Science-Backed Strategies for Lasting Weight Loss

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So what type of physical activity should we be doing to lose the midsection weight?

Aerobic exercise. And aerobic means with air, which means that it's at an intensity low enough that we can breathe comfortably and supply the oxygen.

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So as soon as you start huffing and puffing, It's not a bad thing for short duration, but if you go and you do a 45-minute spin class every day and you're just huffing and puffing, you're gonna make way, way, way too much cortisol. Really? Yes.

So you might be hurting your chances of losing the weight.

Yes.

If you're doing that intense of a workout every day.

Correct.

If you're doing a HIIT training two, three times a week for 45 minutes, is that okay? I feel like that's still intense.

If it's 45 minutes, it's not hit.

Gotcha.

Yeah.

Hit high intensity means that it's so to me, my definition, 10-15 minutes. It's not. Well, maybe the total duration would be 10-15 minutes, but if you do interval high, high intensity interval training is what hit is, then the intervals should be so intense you can't even do them for more than 30 seconds.

Wow.

They should be so intense, provided you're fit enough to do that, of course. But if you do 30 seconds and then you do 30 second rest and then 30 seconds, you should be able to bring your heart rate up to maximum in maybe four or five intervals. That is hit. Now you're done. You've created your four minutes. positive hormones, your growth hormone to stimulate fat burning, your growth hormone to stimulate muscle building to produce and to stimulate new brain synapses to enhance learning and focus. All the good stuff in the brain depends on hormones. And two of those hormones are human growth hormone and BDNF, which is brain-derived neurotrophic factor. And those two hormones are necessary to make new synapses. So your brain is constantly remodeling and every time you learn something, whether you're 20 years old or 80 years old, you make new synapses. And the synapses you use, they get stronger, the ones that you don't use go away. But these two hormones, which some of the strongest ways to produce them is high intensity exercise and fasting are pretty much required to build a brain and to learn, really.

So, what type of high intensity exercise are you doing on a weekly basis?

My favorite to really get the heart rate up is I go to my favorite mountain close to where I live, where there's a trail. And it's like four miles around. And I walk a little bit, I jog a little bit, I walk a little bit, jog a little bit. Just kind of enjoying the movement. And my heart rate probably stays around 100 to 120, 130 maybe. And then there's some hills. And then I do some sprints up the hills. So now I push it a little bit. And 30 second push and my heart rate's 160. And then I walk a little, jog a little, there's another hill, and I push it a little bit more and my heart rate hits 165, 170.

And.

I might do that in 30 seconds or it might take a minute. to get to that heart rate, and then I'm done.

You do a few hills.

Yes.

What if you did 20 hills? Too much, a 10 to 30 second.

That might be okay if you're 20, 25 years old, you're an elite athlete, and that's part of your event. But if you're 45, 50, 60, and you just try to stay as healthy as possible, I think that's too much.

Really?

And in any event, it's unnecessary because it's not about the quantity. Quantity is good for fitness, but not necessarily for health.

Interesting. So you only need a few sprints every couple, is this every day or every few days?

It's, I would say it's no more than twice a week.

Twice a week.

For the average person now, and we have to, If you're watching this, you have to understand if you're in the elite athlete category or in the 50-year-old trying to stave off living life, degenerative disease.

Yes, yes. So if you're more of a, you know, if you're an athlete, even in your 40s and 50s, you could push it a little farther. If you're competing in stuff or doing triathlons or marathons or just wanting to stay lean, Yeah. It's important to be doing that a little bit more.

Yeah.

So there's no doubt. I mean, I talk a lot of my videos about moderation. Like you do these HIIT exercises, you do it twice a week, you keep it short. But obviously that doesn't apply to someone who has a goal in an event. If you're going after fitness, there is no substitute for punishing yourself.

Right.

You gotta do it.

Yeah, because if you're gonna perform in an event, you need to do something similar to that event at that level of intensity and duration.

So fasting and high intensity exercise, but it's not doing a crossfit every day, five days a week, because that creates too much cortisol.

Correct.

Especially if you're older, past 30 or something, it's probably not as good to do that. Is something like that, a 45 to 60 minute CrossFit type of training once a week, you think okay, or is it still creating too much cortisol?

I think that's, I think once or twice a week for the average person, if you feel good, I think is fine. But again, when I have people come in to my clinic, those are people who have been to 20 different doctors, they have tried vegan and carnivore and low carb and yo-yo dieting and gluten free. They've done all that. So these are people with challenges. And now if you're a little frail, now that's where you really have to be careful and get everything right. But yeah, if you're in your 30s, 40s, 50s, you're feeling fine, then go for it. Do one or two of those spin classes. And what I would caution though is pay attention. Notice how your body is reacting. How do you feel after the class? Are you exhausted? Are you stiff in the morning? Do you have trouble getting out of bed? Do your joints hurt the next day? Then you're probably doing too much.

Doing too much, yeah. And what about, you know, we talked about fasting a little bit here. What are the top three benefits of intermittent fasting or longer fasting, you know, 24-hour, 48-hour fasting that you've seen in your research?

So number one is lowering insulin.

Number.

And with that, lowering blood sugar, losing weight, et cetera. The other big thing is that you induce something called autophagy. But that's with longer fasting. Autophagy is called self autophagy stands for self eating. And that's where if you're putting food in your body, if you're putting especially protein in your body, there's plenty of resources. Your body knows, hey, there's some more coming. I can just use that to build tissue and to do the stuff I need. But if you stop putting it in, now it becomes a very, very scarce resource. So now your body has to figure out where else can I get this? And that's where autophagy, self-eating comes in. So now your body upregulates its recycling mechanisms.

How long does it take to fast before autophagy starts.

So, again, that's what everybody asks, and it's not a black or white. It's a continuous, it's a gradient. I would say that it barely starts around 16 to 18 hours. That's where you get like a trickle, but then it increases pretty fast, where there's a significant change between 18 and 24 hours. and then it sort of takes off from there. So 48 hours into it, it's very significant.

48 hours into it. So the longer you can go every extra few hours, it continues to self-eat the fat stored in your body more and more.

Yes.

So the self-eating now, part of what it eats is fat, obviously, because you're not adding any fuel. But the key with autophagy is protein because you need protein to build the tissue. Your cells have so much of a lifespan, they break down and then you have to make new ones and you need protein for that. So when you don't add any, now you have to go look for some and a lot of people will say, oh, well that's where fasting is dangerous. because you're going to eat up your muscles. The body is too smart for that because you need your muscles to go on the next hunt. So we have all these mechanisms to spare muscles and that's why growth hormone increases also exponentially along with autophagy. And growth hormone is muscle sparing. It's basically telling the body, one of the mechanisms that tell the body Don't use the muscle, go find something else. So now it gets much better at recycling these broken cells. It gets much better at finding any kind of resource like virus and bacteria and parasites that may also be made out of protein.

Really?

And eating those things, the bad things first.

Correct.

Interesting. What's the longest you've gone Fasting.

The longest I've done is five days. Four and a half.

No food, water only.

Just water.

Yeah, I've done three days. And you see the benefits a lot after a day and a half, you really start to see and feel the benefits. By day three, I went right up to three and I was like, okay, I was starting to get a little tired and I think I pushed it because I worked out twice, which Yeah. Probably not supposed to do, but I did like an incline walk for an hour, which I don't recommend, but I was trying to be extreme.

Yeah, that's probably too much. And this is where we come into this muscle sparing thing. That I'm all in favor of doing some exercise while you're fasting. Because you're going to increase your ketones, you're going to increase your growth hormone. But if you're not adding any protein and you do something intense enough to break down muscle, now your body has to sort of juggle the resources. It has to repair those muscles and where's the protein going to come from? So it might break down some other muscles to repair that.

Interesting.

I haven't seen specific research on this or anything. It's just kind of common sense.

What.

What would the body do?

Sure.

So I. I would exercise, but I would keep it to purely aerobic. I wouldn't even do hit. Not even brief hit during those times.

Right, right.

What did you do for those four and a half, five days?

I probably not. Didn't do much of anything. Probably just. Yeah, maybe a little bit of walking, but basically just. my everyday activities.

Did you feel pretty sharp after two, three days? Did you start to feel a little slower towards the end?

I don't feel as great as people tell me they feel.

Yeah, I've got so much energy.

Yeah, so I do okay. I don't feel any dramatic improvement in focus, but I do know that it happens because I get the testimonials. and I do know, especially for people who might have insulin resistance, when they fast, they're gonna increase their ketones, which becomes the alternative brain fuel.

Right, and it also kind of helps heal certain things. If you've been driving the insulin, it's allowing that to recover more, right? Yes.

Yeah, your whole carbohydrate processing machine is recovering because you're not adding anything. And one more thing about autophagy and fasting is for brain trauma. And this, I've hardly ever heard it spoken about, that the brain is kind of its own little world up there inside the cranium. We have the blood-brain barrier and a lot of things that go on in the brain are different than the way they work in the the body. So the reason, for example, that spinal cord injuries are so devastating is that the nervous system is really poor at repairing itself. It's encased in bone for a reason. It's not supposed to get damaged. You're not supposed to crack your skull or break your spine. And that tissue is a little different. It's sensitive. and it doesn't have the capacity to repair itself very well. But if you have a concussion, for example, you get some tissue brain trauma, you get some inflammation, and about the only way that the brain can clean that up is through autophagy, the self-eating.

Our government told us to eat six to 11 servings of bread, rice, cereal, pasta today to eat a low-fat diet and fats and oils were sparingly only at the top supposed to be eaten. And yet that advice led to the worst obesity epidemic and diabetes epidemic in the history of mankind. That's like the food charts that we were all saw in school, right? Completely opposite of what we should be doing. And so the science has caught up with this bad advice and the advice unfortunately St. Louis was based on really shoddy science, on very weak evidence, on a few population studies, not really experimental studies. In fact, all the experimental studies that told us to eat low-fat diets, they actually didn't tell us that we should be doing that. They were actually contradicting the recommendations that were developed in 1980 by the UK and the USA. Really? So basically, if you looked at the actual randomized controlled trials, there weren't that many, but there was a few of them, They all said that eating low fat wasn't beneficial, but the...

Were outside of the US, trials.

No, trials all over, trials in the US. They just didn't look at that evidence. So the guideline committees who were working on it didn't, they sort of dismissed that evidence and they had this theory and they went with the theory, because it made sense, right? If you look at calories, for example, fat has nine calories per gram, carbs and protein have four calories per gram. So you think, well gee, if it has more calories per gram, if you eat less of it, you're gonna lose more weight. Logical. Unfortunately, metabolism is not a math problem. It's a metabolic problem. It's a hormonal problem. It's not energy balance. The whole idea of calories in, calories out, this is the biggest crock of, you know what, that's been pushed on the American public because there's a message implicit in that, which is if you just told someone to lose weight by eating less and exercising more, if they don't do it, it's their fault. Just eat less, exercise more. If you don't, you're a lazy glutton. Right. So, it's your fault, you're fat.

Okay.

Right. But the truth is that it's not, it's not just about calorie balance. In fact, that's what the Global Energy Balance Network, which was actually funded by Coca-Cola, and they actually funded university scientists to kind of be the front people for this nonsense that's all about calories in, calories out. has been completely discredited. The New York Times wrote a big expose of this, but what we've been taught is that all calories are the same, they're actually not. So food is not just energy, it's actually information. It gives instructions. So this is like a big breakthrough in science, right? So food is not just calories, it's actually information. So the information in food communicates with your body every single minute. So every bite you take, it turns on or off genes that create health or disease, they make you lose or gain weight. It turns on or off hormones that make you lose or gain weight create health or disease. It's like a feedback for you. It's direct instructions and it works minute by minute. It's not something that takes a long time. It regulates inflammation. It regulates your hormones, as I said. It regulates your brain chemistry. It regulates even your gut microbiome, all the flora in your gut that we now know are linked to everything from weight gain, diabetes, to heart disease, to cancer, to autoimmune diseases and so many other things. It's the gut health. Even to depression and ADD and autism may be linked to changes in your gut flora. So we now know that when you eat food, it's not just about the energy in it. Because if that was true, then you could just survive on soda all day and it wouldn't matter as long as you only eat 1800 calories of soda. And I had this argument. All right, right. I had this argument with the vice chairman of Pepsi. We had dinner together. I'm telling you. No way. Yeah, we had dinner. And the guy in between us, because I was in here, he's sitting here. The guy was like, was like, being in the middle of like a war zone. And I said to him, how can you say that eating 800 calories of soda is the same as having 1800 calories of broccoli or almonds? He says, well, as long as you have that amount of calories, you're not gonna, it's not gonna be any different. I said, this is not how the body works. You're not getting the nutritional value from that, right? Right. I mean, when you, but it's not even nutritional. So just, just like look at a thousand calories, let's say 750 calories of broccoli is, is 21 cups, 35 grams of fiber, half a teaspoon of sugar, and tons of phytonutrients, phytochemicals that upregulate your genes that actually help you prevent cancer, that improve hormone metabolism, so many things, right? Same calories from a big gulp, 750 calories, 46 teaspoons of sugar, high fructose corn syrup, upregulates your liver to turn on a fat production factory that makes high triglycerides. Stores fat more, right? stores fat, lowers triglycerides, I mean, raises triglycerides, lowers the good cholesterol, causes a fatty liver, raises hormones that make you, in women, make them grow hair on their face and have lost hair on their head. Men, they drop their testosterone, they have no sex drive and they lose their hair on their bodies. All this from the same calories, right?

The number of calories.

Calories are the same, but the information in the food is very different. So now we have this concept that is actually really about the hormonal, I call it the hormonal hypothesis, which I talk about eat fat get thin, which is how do you change your hormones so you're not hungry all the time? Because what that's the key. The typical advice, you eat low fat and your fat actually makes you satisfied.

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Because if you eat fat, you're not craving all the time, you're not hungry, and it actually is a brain actually food because it actually stops the addiction center in the brain from turning on, so you never feel hungry or have any cravings. It also speeds up your metabolism. Fat speeds up your metabolism. Yeah. So it helps you burn more fat. It helps you burn more fat. It releases fat from the fat cells. Interesting. Right. So it makes you less hungry. It makes you burn more fat and it liberates the fat from the fat cells. So it's really a powerful whereas if you eat sugar, the opposite happens. You get hungrier because you increase insulin.

You drop...

I used to have so much sugar. It's terrible. I was addicted to it. All of us were. I mean, I was too. I was a vegetarian. I ate like tons of whole wheat bread and sugar and honey and everything. I mean, grape nuts and ice cream for breakfast.

That was my life, right?

So, when did you stop? When did the research become known or the facts or the data become known?

It's not even.

It's honest. That's why I'm asking. Because you're a doctor and you were eating sugar. It's not even. When did you start to realize and.

When did this information about fat become?

Well, it's been mounting for decades, right? So, it's building on a mountain of evidence. And, in the book, I reviewed over a thousand studies or 500 quoted in the book that I referenced. They wouldn't let me put more because there was no room in the back of the book. Yeah, yeah. And, it's all well documented. And, the science of this is very powerful. One of my colleagues, David Ludwig, wrote a book called Always Hungry. He's a Harvard professor. He's done a lot of the research that this is based on where he, for example, gave two groups of people Same calories, same calories but change the percents of fat and carbs. And it was a very well controlled study. And in the first group, they had 60% carbs, 20% fat, 20% protein. The other group switched it, 60% fat, 20% carbs, 20% protein. So it's the opposite. And the group that had the high fat diet, burn 300 calories more a day by doing nothing at all. Really, just by having more fat. By eating more fat, their metabolism sped up 300 calories. That's like running. Same amount of calories though. They ate the same amount of calories in. But they burned 300 calories. Right, because their metabolism sped up. Interesting. Right, so in other words, it's like running an hour a day without getting off the couch. Interesting. Right? That's powerful. Very powerful. Yeah, and I know for me, as I've seen myself and my patients, transformation is amazing and their cholesterol gets better. It's totally contradictory. Right? Fat is supposed to raise your cholesterol, right? Eating cholesterol is supposed to raise your cholesterol. But for the first time since the dietary guidelines came out in 1980, the US government in 2015 completely reversed their stance on fat. There's no more restriction. Really? Like January, first week of January 2016. This year? This year. Like a few weeks ago. A few weeks ago. They just changed this. They changed this completely. The whole guide completely. Really. So the first time they said, forget about fat. You can use as much as you want. No way. No limit on fat. This is the government. The government, the Dietary Guidelines Advisory Committee established these recommendations. This is a scientific group that establishes guidelines for the government, helps them shape policy, and then the government makes the policy. They kind of-- They kind of-- Based around this research or this study. Yeah, they said, you know, don't worry about fat, don't worry about cholesterol, eggs are back. Right, eggs are back. Forget about the egg white omelets, just eat the whole egg. No way. Completely. And they said, it made me laugh. They said cholesterol is no longer a nutrient of concern. Nutrient of concern. Like, well, we got it wrong for 35 years. No way. So it's like, it's totally different. And they also said that we should, for the first time, they said we should reduce sugar. Now, the policy advisors who are the scientists said we should limit sugar-sweetened beverages because they're proven to be linked to obesity and diabetes. But the government, because of the food lobby, changed the wording to say, no, we should be restricting added sugar. So we should eat less added sugars. Now, what's an added sugar? It doesn't say added sugar on the label. So how do you know? Because the food labeling from the FDA is also influenced by the food lobby. So, which is say added sugar on the label, not just sugar. So, you don't know. It's designed to totally confuse people. The truth is that this is a huge advance and now we actually have come to realize that this is not true. The science around fat and how your body burns fat and what makes you fat is all really clear now. It's all based on this hormone idea of insulin, which is a fat storage hormone. So, anything you eat that increases insulin, which is sugar, refined flour, White flour raises your blood sugar more than table sugar. So if you had two slices of white bread, it raises your blood sugar more than a tablespoon of table sugar. People like, I mean, whole wheat bread, it's just as bad. Unless the bread is so dense that you can stand on it without it squishing, then you shouldn't eat it. You shouldn't eat it. No, like the German rye bread. I love bread though. Yeah, everybody loves it. The bread we eat isn't the bread we ate, right? So our ancestors ate very different. It's not the hard bread. It was very coarse and we only had the the grain mills that started in the 1800s. Before that, we couldn't eat refined grain. And now even whole wheat is super refined. It's just... And are all grains bad as well, in your opinion? No, I don't think all grains are bad. I joke, I say, in the book, I talk about an induction plan, like basically a way to get quick start to change you from just being storing fat to burning fat to eating fat to makes you thin. And that's a 21-day plan. And after that, I talk about how you transition to what I call a Pegan diet. Pegan. Pegan as opposed to paleo or vegan. It was kind of a joke because one day I was sitting between. Yeah, I was sitting on a panel with two friends of mine. One was a vegan cardiologist and the other was like a paleo doctor. And I was like, well, I don't know. I guess they must be a Pegan because I'm in the middle here. Okay. What does a Pegan diet look like? So, Pegan diet, you know, it's amazing, Louis, is that the principles of paleo vegan are often very similar. So, Both groups believe that we should be eating whole, unprocessed, unrefined foods.

Yes.

We should get rid of food additives, hormones, pesticides, GMO. We should be having no MSG, no artificial sweeteners, no high fructose corn syrup. Everybody agrees that that's true. We also agree that everybody should be eating lots of fruits and vegetables.

Yes.

Right? A little heavy on the plant foods. Yep. Basic principles. Both agree that we shouldn't have dairy, which is interesting. Yes. Right? We'll talk about that. Paleo, no dairy as well. No dairy, right?

No dairy.

I guess there's some of them that say like some specific cheeses or something. Yeah, you know, grass-fed butter, you know, like there's some things. But, you know, but it's, but the proteins in dairy are very inflammatory and the dairy again we eat isn't the dairy we ate. We've hybridized our cows, all fertilized by one bull. It's not organic dairy. And it's not organic, it's not raw, it's not how our ancestors ate it. Right. Even organic cows, they pump milk them when they're pregnant and there's full of hormones. So, also, you know, it's just not always tolerated well by many people. And then, what else did everybody agree on? Everybody agrees that we should be eating foods that are phytonutrient-rich, that are nutrient-dense, and we should be lots of nuts and seeds and lots of good oils like avocados and olive oil. What's phytonutrient? What does that mean? Phytonutrient is a is a chemical that's in plant foods. Fito means plant. And it's not a vitamin or mineral. It's not a protein, fat, or carb or fiber. It's something else. So for example, like broccoli has glucosinolates, which upregulates detoxification.

Okay.

Catechins are in green tea, which are powerful detoxifiers of metal, powerful antioxidants. Tomatoes have lycopene, which is a powerful cancer preventer for prostate cancer.

Okay.

So anthocyanidins, you're gonna have black rice, which has anthocyanidins, which are powerful antioxidants that are in black rice. It's emperor's rice. Love that. It's also very low glycemic. Sure. So I think the things that they disagree on are basically beans, grains, and meat, like where you get your protein from. Everything else is the same. Paleo and vegan is the same except for meat, beans, and protein. I mean, beans, grains, and protein. Beans, grains, and protein. Okay, right. And, I mean, you know, like meat. Right. And so, you know, what I realized is that, you know, I think many people who are sick do better when you take out certain things that can be inflammatory or high glycemic. So if you're, for example, carbohydrate intolerant and you're diabetic, which affects a lot of people, I talk about how do you find out if you're carbohydrate intolerant in the book, which is as a questionnaire you can tell if you actually know if you're someone who's carbohydrate intolerant, like someone who's gluten intolerant. That means if they eat a lot of starch, if they have like two cups of rice, even if it's brown rice or two cups of beans, it can adversely affect the sugar. So I talk about like having less, like having smaller portions of beans and grains. Sure. And non-gluten grains in particular, because gluten can be very inflammatory for many people. I think for some people who don't react to it, it can be fine, but not in large amounts. And then I think, you know, meat is the big issue, right?

Meat is the big issue.

So should we be eating meat? We were just had dinner the other night.

Right.

We both had meat, right? We had fish.

We had fish. Black cod.

Yes. Which was awesome. I had a mahi-mahi. You had a black cod, is that what it was? Yeah, I had the black cod. Cot. Yeah, yeah, the black guy next to me had meatballs. Yeah, got next to me at Carnegie Hall. But, you know, so, so the issues around meat also, I think are, everybody agrees and fish, everybody agrees that if, if anybody eats meat, it should be humanely raised, it should be sustainably raised, it should be grass-fed it should be not harming the environment. The ethical and the environmental issues around animal eating are big and they're real. Yeah. I mean, I have many Buddhist patients. I have a Buddhist monk who's like an abbot who's a as a diabetic and he's never going to eat an animal. So, I need to help him understand how to never eat an egg, how to eat a high higher fat protein diet which is low glycemic. So, we can do that. So, more nuts and seeds, less rice, more beans, there's strategies for doing that. And, he did great. He lost 35 pounds, reversed his diabetes, and now I have tons of bun people praying for me. that's great. Yeah. And, and then the, the, the meat thing is tricky because, you know, it's also an environmental risk. If you're eating factory farmed animals, there's antibiotics in that and is runoff from the pesticides and fertilizers that damages our water supply and rivers and lakes. There's climate change that happens from the methane produced. It's more, more toxic to the environment than carbon dioxide. There's so, and there's high energy use. One fifth of all our fossil fuels are used for growing animals for human consumption. Our water is being used up at incredible rates for feeding animals. There's basically, I think, 70% of all water use and there's basically only 5% of the world's surface is freshwater.

Usable, right?

Is freshwater.

Right.

1% is in Russia. Wow. And at least 4% for the rest of us. And 70% of that is being used for feeding animals for human consumption. So there's real environmental issues.

Sure.

So I think, you know, a factory farming just should be not supported in any way and we need to change that. And that means we need to change our patterns of consumption around meat. We need to downsize our meat consumption. I call it having condiment.

Condiment.

Condiment. As opposed to like a condiment. Like condiment, you know, it should be a side dish or a dressing. if you're gonna eat it. Sure. And I think not a full plate of steak, you mean? You know, I think there's three issues with me, right? There's environmental issues, there's moral issues, and there's health issues. So, we kind of talked about the moral. I think that's people are entitled to their beliefs and they should be able to follow whatever they want and be healthy. The environmental issues are real. I think everybody would agree whether they're paleo vegan that we need to stop harming the environment. And I think even if you're not paleo vegan, everybody really believes that. In fact, the Dietary Advisory Committee that was advising the government said we should limit meat consumption because of the environmental impact. Now, if you have grass-fed meat, if you have sustainably raised meat, it's not as abundant, you can't produce as much, and so we all have to eat less of it, and it's more expensive. But that's okay. And I think that from a health point of view, when I really looked at the literature and I did this in in Eat Fat Get Thin, I looked at all the research that I could find on meat. Because I was, I'm like, why don't I know for yourself, too? Yeah, I'm like, I'm recommending to my patients. I'm, you know, a human too, and I want to live a long time and I don't want to be doing something stupid. Yeah. So I wanted to find out, what does the science tell us about meat? So you did all the research. So I looked at all the research and I wrote 8,000 words in the book on meat.

Wow.

There's a lot of research in there. And I address all these issues, you know, environmental, moral, and the health issues were quite interesting. You know, when we look at the studies on meat and anybody can quote anything saying anything, right? Right. So you want the paleo people like a meat's healthy, here's all the research. And the vegan, like, meat's gonna kill you, here's all the research. So it's like, and then you're at the average Joe, you're totally confused. And your average doctor, you're totally confused because we had no training in nutrition. And they haven't done the research themselves. So they're going off of their opinion or their theory. Yeah, they're like average people like the rest of us in terms of nutrition science. They don't know because it's not what we learn. Right? I mean, I just at a Cleveland Clinic and we implemented a nutrition curriculum for the first time in the medical school there that's integrated in, which is so great. And I helped Tim Ryan, who's a congressman from Ohio, introduce Tim. You love Tim. He's great. Has he been on your show? He's been on here. Yeah, he's great. You know, introduce a bill called the Enrich Act, which was a bill that is funding $15 million to fund nutrition in medical schools, nutrition education for doctors. Interesting. That's what we need the most because doctors, a lot of the time, I feel like could heal a lot of their patients through food. Oh my god. Well, food is the cause of most chronic disease. It's the cure for most chronic disease.

And yet doctors know nothing about food.

And they just medicate a lot of the times. I mean, listen, it's so bad. I mean, I use food as medicine. That's what I, food is the most powerful drug on the planet. I mean, that's why last week I was in Cleveland at the hospital teaching 300 black women how to cook in a cooking class. Like that's what doctors should be doing. That's how I'm gonna get people to eat real medicine. That's real medicine. Just a quick side note. What is your involvement with, what is functional medicine and what is your involvement at the Cleveland Clinic? Can I finish my meat? Yes, go ahead. I was still rolling on the meat. We'll talk about functional medicine. Then we'll talk about Cleveland Clinic. Perfect, perfect. Because people want to know, like they're like, well, what about meat? They're like probably listening. Let's do it. So, the science. 8,000 words. I'm not going to give you 8,000 words, but I'll give you a few hundred. So, the science of meat was fascinating. So, when I looked at the studies that showed it was harmful, Here's what they were. They were mostly population studies, meaning they looked at groups of people, followed them, and then they asked questions of them. What did you eat last year? What did you last week? What did you last month? And they basically do these food frequency questionnaires, and then they correlate that with the risk of disease. And I try to control for all the confounding factors, but it's very tough. So the people who ate meat, yeah, they had more heart disease and more cancer and more death. But what else was... They were smoking, they were drinking. Yeah, exactly. So sleep, exactly. so if you look at the data, they ate 800 more calories a day. They almost ate no fruits and vegetables. Tons of sugar. They had tons of sugar and processed foods, lots of fried foods, drank more, smoked more, didn't exercise and didn't take any vitamins and minerals. Well, guess what? They weren't as healthy as the other people. So most of the studies were like that. Now, there was a few study that were interesting. I found one was a study of 11, 000 people who shopped at health food stores, and they found there were, like, a lot of vegetarians and a lot of meat eaters. Like, so who are the people who are you know, like healthy meat eaters who only eat grass-fed meat or who, because most these studies were not on grass-fed meat either. They were on factory farmed meat, right? So then again, how do you generalize that? Sure. But then there were these 11,000 people and they followed them for many years and they found that the meat eaters and the vegetarians, there was no difference in their health outcomes. Exactly the same. So if you're a meat eater who basically eats a healthy diet and has grass-fed meat versus a vegan or vegetarian.

No difference in your healthy lifestyle. Healthy lifestyle.

Then there's no different.

What is the main cause in your mind to why it's so hard for people to get rid of that extra 20 or 30 pounds of belly back fat?

So when you think about fat burning, there's two different phenomenon at play. One is thermodynamics, so there's more calories in than calories out. And then the other is lipolysis. So if you're going to restructure or recomp a building or your body, you have to remove blocks in some places and then put blocks in other places. So a lot of fat burners help with lipolysis. So they break fat molecules down and they increase, for example, mitochondrial beta oxidation, which is basically just you're metabolizing fats and then using them in the electron transport chain in the mitochondria. The details don't really matter. but that's essentially the Powerhouse of your cell. And you can do that all you want, but if you're still, you know, in at caloric maintenance or even excess Surplus, then you're just going to take all those blocks and then put them right back into fat cells.

Gotcha. So you need a caloric deficit, it sounds like, somewhere at some point in order to remove. You need to be exercising more than you're consuming, you're burning and burning more calories than you're consuming.

Correct.

Or consuming less than you normally would.

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There's many tools and ways to achieve this, of course.

Sure. What ways?

So the OG way is just counting calories.

Right.

And even if you look at doctors and dieticians, we usually underestimate the amount of calories that we consume, I believe, by at least 10%. And we overestimate the amount of calories that we burn by about 10%. We think we're burning more. Correct. We're not.

Even doctors and dieticians.

Really? And we think we're eating less, but.

There'S always hidden calories in something, right? Or you maybe didn't weigh it perfectly or it was a bigger size. or something, right? Okay, so that's the original ways to count calories. Do you recommend that strategy?

For some individuals, it's particularly helpful. Most of the time that I see a patient in my clinic, and a lot of what I do is obesity medicine, I am board certified in obesity medicine. They have already done that and many of the time they say it doesn't work and I eat like a bird and there is nothing There's nothing quite as powerful to destroy a physician-patient relationship than to just tell the patient that they're lying or that they don't know what they're talking about. So it's not helpful to push that angle of vector. That's just a tool and there's many tools in the toolbox. For some people, whether it's genetic or epigenetic or just their situation that they're in in life or their mental health, or their hormone health. It makes it very difficult for them to lose weight, almost like it's more difficult for someone in quick sand to get out. So you can teach a person how to dig. That's your lifestyle interventions. But you should also give them a shovel to help out. It doesn't necessarily mean that you throw a shovel at them, but that's where medications and supplements come in to address whether it's insulin resistance or whether it's their mental health or their hormone health to help give them the tool to do it themselves.

Okay, so the counting the calories works for some, doesn't work for everyone. What else would you suggest they do then? Or what have you seen has been really effective consistently for people you've worked with?

When I write a prescription for this, I have several different areas or boxes that I can circle. And one of them is number of meals per day. One of them is macronutrients, for example carbohydrates. One of them is timing of meals. One of them is eating speed. So there's a lot of strategies to develop good eating speed habits. For example, split your meal into three different portions. Consume one, wait 10 minutes, consume the next one if you would like, wait 10 minutes, and then consume the last one if you would like.

So don't just put it all in your mouth and 10 seconds is what I'm hearing you say, which is kind of my whole childhood.

Just like eat as fast as you.

Can, not know that you're full and.

Just keep eating more, right? These are extremely powerful for pediatric patients for childhood obesity. I believe in the New England Journal of Medicine did a study and it was called the Turtle Bite Study where every five or 10 bites at some interval, they took one, the kids took one bite that was extremely slow and it was helpful. for recomposition of those kids.

Really?

You mean recomposition of their bodies?

When you're in the field of pediatric obesity medicine, you're not really going, your end target's not weight loss.

Sure.

It's usually weight gain but a body recomposition.

Huh, so less fat weight gain but more like you're growing as a child either way. but it's diversifying the weight gain, I guess, right?

Correct.

Directing it in another place.

Interesting.

Okay, so we have meals per day, timing of meals, eating speed. I think you said one or two others.

Timing of meals, that would kind of incorporate intermittent fasting, which is not, it's more of a health tool rather than.

A weight loss tool.

Meals per day, eating speed, timing. I'm sure there are other tools, those.

Ones that I remember off the top of my head. If you were just saying, hey, listen, I don't want to count calories. you know, I'm probably not going to do the intermittent fasting thing. I'm not going to eat slower or like split it up in three things. That seems like too much work for me. But I will eat one less meal a day, right? Or I'll only eat a certain amount of meals and then I'll essentially be intermittent fasting in that process. But if I looked at it as, okay, what would my meals per day look like if I wanted to consume a little less calories? Obviously, I'm gonna feel hungry, but when can I do it where I'm not gonna wanna munch on extra calories? What would that be?

Skip dinner? Is that, you know, what does that look like? I would say skip eating after dinner and don't even worry about taking away a meal. No eating after 7:00 PM. That being said, if you do remove one meal, whether it's breakfast or lunch or dinner, it is not helpful at.

All for weight loss or body composition.

To remove one meal, it's not helpful. Correct. So in isolation, removing one meal is not helpful at all. for weight loss.

Really?

It's truly an intervention for health reasons if you would benefit from that. Less mTOR signaling, less growth signaling in cells in general, or more of a reprieve where your body's immune system has a chance to go throughout the rest of your cells and see if there is abnormal ones.

Okay.

For most individuals, unless they like doing that for mental clarity or whatever benefit, some people really like skipping breakfast. But many people, especially those that struggle with metabolic syndrome, have other pathologies. There are several new ones. There is sleep eating syndrome where you eat, you're sleeping, you wake up and then you eat and you don't even realize it. You see that there's a bag of chips and you literally don't even remember it, almost like sleepwalking. And there's also night eating where you consume almost all of your calories between dinner and bedtime, often these individuals also stay up late at night.

Those are chips, snacks, and other like kind of emptier calories, right?

Correct. But they don't eat breakfast.

Really? Ice cream cookies or whatever it might be, yeah.

Yeah.

So that's the time where you could really, if you just stop eating after dinner, you'll eat less calories. But that sounds like you're still at kind of like the even maintenance. You're not a caloric deficit, correct? unless you eat less in each meal.

Correct. And obviously it's possible to be in a deficit and do that as well. But that's your biggest bang for the buck is not eating anything after dinner. Because society values family dinners and also social dinners with colleagues and whatnot, it would be very difficult to tell everybody to stop eating dinner. But if you wanted to design the perfect, like in a lab, Truman Show style, whatever you want to call it. Not eating after about 3 p.m. would be even more beneficial.

For weight loss.

For health reasons.

Well, not weight loss.

I don't think it would have any effect with weight loss. Maybe it would, but that I know of it has not been studied.

Gotcha. So, it's truly because you could still consume all your calories in the morning and in the afternoon before 3 o'clock. for the day, you could still consume a lot of calories is what you're saying. So you'd still have to cut the amount of calories in that timing window and then you'd just be intermittent fasting longer, right? Which would help for health benefits and maybe it would, I guess, help cleanse some of the dead cells and kind of like regenerate new cells, that type of thing, but not necessarily for weight loss. So what I'm hearing you say.

But at the end of the day.

It sounds like it's a caloric deficit. Yeah, and it's just a matter of helping provide individuals with the tools that will work best for them. So for some they might need a shovel and for some they might want and/or need a backhoe.

Sure, sure. It doesn't seem like you've ever been out of shape. Have you ever been overweight?

When I had my first child, I was about 40 pounds overweight.

Really?

Yeah, and I could hardly tell because I'm so... You're tall. Tostitos.

Yeah, it's hard to get it. It's kind of like the fat just a little bit everywhere, right?

Yeah.

So, how did you burn that 40 pounds?

What did you do? I eliminated all liquid calories. I ate foods of low caloric density but high nutrient density.

Like what? These five types of food groups are.

A lot of salmon. I love spinach. I ate a lot of spinach. That would kind of go under the fiber category. I love carrots, although carrots don't have a lot of dietary fiber. They're just kind of empty insoluble fiber, if you will. Not totally, of course.

It's not many calories.

Yeah.

And a few months later, I was kind of back at my baseline.

Really?

40 pounds just like that in a few months. Just by changing the way you ate.

My biggest intervention was I eliminated all liquid calories and I did not have any more than two caloric beverages whether it was a coffee with a bunch of cream in it. I did learn to like black coffee during that time and I still do, but no more than two beverages with calories in them per month. Interesting, because something like a Bulletproof coffee.

Which is a lot of people talk about intermittent fasting with a Bulletproof, that still has a lot of calories, doesn't it?

I don't know the macronutrient profile on Bulletproof offhand, but I believe it's mostly protein. Okay. the one exception to that for some individuals could be a protein shake. And you would probably want to consume this in the morning rather than the evening. That way you can have the benefit of some degree of appetite suppression. Some protein shakes like casein, which is an interesting one to talk about because it can also affect prolactin. In some people negatively, if their prolactin is too high, casein can increase it. But casein is also digested very slowly. and it has a lot of amino acids in it that will activate mTOR. So during your eating window through the day, if you consume your casein at the beginning of the eating window, then it can be helpful to provide satiety and also help with anabolism. But if you consume it at the end of your day, then it's going to essentially cut short your fasting period.

So if you have a protein shake after 8 o'clock, right? say someone's working out consistently and they're doing a workout in the morning or the afternoon, they eat their dinner, but then they're still hungry and they say, well, let me just do a protein shake, right? It's 150-200 calories, but it's 20 to 40 grams of protein. Are you saying having that because it's got the calories, it's extending the eating window? So it's not allowing you to burn off those calories more? What are you saying there?

That would be more for health reasons. For example, let's take an intermittent faster. that right before bed every night they have a shake of 50 grams of casein. So that's essentially making their intermittent fasting for health reasons worthless.

Right.

Because their mTOR is still very active for many hours at night. However, if you are looking at the satiety benefit of specifically protein, if your shake has just protein in it, then that's going to help provide some degree of satiety Well, you're not hungry.

That's what you mean, yeah.

And, there's obviously a lot of factors to this. One that has received a lot of press recently is called GLP-1. There's all these different drugs like semaglutide that are GLP-1 agonists. And, if you look at carbs, carbs spike up GLP-1 very quickly. GLP-1 is produced in a lot of areas, but a lot of it is the gut and also the pancreas. And then fat, will increase very, very slowly, but it will increase GLP-1 for a long time. And protein is somewhere in between.

You had like a formula in there that you said about two minutes ago. You said no snacking. You said a few other things. Can you share that formula again?

Yeah.

Yeah. So one, you want to cut down the sugar because sugar is not good. And I think everybody agrees on that, right? cut down the refined foods. So this actually applies mostly to carbohydrates, but refined other stuff is not good either. So refined fats, for example, are not good for you. So fans fats were pretty clearly bad. Refined meat like bologna and hot dogs and stuff are not really good for you either. So you want to eat whole foods, right? So whole foods, you want to eat no sugar, you want to you know, plenty of proteins and fats. And then you want to make sure you have a, you know, cut out the snacks and have a decent period of fasting. And that really just gets you back to 1970, where people were still eating white bread, right? White bread. I know. I grew up in that period. Nobody ate whole wheat bread. Nobody ate whole wheat pasta. It was white bread. It's white pasta, right? But you didn't eat all the time. That was the big difference, right? And it was the same everywhere you went, you know, and the Irish were eating potatoes, the Chinese were eating rice, the Japanese were eating rice, you know, those are all carbs, refined carbs, right? Bread, rice, potatoes. But they were doing okay because they weren't eating all the time. They'd give their bodies a break from eating, right? Where now we don't give our bodies a break from eating. We think that it's healthy to constantly eat. We've lost the idea that there's that balance between eating and not eating. like, why wouldn't you think that that's important? Like, balance everything else in life, right? Why wouldn't you want to balance eating and not eating, right? Don't you think that's, like, fundamentally important? Like, I think it is. But up until sort of I wrote the Obesity Code, people just thought fasting was really bad for you, which is sort of odd, you know, because it's like, up until then, they're, everybody's saying, oh, fasting is so bad for you, right? you're going to do so bad. It's like, you know, we've been doing it for a long time.

So I'm curious then, what effect does fasting have on reducing our chances of getting life-threatening diseases? And also, which diseases are, are most people at risk if they don't fast and improve their, their diet?

Type two diabetes is probably the biggest one. And the reason is that it's a huge one. It's become an epidemic, so lots of people have if you look at pre-diabetes and diabetes, which is sort of, and you do big surveys, it's actually about 50% of adult Americans, right? So it's very common to have pre-diabetes and diabetes. And the problem with it is that it causes all kinds of other problems. It increases your risk of heart attacks, strokes, cancer, it's leading cause of blindness, leading cause non-traumatic amputations, leading cause of kidney disease, all of those things. And in trying to understand type 2 diabetes, you just have to understand that basically your body has too much sugar. That's it. If you have too much sugar, remember, excuse me, your body really has two sources of energy it can use. It can use sugar, which is mostly glucose, and it can use fat. And when your body stores energy, it stores it as sugar or stores it as fat. Makes sense, right? So if you have too much fat, then you have obesity. If you have too much sugar, you have type 2 diabetes.

Interesting.

But the situation, the solution is the same. So think about it. Your body has too much energy in both situations. Obesity, you have too much energy stored away. In type 2 diabetes, you have too much sugar, which is also too much energy stored away because both fat and sugar are sources of energy for the body. So if you think about trying to reverse type 2 diabetes, because again, I wrote about this in the diabetes code and I said it's a reversible disease because your body doesn't have too little energy, it has too much energy. So think about this situation. Think about your car. Suppose you Go to the gas station three times a day, you fill up. Now it's full, but you still keep pumping gas in. So it's spilling out, it's spilling out, it's spilling into your back seat, and it's now making you sick. But what are you going to do? Well, here's what you wouldn't do, is keep going to that gas station three times a day. It's ridiculous. You have to do two things. One, stop putting gas in. And two, drive that car around so that you use the gas that's there. That's what you would do. Now think about the gas.

Burn the gas.

Burn the gas.

Exactly. Think about your body. Your body has too much energy. What are you going to do? One, stop putting it in. Two, let it run without putting it in for a while. That's intermittent fasting. That's all you have to do. And think about the situation. You've got a disease state which has become an epidemic, which contributes to heart attack, strokes, cancer, but you have a solution which is completely free and has been used for thousands of years, which is not anything more complicated than let your body run off of the fuel that's already sitting on there. Is it fun? No, it's not fun. Is it healthy? Yes, it is in those situations very healthy. And people used to say, well, people won't do it. It's like, my job as a doctor is not to tell people what they will and won't do. My job is to tell them how they should get healthy and I'll help them. So if fasting is a good solution, which I believe it is, then I'll help them. Whether they do it or not is up to them. But the point is that it's It's it's free. It's simple. It's been used for thousands of years. It's available to everybody. You don't need special equipment. You don't need a special diet. You don't need a special anything. Everybody in the world can do this at any time, like literally like today, tomorrow, anytime they could do it. It's not like, you know, I have this great drug for people. Yeah, but except it costs $500,000, right? That's serious. No, fasting is not to do that. you're going to save time, you're going to save money, and you're going to get healthier. So what could be better than that? Like, it's a crazy situation where we have this huge health care issue, but the solution is completely free, which explains why there's so few people telling you to do it, because who's going to make money on it?

Right?

And that's not my concern. My concern is telling people what they need to do to get healthy.

Right. What do you think is the biggest.

Mistake people make when it comes to fasting then?

I think the single biggest mistake is sort of overeating afterwards. So you fast for a period of time, then you say, oh, well, I deserve that ice cream. It's like you could do it, but you're going to sort of get a lot less benefit. You're going to like, you got a great benefit from the fasting. Now, you know, you're losing some of that because you're eating the foods that you didn't eat. And that really is a temptation for people to do. And I think it's natural and we've all done it. And, you know, but the point is that after you fast, you should really just eat as normally as possible. So if you eat, you know, a normal breakfast, normal lunch, normal dinner, the next day is your fasting day. You don't eat breakfast, you don't eat lunch. You should eat a normal dinner. Don't try to eat all three meals crammed into one, right? That's not the point. Like, the point is to drop those meals and let your body take the energy. from your body fat. So you drop breakfast, your body normally gets 500 calories from there. You want to take it out of your body fat. Same thing for lunch. If at dinner, instead of taking a thousand calories, you decide to stick in 2,000 calories, well, you've negated a lot of the benefits that you should have gotten because that energy is going to go in. So the good thing is that it's hard to do that. So when you restrict the time, and you don't tell people what to eat or how much to eat, they actually naturally eat less. So it's actually an interesting thing because this gets to the question of hunger. There's, you know, in terms of weight loss, there's sort of two big issues that trip people up. One is metabolic rate and two is hunger. So hunger, people think that hunger will just go up like this, the faster. It's actually not true. So you can actually measure the hunger hormone called ghrelin, which is basically it goes up high and you get hungry. So when you fast, ghrelin is high. So if you normally eat lunch, you're hungry. So ghrelin is high. What happens when you don't eat lunch? You skip your lunch. Well, a couple hours later, your ghrelin level actually falls back to baseline.

So you don't feel hungry anymore.

No, your hunger goes back to baseline level.

Interesting.

So if you eat lunch at 12, you're hungry at 12. Now you skip lunch, you're hungry at 12, you're hungry at one by four. It's no different than if you ate or didn't eat. So people are like, what happened? Well, your body took the energy from your body fat stores. You took the 500 calories from body fat. You basically fed yourself off of that body fat. So why would you be hungry? The answer is you're not. and that's why it goes right back to baseline. Same thing happens at dinner. If you do multiple day fasts, it's actually even more interesting because gorlin actually after day one to two, it actually starts to go down and down and down. So your hunger actually disappears.

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