Transcript
WEBVTT
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This is the eat well.
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Well live well podcast.
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I'm Lisa Salisbury, and this is episode 115 intermittent fasting and women's health.
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The impact on hormones, digestion, and circadian rhythm.
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Jillian Greaves is here with me today and she is a functional dietician and women's health specialist.
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Today, we're going to discuss the difference between how men's and women's bodies respond to fasting in particular.
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I intermittent fast.
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And why skipping breakfast or delaying meals can negatively impact women's health.
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We also discuss by aligning your eating schedule with your circadian rhythm is optimal for metabolism and hormone balance.
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Jillian is big on tools, not rules.
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So be sure to be thinking how you can incorporate these suggestions as tools in your health tool bag, and not as strict rules we are giving you.
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Welcome to Eat Well, Think Well, Live Well; the podcast for women who want to lose weight, but are tired of counting and calculating all the food.
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I'm your host, Lisa Salsbury.
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I'm a certified health and weight loss coach and life coach, and most importantly a recovered chronic dieter.
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I'll teach you to figure out why you are eating when you aren't hungry, instead of worrying so much about what you are eating Welcome back to the Eat Well, Think Well, Live Well podcast.
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I am delighted to have Jillian Greaves with me today.
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She's a functional dietitian and women's health specialist.
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And from the little bit that we've already chatted over email and just a little here, she is a wealth of information.
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So I am super excited to welcome her to the show.
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Welcome Jillian.
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Thank you.
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I'm so excited to be here.
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So I'm going to let you introduce yourself, give us a little bit of background on what it is that you do, and then we're going to jump into our conversation about, well, just a lot of women's health stuff.
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Awesome.
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So I'm, you know, Jillian Greaves, as you mentioned, I'm a functional medicine dietitian that specializes in women's health.
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And essentially what, what I do is, uh, really support women with understanding the why behind their gut and hormone symptoms specifically.
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So, I take a root cause approach towards supporting women with.
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really identifying and addressing their digestive health and hormonal symptoms naturally, utilizing advanced lab testing, personalized nutrition, targeted lifestyle therapies, supplementation, mind body techniques, and really supporting women and bringing the body back to balance and ultimately getting back in the driver's seat of their, their health.
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So, we work with a lot of women that, struggle with, uh, polycystic ovarian syndrome, endometriosis, uh, fertility challenges, uh, IBS.
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That's kind of our, our jam.
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Okay.
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I do not work with that population.
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So I definitely work with, women who are probably a little bit more on the, the norm side, but just have like weight issues.
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But I imagine that a lot of the things you find with the, that population translates easily into those without those sorts of diagnoses.
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Yeah.
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A hundred percent.
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And, and many women we work with too don't have a specific diagnosis.
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And we always say at the end of the day, the label is less important and understanding, you know, symptom root, root causes is.
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And, we actually, you know, a lot of women we work with have.
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weight loss goals or body, you know, body composition goals.
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And ultimately at the end of the day, we always say that, you know, weight loss resistance or, you know, increases with weight that feel, like not, you know, comfortable and optimal in terms of where an individual, feels they're, they're healthiest and best at.
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This is a symptom at the end of the day is, is kind of how we describe it.
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same thing like bloating or, You know, acne.
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And so we really, look to get to the bottom of the why and to kind of support women with the root causes and also the habits, right?
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To help their bodies shift and respond naturally in a way that.
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It doesn't feel like you're fighting against yourself at the end of the day.
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Yeah, yeah, for sure.
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something that you said, and this isn't even the topic that we're going to cover today.
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So this is just like a little bonus question for you already.
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when you said you, you know, you take a root cause approach and there were several tests.
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I, I just came off coaching a client.
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We were talking about her little bit of resistance to keeping a food journal, and it was feeling a little bit diety to her feeling a little bit like restriction, which I totally get.
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And we, We coached through that, but I'm just curious.
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We were talking about all of the reasons why we keep a food journal and the benefits of it that have nothing to do with the hijacked approach of counting calories in an app that the diet industry has stolen from us and, and how valuable that information is.
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And, and when you said root cause approach, I thought, I bet you, one of the first things that you do is ask for a log of people's food.
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Like it's such good information.
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such good information and, and I love that you use the word information because we talk to our clients a lot about, you know, food, food logging or, you know, bowel movement logging or, you know, lab data that we're collecting.
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This is all data at the end of the day and what we try to really encourage clients to do is, to be very observational, and to kind of remove the emotion and the judgment from, you know, uh, kind of the, the tracking of food or, or any of these, different indicators and ultimately to just get curious, right?
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To approach things with curiosity, and to, see, you know, see this as a potential opportunity to create more awareness and to ideally get a sense of how you can better show up and, and, you know, support your body, versus, you know, how, how I think a lot of us approach it in terms of, you know, the diet culture approach in, in terms of, just beating ourselves up and looking for the, the negative versus the opportunity.
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Yeah, yeah.
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And looking to that food log or that calorie count to know how much can I still eat today or, you know, it becomes a real outside of your body situation when you're asking permission of the diet app to eat again.
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It's, it's.
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Crazy.
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Anyway.
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Okay.
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So that was like a side note already to what we're already going to talk about.
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So the first thing that we really, we really wanted to hit on today and really discuss is intermittent fasting.
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This is such a huge, huge deal in the dieting world right now.
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And there's so many people that are like, Oh, You know, it's the best way.
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And if you're eating, you're aging and all of these like mixed messages.
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And it's honestly, it's super confusing.
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It is just super confusing.
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And I know from my own research that a lot of the intermittent fasting studies have been done on men.
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And so then you get authors that are like, no, here's how to do it as a woman.
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You know, like a girl.
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I'm not, not naming any names, but, you know, Where, where does that information come from though, because the studies haven't been done.
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So tell us where, why intermittent fasting can possibly have, negative health repercussions on women and, what you know about that and what you advise for that.
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Yeah, I love this topic and you're spot on.
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The large majority of research we have on intermittent fasting has been done on men, you know, and or animal models.
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And that's a problem because, you know, these studies aren't accounting for female physiology and female hormones.
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And at the end of the day, women and men are very different.
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Well, as Dr.
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Stacey Sims says, women are not small men.
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women are not small men.
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Exactly.
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Exactly.
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And, you know, ultimately at the end of the day, women's bodies respond very differently to stressors than men's do.
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And, you know, At the end of the day, also, you know, intermittent fasting is a stressor.
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It's a hermetic stressor, meaning in the right context, a tool like intermittent fasting or time restricted eating could have some potential health benefits for the right population.
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in the right context.
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In the wrong context, this is going to be, you know, like throwing, throwing gasoline on the fire.
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And something I also want to point out is that there's a lot of different formats when it comes to how intermittent fasting has been studied in research.
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What I see, I'm curious if you see this as well, but what I see in practice with women is a lot of women just interpreting intermittent fasting as skipping breakfast or, you know, delaying eating for, you know, the first part of the day is, do you see that also?
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Yeah.
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And, and the different models, you know, especially the most popular, well, I think it's the most popular is like the 16, eight eating window where it's eight hours of eating and 16 hours of fasting that came about because of a research assistant schedule.
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That was the most convenient time for them to come in and be eight hours on.
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So that's when the subjects got fed.
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Like there was no.
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It's like the 10, 000 steps a day was a marketing gimmick when a pedometer came out in Japan.
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Like, you have to look at the source of where these numbers came from.
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It wasn't because it was a magical, good for you number.
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It was based on convenience and paying an hourly employee.
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Which is, is wild when
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It is
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that down, right?
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And, and in terms of the, the, you know, kind of skipping breakfast piece in particular and, you know, delaying that overnight fast, we, we definitely still need more research here across the board, but in, in women in particular, with the small studies we do have, we are seeing different results than we are seeing in, you know, the, the men in the animal models.
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And, it's thought that you know, different responses to fasting in men and women may be due to, and Stacey Sims is actually someone who talks about this research a lot, it may be due to something called Kisspeptin, which is a neuropeptide that plays a really important role with the regulation of the menstrual cycle and, you know, our fertility, our sex hormones.
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And it also plays a really important role with appetite regulation and insulin sensitivity.
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So in some small studies, Kisspeptin secretion is altered or decreased when women are skipping breakfast or delaying breakfast.
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And this is having a negative ripple effect on, you know, the communication between the brain and the ovaries, and kind of having a snowball effect on hormones.
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It's also, Leading to, dysregulation with appetite hormones as well as decreased insulin sensitivity.
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So ultimately,
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that's also wild, because your intermittent fasting people tell you that it increases your insulin sensitivity.
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right, right, and, and there are animal studies and there are, you know, studies on men that do show that, that benefit.
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But again, these, you know, studies are not meant to be, you know, kind of translated to women where our physiology is very different.
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And I also think what's important to note is that we also have to remember that, you know, thing, nutrition science is, is tough, right?
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Because, you know, we, we don't live in a bubble where these, these, you know, kind of different concepts and, and tools and diet formats are studied.
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And, you know, We have to think about context.
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I always say to clients at the end of the day, context is king.
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And, you know, in someone, again, that's maybe a male with really optimal metabolic health and, you know, very minimal stress in his life.
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Sure.
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Could intermittent fasting be possibly a good helpful tool for, you know, achieving some, some things there.
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Maybe.
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Yeah.
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You know, that's something that person could explore women have completely different.
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Hormone makeups, and we have our infradian rhythms, women of reproductive age, where we're cycling, hormones are, you know, cycling all month long.
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And then we also have different phases of the life cycle for women where the body's going through various different types of stressors with changes hormonally, right?
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And so we have a lot to account for there, but then we also have to think about, like, life stress and, you know, emotional stress, and what other types of stressors are going on in our life that might impact it.
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The context of whether or not this tool is going to be healthy, if that makes sense.
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Yes, for sure.
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So here's, here's the question then if we're like, okay, intermittent fasting is probably not great for women but also, we're not expecting women to get up and have a 3am snack.
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So we do intermittent fast in a way and that we.
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Don't eat while we're sleeping and I prefer just as far as my sleeping goes I prefer to go to bed with a not full stomach.
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Like I prefer to eat around, you know I typically stop eating around 7 or 7 30 and And then I go to bed around 10 and that window just allows me to process the food in my in my stomach and whatnot, so that I feel a little lighter going to bed.
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That's a more comfortable way for me to sleep.
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So I'm already extending my fasting window because I choose not to eat late in the evening.
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So there is fasting going on.
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How do, what do we do?
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Like, what's, what's correct?
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You know?
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right.
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And so what I will say is my analysis of the research and also just experience, you know, working with hundreds of women in practice, you know, ultimately What I do recommend is generally kind of aligning your pattern of eating with your circadian rhythm.
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And we do know that there are a lot of benefits to that hormonally, metabolically, you know, on weight.
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And, you know, that generally is going to mean, you know, eating breakfast within, a couple hours of waking up, eating consistent meals throughout the day, and maybe having a little bit of an earlier dinner so that your body does have some time to digest and to shift into kind of sleep mode and producing hormones that help us fall asleep and have, you know, good deep restorative sleep, you know, at the end of the day, which is, you know, kind of, misaligned in terms of how a lot of us are operating in our modern world where, you know, women are waking up, they're, they're, you know, Skipping actual food, they're fueling on caffeine and, you know, kind of stimulating beverages, and then they're eating the bulk of their food later in the day.
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The second half of the day, they're hangry because they didn't eat enough, you know, the first part of the day.
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And, you know, that's creating hormonal chaos and dysregulation and metabolic dysfunction, ultimately, in my mind.
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And when it comes to the fasting window, You're right.
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You know, we are typically naturally fasting overnight.
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And I think what, what women need to, you know, kind of remember too, is that there's a benefit to just a gentle 12 to maybe 14 hour max, you know, overnight fast.
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It doesn't have to be 15, 16, 17, 18 hours to, to have a benefit.
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you know, 12 to 14 hours is generally what I, I recommend for, You know, sort of that gentle overnight fast, but always at the end of the day, we have to remember, you know, all of these things we're talking about, these are tools.
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These are not rules.
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And, you know, life does its lifey thing, right?
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And, you know, there might be things that disrupt our ability to follow that schedule and that's okay.
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big advocate for tools, not rules.
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And always remember that we have to respond to internal biological cues over external rules always.
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So, you know, if there's a day where, you know, your eating pattern got a little wonky and you're hungry in the evening before bed, Have a snack.
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Have a well rounded snack.
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Respond to that.
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That's going to help you to sleep better, right?
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and if there's a few days a week where you're having that nice gentle 12 to 14, you know, hour overnight fast, you're having that, you know, earlier 7 p.
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m.
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dinner, amazing.
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You're going to get a lot of benefits from that.
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You don't have to do it every single day with rigidity and turn it into an emotionally charged diet.
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Yeah.
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I love that.
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I, and I, I love that tools, not rules.
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That's so great.
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okay.
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So a little bit more on the logistics on this then.
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so obviously good to have dinner, not eat in the evening to just prepare for sleeping.
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I like to work out in the morning and I think many of my clients find that that is their best time as well.
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And it's tricky because For some exercises, I can't eat.
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If I'm going to go and lift weights, I totally can eat a little snack before.
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And so I'm not, you know, I'm not fasting for much longer because I'm having a little bit before I work out.
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But if I do hot yoga, like there's no way.
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I cannot have anything in my stomach or I absolutely will be so nauseous.
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So, and then, you know, cardio is kind of somewhere in the, in between.
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I can have like a tiny bit, but for the most part, I don't love it.
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I don't love food in my stomach.
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So that pushes my fasting window.
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Like yesterday I went to a 9 AM hot yoga and I was hungry before, but I'm like, okay, well, if you eat, you can't go to yoga.
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Like that's just it.
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I've done it and it's a bad idea.
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Yeah.
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So then I'm not eating until, you know, 10 30, almost 11.
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And that feels late to me.
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So talk about, exercise morning exercise and how we can kind of find a solution
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I love that you, you bring that up because the, the morning workouts are, are challenging.
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We're navigating sort of the appetite and the, the movement schedule and, and all of it.
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And, you know, ultimately what I will say to kind of build on the, the conversation around the kisspeptin, you know, secretion disruption and how that has sort of a snowball effect, you know, on blood sugar, on appetite, on sex hormones, if we're also, you know, layering in a workout and, and there's.
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you know, I'll give you kind of some, some rough benchmarks here because I think, movement can, can kind of fall into a number of, of different categories.
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If we're doing something light, say it's like a 20, 30 minute, you know, we're going on 20, 30 minute walk or 20, 30 minute, you know, kind of, slow yoga flow, something that isn't super intense.
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I think often, you know, we, we can get away with doing a little bit.
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you know, something fasted.
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however, if it's, you know, an hour long, you know, heated yoga class, where again, the heat aspect also is going to put more stress on the body.
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If we're, you know, strength training, if we're doing, you know, cardio that's longer in duration or higher in intensity, we're We are absolutely going to want to figure out a way that we can have a little bit of fuel, to replenish those, those glycogen, those carbohydrate stores, that signal to the body that, hey, you're safe.
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You have enough resources.
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So you can actually focus on things like muscle protein synthesis and building lean muscle versus, you know, being in kind of conservation mode.
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And what, what we are seeing in research is, Fasted exercise, and again, there's that threshold there depending on the duration and the intensity, but fasted exercise is leading to, in women, a very, very amplified cortisol response.
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So in the morning, we typically experience something called a cortisol awakening response, where we get this big burst in cortisol soon after waking.
00:18:58.924 --> 00:19:02.980
that's a very, you know, kind of healthy part of our diurnal you know, cortisol pattern.
00:19:03.460 --> 00:19:08.269
but cortisol is already going to be high in the morning and, you know, our energy stores are depleted.
00:19:08.339 --> 00:19:19.470
So when we start putting more demands on our body without any energy and we're stimulating cortisol with movement, we're going to get huge amplification with this cortisol, first thing in the morning.
00:19:20.089 --> 00:19:26.220
And that is going to potentially, again, in, in a repeated sense, have some negative implications for women.
00:19:27.019 --> 00:19:29.609
Definitely negative implications on, you know, blood sugar.
00:19:29.672 --> 00:19:31.382
balance and insulin sensitivity.
00:19:31.711 --> 00:19:37.821
It can also have negative impacts on thyroid function, specifically impacting, thyroid hormone conversion.
00:19:38.162 --> 00:19:48.821
I'll see, uh, in, in practice a lot with my women that are my clients that are, fasted kind of, morning movement people and kind of doing higher intensity stuff in the morning.
00:19:49.071 --> 00:19:52.011
I'll see a lot of low free T3 values.
00:19:52.481 --> 00:20:02.761
and obviously there's, you know, likely more pieces to the puzzle there, but ultimately we do know that it can negatively impact, you know, thyroid function, and sort of work against us at, at the end of the day.
00:20:02.761 --> 00:20:10.291
And what's tough is sometimes with that big burst of cortisol and kind of adrenaline from the fasted workouts, we can feel really energized, right?
00:20:10.291 --> 00:20:12.182
It's like, Ooh, man, that felt great.
00:20:12.422 --> 00:20:15.811
when ultimately our body's going to perceive that stress a little bit differently.
00:20:16.372 --> 00:20:23.152
So, My recommendation would be, and I think everyone's different and, and is gonna need to play around with this a little bit to see what feels best.
00:20:23.481 --> 00:20:30.682
But using your hot yoga example, and, and you know, I know that's like a, a tough thing to, to get down like real food before and have that feel good.
00:20:31.092 --> 00:20:32.801
maybe playing around with something liquid.
00:20:33.301 --> 00:20:36.061
even if, a client was able to, to bring in.
00:20:36.636 --> 00:20:48.487
you know, drink like a coconut water, you know, coconut water, put like a pinch of sea salt in it and at least get like a little sugar or carbohydrate, from, coconut water, that would even be better than just a fasted workout at the end of the day in my mind.
00:20:48.896 --> 00:20:59.596
Or if we could do, you know, a little bit of like a simple, you know, protein shake, even if it's like small frozen banana, scoop of protein, a little bit of liquid and have something like that.
00:20:59.997 --> 00:21:02.196
or something that's super easy to digest.
00:21:02.196 --> 00:21:06.527
I actually love the, I don't know if you've heard of those like fuel for fire, like pouches.
00:21:06.737 --> 00:21:09.807
They're great little kind of convenient pre workout.
00:21:09.856 --> 00:21:12.777
it's basically like blended, you know, fruits.
00:21:12.787 --> 00:21:16.436
Some of them have like a little sweet potato or something in them, but just some whole food carbohydrates.
00:21:16.807 --> 00:21:24.406
And, I think they each have like 10 grams of, of protein added, but just sort of like a quick, easy to digest pre workout fuel.
00:21:24.406 --> 00:21:32.487
So, that's what comes to mind for me, but definitely, you know, everyone has to play around with it a little bit to sort of feel figure out what feels good for them during their workout.
00:21:32.801 --> 00:21:33.142
Yeah.
00:21:33.582 --> 00:21:45.471
So for a first recommendation, then in terms of energy, if you're, if you're looking at the package, we're looking for probably, it sounds like somewhere in the range of like 250 calories, something like that in terms of energy needs,
00:21:45.521 --> 00:21:53.741
yeah, I would say like 150 to 200, even just, yeah, I mean, it could be higher, but I'd say even, even lower is, is fine.
00:21:53.741 --> 00:21:57.551
I think if we could get like 150 to 200, that'd be great.
00:21:57.866 --> 00:21:58.237
Okay.
00:21:58.517 --> 00:22:03.317
I just think even though, my listeners, my clients, We're not really strictly counting calories.
00:22:04.037 --> 00:22:06.547
It's still a form of energy management measurement.
00:22:06.586 --> 00:22:13.007
And so it just helps as a guideline, even if you're not going to count all day long to say like, Oh, okay, this makes sense.
00:22:13.007 --> 00:22:16.717
This is kind of the amount of food that Jillian's recommending.
00:22:16.997 --> 00:22:20.346
So this morning I did, an hour long pool swim.
00:22:20.737 --> 00:22:23.616
And before I had like a, just one.
00:22:23.616 --> 00:22:25.356
Don't know what to call it, like an energy ball.
00:22:25.366 --> 00:22:30.507
It's like oats and a little bit of chocolate, you know, it was primarily carbs and nut butters, that kind of thing.
00:22:31.027 --> 00:22:33.217
And I felt like, great.
00:22:33.287 --> 00:22:34.057
it was packaged.
00:22:34.057 --> 00:22:36.267
And so I know it was 110 calories.
00:22:36.287 --> 00:22:37.946
I probably could have used a little more.
00:22:38.797 --> 00:22:41.646
I think that's kind of along the lines of what we're talking about.
00:22:41.832 --> 00:22:43.152
Yep, absolutely.
00:22:43.152 --> 00:23:08.672
And, and, you know, I think even to, to give another guideline, if you were able to get like 30, you know, 30 grams of carb for, you know, a workout that was like an hour, you know, in duration, if it was a little shorter, you know, even getting like 15 grams of carb, something is going to be better than nothing in terms of, again, kind of giving your body some of that, energy and really kind of telling the brain that you're safe and you have resources that you can use here.
00:23:08.932 --> 00:23:11.951
But I think like 30 grams of carbs would be a good goal.
00:23:12.422 --> 00:23:13.221
Okay, good.