Master Intermittent Fasting for Women with Cynthia Thurlow! | How Humans Heal

Welcome to how humans heal. I'm Dr. Donnie and today I am getting to talk with Cynthia Thurlow, who is a nurse practitioner and CEO and founder of the Everyday Wellness Project. She has a TED Talk that has over 9.6 million views on the topic of intermittent fasting. And now she has her book that's just come out about intermittent fasting. How to do it, how to improve your health with intermittent fasting. Oh my gosh. Cynthia, thank you so much for joining me today. I am so excited to tell everyone and share everyone about what you are up to.

Oh, thank you so much. It has been a labor of love, but certainly one that I feel like there has been a void in the industry really speaking directly to women. And I'll be the first person to say that we are not many men and we can't fast the same way that men do. And, and so this book was really needed because there's either a kind of calculated discussion about women not being able to fast, which is completely inaccurate, or there's a lot of fear mongering that goes on. And so I want to help set the record straight and do it from a place of love and integrity and science.

So your book, the Intermittent Fasting Transformation, is it written for women to really help them be successful? I love that. And to say that.

It'S not the same for women as for men. If you're thinking of the health benefits of fasting or how to do intermittent fasting successfully, tell us more. Why does it need to be different for women?

Well, I think it really comes down to hormones. Men and women share a lot of the same hormones, but women up until the time they go through perimenopause and menopause have periods of the month where they have more estrogen predominates and periods of the month where progesterone predominates. And, and so I really am an advocate of women fasting for their cycle. And then for women that are making that transition, you know, the five to ten years preceding menopause, which is perimenopause, you know, being mindful of specific lifestyle pieces that can impact success with fasting. And then I feel like for in many ways women in menopause are freed from some of the constraints that they are tethered to when they're in their peak fertility years or when they're still menstruating. And I always kind of liken it to being more like a guy in the sense that our hormones are not fluctuating as much as they did when we were Younger. And so I find for many women that menopause is really the time that they can utilize the strategy very effectively to their advantage because they're not getting a menstrual cycle every month. Their hormones aren't nearly as flexible as they once were, with the important caveat that when you're middle aged, you have to live a little differently. And so that's a lot of what I talk about in the book, the things that we have to adjust for and mitigate for as we navigate cycling years, peak fertility years through middle age and beyond.

Well, and I'd love for you to tell a little bit more of your story because I know that's really what helped you to figure this out, that this could be such a solution, especially at this time in your life. Tell us more about that. What brought you to this?

Yeah, well, I mean, the irony is I think I trained at a pretty darn good medical institution and yet I never really learned much about perimenopause. And it wasn't until I hit a wall where I was finding that the type of exercise I was doing, the type of nutrition I was using, not getting enough sleep, not managing my stress. I worked for a very, very busy active cardiology group. So I was doing inpatient and outpatient management of patients, had two little boys, my husband did a lot of international travel. I was probably not getting enough sleep over, you know, doing too intense exercise. And no one had really prepared me for this, this period of time called perimenopause. And so I literally hit it, hit it like a wall. And so if I'm someone that has all this medical training and it happened to me, it's probably happening to countless women. And so through the process of figuring out I had to look at sleep differently, I had to look at nutrition differently, I had to manage my stress. I had to ensure that I was being really strategic about when I was eating, how much I was eating. And so intermittent fasting was introduced to me by a colleague and initially I thought it was crazy, but then I found Jason Fung's book and I felt very confident that if this is a well respected physician that's utilizing with patients who are far more chronically ill than I am, that it might be something worth doing. And I felt better almost instantaneously. I'd never been someone that liked eating breakfast. I, you know, I had an Italian mom and so she was always, you know, trying to force me to eat before I would leave for school. And here was something that really embraced intrinsically the way Our bodies are designed to be. And that is not to be overfed. It's to be strategically fed. And so I kind of dipped my toe in the pond, started having a lot more energy, a lot more mental clarity. And then, you know, through time and making all these lifestyle changes, really realized I was onto something. And almost immediately, I kind of pivoted. I left clinical medicine and had created my own practice, and I was attracting exactly the type of woman that I was. You know, people who are looking for answers who weren't going to sit back and just accept that they were being offered things like synthetic hormones or getting an IUD or getting an ablation or a hysterectomy to address these perimenopause symptoms. And for me, I never realized this would be something that I would. That I would be well known for, but obviously something I'm incredibly passionate about because we need more options than just prescription medication. And so I really stand on the platform of empowering women to make good food choices and talk about nutrient density and talking about eating less often and advocating for more sleep and things that seem probably things that maybe our grandmothers might have talked about and aren't super sexy, but are incredibly powerful. And so I like to empower women to live their best lives and to not feel like the only options are prescription medication. And obviously, there are times when that is the case, but in a lot of instances, that's not what should be the fallback mechanism for controlling hormones or controlling symptoms. Unfortunately, as you know, that's a lot of what allopathic medicine has turned into, is we have a pill for symptom. Instead of digging a little deeper and saying, okay, let's unpack what could be contributing to this problem? And I'm happy to say that I never did go on synthetic hormones. I didn't get an iud, I didn't get an ablation, I didn't have a hysterectomy. And I did, you know, did really well in perimenopause after that, really just making what I consider to be, you know, small, sustainable changes, as opposed to, like, leaning on the medical end in terms of prescription medications, which is. Or surgery, which is really what I wanted to avoid.

Well, thank you so much, because you're touching on a lot of topics that we can go into a little deeper. One is.

Just the broad concept that I keep thinking. You were working in a cardiology office. You were seeing patients and women in particular who were coming in with concerns about their heart health, maybe risk for an MI or stroke. Or other kinds of. I'm imagining with you seeing them coming in, there'd be a part of you that'd be like, oh, my gosh, how can I prevent that for myself? And of course, it's after menopause that these heart disease risks really increase for women. And it's one of those things where it can feel like, oh, that's going to be later in my life. I don't really need to think about that now. But when you get to be in your 40s and 50s now, it starts to show up, whether you like it or not. And your blood work, cholesterol is going up or blood sugar is going up, or sometimes it's showing up as like, you're just gaining a few more pounds. Right. And your waist is getting larger and you're like, how? Where's this weight coming from? And of course, we know weight gain increases risk of diabetes and heart disease, so it starts to catch up with you. I think a lot of women that I talk to too, are saying, oh, my gosh, what the heck's going on? Why is my cholesterol up? Why is my weight going up? What do I do now? And is that part of what we know intermittent fasting can help with.

Absolutely. And I think a lot of things that you're talking about, whether it's insulin resistance, whether it's cholesterol problems, cardiovascular disease, vascular disease, general stroke risk, we're really talking about inflammation, we're really talking about metabolic inflexibility. And we know based on a 2018 study, that 88.2% of the population at that time, so now it's probably worse, it's four years later, Especially given the pandemic, the bulk of us are not metabolically healthy. And so in my 20s and 30s, as a young NP, I didn't really understand why women in their 40s really seemed stuck. There were terms that they were stating to me that their doctors were saying or their healthcare providers were saying, adrenal fatigue, thyroid issues. And I kept thinking, what is going on for these women? Because I believed what they were experiencing was real. I wasn't questioning that, but it was really apparent to me that we were missing opportunities with these patients. And so what are women put on in those years? They're put on antidepressants, they're put on reflux medications.

They'Re becoming increasingly insulin resistant. We know that estrogen, or estradiol is the predominant form of estrogen heading into menopause during our peak fertility years. And as we're losing estrogen we are becoming less insulin sensitive. And so I like to remind people that it doesn't have to be that way. There are ways for us to combat that. But a lot of the pain points show up as fatigue, insomnia, I call it the crime scene period. Very heavy menstrual cycles. So many of these women were frustrated with weight gain and they would say everything I used to work, that I used to work for me no longer works. Because what they used to do is they'd restrict food, they'd exercise more and that would work. And they're just so exhausted they can barely get through their day, let alone do a workout. And they're not going to crave good healthy food when they're sleep deprived and tired. They're going to crave quick sources of energy. It's probably going to be processed carbohydrates or those hyper palatable carbohydrates. I always say, I'm not anti carb, I just want women to be smart about their carbohydrate intake. And we don't eat enough protein and so we're never satiated and it becomes this kind of vicious cycle. So in many ways we really do women a disservice because we're very focused on birth control years, conception birth and delivery postpartum. And then women in many ways are forgotten by modern kind of mainstream medicine. They become invisible. And I'm using a word that a lot of my patients use. They feel invisible, they feel underrepresented. And that's not a good place for women to be in because if we spend half, nearly half of our lifetime in menopause, we have to be cognizant of the fact that we're still very vital, we're still very vocal, but in many ways we're a very ageist focused culture. And so women feel like their opinions don't matter as much or they go to see their healthcare professional and, and again they go back to the, you're offered the synthetic hormones, the iud, the ablation, the hysterectomy, or you know, they're put on antidepressants or they're given sleeping agents. And I just think it creates this really slippery slope where people are just feeling wrecked, you know, by the time they hit menopause, they just think that this can't be the way things are going to be for 20, 30 plus more years. And this is also the time in a woman's life where she probably has older children, they could be teenagers, maybe they're going off to college, they've got parents that are aging. And so in many ways, that sandwich generation, you don't really get a break. You're responsible for so much. You probably are more established in your occupation. You may be more established in your communities. And so we as women are caretakers, but who's taking care of us? And that was largely a lot of the impetus for really wanting to impact women's lives in a really profound and significant way and do it in a sustainable way.

Well, and I hear, too, and I read this in your book, that it's, you know, sometimes we're led to think, oh, this is just normal. You know, it's just normal to gain weight or to have less energy or this is just part of getting old, you know, and like, you and I and so many women are like, we're not willing to accept that anymore. We're like, no, this is not normal, and this is not part of getting old. This is a chance to say, hey, what we were doing before, some of our quick fix, like you said, like, exercise more, eat less. Some of these quick fixes that used to work, our bodies aren't able to flex and respond anymore. So now we need a different solution. And now, of course, we're going to talk more about the solution with intermittent fasting. But of course, it's not just for women in perimenopause. It can work at all different ages.

But I think it's. I'd love to just, you know, like, point out that, like, why you or why you do what you do, helping women to successfully use intermittent fasting is because it can help with so many different issues, right? It's. I love it when, I always love it when we can give something as a practitioner that can kind of multitask, right? Like, it can help with solving metabolic issues, it can help with balancing hormones, it can help with preventing health issues. Like, it's like, yay, we got this all in one thing we can do, right?

Yeah, well, and I think it's, you know, I like to say that it's free and flexible, meaning, you know, unlike a lot of other things that we're tethered to, whether it's maybe you're on medication for your thyroid or maybe you've got a sleep apnea machine. You know, this is something that allows you to have some degree of flexibility. But I also think on so many levels that we as providers really need to be learning strategies that can help our patients beyond just prescription medication. Let's be clear. There are times when you need to Be on a prescription medication, there's no shame in that. But really thinking long term, if we really want to impact more lives, we need to create opportunities where we can share information about nutrition and sleep quality and stress management and eating less often. Sometimes people don't like the word fasting, so I just say, okay, eat less often. Really eat the way that our bodies are designed and to thrive. This ancestral health Perspectives where we're really reflecting on the fact that we would not be here as a species had it not been for the fact that our bodies could go through periods of feasting and fasting, periods where we had food accessibility and then we had food scarcity. And maybe you were eating bark and berries as opposed to eating meat. And so if we didn't have our, if our bodies weren't designed to be able to utilize different types of, of fuel sources, we would not have survived as a species. And so I always like to kind of point that out that our bodies are not designed to be in a surplus all the time. That can be hugely problematic and contributes to the metabolic inflexibility problems that we're really seeing. And we could dive down an entire rabbit hole on that alone. What the modern day diet has done to our health, which is, you know, in our lifetime. I don't know how old you are, Dr. Donnie, but you know, certainly if you look at research from the 60s and 70s, even you look at photos, people looked a whole lot different. I mean, you just didn't see the amount of inflammation and insulin resistance and metabolic disorders that you're seeing now and really reflect on what has contributed to that.

Well, I'm right in your age group. I'm 49 and you know, just as you described. My daughter's now in college and it's. And as a naturopathic doctor, I've been, you know, knowing of all, you know, nutrition from all of these years. This is what I do. But still it's interesting to be experiencing this time of my life, even with all of my knowledge and experience and still observing those shifts. So I can definitely see where it's like, okay, yes, our, our bodies shift and we need to be able to adapt and shift what we're fe ourselves and how we're feeding ourselves to match up with the flux. And the thing is, is that I think we, like you were saying, there's these kind of like societal norms that make it seem like our bodies are not supposed to change. But of course our bodies change. We're human bodies, we're not machines or robots. And we're meant to think, you know, I think there were reasons why the. As a trained nutritionist, I'm sure there were reasons why these dietary guidelines were created to try to help people get healthy. But whenever you put out a dietary guideline, you run the risk of kind of overshooting or overdoing it. And I think that may be part of what happened. It's also that food is so available now, right? Like, we can get food at any time of day or night, and so then we just will eat. Like, I think. I think for a lot of people, when they. And I'm curious with the. With you and your clients, what. What you see as the most common shift that people experience when they. When they start intermittent fasting. I mean, I kind of wonder. For me, it would be not eating in the evening because I tend to have a lot on my to do list. And so, like, after dinner, I still have work to do. And so then I'm like, oh, I'm going to eat again. I'm going to have a snack or whatever. So I'm eating in the evening, which. Then. Then I'm going to sleep. And I'm not eating when I'm sleeping, but then I'm eating when I, you know, say when I wake up in the morning, and it's. So it shortens my overnight fast because I'm eating in the evening. Do you find that is common for people?

Yes. I mean, I think a lot of people have gotten into the habit of snacking, whether it's in between meals or in the evening, at a boredom. You know, you mentioned you work in the evening, and I definitely do as well, especially as we're heading into this book launch. And so I think it's the recognition of acknowledging, like, am I really hungry? And so normally I'm wearing a continuous glucose monitor. So when, if I'm feeling bored, possibly hungry, I'll check my blood sugar. And if it's in the 70s, I'm like, okay, I may legitimately be hungry and need something, but if my blood sugar's in the 90s, low 100s, I'm still digesting a previous meal. I'm like, I don't need food. Maybe what I need to do is take a walk. And so I'm a big proponent of aligning our food intake along with our chronobiology. And so not eating within three to four hours of bedtime. It's interesting. My husband and I were away on a trip in September, and just by virtue of where we stayed, they tended to serve everyone's meals were kind of served at the same time. And so it was like 7:30, 8:00 clock at night. And finally on the second night, we had to have a conversation just to say, listen, is there any possibility we can eat earlier? Like, we don't like to go to bed full. Like, I was going to bed full. My blood sugar was off. I didn't feel good. And so it's the acknowledgement of really honoring. You know, I'd really try in the winter to really eat when it's light outside and to close my feeding window earlier. So more often than not, I will sit with my family when they're eating dinner. I may have already finished eating my kids at this point. They're so used to me fasting. It's not a big deal. But with the understanding that if we're aligned with the chronobiology, so this intrinsic internal clock, and we have this internal clock not just in our brains but throughout our body, that I've noticed that my digestion's better, I sleep better. And so really wanting to honor that as much as possible. But I do find evening snacking is very common, especially for women. A lot of it's out of boredom. We're still on the tail end of a pandemic. And so I think people have created different ways of adapting to what has gone on. And for some people, that has turned into having a glass of wine or two at night. It could be maybe having a dessert, could be just having some pretzels, but always with the acknowledgement that an indiscretion here and there isn't a big deal. But when you get north of 35 or 40, that can work against you. And so it's really kind of deciding.

Where do you want to have those little indiscretions? And I call them indiscretions because we don't want to make it about a judgment. It's not good or bad, it's not good or evil. I mean, that's really. We don't want to assign it to that. It's just the acknowledgment that maybe I didn't eat enough food that day. Maybe that's like. If I'm intuitively tapped into what's going on for me and my body, maybe I just didn't eat enough food and that's why I'm craving something in the evening. Or maybe I'm stressed and what I really need to do is go take a walk or get on the treadmill for 15 minutes, or maybe I'm Just bored and I need to go to bed. So really kind of checking in intuitively with your body. And I find 90% of the time I'm not hungry. It's just I'm one of the above. I'm bored, I'm stressed, I need to go take a walk. My dogs have gotten more walks than they probably ever wanted to have during the course of the pandemic. Because some days you can't do anything else other than take a walk outside and that's okay.

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Yeah.

And it's such a, I love that just to, you know, when we're so quick to reach for food, if we could just take a second and stop and be like, okay, what do I really need right now? And you mentioned the continuous glucose monitors, which I've seen be really helpful as well. And so I just want to let people know who haven't heard of that before.

You can, because of course you can always poke your finger and check your fasting glucose, you know, but these continuous monitors you can stick on your body and it gives you a feed. Tell us more about that, how you use them.

Yeah, I think continuous glucose monitors, and it's an important distinction to state that right now the only way they're covered by insurance is if you're insulin resistant or diabetic, which I think is a crime. I'm very outspoken about this. I think having a continuous glucose monitor, even if you only have one for a month or two, is one of the most impactful biohacking gadgets you can possess. Because each one of us as bio individuals, we may react differently to certain types of foods. I know Personally, I love plantains. I tend to be low carb, not necessarily ketogenic, but I love plantains. Well, plantains don't like me at all. And so it's only with the experimentation of trying different types of carbohydrates, different portions of healthy fats with protein, to find out what works best for my body. And so for a lot of people, they don't know until they wear a continuous glucose monitor, what's their body's response to a certain meal or a certain macronutrient, protein, fat and carbohydrates. And so for me, I am very specific when I'm working with women that I don't want their blood sugar to go up by more than 20 points after eating a meal because that can be a sign they've had too many carbohydrates. And this is what's important. And I'm not anti carb. I want to be really clear about that. I want people to consume smart carbs, the right carbs. But for many people, you don't know until you test. I always say test, don't guess. If you can't get a glucometer, if that doesn't work for your budget having, excuse me, a continuous glucose monitor, you can buy a glucometer, which is just a blood test. You can prick your finger. A lot of people would rather just have the continuous glucose monitor on for 14 days and have it do its magic and then be able to download the data. But I'm also cognizant of the fact that I think being aware of what your blood sugar is doing can be hugely influential. You can look at the impact of stress, poor sleep. You know, we were traveling during Christmas and it was actually kind of stressful coming back from the last place we went in Costa Rica, and we had to take a boat and then a small plane and then two commercial flights and trying to make all of those stops along the way. I looked at my continuous glucose monitor and I was shocked. My blood sugar normally is in the 70s and 80s. It was over 100. Probably related to the fact that we, you know, with your stress levels, you secrete some cortisol that will increase, you know, glucone, you'll get some blood sugar bump. But I acknowledged it for what it was. But I think that the continuous glucose monitor can be very, very helpful. I find a lot of people don't even know they're insulin resistant because they're, they're not getting the right labs checked at their healthcare provider. In addition to A continuous glucose monitor. I like knowing what their fasting insulin is. This is oftentimes the very first biomarker that will become dysregulated as we are getting closer to insulin resistance. And if you're a perimenopausal woman or menopausal woman, that loss of estrogen, estrogen is this estrogen insulin sensitizing hormone. And so I remind people that that can also contribute as well as leptin resistance. So insulin resistance, leptin resistance, the lack of satiety, all of these things can impact our ability to manage and mitigate our blood sugar and help or make more challenging managing our blood sugar. But I do feel like a CGM or a glucometer is a must have for nearly everyone. I find for a lot of people, they're surprised whether it's their blood sugar spikes with squash or sweet potato or rice. This is why I don't eat a lot of grains, because I just find that I just don't do well with them. And I jokingly say it doesn't matter if it's an eighth of a cup of rice or a cup of rice, the same thing happens to my blood sugar. And this is in someone that's metabolically healthy. And so if the bulk of us are not metabolically healthy and we're having carb, carbohydrate lady meals, we're really doing a detriment and a disservice to ourselves. So kind of restructuring our macros and being aware, as hard as it is to admit to ourselves that maybe something we love does not serve us well, finding alternatives, finding other options that are available so that we can ensure that we're remaining as metabolically flexible as possible.

What really strikes me is this, is this being able to connect with yourself and your body. Like, I think so much of the time we're running through life as you described, busy parents and working and all the things we're doing, and we are just eating without kind of realizing how it's what our. What is our body going to do with it? How is it going to affect our blood sugar? And sometimes you can get a feeling for how your blood sugar is fluctuating when it makes you feel awful. Like, if it makes you feel, you know, tired or anxious or grumpy, but to have a monitor tell you, then you actually have some numbers and you can actually go, oh, this is what's happening inside my body. I remember we had to do that as when I was in my nutrition training way back, way back when. And it still sticks with me as so instrumental of just seeing, oh, this is how my body responds to my food. And it's. And to see then that that can, you know, it also shows me that your approach with your intermittent fasting transformation is just as much about how you feed yourself as it is about how you don't feed yourself. You know, when not to feed yourself. Because I want to point out that the key with intermittent fasting is that when we have a certain number of hours of not having food coming in is when there's actually some really good signals to turn on. And my way of thinking of it is kind of this, at least a 12 hour mark. Do you go by that like, it's like if you hit 12 hours of not eating, then the good stuff starts happening or talk us through that.

Yeah. So I think this is one of the common misnomers. I always say eating less often is important. And it might be people that are starting with a standard American diet that are couch potatoes, maybe they're doing 12 hours because they really don't go more than a couple hours without eating because they're eating breakfast early and they're snacking into the evening. So 12 hours will give you digestive rest. I think as we're getting closer to 16 hours fast, we're going to see more and more benefits. But we know, and this is where there's a lot of granularity, there are people that want to say, well, this study says at 18 hours, this is when we see this. And I always say, well, I like to look at it as good, better, Best good is 12 hours. Better is 14 to 16, depending on the individual, depending on where you are in your menstrual cycle, depending on where you are, are you going through a lot of stress? Are you going through a move? Are you going through a divorce? Maybe adding on longer bouts of fasting is not going to be beneficial. So it's all about this bal.

So I think when people are again knowing like, where for my body is what is the right timing of eating and what's the right timing of not eating not right. Like it has to be individualized.

Absolutely. And I know, like, I'll give you an example, days I lift weights, I break my fast earlier because I'm just that much more hungry. And you know, really talking to women about insulin sensitivity, one of those things can be influenced by the amount of muscle mass you have. So think of your muscles as glucose reservoirs. We want to maintain muscle as we get older. That's another reason why we become more prone to insulin resistance is that we have less muscle mass and therefore we become less metabolically flexible. But I don't want anyone that's listening to think that they're still not doing benefit if they're at a starting point. If they do 12 or 13 hours, we have to start from somewhere. And obviously, in the very beginning, I think for me, 14 hours was always easy. That was like breathing. But, you know, the first time I did 15 hours seemed like a lot because I was very fixated on the fact that my stomach was growling me. 16 hours seemed arduous. And then over several weeks, as your body becomes more accustomed to eating less often, you will find that your hunger cues will become less and less, and that's always part of that. Beginners really thinking about it from the perspective that at the very beginning, it's going to be harder. Anything we do with lifestyle changes, it's going to be harder up front as it becomes something that we're doing more consistently. But by the same token, depending on what your goals are, you may want to do some longer fasts. And I do find for people that are really struggling with weight loss, who have a lot of weight to lose, they have plenty of stored energy to be able to do longer fasts, but in the interim, giving themselves grace, acknowledging that, you know, slow and steady wins, gosh. I have a wonderful cardiologist friend. He used to always say that to me when we would talk about patients that wanted to. They were like, they wanted instant gratification. And unfortunately, that's the type of culture that we live in. But I always remind people, like, slow and steady wins, you don't want to lose 20 pounds in a month because it's not going to be sustainable. One to two pounds a week is what we expect. I'm always humbled, surprised, when women will say, oh, my gosh, I've been trying to do this diet and that diet, and all of a sudden all I needed to do was eat less often. I didn't have to change what I was eating. And so I think that it can be a particularly powerful strategy to utilize, but obviously one that each person needs to do it a little bit differently.

And that's okay.

Because it's. I mean, there's also such a thing as too much, you know, and again, it's hard to say what is too much for, because it's different for everybody. Right? Like, you just have to know for yourself, like, okay, at what point is that fast too long for you in this moment in time? Right. It Might be different now than in three months from now.

Yeah, well, and I think our body gives us cues. It's just depending on are we paying attention. And so there are always cues that our body will provide us with that will let us know, like, that was a little too long, you know, really checking in. Like, how's your sleep? What's your stress like? Did you over exercise? Did you not get enough food in your feeding window? All things that can definitely impact your success with fasting. And really just being honest with yourself, it's not sexy to say, did I not get enough sleep? Is my stress out of control? I always say that, you know, women in perimenopause and menopause are particularly susceptible to, you know, a hospitalization, a divorce, a big move, you know, those kind of catastrophic, life changing things that can happen to us. Our bodies don't handle that stress quite as well as it might have when we were 22 or 25 or 30. And it's not a derogatory comment, it's just the recognition that at each stage of life we have to be mindful of where we are.

And this is what you do in your book, but also in your program where you're guiding people. How do you, you know, and I, and I, you know, I know you do it in a step by step way. It's not like you're just diving in day one with, with a, you know, 18 hour fast. Right. Talk us through, like how you, what have you found that, you know, this systematic way of getting into it.

Yeah, well, so if you think about it, there was a study done by Sachin Panda and it was looking at meal frequency and it was done through an app, through the phone, which makes things really convenient. And you know, the average American is eating seven to ten times a day. So if you think about it that way, I like people to stop snacking first. Like, you don't eat in between meals, you don't eat after dinner. It's just not necessary. And so it's, it's really reframing the way our relationship with food, how frequently we're eating and then it's really adjusting your macros because most people are not eating enough protein, they're eating far too many carbohydrates, they're eating the wrong types of fats. I don't know if you know this, but the average American, the fat that is consumed the most in the United States is soybean oil. So if you want to talk about an ingredient that everyone listening should avoid, seed oil. So Soybean oil, canola, cottonseed, you know, sunflower, safflower. They're in most foods. When you go to the grocery stores.

Healthy foods, they stick in there. I'm like, what is that doing in there?

I know, I know. And I always say, like, if you do nothing else, you food labels and avoid seed oils, that's automatically going to make you healthier than most of the population. And why seed oils are important to understand is that they're very inflammatory. They're oftentimes rancid. They're a byproduct of the processed food industry. And if you don't believe me, go to YouTube and Google how canola oil is produced. It's disgusting. And yet we're consuming these adulterated oils, and we know they change things down to a cellular level. They disrupt the cellular membrane of our cells and can do so up to two years. Dr. Kate Shanahan does a lot of work in this area. And the more I understand about seed oils, I always say, if you can't do anything else, stop snacking, adjust your macros, and avoid seed oils. And if you do that automatically, you're a healthier person. But the sad thing is that mostly United States, when you go to a restaurant, you're probably getting seed oils either in your salad dressing, sometimes they spray it, like, on the grill when they're cooking meat. So you really have to be a detective, and there's no shame in asking when you go to a restaurant. And I love when they say olive oil blend, because that, to me, is just another indication that you're probably getting some seed oils. Maybe it's all seed oil with 1% olive oil. But the seed oils are pretty inexpensive, which is why they proliferate in the restaurant industry and the processed food industry, too.

So it begins with just like, cleaning up your diet, so to speak, and kind of like cleaning up your blood sugar levels. And then you can start to go, okay, now let's see if we can space it out a little bit. And I really resonate with us. And you know, you know, my interest in adrenals and cortisol and adrenaline response. And I. And I see so often that by the time a person is experiencing the symptoms we're talking about, they likely have some adrenal imbalances. And I know that's something you help people with, too. So it's like being able to look at the adrenals and help your adrenals heal in this process. Right? So that you can then be keeping your adrenals Healthy while you continue on. Talk about that a little bit, if you don't mind.

Yeah, no. And I think it's almost like that bat lit seesaw effect that our hormones are trying desperately to stay balanced. As we transition from perimenopause into menopause, our ovaries are not producing as much progesterone, which puts a strain on the adrenals. So we don't manage stress and we don't mitigate stress as well. We don't sleep as well because progesterone tends to be a more sedating kind of mellow hormone. And so from my perspective, I find on so many levels that we have to do calculated tasks every single day to support our adrenals. It could be as simple as you get up in the morning, you get sunlight exposure. I'm laughing because it snowed most of today, but now the sun's out. So in terms of timing, but that can help support their circadian rhythm, managing your stress, getting yourself out of this sympathetic, dominant fight or flight response. So you know things that honor the parasympathetic, the rest and repose side. So whether it's meditation, connection with nature, grounding a little hard right now with snow, really thinking about, you know, alternate breathing through your nostrils. I'm reading breath for the second time. I'm getting ready to interview the author. And it's really impressed upon me how important that breathing, the breath, how important it is for honoring and supporting our bodies. Not eating at night, not eating the wrong types of foods, making sure that you're not sitting down with a bowl of popcorn or a bowl of ice cream right before bed. It's the worst thing you could do for your body. And so just being really mindful of the quality of your food, certainly ensuring that when you put your meals together, you're being thoughtful, whether it's a steak with some broccoli or maybe you're having chicken or maybe having salmon with some non starchy vegetables. And I find that salt is one of these underappreciated or electrolytes, really underappreciated ways to honor our bodies. And so I use electrolytes throughout the day and I do encourage my patients to salt their food. And high quality salt, not iodized salt. But I love Redmond's sea salt. In fact, I carry a little thing of Redmond sea salt because I find, I think the statistic I read was that 30% of us, we need 30% more salt or sodium than we realize. And so if we're stressed, we Lose more electrolytes. And whether it's with sodium and potassium and magnesium, really being mindful. So those are the things I really think about working in cardiology. As you can probably imagine, I got very, very savvy with electrolytes. And so there's all sorts of tricks that I have to manage. Low magnesium and managing sodium. I always say when you're craving chips or craving something salty, it's probably that your adrenals are kind of screaming like, help, support me. I need more support. I'm drowning. I'm sending out the sos. So, yeah, when I think about adrenals, I think about the liver, the adrenals and the pancreas and how interrelated blood sugar is. Stress management is. I mean, all these organs should work effectively. But again, if we go back to what I stated earlier, if 88.2% of us are metabolically inflexible, that system or that series of organs do not work as efficiently. And as I know you talk about really, really important that we're managing and mitigating blood sugar, stress management, et cetera, otherwise our adrenals are going to be thrashed. And more often than not, when I do Dutch hormone tests on my patients, 99.9% of the time, their results are definitely less about high cortisol and more about low cortisol. So chronic, long term, unrelenting stressors and their body is just thrashed and weakened and tired.

Which again is why I agree with you. Let's test and not guess. Let's not assume it's high cortisol. It might end up being low cortisol. And I love in your book how you talk through the phases of.

Going into this intermittent fasting transformation. But also you give meal plans and recipes like how to do it. And I. So I want to really encourage everyone who's listening and interested and wanting to learn more to definitely get, get your book and learn about your program. This if 45 you call it, why do you call it that?

You know, it's funny. So in 2019, I did a TED talk after a 13 day hospitalization. And I did the talk for two reasons. One, I wanted to show my kids that I was okay. And number two, I felt really, because they had asked me to do a talk focused on women. So I talked about fasting and women. And so obviously from that the talk went viral. And pretty quickly my team and I realized we had to create a program, a program to meet the needs of people that were trying to figure out who's this person. And so initially it started off as a 60 day program and I just found that 60 days was too long. And so 45 days seemed to be the right amount of time to be able to teach someone how to fast and do it effectively, to learn the best practices. This is something I really stress, best practices and be able to have it become a sustainable long term strategy. And so that's where the 45 days kind of came from. And then I of 45 was just my way of talking about the program. And so as I was writing the book, I kept saying it needs to be part of the book. And so if you look at the COVID it's actually got a little circle that says if 45. But I'm proud of the fact that I think it's a unique program. I don't think there's anything else that's out there that's like it. And it's certainly the only program I'm aware of that's specific just for women that really honors what makes us unique, takes into account women at different stages, whether you're at peak fertile years versus perimenopause versus menopause. I get a lot of questions about guys and I always say, I think of men have a lot more flexibility with fasting just given the fact that their hormonal fluctuations are not as significant. But there's probably very few people listening that shouldn't fast. In fact, most of us could benefit from eating less often, even if it's just 12 hours a day of digestive rest is what I normally like to call it. I think that can be hugely impactful. But that's where the name came from. Just really out of necessity.

I love it. And if for people to find out more from you, I mean I definitely know you're on social media and you have your website, which is your name. Right. The Cynthia slow dot com.

Yes. And a podcast, Everyday Wellness that you've been a guest on. And I know my listeners loved hearing about how to manage stress and the impact of stress on our bodies. And certainly the past two years has tested everyone for sure in terms of, of where their resiliency lies.

And that's why I'm so glad that they now have your book to help guide them. Like how do we get our bodies back, our minds back, our life back on track. Right. Just by even by learning how to eat in a way that works better for our bodies.

Absolutely. And I think that it's not to suggest that every person needs to fast every single day. I would say that Certainly younger women, women at peak fertile years who are very th. Obviously that's a different subset. But now, knowing how many people are metabolically unhealthy, it gives you some context in which to say most of us would benefit from eating a little less frequently.

Even just sometimes it's. You just have to kind of let that sit a little bit and just kind of. Right. Like, just kind of let that sink into your mind and be like, okay, you know, is there times when I could eat a little bit less? Or like you said earlier, maybe there's just something else that, that I maybe need to go to bed, maybe I need to go for a walk, like just checking in and be like, hey, maybe I don't really need to eat again right now, even though I'm craving something. Right. Because these cravings get ahead of us.

It's acknowledging, you know, what. What's the emotion that you're trying not to experience? You know, the one thing that, as I've gotten more savvy, is just, you know, the experiencing of emotions that you want to suppress. Whether you're angry, scared, tired, mad, et cetera. What is the sensation you're uncomfortable with in your body and what's the way that you're manifesting? I tend to be an exerciser, so if I'm stressed, oftentimes just taking a five or ten minute walk, listening to an audiobook or a podcast can be hugely impactful. And so I think it's really just the acknowledgment of what is your body trying to tell you? Because I think in so many ways we numb ourselves, whether it's with alcohol or food or other types of substances that are out there. People are very prone to not feeling uncomfortable feelings. It's really what it comes down to. I know we share a friend, Dr. Joan Rosenberg, and she talks a lot about this. Obviously she's the expert, but definitely her book has influenced a lot of discussions with clients. Just to say, let's reflect on what you might not be wanting to experience, because that could be why you're wanting that two or three glasses of wine at night. And certainly if you're a woman in perimenopause or menopause.

Kind of the standard refrain is, I'm noticing and myself included, less and less of us are drinking because we're finding that's going to precipitate a hot flash or it's going to impact our sleep quality. And so really making the best choices for us, no judgment, just finding what choice would be best served for you and your life circumstances.

I love that.

And I think that unconditionality is so important. You know, how to be more gentle with ourselves and understanding and forgiving and come at it more from a perspective of, okay, let me. From a place of. Of loving and accepting myself. What do I choose from here? What do I want to choose now?

Exactly. And I think that reframing is so important. Unfortunately, I feel as if many people just don't want to feel sad. They don't want to be mad. They just want to continue to suppress and push down and extinguish the feelings that make them really uncomfortable. And I would really encourage people to kind of lean into that. It doesn't mean that you have to jump off the cliff. It's just lean into whatever it is that you're experiencing. If it's something you're fearful about or something you're uncomfortable about, just get it out. I always say it's almost like a frog. If you get the frog out and you get at least talk about it, oftentimes it's not nearly as bad as you think it is in your brain. It's just. It needs to be stated so that you can work through it.

And ultimately, if we're just numbing out, even just with food and eating, then it's ending up causing other health issues. It's not really helping us escape, Right? So we start to go, oh, my gosh, I'm just feeling worse and worse. And if you hit that point where you're just like, enough already, I. I have years of my life and passion for things that I want to do. I got to feel good doing it. And I could imagine that's the person who's going to reach out to you or want to read your book and be like, okay, what do I do to turn this around and get on the path of feeling good and doing what I really want to be doing?

Absolutely well. I think there's always hope. That's one thing that I think is really important. Despite what everyone has been through over the last two years, there's always hope. There's always something that we can do to shift our mindset, shift our perspective, shift our health in the right direction. I'm not a believer that anything is necessarily permanent, but I do think that you can be diagnosed with a metabolic disorder and you can turn things around. I mean, how many people I see on social media that were inspired by a talk and are now off of their blood pressure medicines, they're not taking diabetes medications. Nothing makes me more happy and thrilled is when people take inspired action. And it could start off slowly. It could just be stop snacking. And then next thing you do, maybe you go to bed a little earlier. And then it has this snowball effect as you make all these small, sustainable changes. It can improve your health enormously.

Love it. Oh my gosh, Cynthia, thank you so much for joining me and talking all of this through today. And thank you for your amazing book. What a resource for everyone to turn to when they're trying to solve their health and figure this out. So thank you again so much.

Yeah, thank you for having me. It's been a pleasure.

Thanks for listening to How Humans Heal. If you liked this episode, leave a rating and a review. And for more resources, visit drdonnie.com.