本期节目邀请冯子新博士，针对TFM社区成员提出的关于间歇乏食的问题进行解答，涵盖更年期过渡、初学者如何开始乏食、如何避免皮肤松弛、甲状腺问题与乏食、脂肪炸弹与脂肪乏食、骨质疏松症与乏食以及如何减掉最后5%体重等多个方面。
关于更年期过渡，目前缺乏相关研究支持，但我认为超加工食品可能是导致更年期症状加剧的重要因素。 对于初学者，我建议直接加入社区，利用社区提供的支持和指导，循序渐进地进行乏食，不必一开始就深入学习所有科学原理。
关于避免皮肤松弛，减肥不仅仅是减少脂肪，还包括减少皮肤、结缔组织等蛋白质组织，而乏食可以通过自噬作用帮助减少这些组织，从而减少皮肤松弛。
关于甲状腺问题与乏食，需要根据个体情况和实验室检查结果进行调整，乏食可能改善某些自身免疫性甲状腺疾病。
脂肪炸弹与脂肪乏食是不同的概念，脂肪乏食旨在减少饥饿感，而非摄入大量脂肪。
关于骨质疏松症，关键在于增加骨骼压力，而非单纯补充钙质，建议结合负重训练和日常活动。
对于减重最后阶段，建议尝试不同乏食方案，找到最适合自己的方法，例如较长时间的乏食（3-5天），结合少量蔬菜。
针对TFM社区成员提出的关于间歇性断食的各种问题进行了深入探讨。这次问答涵盖了乏食的诸多方面，从更年期女性的特殊需求，到初学者的入门指导，再到一些常见问题的解决方法，例如如何避免皮肤松弛、如何应对甲状腺问题、如何科学地进行脂肪乏食，以及如何高效地减掉最后5%的体重等等。
更年期过渡与饮食：超加工食品的影响
一位社区成员提问，在饮食健康、控制胰岛素水平的前提下，更年期过渡是否会更容易一些？冯博士指出，目前缺乏直接的研究证据来支持这一说法。然而，他认为超加工食品可能是导致更年期症状加剧的重要因素。超加工食品不仅可能添加有害化学物质，其加工过程还会改变食物的物理结构，导致血糖和胰岛素水平快速飙升，这可能会对更年期女性的健康产生负面影响。虽然目前尚无针对超加工食品与更年期关系的深入研究，但他个人倾向于认为，转向天然食物对更年期女性的健康大有裨益。
乏食入门：加入社区，而非埋头苦读
许多初学者感到学习曲线陡峭，不知从何入手。冯博士给出的建议是：直接加入社区。社区提供的结构化学习路径、同伴支持和定期指导，能够帮助初学者循序渐进地掌握乏食技巧，不必一开始就深入研究所有复杂的科学原理。他将此比作大学教育，强调实践和社群互动的重要性，认为这远比单纯阅读书籍更有效。
避免皮肤松弛：自噬作用的意义
关于减肥后皮肤松弛的问题，冯博士解释说，减肥不仅仅是减少脂肪，还涉及到皮肤、结缔组织等蛋白质组织的减少。乏食通过激活自噬作用，可以帮助分解这些多余的蛋白质组织，从而减少皮肤松弛的风险。他强调，20-30小时的乏食可能是最佳时间范围，超过30小时后，身体主要燃烧脂肪，减少了瘦体重（包括肌肉）的损失。
甲状腺问题与乏食：个体化方案与实验室数据
对于甲状腺疾病患者，断食方案需要根据个体情况和实验室检查结果进行调整。冯博士提到，一些自身免疫性甲状腺疾病患者在乏食后，甲状腺功能反而有所改善，这可能是因为乏食能够抑制过度活跃的免疫系统。然而，他再次强调，症状并非可靠的判断依据，必须结合血液检查结果来制定合理的乏食计划。
脂肪炸弹与脂肪乏食：并非同义词
Fung博士区分了“脂肪炸弹”和“脂肪乏食”这两个概念。“脂肪炸弹”指的是高脂肪饮食，并非乏食的理想选择；而“脂肪乏食”则旨在通过少量脂肪摄入来缓解饥饿感，帮助身体更容易进入生酮状态，并非为了摄入大量脂肪。
骨质疏松症：负重训练与日常活动
针对骨质疏松症，冯博士指出，关键在于增加骨骼压力，而非单纯补充钙质。他建议结合负重训练和日常活动，增加骨骼的负重，从而促进骨骼生长。此外，充足的维生素D摄入也很重要，建议多晒太阳。
减掉最后5%体重：尝试不同方案，找到最适合自己的
对于减重最后阶段，冯博士建议尝试不同的断食方案，例如较长时间的乏食（3-5天），结合少量蔬菜摄入。他强调，找到最适合自己的方法才是最重要的，这需要不断尝试和调整。 他个人更倾向于较长时间的乏食，因为这能够更好地控制心理上的渴望，而非单纯的生理饥饿感。
总而言之， 乏食并非一蹴而就，需要根据自身情况灵活调整，结合社区支持，才能更好地达到目标。 更重要的是，要重视个体差异，找到最适合自己的方法，并坚持下去。
Edit:2025.03.26
00:06
在开始今天的节目之前，我需要快速宣读我们的播客免责声明。本播客仅用于教育目的，不能替代医生或其他合格医疗专业人员的诊疗服务。
00:25
在进行任何禁食、改变饮食结构、服用或调整药物/补充剂、或采用任何健康问题治疗方案前，您必须始终咨询您的医生或其他医疗保健专业人员。
00:42
您因收听本播客而购买的任何其他产品或服务，不会在您与播客相关专家之间建立医患关系。
00:59
所有关于膳食补充剂的信息和声明都未经美国食品药品监督管理局评估，不用于诊断、治疗、治愈或预防任何疾病。好的，我们现在开始今天的节目。大家好，我是丽莎·钱斯，TFM的禁食教练。
01:23
今天我们很荣幸邀请到我们的冯博士进行月度问答。这是一个每月一次的问答环节，冯博士将回答来自TFM社区成员提交的问题。同时也要向我们的播客听众问好——你们将在社区成员之后几周收听到这次与冯博士的问答内容。请记住，冯博士不能回答任何医疗问题，他在这里是解答关于禁食和营养方面的问题。
01:51
我发现这个问题很有意思。这是个很长的问题，但我把它简化成了我认为她真正想问的核心：她谈到过去女性如何更容易地从围绝经期过渡到绝经后，那时我们还没有现在这些加工食品。所以她想问：对于那些采用整体饮食、控制胰岛素水平的女性，这样做是否可以帮助我们不需要激素替代疗法就能更容易地度过这个阶段？
02:13
她希望知道是否有相关研究，包括是否能帮助缓解潮热等更年期症状？
02:30
冯博士：这是个很好的问题。遗憾的是我不知道确切答案。关于超加工食品的数据都比较新。所以我们还不清楚。我的猜测是…
02:53
这个问题比我们大多数人意识到的更严重。过去人们谈论超加工食品，主要是说其中添加的化学物质可能有害。但实际上远不止如此。加工不仅会添加化学物质，而且…
03:11
食物物理结构的改变也可能非常有害。吸收速度的变化。当你食用超加工食品时，它会导致胰岛素和葡萄糖水平飙升得更快更高，这会产生很大影响。除了化学添加剂，超加工食品还有其他问题。至于它们如何影响更年期？我不知道是否有相关研究。
03:37
我猜测这可能很重要，但相关数据还有待研究。所以我无法给出明确答案。关于女性更能耐受更年期的另一个问题，总是存在混淆因素，因为你无法判断旧的研究是否显示…人们只是不怎么抱怨这个问题，对吧？这在过去被认为是…
04:01
你必须忍受的事情。所以没人真正重视它，对吧？特别是在早期的文献中，存在很多性别歧视的观点。你知道，当时的研究主要由男性主导。所以这些问题没有被认真对待。所以是因为我们现在更关注这个问题了，还是因为超加工食品？
04:22
很难说。如果要我猜，我会说超加工食品影响很大。我认为它对很多我们现在还没完全意识到的事情都有重大影响。所以我认为回归天然食品是个好方向。只是这不容易，因为它已经主导了美国饮食。Moon lining（注：此处为口语化表达，指快速渗透），你知道，它渗透得太快了。是的，这有点疯狂。是的。
04:45
好的，这个人说：我是新加入社区的成员，感觉学习曲线非常陡峭。我是否应该先学习相关的科学知识，从基础的禁食开始，比如稳定的限时进食（16:8），每周做几天24小时禁食？
05:07
然后再加入辅导小组或单独练习？还是应该直接加入辅导小组？
05:19
冯博士：我会建议直接加入，因为总有东西要学。你不需要理解背后的科学原理就能实践。这就是整个社区项目的设计初衷，现在它以周为单位安排内容，包括饮食目标、禁食目标，
05:37
还有非常重要的责任目标和心态目标等等，这些都能真正帮助你。因为关键在于，仅仅知道你应该做什么并不一定会让你付诸行动。比如，我们都知道应该锻炼，都知道应该用牙线清洁牙齿。但这不意味着我就会去做。
05:59
但让事情变得更容易的是，第一建立习惯，第二加入讨论这些话题的群体，这样它就会更多地出现在你的意识中。你会想：好吧，也许我可以跳过这顿饭，也许我不需要马上吃东西。所以很多…
06:17
减肥的方面实际上在群体中、在支持性环境中会更容易实现。就像我们知道行为改变在其他方面有多重要，比如匿名戒酒会，对吧？这不是个神奇的项目。如果你自己做，成功率可能只有他们的10%，因为他们…
06:36
运用了很多责任机制。他们有担保人，对吧？所以有人可以随时交流。有小组会议。有所有这些社交支持。这就是我们想在社区中创造的——一个社交支持网络，通过讨论、思考和分享技巧来互相帮助实现目标。这是你无法仅仅…
07:03
通过读书或其他方式获得的，对吧？这就像上大学。如果只需要读书，没人会付那么多钱，
07:13
去上大学。这完全没有道理。要花很多钱，很多年时间，但我们做的几乎所有实际事情，在有指导、有老师、有同伴群体的情况下会做得更好。通过保持趣味性来保持责任感，这类事情。所以我绝对建议加入小组。就像我说的，现在的设置是你不需要理解任何东西。你可以直接实践。
07:36
然后随着进展，你会逐渐理解我们讨论的内容，明白为什么要这么做。是的，我绝对建议利用这个项目，它现在设置得非常实用，就是做这个，做这个，做这个。然后小组会帮助你实现。你提到的是会员附带的12周课程，那个非常棒。我可以作为教练告诉你，
08:03
我的客户中有责任伙伴、每周与我或其他人沟通的，他们的表现要好得多。对他们来说就是更容易。你知道，所以绝对是这样。
08:15
对的。
08:37
关于皮肤松弛的问题，我不知道有多少数据。有趣的是，大多数人认为减脂只是减脂肪，但事实并非如此。实际上还涉及很多相关组织。有一项研究，我试图再次找到它，因为我觉得它非常有趣。
08:57
研究了脂肪细胞中脂肪和蛋白质的比例。我记得脂肪细胞中大约60%多是脂肪。显然，这取决于它的大小。但这说明当你减脂时，你实际上不只是减脂肪，你同时在减脂肪和蛋白质，包括皮肤、结缔组织、血管等所有这些东西。
09:24
你可以从电视上的一些节目中感受到它有多少。那些做皮肤手术的节目，你知道，那些减掉很多脂肪的人，他们真的会切掉大约25磅的皮肤和组织。这不是脂肪。这是蛋白质。所以关键在于在自噬过程中，在禁食期间，你可以激活脂肪…
09:46
和部分蛋白质的分解。这不一定意味着你在流失肌肉。每个人都说，你在流失肌肉，你在流失肌肉。不，不，除了脂肪外，还有很多蛋白质需要减少。这就是为什么在我们的诊所，即使人们减掉很多体重，他们的皮肤松弛问题也少得多，因为…
10:06
禁食是一种有效的方法，不仅能减脂肪，还能减少一些蛋白质。根据我们的最佳推测，自噬大约在20到30小时达到最佳状态。超过30小时后，你的身体主要只是燃烧脂肪，所以你不会流失那么多瘦肉组织。这就是人们总是反复强调的，哦，你的瘦肉组织…
10:33
而我在想，你需要流失一点瘦肉组织，因为它不全是脂肪。如果100%是脂肪组织，你会留下所有这些多余的皮肤，这不是好事。这些都是无用的东西。
10:46
所以禁食是个好方法。当我们开始时，这是人们认识到的重要一点。因为在其他形式中看不到这种效果。其他形式的热量限制没有自噬带来的这种好处。谢谢。这个人正在服用甲状腺药物，想知道：当做禁食时，对有甲状腺问题的人有什么特殊技巧或调整吗？
11:15
我会说这取决于你是否处于发作期。还有你是否检查过实验室指标，对吧？对的。绝对是这样。所以归根结底是要检查实验室指标，因为这是唯一的方法。症状对甲状腺水平的指示性很差。而且…
11:32
当我们禁食时，实际上听到很多人说他们的甲状腺状况改善了。某些甲状腺疾病是自身免疫性的，这意味着是你的免疫系统在抑制或破坏甲状腺功能。所以他们变得甲状腺功能减退，需要甲状腺…
11:49
药物治疗。然而，如果你禁食，虽然这是个例，但很多人说他们检查甲状腺，发现它实际上在好转。这是可能的，因为如果免疫系统稳定下来，所以再次强调，自身免疫意味着你的免疫系统在攻击自己，这意味着它实际上过度活跃。
12:07
当你不进食时，你的身体会试图关闭一些功能。所以过度活跃的免疫系统会降到正常水平。因此，也许甲状腺功能确实改善了，这意味着你实际上可能过量服用了甲状腺药物。
12:22
所以这是个问题。但再次强调，症状是个很差的指标。你必须通过血液检查来确认。但我们听到很多人说，哦，是的，我开始禁食后，就停掉了所有甲状腺药物。这实际上不应该影响甲状腺。但因为自身免疫性甲状腺炎很常见，我们确实经常听到这种情况。所以这是个有趣的现象。是的，我有几个客户，其中一位实际上有甲状腺炎。
12:50
甲状腺癌。她进行了严格的治疗性禁食，你知道，但她总是每六周检查一次指标，以便相应调整药物。现在她的影像检查显示所有囊肿都空了。
13:05
当然，医生们都惊呆了。她一直告诉他们，我在禁食。他们就像，这怎么可能逆转成这样？所以这很酷。她在房间里大喊，因为他们又叫来一位放射科医生和另一位医生。他们就像，我们拿错了X光片对比。她就像，我在禁食。我就像，
13:25
是的，他们不明白。因为他们从未学过这个。我有个病人有出血性囊肿，实际上出血很严重，甚至不得不切除部分肾脏，因为肾囊肿一直在出血。总之，开始禁食。同样的情况。当你禁食时，你的身体会试图关闭外源性生长，转而进行维护和修复。
13:52
囊肿是生长的。所以当你禁食时，它会试图减少这种过度生长。事实上，她的囊肿完全稳定了。她停止了出血。又开始缩小。同样的情况。你应该去做超声波检查。他们就像，这不可能是，这不可能是对的。她就像，你知道，没关系。但作为教练很令人兴奋。
14:12
你知道听到这些发生在乳房囊肿、肾脏囊肿或甲状腺囊肿上，真的让我感觉很好，非常有成就感。所以谢谢你，冯博士。这个人说，我读过你关于谁应该避免脂肪炸弹的博客文章，你想要足够的脂肪但不要太多脂肪，那么这如何适用于脂肪禁食？
14:37
在脂肪禁食期间，我们每餐每天应该摄入多少克脂肪？我知道我们的脂肪禁食大约是80%的脂肪，对吧？除非是植物性的，那么大约是70%。是的。所以脂肪很有趣，因为它的代谢方式是当你吃脂肪时，
14:55
它不会进入肝脏，而是通过淋巴吸收，然后沉积到血液中，脂肪细胞再将其取出。所以它直接进入脂肪储存。这就是为什么吃脂肪炸弹…脂肪炸弹是较旧的概念，我不认为现在还有人这么做。
15:14
就是超高脂肪的东西，你可以随时想吃多少就吃多少。问题是，你知道，当你进入酮症时，酮症很有趣，因为它告诉你处于燃脂状态，这很好。但是…
15:34
如果你同时摄入脂肪又在燃烧脂肪，那么你就不是在减脂。所以无节制地吃脂肪炸弹对你没好处。它不会让你减肥。脂肪禁食不同。你不是无缘无故地吃大量脂肪。你只是吃足够缓解饥饿感，对吧？
15:55
所以即使你不减肥，至少你让身体适应进入酮症的过程。所以我们称之为训练轮，因为你不会像纯水禁食那样减那么多脂肪。例如，在纯水禁食中，你燃烧脂肪但不补充脂肪。脂肪禁食只是为了缓解不适，让它更容易，让你进入状态。而且…
16:22
因为他们一天燃烧的脂肪远少于摄入的，他们仍然在减肥。再说一次，你只需要吃到不饿的程度。目的是让它更容易。它不一定更好，但有些人效果很好，因为你不那么…
16:40
饥饿，因为你要意识到人们吃东西有不同原因。有些人只是感觉被剥夺了。他们觉得，如果不能吃任何东西，最终会暴食。所以你只是稍微调节一下，让整个过程更容易些。
17:00
但脂肪炸弹不是我们脂肪禁食的目标。我们试图做的是减轻饥饿感和被剥夺感这类事情。而且，你知道，根据经验，我认为它实际上很有效。
17:14
你知道，当我以前做五天禁食时，到第三四天，纯水禁食变得不太容易。身体饥饿从来不是最难的部分。最难的部分总是心理上的，哇，我真的很想吃这个，因为它非常美味。这就是…
17:35
我发现吃点东西很有用。这不是经典的完整禁食。另一方面，它足以缓解不适，但又不足以让我停止减肥或失去其他好处。所以关键是找到适合你的方法。适合我的方法，也许我需要通常在第三天、第四天。有些人可能需要第一天。没关系。
17:58
是的，你不会减那么多体重，但你仍然会减肥。我尝试过模仿禁食饮食，实际上觉得太多了。我吃不完所有东西，因为我不需要。所以我没有。对的。所以我认为第一天大约是1100卡路里。但太多了。我就像，我吃不了那么多。对的。就像在禁食日。对我来说太多了。
18:21
所以我实际上减少了。我想我吃了他们建议的一半。我必须说，这确实让它更容易。但对我来说还是太多了。你必须随时调整。脂肪炸弹是这种想法，你可以放纵自己想吃多少就吃多少，因为它是自由食物。它不是自由食物，但脂肪禁食是为了减轻饥饿感。我们经常从客户那里听到这个问题，而且…
18:44
一个训练轮或脂肪炸弹，你知道，我总是用一汤匙非常好的。我住在纳帕附近。所以非常好的农贸市场手工橄榄油，本地种植，非常新鲜。我随时都会喝一汤匙，如果刚开始时很困难，它含有很多抗氧化剂。我总是把它看作是一种启动。
19:11
你总是谈到两个不同的炉子，对吧？一个葡萄糖燃烧炉和一个脂肪燃烧炉。我想转到那个脂肪燃烧炉。所以我遵循你的建议，但我说的是一汤匙。我不是在喝500卡路里的脂肪炸弹饮料，对吧？
19:26
对的，没错。这些就像你可以做的小零食，我的意思是，相当多，对吧？完全正确。这样做的方法就是转到那边，这样你仍然保持脂肪燃烧状态。
19:42
但你吃一点，因为它主要是脂肪，你仍然保持脂肪燃烧状态。你显然补充了一点脂肪，这是你必须做的。但因为你在那里保持，所以你管理饥饿，但也管理心理方面。所以这很重要。不是说，哦，太好了，我可以有禁食辅助。而是，我需要禁食辅助吗？
20:07
我现在真的需要吗？它能帮助我再禁食12小时吗？如果不是，如果我只是因为它可以吃而吃，你知道，这不是我们的做法。对的。完全正确。完全正确。这就是我发现有时…
20:33
我想让我的身体燃烧自己的脂肪。我不需要它燃烧我摄入的脂肪。我宁愿少吃一点，让我的身体燃烧自己的脂肪和自己的糖。是的。我有两个DEXA问题。所以这个人说去年夏天，他们做了DEXA扫描，发现从骨质减少变成了骨质疏松。从那时起，他们一直在…
20:56
安排锻炼，抗阻训练。围绕禁食安排锻炼的最佳方式是什么？应该在禁食状态下锻炼吗？这类问题。
21:09
是的，我认为在禁食状态下锻炼是有益的。然后有些人，如果他们试图增肌，不是骨骼，而是肌肉，会在禁食和锻炼后大约4到6小时内吃一些高蛋白食物，因为在这种状态下你更容易增肌。
21:31
对于骨质疏松症，定义要模糊得多，因为人们不知道。所以人们过去认为，这是缺钙。根本不是缺钙。如果你看世界范围内的骨质疏松症，例如在日本，他们摄入的钙量大约是美国人的三分之一，但骨质疏松性骨折少大约10倍。差别巨大。
21:54
问题是造成这种差异的原因是什么？不是钙。这才是重点。因为我们都会陷入这种状态，每个人都像，你应该多喝牛奶，多补钙。我不认为这是问题所在。我认为问题在于，第一，骨骼在受力时会变得更强壮。
22:12
所以如果你久坐，这是北美普遍的问题，白天坐得多，住在郊区开车，而不是走路。所以你没有给骨骼施加压力。只有给骨骼施加压力，骨骼才会变得更强壮。这就是为什么宇航员会得骨质疏松症。他们饮食没问题。
22:41
所以每个人都认为是我吃什么？我吃什么？多吃这个。不，不，不。如果你需要强壮的骨骼，你需要给骨骼施加压力。如果你需要强壮的肌肉，你需要给肌肉施加压力。你不能靠吃来解决这些问题。你能调整饮食吗？禁食可能有帮助，因为生长激素增加。
22:58
但这可能需要更长时间。所以你可能需要进行更长时间的禁食。当然，进食时，你要确保摄入所有必要的维生素。你不必一直吃，但要确保摄入。可能需要晒太阳。你知道，维生素D非常重要。我过去经常测量病人的维生素D水平。
23:20
大约90%的人都低，因为长期以来，我们总是说避免阳光，避免阳光，导致很多人维生素D不足，而维生素D显然对骨骼发育非常重要。所以骨质疏松症很棘手，因为它实际上与很多因素相关。
23:39
但本质上，抗阻运动比运动更重要，因为它是日常，你做什么样的事情，对吧？所以如果你看世界上很多地方，他们做得更好，因为不是那么依赖汽车。比如你去某些城市，去哪里都是走路，你知道，我记得在意大利，你知道，你只是…
24:04
第一，你走到哪里都是走路。第二，到处都是山，对吧？所以你总是上下楼梯。而且，你会施加更多压力，因为即使下山或下楼梯，你也会给骨骼多一点冲击，这会使其更强壮。所以每周三次，每次30分钟的额外运动没问题。但问题是，你…
24:28
每天10小时在做什么？你走到哪里都是走路吗？这才是长期的关键。不是说差别那么大，但长期的小差别仍然可能是大差别。所以骨质疏松症很难，但增加骨骼压力绝对是最重要的。
24:47
你对K2有什么看法，特别是D3和K2补充剂？K2可能比我们想象的重要得多。这是最近人们认识到其重要性的维生素之一。所以维生素D和K2，我现在经常看到一起补充。人们几乎会同时服用。所以补充这些维生素值得考虑。
25:10
如果你想，但晒太阳可能同样有效。你知道，他们说这是新的吸烟。所以是的，出去每天稍微走一走。是的。这个人，另一个DEXA问题是，她终于达到了目标体脂率25%。她不再是2型糖尿病，逆转了非酒精性脂肪肝，但她想减掉最后的5%。
25:37
对于最后这个减肥阶段，你会建议什么禁食方案？
25:43
再说一次，每个人对不同方法反应不同。所以我不知道哪个最好。我认为你必须尝试，然后看看哪个最适合你。这没什么不同。就像有人喜欢吃羊肉，有人不喜欢。有人喜欢豆腐，有人不喜欢。有人喜欢茄子，有人不喜欢。不是说哪个对哪个错，对吧？所以如果你发现一日一餐很适合你，符合你的日程，
26:12
对你来说容易。其他人觉得很难。所以不是说这对每个人都最好，但对你最好。所以我会尝试常规方法，但人们不太尝试的是更长时间的禁食。最近，我发现它们更有用。这些3到5天的较长禁食，
26:34
但不是完全禁食，比如吃一点蔬菜之类的，因为我觉得对我自己来说，到第三天第四天，它会占据我的全部思想。就像，我只想着，哦，等我吃东西时要吃什么，不是身体饥饿。实际上几乎没有身体饥饿。第三天第四天我从不感到身体饥饿，但我感觉，哦，我应该做这个。我不知道是不是因为你接触太多，因为你开车上高速，你看到…
27:02
标志，你看到麦当劳，在医院看到Tim Hortons，它无时无刻不在你面前。所以这就是为什么我认为这些实际上最近很有用。而以前我做得更多的是24小时禁食。所以它可能随时间变化。
27:21
所以我转向做，你知道，我仍然做24小时禁食，但现在我有这些更长的禁食。这不是每个人都做过的。可能有教练会很有帮助。这就是社区的用处，因为他们说，嗯，这对我很有用。不意味着对你有用。意味着你可以尝试，然后自己决定，嘿，这太棒了。或者这个真的很难。我觉得我做不到。
27:49
没关系。你只对自己负责。但不意味着因为它对你有用而对我不起作用，不意味着…
27:58
我对或错。不，只是意味着你必须承认，嘿，这是我尝试的。这对我最有效。有些人不喜欢禁食。没关系。如果你不喜欢禁食，你可以改变饮食为天然食物或低碳水食物。效果一样好。我认为它对很多事情都是有用的辅助。所以…
28:20
能做多快就做多快。对的。学习所有这些，转舵的艺术，你知道，你需要上调还是下调？重新学会信任你的身体，所有这些，这都是我们教的东西，对吧？对的。
28:34
好的。所以谢谢你，冯博士。我要回顾一些重复的问题，并告诉人们在哪里可以找到之前播客和文章中的答案。我们收到很多关于卡路里的问题。最好的资源是，如果你查看我们网站上的资源，好的，然后看下拉菜单，你会看到冯博士的Medium文章。
29:03
《过度喂养悖论》，《体脂恒温器，第六部分》是其中一篇关于卡路里的文章。还有他的另一篇Medium文章是《Ozempic、Wegovy、Manjaro教给我们关于减肥的事》。是关于控制饥饿，而非卡路里。这是标题。
29:28
另一个你可以查阅的不在我们网站上，但冯博士非常尊重的Ben Bickman博士的文章是《卡路里计算无效的四个原因》。这是篇很棒的文章。还有人问关于肾结石。
29:47
你会在播客第189期找到答案。还有人问关于美国心脏协会的播客。
29:58
抨击禁食，说它多么危险，增加心脏病发作和心脏问题的风险。冯博士对此做了反驳文章。你也可以在Medium文章中找到。请记住，那是个海报展示，不是研究文章。它也是问卷式数据收集，这是最不准确的。它跨越18年，而且…
30:27
人们不认为早上喝咖啡吃羊角面包是一餐。他们认为那仍然是禁食的一部分。而且在那次海报展示中没有人是故意禁食的。我们在社区论坛的各种帖子中有很多这方面的信息。
Edit:2025.03.28
00:06
Before we get started with today's episode, I would like to quickly read you our podcast disclaimer. This podcast is for educational purposes only, and it is not to substitute for professional care by a doctor or other qualified medical professional.
00:25
You should always speak with your physician or other healthcare professionals before doing any fasting, changing your diet in any way, taking or adjusting any medications or supplements, or adopting any treatment plan for a health problem.
00:42
The use of any other products or services purchased by you as a result of this podcast does not create a healthcare provider-patient relationship between you and any of the experts affiliated with this podcast.
00:59
Any information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. All right, and now we'll get started with today's episode. Welcome everyone. My name is Lisa Chance. I'm a fasting coach here at TFM.
01:23
We are here today with our very own Dr. Fung for our monthly Q&A. This is a monthly Q&A where he answers questions submitted by our TFM community members. And hello to our podcast listeners who will be able to listen to this Q&A with Dr. Fung a few weeks after our community members. Please remember that Dr. Fung cannot answer any medical questions. He's here to answer your fasting and nutrition questions.
01:51
This question I found kind of intriguing. It was quite a long question, but I kind of broke it down to what I believe she was trying to ask. She was talking about, you know, how in the past women would transition from a perimenopausal to postmenopausal much easier before we started getting all this processed food and everything.
02:13
So she's saying she's hoping that you may be able to offer us women in this category that are eating holistically, getting our insulin down. Would doing that help us transition without hormone replacement therapy easier?
02:30
Are there any research articles on that, including helping with symptoms like hot flashes, the other things that come with transition into menopause? Yeah, that's a great question. Unfortunately, I don't know the answer to that. A lot of the data around ultra processed foods is relatively new. So we don't know. My guess is that
02:53
It's a bigger problem than most of us recognize. In the past, people talked about ultra processed foods, mostly in terms of maybe the chemicals that they add are bad for us. But there's actually a lot more to it than that. The processing not only can add chemicals, but also.
03:11
The way that it changes the physical structure of the food can be very bad. The speed of absorption. So if you eat ultra processed foods, it tends to deliver the insulin, the glucose spikes very much higher and very much quicker, which makes a big difference. There's other things other than the chemical additives that may be an issue with ultra processed foods. And how do they affect menopause? I don't know that there's a lot of research into that.
03:37
My guess is that it's probably very important, but the data is still sort of to come. So I couldn't give a definitive answer. The other question about women tolerating menopause better, it always gets confounded because you can't tell if old studies show, you know, people just didn't complain about it as much, right? It was sort of one of these things.
04:01
that you had to deal with. So nobody really took it seriously, right? There is, especially when you go into the older literature, there's a lot of sort of sexist points of view in that case. You know, it was very male dominated, the research back then. So these things weren't taken that seriously. So is it just that we're acknowledging it more or is it due to the ultra processed foods?
04:22
Hard to know. If I had to guess, I'd say the ultra processed foods makes a big, big difference. I think it impacts a lot of things that we're not fully aware of these days. So I think that movement towards natural foods is a good one. It's just not easy because it dominates the American diet. Moon lining, you know, it goes in so fast. Yeah. It's just kind of insane. Yeah.
04:45
All right, this person says, I'm new to joining the community and I feel like my learning curve is vertical. Should I really learn the science behind all of this and get my sea legs with fasting, such as solid TRE doing 16-8 on eating days and maybe a few days a week of 24s?
05:07
And then start joining a coaching group or even solo. And then later dive into therapeutic fasting or should I join a coaching group right away?
05:19
I would join right away because there's always things to learn. You don't have to understand the science of it to do it. You can just do it. And that's the whole community program, which is now laid out in a weekly session, has things to focus on, you know, the eating goals, the fasting goals,
05:37
But also very important are accountability goals and there's mindset goals and so on that really help you because the whole point is that just knowing that you're supposed to do something is not necessarily going to make you do it. Like, for example, we all know we should exercise. We all know we should floss our teeth. It doesn't mean that I'm going to do it.
05:59
But what makes it easier is, you know, one establishing that habit, but also getting into groups where people talk about it, it sort of becomes a bit more top of mind so that you think, okay, well, maybe I could skip this, you know, maybe I don't need to eat right away. So a lot of the sort of aspects of
06:17
losing weight are actually much easier done in a group, in a supportive setting. Like we know how important it is for all other aspects of behavior change, like Alcoholics Anonymous, right? It's not a magic program. If you did it yourself, you'd probably be 10% as successful as what they are because they,
06:36
leverage a lot of the sort of accountability. They have sponsors, right? So they have people you can talk to. You can always talk to. There's group meetings. There's all this social things. That's what we're trying to create in the community is a social support network where we all help each other achieve those goals by talking about it, by thinking about it, by sharing tips, that kind of thing. And that's what you can't get just…
07:03
just by reading a book or whatever, right? And that's the thing. If we could all, it's like going to university. If all you need to do is read a book, nobody would pay that amount of money, right?
07:13
to go to university. It makes no sense at all. It's a lot of money. It's a lot of years, but it's because everything we do practically is done better with the guide, with a teacher, with a peer group, you know, keeping yourself accountable by keeping it fun, that kind of thing. So I would definitely join the group. And like I said, the way it's set up now is you don't need to understand anything. You can just do it.
07:36
And then as you go learn some of the stuff we're talking about, why we're doing what we're doing. So you understand why it is, but yeah, I would definitely try to take advantage of the program, which is set out very practically now just to do this, do this, do this. And then the groups which are there to help you do that. You're talking about the 12 week cohort that comes with membership and that is excellent. And I can tell you as a coach, I can see why,
08:03
My clients who have accountability buddies who check in with me or somebody else every week, they do so much better. It's just easier for them. You know, so absolutely.
08:15
Right.
08:37
I don't know that there's much data. I mean, the loose skin issue is something that there's not a lot of data on. What's interesting is that most people think of fat loss as purely fat, but it's not. There's actually a lot of associated tissue. One study, and I was trying to find it again because I actually thought it was super interesting.
08:57
looked at fat cells and what percentage is actually fat and what percentage is actually sort of proteins. And I think it was around 60 something percent of the fat cell is actually fat. Obviously, it changes how big it is. But what it points out is that whenever you're trying to lose fat, you're actually not trying to just lose fat, you're trying to lose both fat and protein, which consists of skin, connective tissue, blood vessels, all that kind of thing.
09:24
You get a sense of how much it can be when you see some of these shows on TV where they do the skin surgery. And, you know, people who have lost a lot of fat, they take off like they literally cut off like 25 pounds of skin and tissue. Right. And that's not fat. That's protein. So the whole point is during autophagy, during fasting, you can activate fat.
09:46
a little bit of this protein breakdown and it doesn't necessarily mean that you're losing muscle. Everybody says this, you're losing muscle, you're losing muscle. No, no, there's a lot of protein that needs to go in addition to the fat. And that's why when we had our clinic, you know, even when people were losing lots of weight, they were having a lot less problems with the loose skin because
10:06
than before you know the fasting is a useful method to try to get not just getting the fat but also getting a little bit of that protein down and the autophagy is as best as we can guess is somewhere around 20 to 30 hours is going to be the sweet spot when you get beyond 30 hours your body mostly is just burning fat so therefore you're not losing as much lean tissue and that's the that's the thing that people always harp on and on about is like oh you've got lean muscle
10:33
And I'm thinking you want to have a little bit of lean muscle loss because it's not purely fat. So if it's 100% fat tissue, you're going to be left with all this excess skin, which is not a good thing. It's just useless stuff.
10:46
So fasting is a great way. And when we started, it was one of these sort of things that people recognize. It was very important because they didn't see it in other forms because the other forms of the calorie restriction didn't have that benefit of having the autophagy installed. Thank you. This person is taking thyroid medication and they want to know, are there any special tricks or accommodations in their fasting schedule when they do have thyroid issues that
11:15
And I would say it depends on if you're in a flare or not. And if you've checked your labs level, right? Right. Absolutely. So it always comes down to checking the labs because that's the only way. Symptoms are a very poor guide to what your thyroid level is. And
11:32
When you're fasting, we've actually heard a lot of people, a lot of people say that their thyroids get better. Certain thyroid diseases are autoimmune in nature, which means that it's your own immune system, which is suppressing or destroying your thyroid function. So they become hypothyroid and they need thyroid
11:49
medication. However, if you do the fasting, and this is anecdotal, but a lot of people have said they, they check their thyroid, and it's actually getting better. And that's possible because if the immune system is settling down, so again, autoimmune means your immune system is attacking itself, which means it's really overactive.
12:07
When you don't eat, your body wants to sort of shut down anything. And so an overactive immune system is going to get reduced to sort of a normal level. And therefore, maybe the thyroid actually improves, which means that the thyroid medication you're actually overdosing on.
12:22
So then that's a problem. But again, the symptoms are a poor guide. You actually have to check with your blood work to see. But we've had lots of people say, oh, yeah, I started doing fasting and then I got off all my thyroid medication. And it's like it shouldn't actually affect the thyroid. But because it is a common thing that happens is autoimmune thyroiditis. We do hear it quite a bit, actually. So it's an interesting phenomenon. Yeah, I have had several clients and I have one client who actually had thyroiditis.
12:50
thyroid cancer. And she hit it hard therapeutic fasting, you know, but she always checked her levels every six weeks so that her medication was adjusted accordingly. And all her cysts are now empty on imaging.
13:05
And of course, the doctors are freaking out. And she keeps telling them, I've been fasting. And they're like, how can this have been reversed like this? So it's pretty cool. She's like yelling from the room because they're bringing in another radiologist and another doctor. And they're like, we've got the wrong x-ray comparison. And she's like, I'm fasting. I'm like,
13:25
Yeah, they don't understand it. That's why because they never learn about it. There is a patient I had with had hemorrhagic cysts, which were bleeding a lot actually actually even wound up having to get part of the one kidney taken out because the kidney cysts were always bleeding. Anyway, started fasting. And again, it's the same thing. When you fast, your body wants to sort of shut down any exogenous instead of trying to grow it tries to sort of maintain and repair.
13:52
And cysts are growing. So therefore, when you're fasting, it tries to reduce that excessive growth. And in fact, her cysts just totally stabilized. She stopped bleeding. And again, it started to shrink. And same thing. You should go get an ultrasound. And they're like, well, this can't be, this can't be right. And she's just like, you know, it's okay. But it's exciting as a coach.
14:12
you know to hear that this is happening and rather they're cyst in the breasts or cyst in the kidneys or cyst in the thyroid and it's just really it makes me feel so good it's so rewarding so thank you for that Dr. Fung this person says I've read your blog post about who should avoid fat bombs you want enough fat but not too much fat so how does that apply to a fat fast
14:37
How many grams of fat should we be eating per meal per day on a fat fast? And I know our fat fast is about 80% fat, right? Unless it's the plant-based, then it's about 70. Yeah. So the fat is interesting because the way it's metabolized is that when you eat fat,
14:55
It doesn't go to your liver, it sort of just gets absorbed through the lymph and then gets deposited into the blood where the fat cells then take it out. So it sort of goes directly into fat storage. So that's why eating fat bombs and so fat bombs was this sort of older idea, which I don't know that anybody does too much anymore.
15:14
was this sort of ultra fat, you know, something that is just very, very, very high in fat, which people could eat whenever you wanted and however much you wanted. The problem is that, you know, when you go into ketosis, ketosis is interesting because it tells you that you're in a fat burning state, which is fine. But
15:34
But if you're adding fat at the same time and you're burning fat, well, then you're not losing fat. So eating a lot of fat bombs for no reason is not that good for you. It doesn't make you lose weight. The fat fast is different. You're not trying to eat a whole lot of fat for no reason. You're just trying to eat enough that you're taking the edge off that hunger, right?
15:55
So even if you don't lose weight, at least you're getting your body used to the whole process of getting into ketosis and all that. So that's why we call it like a training wheel, because you're not going to get as much fat loss. And if you did a full water only fast, for example, because on a water only fast, you're burning your fat, but you're not adding fat back in. Fat fast is just to take that sort of edge off, make it easier and get you into it. And a
16:22
because the amount of fat they're burning in a day is a lot less than they're taking in, they're still losing weight on it. And again, you just want to eat enough that you're not hungry. The point is to make it easier. It's not better necessarily, but some people get great results because you're not having so much of the
16:40
hunger, because you have to realize there's different reasons why people eat. And some people just feel that deprivation. They feel like, you know, if they can't eat anything, then they're going to wind up binge. So you're just trying to dial it down a little bit so that you're taking it a little easier into that whole process.
17:00
But yeah, fat bombs is not what we're aiming for with the fat fast. What we're trying to do is just sort of dial back the feeling of hunger, the feeling deprivation, that kind of thing. And, you know, from experience, I think it works actually quite well.
17:14
You know, personally, when I used to do some five-day fasts, and it used to be like a water only by three or four days, it was getting not difficult. The physical hunger was never the hardest part. The hardest part was always that sort of mental, psychological, whoa, I really, really want to eat this because it's really delicious. And that's where…
17:35
I found it useful to have a little bit. That's not a full classic fast. On the other hand, it was enough to take the edge off, but not enough that I wasn't still losing weight and getting the other benefits. So it's all a matter of finding what works for you. What works for me, maybe something, you know, I need it usually around day three, day four. Some people might need it day one. It's okay.
17:58
Yes, you're not going to lose as much weight, but you will still lose weight. I tried the fasting mimicking diet and I actually thought it was too much. I couldn't eat the whole thing because I didn't need to. So I didn't. Right. So I think the first day is like, you know, eleven hundred calories sort of thing. But it was too much. I was like, I can't eat all that. Right. It's like on a fasting day. That's just way too much for me.
18:21
So I actually just dialed it back. I think I took half of what they did. It really made it easy, I have to say. But for me, it was just too much. You have to always adjust. And the fat bombs is this idea that you could indulge yourself and eat as much as you want because it's a free food. It's not a free food, but the fast fast is to dial back that hunger. We often get this question from clients and it's,
18:44
a training wheel or a fat bomb or, you know, like I would always use like a tablespoon of really good. I live near Napa. So really good artisanal farmer's market, olive oil that's locally grown and really fresh. And I would just take a tablespoon of that had a lot of antioxidants in it. And I would take that any time of the day or night if I was struggling when I first started, if I was struggling and I always looked at it as kind of priming the pump and
19:11
You always talk about two different ovens, right? A glucose burning oven and a fat burning oven. I want to get over to that fat burning oven. So I followed your advice, but I'm talking one tablespoon. I'm not taking a 500 calorie fat bomb drink, right?
19:26
Right. Yeah, exactly. These were like little treats that you could make and stuff where I mean, quite a lot, right? It's and it's exactly right. That's the way to do it is just to get over there so that you're still staying in that fat burning state.
19:42
But you're taking a little bit, but because it's mostly fat, you're still staying in that fat burning state. You are adding a little bit of fat back, obviously, that's what you have to do. But because you're staying in there, then you're managing the hunger, but you're managing the sort of mental side as well. So that's important. It's not that, you know, oh, goody, I can have a fasting aid. It's like, do I need a fasting aid?
20:07
Do I really need it right now? Will it help me fast another 12 hours? If not, if I'm just having it because I can have it, that's, you know, that's not the way we do it. Right. Exactly. Exactly. And that was the thing that I found sometimes it was that, you know, it's like, oh, you can have all this. And I was like, I don't, I don't need all that. I'm perfectly fine with like this much. That's all I need to take. Right. Because
20:33
I want my body to burn my own fat. I don't need it to burn the fat that I'm taking in. I'd rather take a little less than let my body burn my own fat and my own sugar. Yes. I have two DEXA questions. So this person says last summer, they did a DEXA scan and they noticed that they had gone from osteopenia to osteoporosis. Since then, they have been
20:56
fitting in workouts, resistance training. What is the best way to fit in your workouts around your fasting schedule? Should you exercise in the fasted state or not? That type of thing.
21:09
Yeah, I think exercising in the fasted state is beneficial. And then some people what they do if they're trying to build muscle, not bone, but muscle is eat some high protein foods within sort of like four hours, six hours after the fasting and the workout, because you're more primed to build muscle in that state.
21:31
For osteoporosis, it's a lot less well-defined because people don't know. So people used to think, well, it's a calcium deficiency. It's not a calcium deficiency at all. If you look at osteoporosis around the world, for example, in Japan, they drink about a third of the calcium that Americans do, but they have like 10 times less osteoporotic fractures. It's a huge difference.
21:54
The question is what causes that difference? And it's not the calcium. That's the point. Because we all get into the state where everybody's like, well, you should drink more milk and you should take more calcium. I don't think that's the issue. I think the issue is one, bones get stronger when you put stress on them.
22:12
So if you're sitting a lot, and this is the whole problem with North America in general, is that you're sitting more during the day, you're using your car when you live in the suburbs, for example, you're driving everywhere as opposed to walking. So you're not putting the stress on the bones. And it's only putting stress on bones that causes the bones to get stronger. That's why astronauts get osteoporosis. They're eating fine.
22:41
So everybody thinks it's what am I eating? What am I eating? Eat more of this. No, no, no. If you need strong bones, you need to put stress on the bone. If you want strong muscles, you need to put stress on the muscles. You can't eat your way out of these things. Can you adjust your eating? Well, the fasting may help because of the increased growth hormone.
22:58
But that may take a little bit longer. So you may have to get into the longer fast to do that. And of course, when you're eating, you want to make sure you're getting all your good vitamins when you eat. You don't have to eat all the time, but you want to make sure that you get it. Probably need to get out in the sun. You know, vitamin D is very important. I used to measure vitamin D levels in my patients regularly.
23:20
Like 90% of them were low, because for so long, we've been so sort of stay out of the sun, stay out of the sun, that a lot of us are sort of low in vitamin D and vitamin D is obviously very important for bone development. So osteoporosis is a tricky one, because it's actually tied into a whole lot of things.
23:39
but essentially the resistance exercises is more than the exercise because it's the everyday, what are you doing sort of thing, right? So if you look at a lot of places around the world, they do better because it's not so car centric. Like you go to certain cities and everywhere you go, you walk, you know, I remember in Italy, there's this, you know, you just
24:04
One, you're just walking everywhere. And two, there's hills everywhere, right? So you're always walking up and downstairs. And again, you're putting more stress because let's say even when you're going downhill or downstairs, you're putting a little extra jolt against your bones, which is going to make it stronger. So it's fine to get that extra 30 minutes, three times a week of your exercise. But it's like, what are you doing?
24:28
10 hours a day? Are you walking everywhere? That's what's going to make a difference in the long term. It's not that it's so much of a difference, but a little difference over a long period of time can still be a big difference. So osteoporosis is tough, but it's definitely something that increased stress on the bone is probably the most important.
24:47
How do you feel about K2, specifically D3 and K2 supplementation? K2 is probably much more important than we thought. It's one of these vitamins that lately has been, people are recognizing how important K2 is. So vitamin D and K2, I see it together a lot now too. So people will take it in the same pill almost. So it is worth taking those vitamins.
25:10
if you want, but getting out in the sun is probably as good as anything too. You know, it is the new smoking they say. So yeah, get out and, you know, walk a little bit throughout the day. Yeah. And this person, the other Dexa question is that she's finally gotten to her goal or 25% body fat. She's no longer type two diabetic. She has reversed her non-alcoholic fatty liver disease, but she wants to get that final 5% off and,
25:37
What fasting regime would you suggest for getting to that last weight loss stage?
25:43
Again, everything works differently for different people. So I don't know that there's a best. I think you have to try them and then see what really works well for yourself. It's no different. Like some people like to eat lamb and some people don't. Some people love tofu and some people don't. Some people love eggplant. Some people doesn't mean one's right and one's wrong, right? So if you find that one meal a day works really well, fits into your schedule, fits
26:12
easy for you to do. Other people find it really difficult. So it's not that that's the best for everybody, but it's the, it'll be the best for you. So I would try the regular ones, but then the ones that people haven't tried as much are the longer fast. Lately, I've found them more useful. These longer fasts, three to five days,
26:34
but not a full fast, like with a little bit of vegetables or something, because I find for myself anyway, that it winds up dominating my thoughts by day three and day four. It's like, all I'm thinking about is, oh, this is what I'm going to eat when I eat that, not the physical hunger. There actually is almost no physical hunger. I never feel the physical hunger at day three, day four, but I feel the sort of, oh, I should do this. And I don't know if it's because you get exposed to it so much because you drive on the highway, you see
27:02
signs, you see the McDonald's, you see the Tim Hortons at the hospital, it's just in your face all the time. So that's why I actually think that those ones are actually I find very useful these days. Whereas before I used to do a lot more of the 24 hour fast. So it may change over time, too.
27:21
So that's why I switched over to doing, you know, I still do the 24 hour fast, but now I'd have these sort of longer fasts. And that's not something everybody's done before. And it might be useful to have a coach. And this is where the community is helpful because they say, well, this is what I found useful for me. It doesn't mean it'll be helpful for you. It means you can try it and then decide for yourself, hey, this was fantastic. Or this one really was hard. I don't think I can do it.
27:49
And it's okay. You're only responsible for yourself. But it doesn't mean that just because it didn't work for you and it worked for me, it doesn't mean that
27:58
I'm right or wrong. No, it just means that you have to have some acknowledgement that, hey, this is what I tried. And this was what works best for me. Some people don't like fasting at all. And it's okay. If you don't like the fasting, you can always change your diet to sort of natural foods or low carb foods. It works just fine. I think that it is useful adjunct for a lot of different things. So that's why.
28:20
As fast as the one you can do. Right. And learning all of this, the art of the pivot, you know, do you need to pivot up? Do you need to pivot down? Learning to trust your body again, all of this, this is all the things we teach, right? Right.
28:34
All right. So thank you, Dr. Fung. I am going to go over some of the questions that were repeat questions and tell people where they can find the answers on previous podcasts and articles. We get a lot of questions about calories, calories, calories, calories. The best resources that you can go look at is if you look under resources on our website, all right, and go to the drop down menu and you'll see Dr. Fung's medium articles.
29:03
The Overfeeding Paradox, The Body Fat Thermostat, Part 6 is one of those articles that you can read about calories. And also another one of his medium articles is What Ozempic, Wegovy, Manjaro teaches us about weight loss. It's about controlling hunger, not calories. That's the title.
29:28
Another one that you could look up that's not on our website, but is by Dr. Ben Bickman, who Dr. Fung highly respects. His article is Four Reasons Calorie Counting Doesn't Work. It's an excellent article. Also, some people asked about kidney stones.
29:47
You will find answers to that on podcast 189. Another one sent in the questions about the American Heart Association podcast.
29:58
that was blasting fasting and how dangerous it was and increased your risk of heart attack and heart issues. Dr. Fung did a rebuttal article to that. You can find that under the Medium article also. Please remember that it was a poster presentation. It was not a research article. It was also a questionnaire type of data gathering, which is the most inaccurate. It was over an 18-year period, and
30:27
And people did not consider having a coffee and a croissant in the morning as a meal. They considered that as still part of fasting. And nobody was intentionally fasting on that poster presentation. We have a bunch of information on that on various threads over in the community forum.
30:49
Somebody also asked about protein, the amount of protein. Dr. Fung, again, referenced that on the last podcast of his, which was number 189. And then somebody also was asking about at-home hemoglobin A1C testing devices. There are several that are out there.
31:12
I personally like P as in Peter, T as in Tom, S as in Sam, ptsdiagnostics.com. I have no kickback on that or anything. There are several that are out there. That's just the ones that we used in the hospital. I would watch the instruction video several times if you're going to do this at home because it is a little complicated about doing the quality assurance and stuff on it.
31:38
They are reasonably accurate. They are required by FDA to be within 68% of what a lab value would be. So you have the convenience of doing it at home. It usually takes about five minutes. The more of them you buy, the less expensive they are. So you can buy packs of one, three, all the way up to 12, I believe. All right.
32:02
I did it one year while I did a trailing hemoglobin A1c. In other words, I tested it every month instead of waiting three months. Because remember, a hemoglobin A1c is the amount of glycation, the amount of sugar attached to red blood cell over a three-month period.
32:21
And I did one every month just to see if what I was doing, my lifestyle was changing. So it can be very effective to help track those. But again, they are more expensive. You could be paying about anywhere between 50 to 75 if you were working
32:38
purchasing it individually whereas if you bought it in a pack and maybe did your family members or I did my friends and family and I bought a big pack and so then I was more around $12 on those all right insurance may not cover your home testing equipment for this so I would ask but again pay careful attention to the techniques and instructions on that
Edit:2025.03.28