it's in your liver, if you're taking medication in addition to lower your blood glucose, you could possibly go too low. And yes, it can be very, very dangerous. So if you're on medications, you should always speak to your doctor. For a long time, people used to say, well, that's why type two diabetes can't fast. It's like, no, that's why you have to be careful because the thing about the fasting is that it is a way to help lower your blood glucose. If you're lowering it with fasting and you're taking your medication, then you'll go too low. But it doesn't mean that you should not fast. It means you need to take less medication. It means you're over-medicated. So you need to adjust that medication, not that the fasting was wrong. Because this is a natural way to lower your blood glucose. What could be better than that? Yeah, but we don't see that as doctor's, do we? You don't know. No, it's given that you stay on the medication. Oh no, this is dangerous. So adding in fasting, it's like, well, hold on a minute. It's just, you can think of it as a third medication and just saying, oh, if I'm going to add this one in, maybe I need to add it in. take this one down or take this one off, but it's not, it speaks to this wider problem that we don't, as a profession, in my view, give things like fasting or changes in food quality, the same priority, the same level of importance, as you know, tinkering this medication by 10 Mg. You don't want to mean it's kind of like, - Absolutely. - No, it's very frustrating. - It is, because, for example, you'll have, if somebody is on insulin, for example, and their blood glucose goes down. So what is the advice that we as a profession give? Well, eat something, right? It's like, okay, well, sure, and at that one specific time, yes, I agree, but in general, if you're going down and means you're over-medicated, because I'm giving you this insulin to get your sugars low and your sugars are going too low. So you're over-medicated, so you need to reduce the dose, but we don't think that way, because we think, okay, well, what you should do, and this is, I've heard actually dieticians say this all the time, you need to eat to cover your insulin. It's like, what? So if you take insulin, your sugars go low, then you eat. What do you think is going to happen? You're going to gain weight. If you gain weight, what happens to your type of diabetes? It gets worse. Why don't you instead not eat, take less insulin, and then you're going to lose weight. As you lose weight, your type 2 diabetes will get better, but you're absolutely right. We've gone in the wrong direction, thinking that the medications are what's good for us, and everything else has to fit around that. And it's part of the problem is medical education, because again, I've gone to so many meetings, and these are given by the heads of diabetes associations and stuff, right? And they'll go, okay, the number one, two, and three treatments for type 2 diabetes is diet, diet, diet. Right? Okay, great. Then they spend the next 59 minutes out of that 60-unit lecture telling you about drugs. So the message to all the doctors, these are training doctors and established doctors, is that yes, we will give you lip service about diet and lifestyle, but what we're really here to talk about is meds, right? And that's wrong. That's an absolutely wrong thing, because, think about this simplistically, right? Type 2 diabetes is largely a dietary disease. And we're using drugs to control a dietary disease, while you're not going to get as much effect as you think you will, because you're not focused on the root cause, which is the diet. - Yeah, this is such an important point. When I teach doctors on this prescribing lifestyle medicine course, a lot of doctors will say initially that old patients don't do what I tell them to do, you know? And I often give the example of a 10 minute or a 15 minute consultation with a patient in general practice, where they've just been diagnosed with Type 2 diabetes, and we do a role play on stage. I basically try and demonstrate two different consultations. One, where basically you spend the first nine of those 10 minutes or 14 out of those 15 minutes, talking about medication, and the fact that this will stabilize your blood sugar, you're probably going to need another medication in the next year. And within a few years, you're going to be on insulin. And then as they're walking out, you say, "Oh, and if you could lose a bit of weight and move a bit more, it's going to help you." And then we do another one where actually you spend the first 90% of that consultation, helping them understand what's caused it, giving them help us to how they might change their lifestyle, all these kinds of things. And then you also mention that there may be some medications. And you ask the question to the doctor, "Well, what message is that patient going to get?" If you spend 90% of the time on lifestyle, and 10% on medication versus the opposite, what's going to happen? Of course, the patient's going to go out with the impression. Yeah, he mentioned diet at the end, but really it was all about these medications, but it is starting to change. That is for sure, maybe not fast enough for people. You mentioned women before, and a woman who was full of energy and her husband wasn't able to keep up. There's another kind of, maybe a myth about fasting, which is that it suits men better than women. Have you heard that myth? And what is your experience being with that? Yeah, I've heard this myth before that women shouldn't fast or they can't fast, or they don't get results from fasting. And it's really, I think, just not true. Like not all men do well. Like, that's not some men who don't do well. You just don't hear about them. The women can fast. Like there's nothing inherently dangerous about fasting in women. They do probably respond a little bit differently. Men tend to, some men lose a lot of weight right up front very, very quickly, 60 pounds and a month sort of thing. Like really, really fast. And whereas women do tend to be more slower and stable, and I think some of it is just the baseline. Some men really just, their diets are just really, they're obviously not good. Like they're just eating out fast food, like 100% of their meals sort of thing. Right, so it's just such a horrific baseline of processed food that as soon as you change that, like, and you don't see that with women. Women tend to be a lot more diet conscious. So then you don't get people who have those horrific baselines of McDonald's for every meal sort of thing. Whereas you do see that with men, like with men you get that. And therefore, as soon as you change them to sort of like whole foods, their weight just undergoes these dramatic changes. So I think that it's not just the fasting, but it's the foods as well, right? So there's two components, right? There's the foods that you eat, and then there's the time that you're not eating. And I think it's, yes, there probably are some differences with men and women. Like people talk about sex hormones, men and pause, for example. And I think that there is definitely something there. Like the sex hormones do play a role in how much fat you gain in lose. It's just a fact. And this is another part of this whole calories thing that I always find incredibly, like I don't understand how any serious scientists can think about calories as the only thing, has think about adolescent girls and boys, okay? So pre puberty, girls and boys are roughly the same sort of weight and body fat and so on. Then you go through puberty and women, in general, are about 50% more fat than boys. It's not that they have less willpower, like obviously not. The difference was that the boys had a bunch of testosterone to gain more muscle, whereas women tend to develop fat in their hips and their breasts, right? It's just that physiology. That's the difference between exposing somebody to a lot of estrogen versus testosterone, but it's not a willpower problem. It's not a problem with their diets necessarily, right? So it's not like, you know, and this is, you know, people who say, well, you know, it's all about willpower. It's like, well, then you must think that women have less willpower than men. It's like that's not true, like it's not true in any sense. So therefore it's sex hormones that play a huge role. Women do have a difference in sex hormones during menopause. So we know that there's a certain number of changes and that may play a role in weight loss, but there's nothing you can do about it. Like I'm not gonna say they're menopause. So therefore you just have to deal with it. So does it mean they can't fast? No, does it mean they may respond differently than men? Yes, absolutely. They may take a little bit more time because their bodies had been programmed, programmed by nature to carry more fat. That's not their fault or anything necessarily bad. That's the hormones speaking. And I think, you know, all these things are very individual, right? Some things work well and quickly for some people. Some things don't. Thus it's kind of the way it is. And then also we have to be careful about how we're measuring the impacts. I mean, if weight loss is the only metric people are looking at, they may think they're intermittent fasting, potentially has failed for them. But actually the benefits, as we've touched on, on multiple occasions throughout this conversation, go far beyond just weight. So there are implications for your gut function, often I've found, people with IBS types and it's really clears up massively when they have periods of fasting, sleep can improve. You know, all kinds of things, other things can benefit. So, you know, I definitely encourage people to experiment and see. The other thing Jason often comes up with fasting, particularly these days, is the issue of eating disorders, which as you know are rampants that on the rise, particularly in adolescence. You released a video on this recently. I saw on your YouTube channel, which I found really really interesting. What is your view on whether intermittent fasting, whether me and you having a conversation like this is toxic for people who may be suffering with eating disorders. I mean, what is your view on that? - Yeah, and this, the literature really says that there is not a lot of danger with that. So when we're talking eating disorders, generally we're talking about anorexia nervosa and bulimia, those are the two big sort of eating disorders. So they've done studies where they've basically looked at it. So they take people, So not, you know, there's two domain concerns, right, with dieting or fasting and eating disorders. One, is that you're going to be so hungry that you're going to trigger like overeating or binge eating. And two, is that there's maybe you don't take enough amino acids and triptophan, therefore you're going to get a little bit depressed and then therefore you're going to overeat. Neither of those possibilities turned out to be true. So in the studies what they did was there's one study where they looked at this, where they had people, they fasted them and then said, you know, what are your levels of hunger, do you overeat and so on. And the bottom line was that people tend to eat a bit more of the meal after a fast. And this is a 24 hour fast. But if you look at the full 24 hours, they're still not eating nearly as much as they used to. And two, was that they took people with diagnosed anorexia and bulimia. This was a separate study. And they, again, put them through fasting and they were basically wanted to see if this was going to trigger their eating disorder. And again, the conclusion from that study was that it did not. So it sounds like it's a plausible concern and you know, I don't want to minimize it because eating disorders is a very serious problem, of course. But the available data so far hasn't really borne out the danger that it does. Like it doesn't suggest that there is any danger from that. You know, I want to just be careful because there's just not a lot of research into that. And I always want to be careful because you know, fasting is a tool and tools always, they can help or they can hurt. It's not the tool. You use that tool. So if you use, you know, blade, you can cut out a tumor, for example, you can cure somebody, but you can also kill somebody. So if you're talking about intermittent fasting, like in, you know, somebody, you know, you have a 16 year old girl who weighs like next to nothing with a BMI of 15. No, you do not want to be talking about it. You have a 60 year old man with type 2 diabetes who weighs sort of like, you know, has a body mass index of 45. Well, then yes, absolutely you want to be talking about it. But it's the skill of the person using it. So, you know, you have to choose your situation. Like to say that fasting is back for everybody. Well, that 60 year old man who's, you know, super, super, you know, morbidly obese, his risk of interacting nervosa is almost zero. Like there's no reason not to talk about it with him. The risk of a 16 year old girl who weighs almost nothing and as a BMI of 16, yes, her risk is extremely high. You should not be talking about that with her. So, you know, it's, it's, it's not the knife. It's the way you use that knife. And fasting is exactly the same. HPA1C is a common blood marker that many people get done at their doctors, which is a, you know, an average measurement of our blood sugar over the past two or three months. With all your experience, of course, if it hits a certain point, we call that type two diabetes, if it hits a slightly lower point, we call it pre-diabetes, do you have a sense these days of what an optimal level might look like for someone? I understand that you deal with a lot of type two diabetics in your kidney clinic and you help them put their type two diabetes into a mission, certainly get a lot better using the things that we're speaking about. But I, but I, I've often thought in medicine that we, it's very black and white. You either have pre-diabetes and type two diabetes or you're normal. But clearly, that's not the case. This is a progression that at some point you flip into pre-diabetes and at some point, you flip into the type two diabetes diagnosis. So do you have a sense of what an optimal level might look like for someone who's trying to safeguard their health for the future? If you look at studies, really, the lower the better. And I think that those definitions are mostly because the whole, the whole thing is that you have to have definitions to do studies. So you need to classify. So 6.4 is not that bad. The 6.5 is that bad. Like the difference is very small. But at some point, you have to draw that line. And it's an, it's an artifact of doing studies. So you have to classify people because you can't just say 6.1, 6.2, you can't have like, you know, 15 different kind of queries in the study. It'd be really confusing. So you break it up and you say, okay, well, at 6.5, you're this, and 6.0 to 6.4 is this and less than that. But it's really a continuum. So there's no real best number in clinical practice though. I've seen a lot of people who are like 5.9, 6.0 and they seem to do fine. What I think is important from an individual basis too is not just the level, but also the stability of that level over time. So I've actually seen a number of people and I always thought this was wow, you're like almost prediabetic or you're prediabetic. But they actually just trundle along just fine. And they're always at 6.0. And I think that that's another thing that I'm not sure is captured with the actual number is sort of, if they've been like this for this many years, is it really bad or is it not? I actually thought this because it was a relative of mine who are tracked relatively closely for like 20 years. And it was like 6.1, 6.0, 6.1, 6.0. And they did fine. They'd actually never had any problems whatsoever. And I thought, I wonder if it's just like the diet and change that we've been changed and they're pretty healthy throughout. But I just always wondered, is it really bad or is it that person who goes from 5.3 to 5.5 to 5.7 to 6.0 to 6.2? Maybe that's what's bad. I think there's two things. One is the actual level. And two is if it's at a sort of borderline level, is it going up or is it sort of stable? Because what's really going to be bad, of course, is when it goes up over 6.5. Then clearly you're in the abnormal way. No, I think that's super interesting. And I suspect over the next few years, we'll get a lot more clarity on this as science in this area progresses. Jason, had we had more time, I was wanting to get into your latest book, The Cancer Code, which is just brilliant. Maybe I can tempt you with a part two at some point in the future because I think the way you've articulated your thoughts on cancer and how our understanding of it is developing is pretty profound and it's a brilliant read for anyone. To finish off this conversation, we've covered a lot so far. This podcast is called Feel Better Live More when we feel better in ourselves, we get more out of life. Right at the end now, Jason, in all your years of experience, yes and clinic, but also spreading information on the web through your books, what are some of your very best tips for people who have heard what you had to say, go right, I'm in. I want to make some changes. I want to start looking after my health. I want to start lowering my insulin. What could advice have you for them right at the end? I think that the most important thing I think is to focus on sort of foods and less on nutrients like carbs or that kind of thing. Focus on the sort of eating whole foods is still probably the most important thing, whether it's a carb or whether it's not. I think that's still probably the biggest thing. We don't talk about it as much as we probably should, right, in the whole thing about carbs and keto and this diet and that diet. It all winds up vegetarianism and that's sort of, it always comes back to eating sort of natural foods and eating in a way that's not constantly stimulating. To me, it's relatively simple and not that controversial. One, don't eat too much sugar. I don't think that's very controversial to try to eat unprocessed foods, which again, I don't think is all that controversial. And three, don't eat all the time. If you're overweight, don't eat all the time. Cut out those snacks. To me, just seems like, hey, this is just what it was in the 1970s. There was none of this, count your carbs, count your calories, count this, count that. Eat whole unprocessed foods, whether it's vegetables or even meats. Enjoy your foods when you do eat them, but don't eat constantly. Give your body a break once in a while from eating so that you can digest your foods. That's all your grandmother ever wanted to tell you. Give your body a chance to digest the food that you ate. Don't just keep shoveling it in. You've got to use it because when you're putting it in, it's going to come out at some point, otherwise you're going to get into problem. Those three things, I think, are still the core of everything without getting too complicated. Don't eat too much sugar, eat unprocessed foods and don't eat all the time. Great advice to finish off. Jason, want to acknowledge you doing fantastic work? You're helping so many people. I think your books are fantastic. Which books would you drive people to and where are asking people to stay in touch with you if they want to? Keep up today with your work. Yeah, so I think the best place to start is the obesity code. It sort of goes into the science of weight gain and weight loss. I have a number of YouTube videos now which sort of covers a lot of that material in sort of less than 10-minute chunks. So I think that's what I've been doing sort of the last year to sort of help spread the message. And the other ones, you know, you can also follow me on Twitter @DrJasonFung. And then, you know, the cancer code, just to address that, I actually think is the most interesting to me. It was the most new information about cancer, but not it doesn't follow along with diets and insulin and so on quite as much as the others. It's more of an exploration of sort of what this disease is to me, that which is, you know, and actually a really fascinating story. But it's not it's not going to change in terms of what you do with the medicine that you do. It's not a diet, it's not completely a dietary disease. So therefore, it's not a dietary solution. As opposed to say that the obesity and diet type 2 diabetes, which are dietary diseases. So the obesity code, the diabetes code are both there to, you know, just for you to get more information about that. Yeah, thanks Jason. That's your work and hopefully get you back on some point in the future. Really hope you enjoyed that conversation. Thank you so much for listening. Have a wonderful week and always remember, you are the architects of your own health. Making lifestyle changes always worth it because when you feel better, you live more. [BLANK_AUDIO]