https://www.listennotes.com/e/6218d3371c804a79a44b041eb3f6b7cb

[New-Tag: No title] so let me tell you a little bit about Cynthia. Cynthia is somebody that I've known actually for a little while, not that long. She's a nurse practitioner just like I am, so I'm so excited to introduce her. So she's an author of the best-selling book, Intermittent Fasting Transformation. and a two-time TED speaker with her second talk, having more than 13 million views, and the host of Everyday Wellness Podcast and co-host of the Intermittent Fasting Podcast with Melanie Avalon, averaging more than 700,000 downloads per month combined, which is unbelievable. With over 20 years experience in health and wellness, Cynthia is a globally recognized expert in intermittent fasting and women's health and has been featured on ABC, Fox 5, KTLA, CW medium, entrepreneur, and the Megan Kelly Show. Her mission is to educate women in the benefits of intermittent fasting and overall holistic health and wellness so they feel empowered to live their most optimal lives. So now we get to have great conversation with her as well. Let's begin with some wonderful questions. So I know that the audience really wants to hear from you in regards to how did you ever get interested in intermittent fasting and let's kind of find out your story. This is real casual. If you want to know about you, want to know about how you got into the work. So let's start there. How did you get involved?

Well, I think it's the beauty of the N of one. You know, I was the typical perimenopausal clinician that was not adequately counseled on what was going to happen in reverse puberty. And so, like so many women, you know, I've been doing all the right things, exercise, you know, eating the right foods, And then I hit a wall because I had a super stressful job in cardiology as an NP. I did super intense exercise. I was probably too low carb. And I hit that wall. Not enough sleep. Husband traveled a lot, young kids. And hitting the wall meant I suddenly became weight loss resistant. And this had never been an issue for me my entire life. I was very privileged. I say this all the time with great reverence. I was very privileged that I'd never experienced that before. But in figuring out what was going on with my body, I came to intermittent fasting with a desire and curiosity to see if maybe this was going to help me change my body composition. Maybe I was going to lose the weight I had, you know, unintentionally gained in my early 40s. And so initially it was the beauty of the end of one. I didn't instantaneously lose weight, but I did feel better. I had more energy. I started sleeping better. I had better cognition. And that really started the process. And I started talking to my cardiology patients who thought I was crazy and my colleagues who thought I crazy. And then it really just started to weave its way into everything I was doing. Everyone I talked to, patients and personally, and it really became a strategy that I felt was one that we all should be talking to our patients about really eating less often, even if you don't want to call it intermittent fasting, but not having these massive pig out fasts from the moment our feet hit the floor in the morning until we go to bed. And so that's really where it started from. And the irony is I left clinical cardiology in 2016 because I felt really constrained in the current medical model. I toed the party line for as long as I could. And I told my husband I was just really tired of writing prescriptions because in cardiology, that's what you do. And so I took a leap of faith and started my own business. And so initially almost instantaneously attracted women just like myself, people who felt like the current medical model was not meeting their needs. They were perimenopausal and menopausal. and so my business really started to kind of unroll and everyone, I was talking to everyone about eating less often and intermittent fasting and that that's really where it stemmed from was really a desire to be able to practice in a way that was more aligned with looking at lifestyle as medicine and less about leaning into pharmaceuticals. And there's certainly a place for them, but I got very tired, very, very tired of writing prescriptions. And so now I get to do all the things that I was more interested in, you know, 10 years ago, I got to talk to people about sleep and nutrition and exercise and, you know, tapping into the parasympathetic nervous system and all of these different strategies that I think are equally as important and really lay a foundation for health and wellness that, that the conventional model is missing because we're so solely focused on symptomatology and addressing it with a medication, and we need to kind of back things up and think about it as a what's driving the root cause of this problem and then digging a bit deeper.

Yeah. So you said two things that I think are interesting. One is that initially you think you will look too low carb. Let's talk about that because many times intermittent fasting is together with keto. And keto means, you know, no or minimal carbohydrates. And also let's talk about caloric intake because what a lot of people are thinking is if you do intermittent fasting, you're doing like 800 calories a day, which is not so great for the metabolism. So let's talk about those two key issues because women ask me those questions all the time. I bet.

Well, you know, carbohydrates in and of themselves are not bad. And unfortunately, they've gotten this misnomer. There's the boogeyman and it's carbohydrates. And I would be the first person to say, I love carbohydrates, but I eat the less processed variety. Like I just had lunch and I had a bison burger and I had shishito peppers and I had cabbage. So I was absolutely getting carbohydrates from the vegetables I was consuming, but I think most of us are consuming the processed variety, the bread, the pasta, a lot of grains, and those are the things that oftentimes get us in trouble. So when I look at women as a whole and I'm talking to them about whether intermittent fasting is the right strategy, are they insulin sensitive? Are they metabolically flexible? Is really what determines how much carbohydrates should they be consuming. If you are 100 pounds overweight, 50 pounds overweight, very likely we have to reduce your carbohydrate intake, but we're not going from 400 grams a day down to 20. I think that's not sustainable and I'm all about sustainability. So I think a lot of that, that carbohydrate cycling or that carbohydrate intake is really mitigated on whether or not you're insulin sensitive. And we know based on study research, you know, nearly three years into the pandemic, about 78% of the population in the United States is metabolically flexible. So most people would benefit from curtailing the processed carbohydrates and consuming more or carbon, you know, the unprocessed varieties, low glycemic berries, green leafy vegetables. And so as a starting place, I usually say if you're currently consuming, and this is why I think tracking can be beneficial to give people awareness, if you're currently consuming 300 grams of carbohydrates total a day, we want to slowly start reducing that. And why we are doing that is to help our bodies become more metabolically flexible, allow our bodies to be able to use either glucose or fatty acids as a fuel source. And that is how our bodies are designed to thrive. But in this kind of over-hairy, overstressed existence where we eat too frequently and we overfeed ourselves and we eat too many of the wrong types of carbohydrates, wrong types of fats, and too little protein, we're never satiated. And so those carbs, it's just a never-ending bowl of stuff. And so you don't have to be ketogenic. to intermittent fast. If you are someone that is obese or overweight or insulin resistant or diabetic, then I do encourage you to consume less carbohydrate. I'm not saying no carbohydrate. I actually interviewed someone on the podcast yesterday who's a male and really abstains. He's a carnivore diet, doesn't have any carbohydrates or little to none. And I've asked him, I think that's great that that works for you, but I think for the average person, it's not sustainable forever. so I think that's the first piece. The other thing that I think is so important is people to understand there's a threshold of macronutrients, protein, fat and carbohydrates that are critically important to consume in your feeding window in the amount of time, whether that's eight hours, 10 hours, six hours. And so this is where I will say to women in particular, I want you to aim for a hundred grams of protein a day. Now, for many women, they're probably eating 40 or 50 grams. And this is where, again, tracking allows us to get a sense of how much carbohydrate, protein, and fat we're consuming. But if you are having two good-sized meals with 40 to 50 grams of protein in each one of them, then you're probably getting sufficient amount of macronutrients. And I always say macros are important. Intermittent fasting is not about caloric restriction. It is actually about having periods of time when we are eating and periods of time where we are not. And when we're not eating, that's where the magic of fasting kind of comes in. Autophagy and some of these other processes. So if a woman were to say to me, Cynthia, I track my macros and I'm only consuming 800 calories in my window. I would say you need a larger window because that is a surefire way to break your metabolism, to get to a point where your body thinks you're starving. It's going to hold on to every single pound ounce of body weight because it is convinced that you are in a starvation state. And that's an important distinction. So when people start counting their macros and they realize they're really not eating enough food, then we find ways to slowly start increasing their protein intake day to day to day and monitoring how they're feeling and monitoring their blood sugar. Like, I love glucometers. I like continuous glucose monitors. I'm not a fan of people being a slave to the scale, but appropriately used, you know, if you're getting on the scale once a week or once every two weeks can be a way to get a sense for where you're going metabolically. But I do agree with you that that can be a huge problem. It's almost like this message. This is why OMAD is not is not a system of intermittent fasting that I think is healthy to sustain, especially for women, because you just can't get enough protein in. And your viewers may know or listeners may know that our protein needs increase as we get older. The muscle protein synthesis, protein leverage hypothesis, all these things really speak to the fact that we need more protein as we get older, not less. So if you're getting by on 50 grams a day, Not only are you going to lose muscle mass, not only are you going to lose insulin sensitivity, you're going to put yourself at risk for, you know, the metabolic diseases that we've kind of talked about, insulin resistance, diabetes, high blood pressure, a multiplicity of things that we want you to try to avoid being diagnosed with.

So if people come to you and say, well, calorically, what do you want me to do during that shorter window from maybe 12 to 6, what would you say?

Yeah, well, I always say we don't count calories. I think that's very important. calories are a unit of measurement. You use a bomb calorimeter and our bodies are way more sophisticated. Our bodies get information from the types of foods that we consume. Now, is it helpful to understand that a macronutrient, a protein, one gram of protein or carbohydrate is not as calorically dense as fat, correct? Four calories per gram for protein and carbohydrates. nine calories per gram for fats. It's important to understand that. So a little bit goes a long way. And this is where I'll sometimes say measure your fats, like not five avocados, maybe it's half an avocado, maybe it's a tablespoon of nut butter, not so that you become restrictive, but just this building and awareness that twice as much calories come from the fat than they do from these other entities. So I always say count your macros, track your macros. That's certainly a better way. And it's so different from when you and I both trained. I mean, it was all about the food guide pyramid and the food guide labels and tracking calories. And I oftentimes have to remind people that our bodies are way more sophisticated than just this caloric measurement. And, you know, prior to like the 1920s, 1930s, the concept of a calorie was not even a concept people talked about. And so in a lab, obviously, if you're in a research environment, it makes sense to have a unit of measurement, but our bodies are way more sophisticated than that. And I would actually argue that It's not a calorie issue when people are struggling with weight gain and struggling with weight loss resistance. It is more of a hormonal imbalance, whether it's a carb insulin issue, whether it's a sex hormone issue, thyroid, these contributing chemical messengers in the bodies are generally what is driving the weight loss resistance or the inability to lose weight. There's some imbalance that has not been properly addressed. Now, adjusting our macros can improve these hormonal balances significantly. But unfortunately, we're still stuck in a secO, you know, the calories in, calories out, which I'm embarrassed to admit, I used to tell patients that, you know, exercise more, eat less, and then wonder why nothing worked. I'm like, okay, now they're hungry, they're really hungry, and they're not eating a food.

And so we're just making the process worse. So, you know, our patients, certainly in my population that are menopausal or post-menopausal have had their entire lives predicated on calories. And to get them out of that mindset is always so difficult to truly learn to trust their body when they, in some ways, have betrayed it unbeknownst to them because they eat too little. I mean, it's not unusual for me to see people that have been doing a thousand calories for years.

Yeah.

So for some of those, you know, I, I oftentimes will recommend just slowly increasing it. And for some of my acts, you may even not have them do intermittent fasting. I might have them really work on their metabolism first and then do the intermittent fasting on the other side because they're so, their whole metabolism is so broken.

Yeah. And I think it's really important for people to understand, you know, I routinely have patients that I will say, I don't want you to fast. And they always freak out. They're like, wait a minute. I was like, you know, we've looked at your labs. We know your cortisol is completely dysregulated. You have a chronic stress inflammation pattern on your labs. We don't want to add more stress. Like, it's important to understand that intermittent fasting is a type of hormesis. beneficial stress in the right amount at the right time, just like cold exposure, heat exposure, exercise. And it's important to understand that, you know, just because you're weight loss resistant doesn't mean that the next step needs to be intermittent fasting. As you said very appropriately, and I do the same with my own patients, we need to build your metabolism back. And it may be that we're gonna, you're gonna consume a hundred calories more protein every day, and we're gonna carefully monitor you Sometimes they use the term reverse dieting, which I don't like that term, but in the lay vernacular, people may have heard that we want to get to a point where we're helping to fix the metabolism. And to me, it's not this knee-jerk reaction of it has to be fasting, it's semi-glutetide, it's crash dieting, more is not better. I always say if a little bit of fasting is good, more fasting is not better. If a little bit of exercise is good, more exercise isn't better. If a little bit of restriction is good, more is not better. And so unfortunately, I think we've fed into this mindset of a lot of our patients that they think if things aren't going the direction I want, I just have to work harder. And I always say sometimes the body just needs us to take the foot off our foot off the accelerator and trust the process and really work diligently at quieting inflammation in the body, connecting with nature. Back when I was mentioning in my early 40s when I hit the wall of perimenopause, I went from doing very hardcore CrossFit type classes to walking, walking. That's all I did for an entire year because my body was just so traumatized by so much cumulative stress that that was the most I could handle. And I remember how humbling that was that I could tell if I had done too much physical activity by walking, if I was really tired later in the day, I was like, okay, that's my sign that that was too much. And so really, you know, leaning into the clues our body is trying to communicate to us, for us.

So let's get on to the Hot Topic. You mentioned it, so let's just go for it. Semiglutide, everybody in their sister now is wanting it. That's the magic button. It's the thing. And if you look at the statistics in terms of how many people gain the weight back afterwards, it's pretty abysmal. But everybody's going for it and you can't get prescriptions anywhere. They're on wait lists. They're now compounding it. what are your thoughts on all that?

Yeah, it's a great question. And it's one that my team is fielding almost daily because I think well-meaning people, I have to believe, started utilizing the drug for people who were weight loss resistant. But it's been my experience that my patients that were taking it not prescribed by me, but prescribed by other providers, they were nauseous, constipated, they had no appetite. So imagine you have a broken metabolism. you were intermittent fasting, you had this very tight feeding window, and then you add in semi-glutide, and now they don't want to eat at all. And now I see a lot of biohackers that are micro-dosing it like, oh, this is part of their stack that they use every other week to kind of curtail their appetite. And so I think anything that's not sustainable, it's not beneficial. And I really think if there's someone who has 40, 50 plus pounds to lose, and they're craving and they're not fueling their bodies, this is not a sustainable strategy. And I get concerned that, you know, much like you and I, you know, were prescribing during the time of fen-phen, and, you know, you just start to think about these magic weight loss drugs that have a slew of side effects. And it was interesting in one of my groups the other day, this question came up. And so I answered, honestly. And there were so many people that said, if you look at the research and the amount of like liver and hepatic toxicities and the fact that when people stop the drug, they gain the weight back, what does that really say? And I just say, because it's not a sustainable strategy. And so if your appetite's out of control, what that tells me is there's a hormonal imbalance. We have to deal with that first before we even consider. But to me personally, if I got constipated and was nauseous all the time, that would be miserable. Like that wouldn't necessarily, that would not, that would not influence me to want to continue taking the drug. I would just say, time out. This is, this is, I'm bloated, I'm constipated, I'm nauseous. It's like being pregnant, you know, but I don't want to be pregnant at this stage in my life. And I'm not sure for you, you know, in your clinical, you know, practice, if you're seeing people that are just, they're, they're getting results temporarily, but they're not, They're not results that they can sustain for the next 5, 10, 15 years. And that to me is concerning because you have these yo-yo dieters and we know what yo-yo dieting does to our metabolism. I get concerned that, you know, they may not be getting the communication between their brain and their gut telling them that they're hungry, but they're essentially starving themselves. I mean, they're taking a drug that is disconnecting appropriate communication between the gut and the brain. and I just have to believe that there are better options out there. It's just unfortunately we've conditioned our patients to want quick fixes as opposed to really doing the work. And semiglutide is one of many examples. I think there's so many celebrities using it now. I think the, I can't believe I'm going to say this, the Kardashians, I know this because my kids and I were talking about it and I said, you know, there are so many young people that look up to these pseudo celebrities and think if they're doing it, then I need to do it. And I think it just really sets a poor example.

I mean, it's interesting. We started women to women many, many, many years ago, and the whole notion was, how can I teach my patients to become their own midwives? And how do we teach women to learn intuitively what they need? And unfortunately, my population is probably older than yours, and they've all been, you know, kind of the twiggy era and we have to eat less and we have to exercise more. And when that doesn't work anymore, then we have a problem. And I did develop a weight loss program and my success is 70% keep the weight off long term.

Amazing.

And it is amazing, primarily because we do so much coaching and we have 60 hours of coaching with people in the 12 weeks and we do a genetic profile to find out what they need to do. But here's the irony, most of them do intermittent fasting because they're not hungry in the morning. yes, I've, you know, doing an elimination diet with them later, but then they start adding foods back and they've rehabbed in some ways their metabolism. So it's very successful because we're teaching them to listen, you know, as they add dairy back, how do they feel? As they add grains back, you know, very similar to what you do in your practice. But now the rage is semiglutide. I mean, it is everywhere now. And if you look up the statistics, sure enough, pancreatitis, as a side effect. It's like, oh, and you know, if you have that, then you just do clear liquids for a few days. No. What have you done for the pancreas in the meantime?

Yeah. So I was an ER nurse in my past life. Pancreatitis, from what my patients have told me, is one of the most painful things that you can have go on in your digestive system. And so it's not just this benign entity. I saw plenty of alcoholics with pancreatitis, but, you know, for me, we're again missing these opportunities to educate our patients and really help them find ways, as you mentioned, this intuition kind of leaning into our bodies. That's never what we were telling, at least I was not telling my patients in cardiology, lean into what your body is telling you. It was more, are you having chest pain and shortness of breath? And if not, okay, I don't want to hear any more about it. But I think it's so important to have those conversations. The other thing that that definitely comes along with weight loss resistance and obesity is this degree of shame. You know, in our society, there's so much shame about women and their weight and add in like the aging process and how much pressure people feel to look a certain way to be a certain size. I mean, I have women almost every day say to me, I want to be the size I was at 18. And I was like, that's great. I'm never going to be that size again. And I'm okay with it. But I think we have unrealistic expectations and we're so unkind to ourselves. Like if someone's saying it out loud, you can imagine what they're saying inside to themselves. And that to me is heartbreaking.

I have a couple of programs that I do. One is the hormone program that I do for the bone coach. And one of the things I've had them do is take an hour and I want you to see how many times you self-deprecate yourself. And it's usually 50, 60. That's one hour. And I do it also in my program. And I think it's so unconscious. Oh, my arms, my face, my hair, my and where so objectified as a culture, women are in general. And it's really learning to love. And I don't mean you have to go in front of the mirror and say, I love my body. But it's really more about how do I come to this place in which I'm not so hard on myself? How do I understand what you're talking about is if I have been beating myself up for so long and I have adrenal dysfunction, how do I intuitively listen and be quiet? How do I do it from that perspective and then understand the enormous benefits that we know now have intermittent fasting because in ancient times we're either feasting or fasting, so to speak. And I love your concept because it lines up so much with what I've been teaching for so long that we have to listen to ourselves and be honoring of our bodies. And we as a culture for women, we don't do that. No.

And it's interesting, you know, during, so obviously in 2022, I had a book launch and it was an exhaustive, wonderfully exhaustive process. and during Christmas, we didn't travel. My kids really wanted to stay home. They felt like they had a really busy year. They were teenagers. And so for nine days, I didn't set an alarm. I got up when I wanted to. And I said to my husband, I need to do this more often because I, I think for so many of us, we set these expectations. We have to get some, have to get so much done during the day. And what that experiment showed me was I need more sleep than even I think I do. And number two, how beautiful it is to wake up on your own, which is inevitably later than you normally would wake up. But I felt so much better. I wasn't grumpy. I wasn't, you know, complaining to my husband or giving my kids a hard time. I was getting walks outside in nature. I mean, all the things were supposed to, if I felt like going to the gym, I went to the gym. And so I think for each one of us, it's determining that We get to a point in our lives where what's our energy like? What do we feel like doing? The have to's are not part of my lifestyle right now. I was actually comparing my calendar from the first week in January last year pre-book launch to this week. And I said to my husband, what I know now is I never want to have that experience again. I love the experience, but it also taught me a lot. Next time it would be more discerning, more careful about where I was putting my time and my attention. and I think this is applicable to all of us as women that, you know, what treadmill do we want to put ourselves on? You know, I know I'm at a stage in my life where I'm thinking a lot more thoughtfully about, you know, I'm going to be empty nester soon and, you know, both my boys will be in college in the next four years. And so saying to my husband, like, what do we like doing? Let's prioritize doing more of that. You know, let's, let's put less on the calendar. You know, let's feel less about having expectations whether it's familial expectations, it's friend expectations, just learning the beauty of having healthy boundaries.

You know, one of the things that I say to my patients a lot of times is it's unlikely when we're dying, when we're 200, that we're going to say, I wish I'd worked more. More likely it's going to be, where did the years go? Why didn't I smell the roses more? And I think for some people, COVID did that to them. and for some it didn't. And we are so much on the same page, which is how do we embrace what we have? How do we create more of this wonderfulness and also not have days that are cuckoo? Because at some point there's a wake-up call, a 2x4, a 4x8, an 8x12, whatever it takes that comes along to say, nope, you can't do this anymore.

Yeah, and I think it's the one thing I've come to learn. I have a parent that was incredibly successful and, you know, I watched her in this amazing trajectory of her, her business life. And when she retired, because she had been so ego focused, when she retired, it was such, it's almost like she went from going a thousand miles an hour that she crashed into a wall. And it's taken her, she's now five years into retirement, and she's just starting to settle down. But the one of the things she said to me unsolicitedly was, this. I never realized how little sleep I got and all the weight she had been complaining that was stuck on her for years that she complained about. You know, she was, it was weight that bothered her. She lost 20 pounds when she retired. And I said, that is the impact of chronic stress. And so for her, she said more than once, I don't believe in having regrets, but I do regret that I didn't slow down and, and savor more. And so for me, that has been very eye-opening to watch my parent go through that, but also understand that I don't want that to be my trajectory of my life. Like, I want to ensure that my kids actually spend time. We spend time together, we take trips together, we prioritize the relationships and the friendships like mine with yours that we want to, you know, really leaning into things that make us happy and people that make us feel good and letting go of things that don't. I think a lot of us feel a strong sense of obligation. I always say I was raised Roman Catholic and that that kind of guilt part of my upbringing has taken a long time to unravel. And so I say now that we make the best decisions for what's best for my nuclear family. And then, you know, we go from there. We're thoughtful, but, you know, the half two days are long behind me. And I'm grateful for that.

Amen. Absolutely. So if they want to learn more about you, How do they begin to do that and reach out if they're interested? What is the name of your book? And how did they get that as well?

Thank you. So probably easiest to go to my website. So it's www.cynthiathurlo.com. You get access to my podcast, Everyday Wellness, and I co-host another podcast with Melanie Avalon called the Intermittent Fasting Podcast. My book is the Intermittent Fasting Transformation, which is a play on a talk that I gave almost four years ago that went viral. you can find me on social media. I'm probably most active on Instagram. I'm a little snarky on Twitter. I do have a free Facebook group called the intermittent fasting lifestyle backslash my name. I do have to say that about Twitter because sometimes I'll get people on my DMs. They're like, oh, my God, I see an entirely different side of your personality. I said, well, I am snarky, but I'm thoughtfully snarky. And with that being said, yeah, I love for people to reach out. Let me know if this is how, if you came to me through Marcel's podcast, let me know. We definitely have a lot of alignment, a lot of focus on middle-aged perimenopausal and menopausal women, because let's be honest, there's not enough resources and focus and research on us. And, you know, our generations are not going to go down, you know, easily. We're definitely demanding more so that subsequent generations will have more and better information.

Absolutely. Well, thank you so much. I really appreciate you.

Thanks so much.