#36: New Year, New Foods with Arthur Agatston

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When you join me, you're going to chase down our goals, overcome adversity, and set you up for a better tomorrow. Come on this journey with me. Hi and welcome back. Thank you so much for joining me again this week. Okay, so this week is a little different in that my guest has really gotten me to think about something I rarely think about. My entire life I have been into fitness, working out and I love working out. It's definitely a stress reliever for me as well as it helps to ensure I stay healthy and don't gain too much weight. However, I've traveled for my entire career the past two decades, constantly on airplanes, which is really challenging in regards to being able to work out and you know, with your meeting schedule when you travel oftentimes. I'll be in LA this week and there's four days I'm in back to back meetings I won't be able to work out. So I have this swing with my weight from anywhere from five to ten pounds that I can go up and down. Typically when I'm home and I'm at the gym every day, I'm able to balance things out a little easier. But you know, I've never been one that's gotten that much into, you know, what is eating healthy. I just figured eating healthy is, you know, eating apples, eating proteins, eating salad, whatever. Well, I am with an expert this week and it's so interesting because the basis of food, food as medicine is really new to me and that's really what we talk about today so much more than just weight. I've just thought about food and the role it plays with if I like the way something tastes or if it made me fat or made me skinny. And today we're diving into the conversation where food is so beyond that. And it really opened my mind to if I want to be really successful in 2020, if I want to do things differently, go bigger, I need to do things differently to prepare myself for that. And one of the ways that I can do it is to eat differently and eat with the goal of having food as medicine to help me and optimize me and give me more energy instead of just focusing on what a scale says or how my pants fit, which up until now that really is the only way that I looked at food. So it's really, I'm blown away. I'm consumed by this. And you'll see on my social media I did a video the second I got out of this interview. I mean, I'm just, as soon as I got home, I started watching all these videos. I'm obsessed with this concept of food as medicine and working with an expert and having this amazing opportunity that I did today. You know, the person I'm going to interview is the author of the South Beach Diet. And just to give you a little insight, he has sold more than 25 million copies of his book. Do you understand how big that is, how much success this man has achieved? This is mind blowing. He clearly does not have to work ever again a day in his life. If you sell 25 million books. Let me just put it this way. You are sitting pretty happy financially, but it's very clear that's not why he works. He spent so much time with me. I actually missed my next meeting, which was terrible, but it was so worth it because he's such a loving and kind and wonderful doctor and expert in helping people care for themselves. Which it's not something a lot of us think about, right? We're so busy, we're living these fast paced lives and to take a step back and access the information of someone who's dedicated their life to helping to address the issue of heart attacks and solving how can we make people healthier so they don't have them and you know, know really this journey in met through medicine that this, my, my guest has been on, it's just, it's eye opening to me to see the massive role that food plays in all of this. So wanted to get into some of the takeaways that I take in in the most simplistic way possible to tee you up, you know, to. Obviously I'm not going to be the, I'm not by far the expert on this topic. I'm be on a rookie. But I think I had shared with you, I, I watched the movie the Game Changer on Netflix a couple of months ago and I wanted to go plant based and I made a run for it and was really focusing on eating plant based. What's interesting is that I ended up gaining weight and yes, it was over the holidays. So of course, you know, I definitely had more junk type food, more desserts, you know, I wasn't eating the way that I typically would eat. So that could be part of it. But the other part was, and I learned this from my guest today because I shared with him what I was eating and what happened. I really was eating a lot of processed carbohydrates and there's so much in the plant based food world, you know, fake chicken strips, fake chicken patties, fake crab cake, fake veggie dumplings, all these different things. But it's essentially all carbohydrates and sugar. And I'm sure there's plenty of people that do the plant based diet diet that don't do it the way that I did with so much of an artificial focus. But that's how I did it and that's how I found it easiest to do. However, that did not work for my body and basically my guest today explained to me why I was shutting off my body's ability to burn fat. I was making it easy for my body to gain weight and hard for my body to maintain or lose. Essentially impossible. And I didn't realize that the time that we eat and the calories that we choose have a massive impact on how efficient our bodies can be, our mood, our skin, so many different elements, it's mind blowing. So it wasn't a surprise to him at all that I gained weight on the diet that I was on. He was not blown away, but he told me, listen, if you want to be able to get back into your regular clothes, I would suggest you reading my new book which is the updated version of the South Beach Diet. It's the new Keto Friendly South Beach Diet which is adding all of the elements of research that he's accessed in the past decade since the South Beach Diet came out. He's put all, he's put all that research, all that information into this new book. Plus 75 full color recipes, plus testimonials, plus it's unbelievable. Plus the work that he did in school systems with children and the results that he had not only with their weight and health, but with their test scores because what you eat affects your brain in a massive way. So. And he's doing work with Alzheimer's patients to improve memory by food choices. It just, it really has blown me away. I'm all in. And, and I always figure I can do anything for 30 days. You know what, you can't be hurt by this. So I'm going all in for 30 days. If I'm going to feel the way that I anticipate I am, if I'm going to lose weight and feel better and not have to go on this yo, yo, up and down, just because I travel one week versus another, then I don't have to rely so heavily on the gym and get frustrated with my schedule. I'm all in. And I actually remembered the last time I was at my leanest was five years ago. And I went back and looked at some pictures online to see I was eating an extremely low carb diet. And I did that for over a year. I don't know why I stopped, but it's so funny. I look back at how happy I was and how lean I was and I actually worked out less than because I didn't have to, what I didn't realize and this is what worked for me. And again, I'm not pushing this on anybody. However, you know, the research shows that this works and the science is behind it. You know, I was feeling great. I'm giving this same plan a shot now, especially after meeting with my guest today to see this is proven through medicine, through so much research, through so many testimonials of patients and it, it really opened my mind to so many things. Here's some of the keys that I took away. Sugar. It's a killer. I, I, I didn't realize that it's more addictive than any drug that's out there. Grazing is a failed strategy. That's how I used to eat. I would just eat bits and snacks all day long. I thought that was the right thing. No, intermittent fasting is the right thing. And I just started yesterday, not eating breakfast and not eating at least until noon, if not later. And it wasn't actually that hard to do. I also learned that a lot of self doubt happens to people when they gain weight because they think, oh gosh, I, I don't have self control, I don't have willpower when that's actually not the case. So your confidence can be affected by your weight, which is actually being driven by your food choices. So let's say it's the holidays and you eat more sugar based products and foods, your body is gonna crave more sugar and it's not gonna have an ability, it's gonna shut off the ability to burn fat and burn the sugar off and you're gonna start craving it, you're gonna get hungrier. Versus if you make different food choices. Eliminating processed carbohydrates and eliminating sugar and choosing different foods that you know, we'll get into and the book gets into in detail with specific recipes. You know, it's healthy fats, proteins, green leafy vegetables, low, very, very low carb vegetables. So when you lean into that food plan, you don't feel hungry and you are able to constantly burn fat. So the real eye openers for me were sugar. Sugar is in everything. And if you think think it's easy to eliminate, it's not. Because now I am so dialed in and looking where it is in every food, but doing all that you can to eliminate sugar from your diet. Ending grazing, ending snacking. Instead, looking into intermittent fasting. Some people fast for a day or two a month just to reset their metabolism. I have not tried that yet. That sounds a little aggressive. However, I guess there's benefits there too. Getting rid of processed carbohydrates, getting rid of fruit. He gives a great analogy of grizzly bears as to why high sugar fruit is not helpful. And the impact that this has had on people, this diet has had on people is not only weight, it's helping to eliminate anxiety, depression, heart attacks, improve mood, improve sleep, improve energy levels and so many other amazing things, specifically brain function. And it's been reflected in grades with students. So I'm blown away by the research that I was exposed to. I'm blown away by my guest today who's such an amazing human being, person and doctor. So let me give you a little bit about our guest today. Our guest is Dr. Arthur Agustin. He is an internationally recognized pioneer in cardiac disease prevention. Dr. Agustin worked with Dr. Warren to develop the Agatson score, also known as the calcium score, a method of screening for coronary calcium as an indicator of atheroscellaris that is used at medical centers throughout the world. Dr. Agatson and colleagues initiated the Healthy Options in Public Schools study which demonstrated that by providing healthy school lunches, combined with an innovative education program pre K through grade six, you can encourage healthy weights and improve blood pressures and standardized test scores in children. This project continues through the Agustin Urban Nutritional Initiative at the University of Pennsylvania. This is so amazing. And that's getting rid of sugar, getting rid of processed carbs, healthy fats, healthy proteins and vegetables. Dr. Agustin is an associate professor of medicine at the University of Miami Miller School of Medicine and a clinical professor of medicine at Florida International University Herbert Wertheim College of Medicine. He's a member of the American College of Cardiology. He is the medical director of the Agustin center for Private Medicine. He's known as the author of the internationally best selling book, over 25 million copies sold, the South Beach Diet, his first non academic work. Dr. Agostin created his balanced approach to healthy eating to help his patients improve their blood chemistry, lose weight and prevent diabetes and heart disease. The Today, the South Beach Diet remains the trusted choice of millions with more than 23 million copies of the book are sold. Dr. Agatson's most recent book, the South Beach Diet Gluten Solution was published in 2013. But his newest book actually just came out in 2019 and that's the one that we're talking about today. Dr. Agatston has published more than 200 scientific articles and abstracts in medical journals and is a frequent lecturer across the US and around the world on diet coast cardiac imaging and the prevention of heart disease. All of these things go hand in hand. In recognition of his contributions to cardiac prevention, the Society of Cardiovascular Computed Tomography created the prestigious Arthur Agustin Cardiovascular Disease Prevention Award which is given annually to pioneers in cardiac prevention. He was named one of the Times 100 Most Influential People in 2004. Among his many television appearances, Dr. Agatson was featured along with President Bill Clinton on Sanjay Gupta's 2011 CNN special the Last Heart Attack. So to say that my guest today is an expert is an understatement. But to let you know what a really sweet, nice, caring person he is, he really is. He's fantastic. He's a wealth of knowledge and I'm so excited that I got the chance to sit with him and spend hours with him, learning from him. Some of the information you're about to hear is going to blow you away. But I figured if I really want to go to the next level in 2020, this is definitely a difference maker that can set me up to do it and it can set you up to do it too. So I'm really hoping that you give this a shot. It's I'm going all in and you can keep up with me on it. Before we get there, I've got a 30 second commercial for you. And I'm going to throw a lot of numbers at you, but please stay with me and just 15 minutes. You could save 15% or more on car insurance. This company has been offering great rates and great service for over 75 years. And anytime you need help, you can speak to one of their trained specialists. 24 7. The company is Geico. Go to geico.com today. Sorry for all the numbers. And in 5, 4, 3, 2, 1. I'm out of time. I'll be right back.

America, and frankly the world now is becoming fatter and sicker on what were the national recommendations? And we have a very good handle on what happened. But the main thing is people blame themselves. They say, I thought I was following the guidelines, I must be doing something wrong. And since nutrition is not really taught at medical schools, it may be just beginning. Now doctors aren't very helpful, which is.

Really perplexing to me. And as you know, it's challenging because we have to wonder as end users, who do you trust? There's so many different messages out there from plant based to intermittent fasting diets to like you said, low fat or now low carb keto. It's very hard as a parent and as someone who wants to live within a healthy diet. How there's countless movies out there and I know we discussed some people without credibility, without research and without experience experience telling us what to do. How do we figure out what that right approach is?

Yeah, and I mean I think the evidence is overwhelming. So and more and more doctors, in fact, you know, I'm a cardiologist and cardiologist. One of the reasons they didn't teach the low fat approach was it just didn't work. And by the way, I'm not saying you can be a healthy vegan. There's a big variety of diets. They talk about the French paradox because here they're eating all the cream and cheese and good stuff and they never had heart disease. But then if you say, well I'm just, I'm a low carb advocate. Well what about the Asian paradox that they were having all rice and the all Okinawa. They were having a lot of sweet potatoes and they were just fine. Okinawans were living. There were more Centagenarians there than any place. And we do know how to put it together. But the other thing is trying the approaches that we advocate now, there's no downside and you feel better in a matter of days, weeks and months and there's no downside. And if you want to try to be a you Know, a pure vegan, it's. It's tough, but, you know, people can do well if they avoid the bad carbohydrates and the. And the bad. And the bad fats. And so what we always said from the original south beach diet is it's not low carb versus low fat. It's the right fats, the right carbs. And we stick to those principles today. But we've also learned a lot more about nutrition since 2003, 2005, when we wrote the first books. And one of the real issues with men and women, but particularly with women, is they said, well, they followed the rules and it didn't work, and they blame themselves. And my kind of interesting experience which led to the current book was the summer before last, the summer of 2018. And so I was a cardiologist and diet doctor, but I would do the first phase of the south beach diet, which is quite low carb, what we call keto friendly. You don't actually have to be in ketosis, and we can discuss what. What that is. But as soon as I went to the second phase and added back particular fruits, whole grains, I would begin to put on weight and put on a belly. And my wife would say, arthur, no more TV for you, only radio. Because, you know, here's a diet doctor putting on a belly. I could hide it pretty well with a suit, but it was. It was frustrating. And so it was last. Last summer, I was actually reading a great book by. By a friend, Dr. Robert Lustig. He's a pediatric endocrinologist who's one of the foremost really educators about sugar is really our primary enemy. And he also wrote a book, how it was. It was called the Hacking of the American Mind and How so Many of Us are Truly addict. Addicted to Sugar. And it's a real addiction. It lights up the same area in your brain called the nucleus accumbens, as is lit up. If you're an alcoholic, you're. You're addicted to cigarettes, to gambling, to video games. With. With kids, vaping is a total disaster because it's. It's very addictive. But when you do an mri, the same area of the brain lights up. And I was reading the book, and we were on vacation with. With the family. Both my boys were visiting. And we had a good, healthy dinner, salmon and broccoli. And then brought out dessert from a favorite local farm farm stand, which was a blueberry pie. And so after eating the good, healthy usual dinner, inhaling the blueberry pie, as I tend to, and my wife Says, you know, author, slow up. And my son says, dad, like, what are you doing? I say, okay, okay. I stop. And then the family clears out of the dining area and kitchen. I sneak back, I finish the entire blueberry piece, telling myself, Mr. Diet Doctor, they're blueberries. They're antioxidants. They're good for you. Which. And then I'm reading the book, and there's more and more about addiction. It's just recent years with much better science we call functional mri, where you can really see the pathways of the brain. And one of the interesting things was in studies in rats when they were made addicted, addicted to both cocaine and sugar. And they could hit the sugar bar or the cocaine bar. They hit the sugar bar more than the cocaine.

Wow.

And so I realized, and I thought it was lack of discipline. You know, my wife and kids are not addicted. At least not, you know, not now. I mean, my wife, I think it's too late. She's not addicted. She could have scoops of a dessert. But if here we were in Joe's and having a key lime pie for dessert, you know, I would finish a thing before anybody else got it, you know, or share desserts before anybody else had a chance. So once I realized I was truly addicted, not to mention, you know, patients, I always said, oh, I'm a chocoholic, which I am, and was. But it was almost half. You kidding around now, I realized this had really happened. So I set August 1st of 2018 as my D day and really went cold turkey from sugar, which I had done this anytime I went back to phase one of the south beach diet. It worked like a charm. But our first phase was only two weeks for a bunch of what seemed like good reasons at that time. And so now I realize I couldn't go back to these. Some of the phase two fruits and in what seemed like whole grain bread. But our whole grain bread is not really like what our grandparents and great grandparents were eating years ago. And so with the knowledge, I insist in prolonging the phase one diet, the really low carb approach and no sugar at all, and no processed carbohydrates, which are the carbohydrates that turn to sugar quickly when you. When you consume them. And I lost my cravings and my belly as I usually did with the first phase, but now I sustained it. And what makes me sustain it today, now it's a year and a half, is that I just feel so good. I mean, people say I look younger, I look better, skin improves, for sure. I mean there's so many things that improve that I, I won't go back just because I feel so good. I. I feel mentally much better focused and my. Well, one reason we extend the first phase of diet is it takes time to get what we call fat adapted. And this one thing we, we didn't understand and know when we did the first book. So if. Are you a runner? I forget.

Yes.

And some long distance running I used.

To do long distance until I had problems with my knees. But yes, me too.

That's knees and hips. But anyway but so in marathons you carb load and the idea is you load up as much sugar carbohydrates in the form of glycogen in your liver and your muscles. You have the pasta parties the night before so that it takes longer to burn through all that starch, the glycogen carbohydrate. And because once you did burn through that you would, it was called hitting the wall. You'd run out of the starch and you'd have to begin to burn fat. And none of the marathon has ever practiced. They ran but not did not train hitting the wall. And I recalled in this fat adaption I actually went to the very first international meeting on the Marathon in 1976 in New York when I was a resident.

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Much about carb loading but there was a group from the University of Florida where they have great exercise physiology. They discovered Gatorade and he took his endurance athletes and he trained them on super low carb. And this was before any low carb though carb was was popular and he he actually thought if he trained them when they had hit the wall and had to burn fat they would do better. And they did. And so now we actually know that you can train yourself to burn fat much more efficiently. So today endurance athletes, the triathletes, the super endurance runners who do 50 mile races, more and more marathoners are going low carb where they're Training you have enough fat to last for, you know, really for months to burn. Whereas I mean, if you're running, you run through your starch in a couple hours. Otherwise depending, it's days before you run out of the starch. And then you often feel weak because you're not so good at metabolizing your fat. But when you stick with it, you get better and better. And so, you know, for me, I came back after the summer vacation and I. One of my favorite sports now is boxing and don't worry, they can't hit me. I only hit them with, with the, sometimes hits me but not hard and, and I did with my trainer who was never easy on me. It was, it was a Tuesday morning when I trained. It was the end of September was hot and I used to have to sit out around or two depending on the heat and my, you know, how much I ate the night before, I guess. And, and so I, I felt fantastic from the time I woke up and I didn't take any rounds off and I said, boy, I've now been on the low carb long enough to become fat adapted. And now we've, we've seen that the studies have been done about fat adaption and it's really important and unless your low carb and get rid of all those starch glycogen stores, you will never efficiently metabolize and burn your fat.

And how long does that take?

That takes a month to sometimes several months and many people improve. One of the interesting studies was done with majorly American Major League Soccer team where they went low carb and they wore GPSs and they found that they ran further during this, during the soccer match and faster with low carb. And once they, once they were fat adapted and there are a lot of, a lot of good studies. The, the only question with that is if you're doing speed work, there's an argument that you may need some starch.

What kind of carbs are you saying that you can eat during that period?

Well, if you're the carbs we recommend are vegetables that are low in starch and they're all low in sugar. So asparagus, broccoli, cauliflower, all the leafy greens, spinach and you know, and Brussels sprouts, one of, one of my favorites. And so that's where that's, those are, those are healthy. And we always lump vegetables or fruits and vegetables together and vegetables were really made to ripen in the fall and that's when it was good to get some sugar to build up Some fat in your belly for winter famine. And you know, it's my best example I use in the book is with grizzly bears. And so what happens at the end of the summer? They naturally have their insulin levels. And be important to talk about insulin. The insulin levels go up because they have to begin storing fat for their winter hibernation. And insulin is the fat storage hormone, as we can talk about. We're always in either a fat storage mode or a fat burning mode. And if you're heading towards a winter hibernation or for early man, which we are no longer, which we are no longer, and it's, it's important to store a lot of fat and calories. So the grizzly bear, they first, their insulin natural, naturally goes up. In humans, it goes up before with pregnancy because you have to store enough fat for you and for the baby. And you may have run into women who are marathoners who they no longer menstruate because they have very little fat. And if you're exercising that much or if you're dieting that severely that you don't have enough fat, then you don't have enough fat to carry the pregnancy. And so that's. And so naturally at the beginning of pregnancy, your insulin levels go up. And that's why with women today, they always do a glucose tolerance test. It should be an insulin tolerance test, but they, they have a tendency and often if they're heading for diabetes, it's unmasked during pregnancy because of the higher insulin levels. And the other is adolescents who they need a lot of energy for the growth spurt and their insulin levels go up. So with the grizzly bears, they get that head start and then the fruit ripens. And the grizzlies, they completely deplete berries and fruit from the forest where they're living. They have up to like 10,000 berries a day. It's been looked at and they are storing fat. And now they have already 400, 600 pounds in the late fall turning winter of extra fat. So why are they ravenously hungry? It's because their insulin levels have gotten higher and higher from the fructose, the sugar in the fruit, and that blocks the access to all that stored fat. You know, the first what insulin does is it, it stimulates, activates enzymes that build up the fat and it blocks enzymes that break it down. So if you sit at the airport, like talk about where I do a lot of my research while I'm waiting for a plane, and you see, you know, frankly overweight or just people with Little bellies coming out of fast food with the Cokes and they look like they're starving and don't they have any self discipline and there's all that energy. They do feel like they're starving because their insulin levels are high and that blocks access to the fat in their bellies and even to the starch in their, in their livers. So, you know, when people have prediabetes, or what I call pre, pre diabetes, high insulin levels, they wake up in the middle of the night really starving. And that's because at night, normally you normally eat during the day. And when you eat, you increase insulin levels. That's what gets the blood sugar and energy from your bloodstream into your cells when you need it. And some of the excess is stored as fat and as starch in, in your liver. And then when you're not, when you're doing an overnight fast, your insulin levels go down and you have access to the starch and to the end, to the fat. And that's why you don't die in the middle of the night. And you normally sleep through, through the night. But when you've had so much sugar and bad carbohydrates, your insulin level doesn't drop down during the night, so it's blocking access to that starch and to that fat. So you wake up in the middle of the night and even though you got plenty of starch and fat, you don't have access to it. And so you go down and hit the refrigerator. And so this, the role of insulin is so important. I call it the invisible killer because we always call, you know, hypertension the silent killer, because you can measure your blood pressure, but you, but it doesn't cause symptoms. I mean, high blood pressure, where it is today, just, it doesn't cause headaches, it doesn't cause symptoms. It's kind of a myth. But insulin is way before your blood sugars are elevated. That's why we should be measuring insulin levels, which we can describe. It's a pretty simple, inexpensive test. But your insulin levels are high for many, many years before your blood sugar goes up and you're diagnosed as prediabetes or diabetes. And that's seen in teenagers. They're bad, they're excess sugar and their bad carbohydrates. The white bread, white rice, all, all that bad diet is turning the sugar and bad carbohydrates into fat. And the fat is in their livers. That's the first place it goes. And it overflows the cells in the liver, causes A fatty liver. Which fatty liver is the number one cause of liver failure, cirrhosis of liver and liver transplants today. And it starts in teenagers. They're turning too much sugar from eating too much sugar. It reverses when they just get rid of the sugar for a few weeks. It begins, it begins to reverse. They're very, very good study. This is not controversial at all. And all gastroenterologists are seeing liver dysfunction at the beginning. You don't see the dysfunction liver. You can only see it if you do a very high resolution mri, which is not practical and it's not being done, but you can measure the, the insulin levels. And so the insulin is turning the sugar and the bad carbohydrates into fat. The fat overflows from your liver. That's why you get the belly fat. Anybody you see get in the airport with a belly, and people don't think of themselves as overweight or fat. I mean, the big fat bellies, you know, it's clear. But many others have it and don't realize it. But if you see belly fat, you don't have to do an mri. You have fat in your liver. And the way the fat is metabolized, because the fat is overwhelming our storage mechanisms, some of that fat turns into small cholesterol particles, which are the particles that get into our vessel walls and cause heart attacks. And one of the big problems, the full fat, dairy, saturated fat, meat, will increase our total cholesterol, but it's increasing mainly big cholesterol. It's only little small cholesterol particles that stick to our vessel walls like Velcro and get in and cause the plaque buildup. So that was one of the reasons for a lot of misunderstanding about saturated fat, full fat dairy in meats. And it doesn't cause heart disease, and it also doesn't cause cancer. The other interesting part about insulin is the high insulin levels are associated not just with obesity or diabetes, but with, or with heart attacks as well. But also cancer, autoimmune disease, which affects your skin, it affects your whole body. And this is when I talk about all the things it can cause. You know, I sometimes feel like a snake oil salesman because we, and we see it with our patients all the time. And again with me, since I've been consistent a year and a half, you feel better mentally, physically, endurance, your skin, your skin is, is better. And we, we know the reason for most of this. So high insulin levels will cause what I call the big five. Obesity, diabetes, heart attacks, cancer, autoimmune disease. But from Your head down, headaches, dizziness, ringing in the, in the ears, asthma, irritable bowel reflux, so many of these complaints, anxiety, depression, you know, even schizophrenia, it's all associated with our blood sugars bouncing around all day because of, because of bad insulin levels and it's causing us to be sick. And the other thing is we're walking around hungry all day because our blood sugars are, are on a roller coaster. They're going up and down, and that's part of what makes us anxious and sick. But also snacking all day. And so compared to the 1970s, when we have three meals and maybe a snack, there are very good studies now where most people are what we call grazing. I mean, when I grew up, I mean, we never heard of that. They're sort of eating around the clock and that doesn't give time for your insulin levels to drop. And your insulin levels stay high. So you can't access your fat day or night. And that's why frequent, frequent meals. You can put it this way, if you eat a given number of the same food in one meal at the evening versus 6, 7 feedings during the day, when you do time restricted feeding, you do lose weight and you feel better because your insulin levels aren't being jacked up all day.

And that's the intermittent fasting that you talk about in the book.

That's the reason for intermittent fasting.

How many hours? Is there a recipe for success with it? Should you only eat once a day or is it twice?

Well, it depends. The higher your insulin levels, which has to do a lot with genetics. If there's type 2 diabetes in the family, then you have some of the gene. If you have a history of, of putting on weight, particularly in your belly, and a lot of, by the way, yo yo, dieting is a sign of prediabetes. Some people are what we call fat and fit their skin. Their, their fat is under the skin but not in the belly. And that's safe fat. You can be extremely overweight and that. Well, the good news is you won't get heart disease, disease or diabetes or cancer. The bad news is it's tougher to get rid of that fat.

And that's when you don't have belly.

Fat, and that's when you don't have belly fat. And, and you really sort of have, have diffuse fat. And to the degree, you know, Americans in general can store a lot more fat under the skin than Asians. So if you're in Mumbai, they're in Mumbai, Beijing, Dubai, their incidence of diabetes is pretty much the same as it is in the US now, but less obesity. Because they're not able to store their fat. We call subcutaneously under the skin. It goes right to the belly. And the belly fat is what overflows the liver and causes a lot of disease that way. And fat under the skin when depending somewhat on genetics also as you add more fat, you develop more fat cells. So the individual fat cells are no, are never overwhelmed in your belly. You can't divide the fat cells. So the individual cells gets bigger and bigger, what we call hypertrophy until it disrupts the, the structure of the cell and it causes inflammation. So inflammatory cells come in and anybody with a belly will also will also have markers of inflammation and more likely to have joint pains and again all kinds of symptoms from inflammation. And it's too much belly fat. Sometimes we call people tophis thin on the outside, fat on the inside. We do imaging and we can see a lot of excess belly fat. And they, they don't think of themselves as fat at all. So there is a whole spectrum. But we know certain populations, particularly Asians, who were living with a lot of famine up until recent decades. And the ability to store belly fat is what helped them survive the inevitable famines. And so it's a little bit different than other western groups.

So what do you suggest now for us for intermittent fasting?

So that's. So it depends on individuals. I would start in general by skipping breakfast in the morning when you get up, hormones, your cortisol, your adrenaline starts firing to get you ready for the day. And that also causes you to burn some, some carbohydrates, the starch and the fat. So you're usually less hungry because you're feeding off your, your own, your own energy stores and so skipping that and then having a good lunch. And you know, we prefer certainly that it is what we call low glycemic, low sugar lunch. If you want eggs for lunch, eggs are great. They rarely increase your cholesterol and if they do, it won't hurt you. And, and then you, you can extend the fast. So eating within from an eight to a six or even four hour window is. I didn't have lunch today, I didn't have breakfast and I exercise fasting, which helps you burn whatever starch you have left over and burn fat. And you know, you just, you do have to keep up with salt and fluids. And we should, we should talk a little bit about that. That's called the keto flu. When you don't Keep up with salt and fluids. But then I'm not hungry. I generally break the fast around three, four o' clock, and then I do get hungry. But that's because you produce a hormone called ghrelin, which is what makes your stomach growl and makes you hungry, but it goes up and down. So I'm sure you've had the experience where you in a sense, work through lunch, you feel a little hungry, but you're busy with a project, you don't work, and then it all of a sudden, two, three hours later and say, I'm not hungry anymore. And that's because the ghrelin goes up and then goes down. And when it goes down, you don't feel hungry.

And so it's completely safe not to eat until 3 or 4.

Absolutely. Say the one thing, and this is, this has to do with, with ketosis. When you're, when you're burning fat and not getting fluid. There are several things that happen. For one thing, when you begin low carb or keto friendly, and you get. The first thing you burn off is the starch in, in your liver and in your muscle. And that is stored with a lot of water, a lot of fluid. Actually, fat is not. So at the beginning, a lot of diets say, oh, lose, you know, £12 in one week or whatever. They say most of that at the beginning is water weight. And it's not, you can't really lose more than a pound a day if you're, if you're fasting. And so you're losing that water weight, which tends to make you dehydrated. And then the, the most common cause actually of high blood pressure today is again, high insulin levels. The invisible killer, we used to call it, we call it essential hypertension, which meant we didn't know it was causing the hypertension in. And hypertension doesn't occur in primitive societies where they don't have sugar or the processed carbohydrates, the, that are increasing their insulin levels. So insulin causes you to retain salt from your kidneys, and that raises your blood pressure because you have this extra fluid from retaining salt that keeps fluid in your, in your bloodstream. When you go on low carb and you lower your insulin levels, you no longer retaining that salt, and so you're excreting salt and you're losing fluid that way. And so at the beginning, it's been called the keto flu or low carb flu. A patient will come in and we always tell them they have to keep up on salt and fluid, but they'll say, oh, I did the diet for a few days and I'm not hungry, but I'm weak, I'm tired, my exercise endurance wasn't the same. And I tell them that's a very good sign. Why that I feel lousy and sick. That's the keto flu. That means that your insulin levels dropped and you burned up the starch and you became dehydrated. Somebody who's fat and fit doesn't get they don't have high insulin levels to begin with, and that's a small minority of the overweight people in this country. The whole epidemic of obesity is from insulin and what we're eating.

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I love that idea that it's not self discipline, it's the, the food choices that we're making driving how we feel.

Absolutely. And that's again that when I realized and here I'm a diet doctor and I'm coming in if I have a belly and it's not covered up, you know. Well, my wife was always the first one to point it out but I, you know, I knew it was there and once I realized it was truly an addiction and it wasn't my fault, my lack of discipline for me that did it and the first year I was feeling so good I didn't the whole first Thanksgiving holiday season I did not cheat. Since then I have cheated. And I mean over Thanksgiving this year I said yeah, I'm gonna have the pumpkin pie and everything. And I gained a bunch of weight in one day and I knew it. Any big swings is fluid. It, it went away. I frankly did a longer fast but it, it all went away also in, in a few days. And some people, you know, particularly if you're doing the, the time restricted feeding or fasting can get away with a dessert or they want their glasses of wine. And you know, we see all this all the time and it's, it's an individual choice and there's flexibility what people can get away with. When I, you know, it was, it was my first Joe's Key Lime pie when you know, I took a bite or two and I didn't inhale the whole thing. I had lost a lot of that of, of, of that addiction. But I've already had the experience. It can come, come back quickly. But I know what to do and I'm confident now. And you know, it's again, it's been a year and a half and I, I feel too good. I feel it's too important again, mentally, physically, that I'm just not, it's more.

Than weight, it's wellness now.

It's, it's, it's, it's, it's wellness. Absolutely.

Well, I'm going on it, I'm telling you right now, you, you have sold me. And for people that don't know where can they find your book, your new.

Book that we're talking about on Amazon and there's a southbeach diet.com website and it's a, again, it's not your fault, I should say with you, with the fasting that you can prolong and longer fasting can be effective and sometimes we do it in type 2 diabetics and some people it's all or nothing and we want them to feel the benefits. So we'll do a longer fast. But you should only do that with, with professional guidance. You, I mentioned you tend, you, you lose some salt. You have to keep up with salt and fluids. Which by the way is a big myth, is the super salt. Low salt diets are healthy. They're not, they're actually dangerous. And so now if you're, some people have salt sensitive high blood pressure, if they're eating fast food with a lot of salt, I mean you can certainly overdo it with the salt. But we used to, when we admitted patients to the hospital, it was a 2 gram sodium diet, particularly for heart patients. We now know that when you get below 4 grams a day, which is a teaspoon or so, you actually do worse. So we were, we were literally putting patients on a diet which was making them more likely to have a heart attack and stroke. And that's a bit of a lower, a longer story. We, we describe it in the, in the book, but particularly once you're low carb you need fluids and you need salt. You need to make sure you get enough magnesium, enough potassium. And so if we're, you know, both at the beginning of a more strict low carb, if you're truly doing keto, then we, we measure electrolytes, the potassium and the magnesium, and that, that's, that, that becomes, that becomes important.

But you actually lay out that plan and you lay out step 75 full recipes for the diet within the book. So everybody needs to check out the new keto friendly South Beach Diet you can find at Amazon or you can find it on your website, the South Beach Diet. And check it out, because Dr. Agatson knows what he's doing. This is his life's work. Not only is he a cardiologist, but he is a diet doctor. And you will read in the book testimonials from your patients and experience their journey with weight loss and just well being.

We are amazed with the results with our patients. And over the years, we've seen good results. Everybody wanted to stay on the first phase of the diet for more than two weeks. And they were right, we were wrong. We thought they just enjoyed the fast weight loss, but they saw psoriasis go away, they felt headaches go away, reflux, and that was all the benefits of getting rid of all the grains and the sugar.

All right, well, they're out at my house and I can't wait to report back.

Okay, we'll look, look forward to your report.

All right, well, thank you so much for sharing your knowledge with everyone and for helping us and creating this fantastic book with this step by step process. We're all in.

Thanks. My, my pleasure. Really enjoy it.

All right, hang tight. We'll be right back. I hope you enjoyed meeting Dr. Agatson as much as I did. I'd love for you to check out his book. I'm really impressed with it. I'm so impressed with the work he's doing and I'm going all in. I definitely know it's going to be tough to completely remove sugar, but I'm going to make a run for it. And over the next month, I am anticipating some big health gains which will set me up for further success for 2020 and achieving my goals. And I hope you join me. But before we get started in my Q and A, I've got to give give some podcast one love. If you love true crime podcasts, podcast one is the perfect destination. We've got two awesome true crime podcasts trending right now and you have to check them out first up Based on the iconic series on A and E, Cold Case Files explores some of the most difficult to solve murders which stymied investigators and went cold, sometimes for decades. Next up, Copycat Killers is the latest podcast from Reels and Podcast one. Every episode takes you behind the scenes of real life murder cases which copy memorable slaying seen in Hollywood movies. Check out both Cold Case Files and Copycat Killers. They're going to be your next favorite true crime podcast. Be sure to subscribe on Apple Podcasts, Podcast one and many of your favorite podcast listening apps. Oh my gosh. I cannot watch scary things like that because I get nightmares. But I know so many of you absolutely love them.

So.

So I want to talk today about a couple of questions that I received recently. These are DMS that I received. One was on Instagram and one was on LinkedIn. So if you ever have any questions, shoot them at me at my website, heather monahan.com or you can DM me on any social media platform. Okay. Hey Heather, I'm a salesperson, I'm not going to say in what city, in the electronics industry. Big fan of Gary V. Huge entrepreneur at heart and admire your story and respect your accomplishments. Wanted to ask about trade shows. I'm working a booth for a customer of mine and he tells me about the product that's actually me holding the guitar in the picture. So wondering if you have any advice on how to find buyers, distributors and the big fish to help sell the product as big, fast and wide as possible. So here's the thing. This is a lot of work. So I liken that to me getting to Gary Vee or, or I liken that to back when I was in the radio business. I'll never forget I went on a meeting with one of the largest companies in the U.S. one of the largest advertising brands in the U.S. and I met with the ultimate decision maker. And I'm not saying who it is because I don't want to call them out, but I, I basically said to the client, I said, listen, I'd love to expand our relationship, grow your business this year and I'm committed to showing you I'll provide you results. The best service, service. You know, I was going through the whole list of things I would be able to provide him. And he said, ah, that stuff doesn't excite me anymore. I can work with anyone, Heather, why should I work with you? I said, well, what matters to you? He said, I want to eat at this restaurant called Rao's. And that was in New York. And I Said, okay, no problem, done, I'll get your reservation. And he started laughing. He said, you get that done and I guarantee you I'll double your business with me. Great, I'll make it happen. I'll be in touch. Well, little did I know at the time. This is a few years ago, Rao's was incredibly hard to get into. There was only, I think, 10 tables in the whole restaurant. They were actually owned individually by a family. Each family owned a table. And so you'd have to get to someone. It was just impossible. You couldn't do it. So everyone I asked told me, it's impossible, Heather, you can't do it. Well, I like a challenge. So I here's how I approached it, and this is how I would suggest to this message of how do I get to the big fish? I was relentlessly focused on it and it took me a month, maybe even two months. I, I called American Express and asked them if they had any ins to get into there. I called different vendors, people who I thought rolled at a real high level, maybe they could get me in. I called in favors, I posted about it on social media. I called the restaurant, I planned on going to the restaurant on my next trip to New York. I asked every single person I could think of, and every single day I would ask, you know, 10 or 15 people if they could help me to get a reservation. And this went on, like I said, for a couple of months. So I was getting no luck. Getting no luck. And it was a Friday night and I was out for dinner with some friends and we went up for drinks at this restaurant after dinner, and there was this huge group of people, and I walked up and introduced myself to them and said, does anyone here have any way to get a reservation at Rao's? And one guy started laughing. He said, yeah, my brother in law owns a table there. I said, could you call him right now for me? And he did. And I got on the phone with this brother in law, didn't know him, and the guy was so gracious and super funny. We hit it off on the phone. He said, I'm happy to give you my table on such and such date. It's available, you know, just go there, it's yours. So I was able to get something that no one else could get done. And it wasn't that I had some really tricky approach. It was that I was relentless in and frequent in my messaging, frequent in my asking, frequent in trying different people, trying different approaches. So if you want to get to the big fish, Google them. Find out everything that there is to find out about them, find out who is in their inner circle, see who they are connected to and reach out to the people they're connected to. The way I got to Gary v, I was DMing him for years on Instagram and occasionally he'd message back, but he, he'd never commit to meeting with me. And finally, when I knew I was launching this show and I wanted him as the biggest guest to kick off my podcast, I googled him and saw he had just launched a new business, a wine business with Trouty. And so I googled Trouty. I found information on him, I found him on LinkedIn and I thought, I bet it's easier to get to this guy Trouty than it is to get to Gary Vee. I direct messaged Trouty and said, listen, I was in the wine business for years. I drive hundreds of millions of dollars of revenue in advertising and media. I definitely can help you and give you some suggestions around growing your wine business. Do you have time for a quick call so I can share some of my ideas with you? I was going to him, telling him how I could help him. He took that call. After the call, he said, hey, Heather, I'd love to help you out sometime and any way you can help me move more wine? I said, how about I'll help you move more wine. Can you get me a meeting with Gary V? And he did, and I helped him move wine and he helped get me a meeting. So, you know, make it about the other person. Find everyone and anyone in their circle. Be relentless in your pursuit. Don't just give up. Google other ways. Google different ideas, ask different people, ask their competitors. You know, just be relentless in your pursuit and you will figure it out and you will get to that person. But it's done through frequency, consistency and trying different approaches. I've had people say to me, yeah, well, I reached out to this person. I never heard back. I guess they're not interested. No, I think of it this way. I reached out to this person. I didn't hear back. I bet they were probably on a plane. My email got buried amongst 700 others they received that day. It's on me. I've got to find a way to step out from the crowd and raise my hand. And, you know, that's exactly what I did with Ed Mylett when I was trying to get Ed Mylett on my show. I DM'd him and DM'd him. I would comment on his post and ask how I could help and And. And then I DM'd him and said, I can help you grow your LinkedIn following. Because I saw he was rather new on LinkedIn. You know, I'm relentless in my pursuit of trying to differentiate myself and raise my hand. And one day he just responded back to the dm. Hey, Heather, how are you? I just landed. I'm in Vegas. I'm going to give a speech. I just heard your message. Thank you so much. Yeah, I'd love to be on your show. So that came from. I don't even know how many messages that I have reached out that I have sent, how many comments I've made on his post, how many times I've shared his post. Oh, my gosh. I'm constantly promoting his brand. So, you know, find ways to help people. Be relentless in your pursuit of them and do not give up, because giving up is something quitters do, and we are not quitters. Okay, so I've got some interesting news for you. If you don't know your numbers, you don't know your business. And if you don't know your numbers, we've got some issues. That is what netsuite by Oracle has set out to solve for you. Most companies don't have a clear picture of their finances, and that's why most businesses fail. The question for any business owner out there is, are you confident that you've got the right numbers at your fingertips? And that's exactly what you need. Serious entrepreneurs and finance teams run on NetSuite by Oracle, the world's number one cloud business system. And you might remember I had Evan, the founder, on last week talking about the business innovation and changes and growth that NetSuite has been through. If you haven't heard that episode, definitely check it out. There's no more guessing, no more worry that what you don't know could kill your company. Schedule your free demo right now and receive their free guide, 7 key strategies strategies to grow your profits at netsuite.com confidence set up your free demo and get your free guide today@netuite.com confidence netsuite.com confidence okay, so my last question that I'm going to answer today because I do not want to keep you on your podcast forever. Well, actually, I would like to, but I'm trying to be respectful. Okay, so this. I get a lot of these questions and I don't talk to you guys about them a lot, but I've got to share this one. Hey, Heather, I just got fired and I had moved out to this new city for My job, it's just crazy. It's awful. I'm a great asset, but I want you to know, bullies are real. I didn't sign the severance offer that I was offered. You're my inspiration for that. I'm listening to your audiobook. I'm weighing out options, and I have a few. I have a story to tell. I want the possibility to branch out on my own and call these people out, out for this awful stuff they did to me. My question is this. How did you navigate the waters of telling your truth while not being unprofessional or unlawful? This has happened to me a few times, and I am ready to stand up for myself and stand in my power. Any advice on if I should negotiate.

With the CEO to get a larger.

Severance or should I just walk away and share my story? Okay, first of all, this is a very personal question. No one can tell you what. What to do on something. A magnitude of this, right? Someone's not asking me. I'm happy to answer a question where someone says, how do I get to the big fish? I'll give you a million different ideas on how to do that, right? And I just shared a couple. But this is a very personal experience, and I've been through it. People will tell you, I don't think you should do that. I think you should do that. Whatever that's about them, their fears, their limitations. Only you know your truth. When it comes to something like being fired, being bullied, you know, that's up to you. I can tell you this. I. The past couple of years since I got fired have been super scary because, of course, anyone can sue you for anything. So knowing that in the back of my mind, right before my book came out or right before my TED Talk dropped, you know, I would have this resurgence of, oh, my gosh, what if this is the final straw? And they just. They try to shut me down and, you know, they try to sue me. And what. And what if, what if, what if? And whenever I think about that, I go back to this James Altucher podcast that I was on. I was on his podcast in 2018, in 2019, he was on my podcast. But I go back to the podcast where I was on his show and I said to him, I'm really scared I'm gonna get sued with my book dropping. And he did this whole Q and A with me where he explained, yeah, anyone can sue you for anything. However, you can turn that into good publicity and PR for you. And if they're going to sue you, they're going to shine a brighter light.

On your book, helping you garner more.

Book sales, more press. The reality is companies want to hide errors that they make. The company will probably never sue you. And he ended up being absolutely correct. But, you know, I decided to take that risk and make that decision because I had a burning desire and felt a drive and need to do it. If you don't feel that really strong desire, even though I felt afraid, don't get me wrong, I was petrified. But fear is different than, you know, you can feel driven to do something and feel afraid to do it, but if you're not really feeling driven to do it, that doesn't have that purpose or passion to you that you really feel there's something bigger pushing you to do this. I would say don't do it because it's not an easy ride and it definitely is a scary one. And people close, close to you will tell you you're crazy and, you know, everyone will second guess you and you'll second guess yourself. It's, it's definitely a very serious decision to make. So I would say get quiet, listen to yourself. You have that answer, Tune everybody else out. And the other thing is, you know, show up as you. The more you tell the truth and show up as the person you really are, the less you have to worry about those other elements. Again, I'm not saying it's easy, but it is pretty simple. You know, just tune into your own voice, listen to yourself, and make the best decision for you. I think back, I would have regretted it so much had I not written my book, had I just gone back and taken another job in corporate America, I'm so grateful I doubled down on me and took the chance to go to work for myself. So I'm super grateful for the decisions I made. However, there have been countless sleepless nights. There's been so many challenges along the way. Navigating becoming an entrepreneur, becoming an author, becoming a speaker, becoming a podcast host, being here with you now, all this stuff is new to me. And anytime you start off new, you're a beginner. You're gonna make mistakes, you're gonna fall down, you're not gonna know the fastest way to grow, the right things to do. And that can be hard. So just get ready for it. You've gotta just jump into it and don't look back. And that's how I feel about 2020. Onto bigger and better. I'm setting myself up with this new found information on how to be as efficient as possible and use food as medicine to help me get to achieve my goals and live a better life. So I'm super excited. I hope you enjoyed the show today. I hope it helps you. If you could please leave a review of the show on Apple Podcasts, send me a screenshot. I will buy you my $299 co confidence video course as a big thank you. It really helps so much when I get reviews. Please share on social media and when you tag me, I will retweet, I will repost, I will put it in my stories and I appreciate your support immensely. Until next week, we will be creating confidence together.