#78 – Debunking Intermittent Fasting Myths, How to Do a 5 Day Fast, How Many Supplements is TOO MUCH?? w/ Megan Ramos – IDM Program Director

Show Notes:

Today’s guest is president of the Intensive Dietary Management Program, which she founded with her partner Dr. Jason Fung, who I am sure you are all familiar with.  She coaches clients all over the world, teaching them the principles that allowed her to lose 60 pounds herself and maintain that healthy lifestyle. It’s such an honor to have her on the show today, please welcome Megan Ramos!

Video Version: https://youtu.be/c9W1EHdiaVc

Megan's Website: https://idmprogram.com/

STARTER QUESTIONS:

Tell us a little about your health journey? through all of my interviews, I have found a common theme that most people have a huge personal “Why” for what they do.

How did IDM come to be? From what I understand, it started small and has just BLOWN up!

You guys offer a great community, both on Facebook, and Live Q and As and different forums, as well as individualized coaching. Can you tell us more about everything that IDM offers?

I know that personally, you tend to follow the Ketogenic diet for the most part, with a few cheats here and there. I don’t follow the Keto diet, but it seems like there are a lot of Intermittent Fasting fans out there who also eat Ketogenic. How do these two go hand in hand? People ask me all the time if you can be in Ketosis without eating Keto.

A question that I like to ask every guest, is what is a day in the life of Megan like? Can you tell us what you eat from the time you wake up until you go to bed at night? What hours do you eat and fast, etc? Take yesterday for example.

Today, I want to do something a little different. Our podcast started out talking about Intermittent Fasting, and it is really the backbone of the show, though we have guests that come on and talk about all kinds of things like Thyroids, Hormones, Gut Health, etc. But today I really want to get back to the basics of Intermittent Fasting and have you debunk 5 of the Most Common Intermittent Fasting Myths that we hear all the time. So I’m going to share the myths, and you will respond to them. Ready?

MYTHS:

Myth #1- 25:50 - Intermittent fasting will cause my metabolism to slow down because my body will think it’s starving.

Myth #2- 28:20 - Intermittent fasting is bad for my blood sugar. If I don’t eat sugar every couple hours, I will see my blood sugar drop and I will pass out and feel week.

Myth #3- 30:10 - When I am following Intermittent fasting, I can eat whatever I want and as much as I want, as long as it is in my eating window.

Myth #4- 31:36 - It is not safe to workout while Intermittent fasting. I need to eat carbs and sugar before working out.

 

Listener Questions:

Q1 - 40:04

I was listening to a doctor on another podcast recently who mentioned that he does Intermittent Fasting for half of the year, every year, from January-June. He did not really give his reasoning why but said he had been doing this for many years. This was the first I heard of a regimen like this, and I am assuming since he was a Dr that there was some reason for it. Do you know of any benefits to intense Intermittent Fasting for a short portion of the year, and “normal” eating for the rest of the year?

  • Joyce in Colorado

Q2 - 43:00

I love your show but I feel like I’ve listened to different people, and different people recommend different supplements and I love all the different people, but I keep adding different supplements every time I listen to a new show. I’m up to 14 different ones and I think this is too much and out of control with too many supplements. How many is too many, and is there 1 that I should be taking for sure, and how can I dial this number down.

  • Judy Calgary

Q3 - 50:04

I have been doing the Keto diet for the past couple months, and since then I have joined several Facebook groups of people who are doing the same. I have noticed several comments when people are talking about a specific food item or recipe, where they will say “Such and such is low carb, but it’s not keto”, or some people will refer to their personal diets like low carb but not keto. Can you explain the difference in the low carb diet and the Keto Diet?

-Tarryn in Bedford

Q4 - 53:06

I have been consistent with Intermittent Fasting for 3 months now, and I can’t believe the results I am seeing! Not only in my weight loss, but with my mental clarity and energy. 6 days a week, I eat in a 6-hour window, typically from noon to 6 pm. The only exception to my eating window is my morning coffee. I have found some flavored Keurig cups that don’t appear to have any calories or sugar, but the ingredients say: “Coffee and other natural flavors”. I am not someone who likes to ask questions that I can easily find on Google, but I have literally spent hours trying to find an answer for this online, and haven’t come to any conclusions! It’s not just one Keurig cup brand either, I notice a trend in these “other natural flavors” with no explanation. Will these flavors break my fast, and hurt my weight loss, even if they appear to be calorie free?

  • Jenna in Connecticut

Q5 - 54:47

I recently started working out with a new trainer, who is insistent that I eat 4-5 small meals a day. I try to explain to him that this way of thinking is extremely old school, that our body doesn’t need to eat all day long, but the problem is that he is in shape and the expert, and I am someone with a lot of weight left to lose. From everything I’ve learned from this podcast and in your book, I truly believe I shouldn’t be feeding my body all day long, and that I need to give it time to rest and digest! Not only that, but I don’t have time to be prepping and shopping and eating that many meals each day. How should I explain this to him in a way that he will respect and accept? I want his help with my workouts but simply don’t agree with this way of thinking.

  • Heather in Virginia

Q6 - 58:08

If I want to do a longer fast, let’s say 5 full days. There’s no way I can do it without green juice, lemon in my water, or cream in my coffee. Are you ok with this?

  • Judy in San Diego

Transcription:

Hey, guys. Welcome to this week's episode. Today's guest is the president of the Intensive Dietary Management Program, which she founded with her partner, Dr. Jason Fung, who I'm sure that you're all familiar with. She coaches clients all over the world, teaching them principles that allowed her, herself, to lose 60 pounds and to maintain a healthy lifestyle. It's such an honor to have her on the show. Please welcome Megan Ramos. Oh, I'm sorry. Megan Ramos. Is that, right?

Thanks, Chantel.

[crosstalk 00:00:34].

That's correct. Thank you and thank you for having me on. That's true. I did lose 60 pounds, but then I lost another 26.

Oh, wow.

My initial weight loss goal was 60, so I was super pumped about that, but then just keep continuing to adopt this into a healthy lifestyle, I lost another 26 pounds beyond my goal. I didn't realize I had such a poor body composition. Even after losing 60 pounds and hitting 120 pounds on the scale, I was like oh, I should be feeling great and I didn't, but continuing with this lifestyle, I lost another 26 pounds of body fat. I have put on muscle mass, so I don't weigh like 80 pounds. I have [crosstalk 00:01:25].

How much do you weigh now?

Currently, 112 pounds.

112? Yeah, you look very thin.

Yeah, so I lost more body fat. Yeah, I actually got below 100 as I was losing body fat and like okay, I've got to take my scrawny butt to the gym and start doing some weight training and incorporate more good fats into my diet. I actually have a better body composition and less body fat at 112 pounds than I did at 97 pounds.

Wow. How tall are you, Megan?

I'm five feet tall, 5'1" is what I tell people.

But you're probably really only five foot, right?

Yeah.

Your like five foot and a half. I know. That's what they say. I used to tell people I'm 5'4-1/2", but I'm probably more like 5'4-1/4" barely and then I'll poof my hair up a little bit to make it a little bit taller. Right?

I've done that.

Well, tell us a little bit more about your personal health journey and what's your why for why you do what you do?

Yeah, absolutely. Looking back at my health, I was always obnoxiously skinny until I was about 25, but I wasn't healthy. Going back to the importance of body composition, I was very fat on the inside, so I looked like a twig, but my organs were full of fat. I was diagnosed with fatty liver disease when I was 12 and polycystic ovarian syndrome when I was 14. Most people-

Talk about that fatty liver because what are some of the causes? Oh, I know. I wanted to ask you before we get in, so how did you and Dr. Jason Fung meet?

Oh, yeah. When I was 14 years old, I was interested in doing medical research and one of my dad's good friends was the director of the largest kidney clinic in North America, kidney clinic, so a nephrology clinic. Nephrology is the study of kidney disease, so in his clinic, he saw people with early kidney disease, more severe kidney disease, and even to the point where they've had transplants or they're getting ready for a transplant or they're on dialysis. When someone's kidneys fail, they have to get connected to a machine about three or four times a week for four to six hours at a time to filter their blood because kidneys' main job is to filter the blood and keep the good stuff in and let the bad stuff go out, so a machine would do that.

He had this really big clinic and I was interested in studying kidney disease because I had a family history of it. This doctor, his kids were interested in studying law, so for the summer, our parents switched. His kinds went to my dad's law practice and I went to his medical practice and I got assigned to a bunch of research projects that summer. One of the nephrologists, so one of the kidney doctors that I was working with Dr. Fung. Jason was a brand new nephrologist, just fresh out of his nephrology fellowship. He had just joined the group and had to complete some research projects. Felt like going back like I was a toddler back then, so we met when I was 14. I'm 34. I'm going to be 35 this year. We've been working together for just over 20 years now.

That is awesome. That is so awesome. Just so you know a little bit of background, when I first found out about intermittent fasting, my trainer at the time, Chris [Sikes 00:05:07], was the one who told me about it. He told me, he was like, "What I want you to do is go online and I want you to Google Dr. Jason Fung and I want you to watch his videos on intermittent fasting." I want you to make sure he listens to this episode and tell him that I feel very indebted because I think I definitely watched like four or five videos on intermittent fasting and he was the first person. My trainer Chris Sikes told me about it and then I watched those videos with Dr. Jason Fung and that's how I got into intermittent fasting. I loved it so much and lost weight and so that's when I wrote my own personal journey about it.

That's awesome.

Yeah. Anyway, I'm sorry. Go back to what you were saying. You said you were diagnosed with fatty liver, right?

Yes. Fatty liver disease is sort of the precursor to diabetes and actually, at 12, got my fatty liver disease probably because I drank like four liters of apple juice a day for 12 years. I loved apple juice. My parents thought it was good for me and they didn't think of the fruit being sugar or juice being sugar and fructose is one of the biggest culprits of fatty liver disease. I drank all this juice and it made my liver really fat. Even though my arms were skinny, my legs were skinny, I had no belly, my liver became fat. Because my doctor considered me to be underweight, she was really confused as to why I had these diseases of obesity because back then, they only saw fatty liver disease in people who were obese and generally a lot older than I was, so they kept an eye on it.

How much apple juice were you drinking?

Probably about four liters a day of apple juice, so that's close to a gallon for American friends listening, but I did that from the time I was about two.

Where do you live? Where do you live?

We're in Toronto, Canada.

Okay. Okay. Both of you are. That's where Dr. Jason Fung is, as well, right?

Yeah. We're about 20 minutes away from each other.

Awesome. How far are you from Virginia Beach? I live in Virginia Beach? Just curious.

I have no idea. Probably an hour-and-a-half plane ride, I suspect. It's not too far.

No, that's not too bad. Okay. Keep going about the fat. You said you were diagnosed with fatty liver. Was it prediabetes?

Well, usually fatty liver, most people with prediabetes have fatty liver disease. My doctors just decided to keep checking in on it every year, but because I was so skinny, they didn't really think anything of it. I just remember one day my doctor told my mom, "She'll probably grow out of it because it doesn't make sense because she's so underweight," but I had these fatty organs.

When I got older, I was doing research in nephrology, obviously, since a young age and I got really disheartening. The reason why I wanted to be a researcher was to make medical breakthroughs and to help people and I realized with diabetic kidney disease, which was what I was studying, that unless you can make the diabetes better, you couldn't make the kidneys better. They always tell you that diabetes is a chronic, progressive illness, so it was really, really frustrating and I got frustrated in my mid-20s. I was like okay, I can't do this for a job anymore. All I'm doing is watching people die and I'm never going to be able to help them because you can't get rid of the diabetes, so I said well, at least try to help yourself. You're young, so try to change your diet and get a personal trainer and see a fancy dietitian, so I did all those things and within a year and a half, I had gained almost 100 pounds.

[inaudible 00:09:13] looking back in my youth, I wasn't visually obese, but I fasted all the time. I loathed eating breakfast in the morning. It was a big fight between me and my parents. It definitely never happened when I was in university. In university, too, even though I was surviving off of pizza and other fast food, in hindsight, I was fasting all the time because I would go for days sometimes without eating, so I was able to maintain my weight, but I was still sick from what I ate.

Then I started changing my diet, following the Canadian Food Guide, which is the same thing as the US Food Guide. I gained an incredible amount of weight, so this is with a dietitian guiding me, telling me I'm doing everything right. This is working out with a personal trainer three or four times a week and I gained that much weight. It was not muscle mass and for the first time in my life, I became just visually obese and overweight according to the body mass index. Along with that came the diagnosis of diabetes.

Personally, I was frustrated with my career choice and that's what drove me to try to take control of my health, which was a disaster, but Jason was also disgruntled with his career choice, too, because he wanted to be a doctor to make people better and he wasn't able to help his diabetic kidney patients. He started thinking outside the box. Well, okay, I can't fix the kidneys unless I can fix the diabetes and, well, why is diabetes such a huge epidemic these days when it wasn't a hundred years ago? Yes, diabetes was around a hundred years ago, but why was it not as prevalent as it is today? Why do you see these big gaps?

This was something that bothered him particularly about my case. My grandmother and my father both had diabetes. My father's mom was diagnosed, but she wasn't diagnosed until she was 75. My father was around 55. I was like 27 when I was formally diagnosed with diabetes, so why the big gaps in time? Why did my grandmother get an extra 20 years on my dad and 50 years on me of living a healthy life without diabetes? Why was I diagnosed so young compared to both of them? What goes back? What changed, happened? How did I grow up eating that wasn't different from my grandmother?

Well, my grandmother never snacked and she often fasted for religious reasons because she was Catholic and Lent used to be like 40 days of fasting and there was fasting on Fridays throughout the year. I didn't grow up in a particularly religious household. There was no fasting. We snacked all of the time. I went to school with like a huge box full of food so my mother wouldn't worry about me going hungry at any given point throughout the day.

My family has a song. You know that song all I do is win, win, win no matter what? Do you know that song? Do you guys have that in Canada? Well, my family ... I don't snack like this anymore, but they used to say all I do is snack, snack, snack no matter what because I'd always be like, "Okay. Do you want a snack? Do you want a snack? Do you want a snack? Do you want a snack?" It was out of control.

It was totally out of control. My grandmother was the first one to point it out. She's like, "You know, we totally changed our diets." She said, "And I went from eating real food to not real food, like I went from eating butter to eating margarine and who the hell knows where that margarine actually comes from." For a woman who was in her 70s with dementia, she had a really good handle on this.

Toronto is the most multiculturally diverse city in the entire world and over 50% of the population wasn't born in Canada and we have so many people that fast for religious reasons, particularly Ramadan. This is something that really sparked Jason to think about fasting as a therapeutic treatment because we see all these patients go through Ramadan, lose weight, come off their blood pressure meds, get improved diabetes, come off diabetic medications. Then they go back to eating after 30 days and their weight go up, their blood pressure, blood sugars again.

Jason also grew up in a or I didn't grow up in a religious family. Jason grew up in a religious family and he'd always heard about fasting for spirituality, but what about the therapeutic side? Was there more to it? Now, if every major religion in the world incorporates fasting, there's got to be more to it than connection with oneself and the environment and with each other, so he started doing research into fasting in religion and particularly looking for therapeutic properties or reports over the centuries.

It was interesting and for me, I was struggling to go low carb because I knew low carb was a great way of eating, but I grew up eating the worst food, with two busy parents, one really sick parent. My mom one year was in the hospital for the entire year, so I lived off of pizza, Chinese food, McDonald's growing up, so it was I didn't know how to cook, either. My parents were too busy and there wasn't like a mom at home cooking that I could learn from all the time. She was sick or she was busy, so it was tough trying to change my diet. I was a carbohydrate addict.

Now, you are tending to follow more of a ketogenic diet for the most part with a few cheats or-

Yeah.

Now, I don't follow a ketogenic diet, but it seems like there's a lot of intermittent fasting fans out there who also eat a ketogenic diet, so talk to people. How do these two go hand-in-hand? People ask me all the time can you be in ketosis without eating keto? Can you talk about that?

Yeah, you can be in ketosis without eating keto if you fast enough because ketosis means fat burning and fat fueling. You might not be eating a perfectly strict ketogenic diet. Actually, through my entire weight loss, I was just working on improving my diet, but I wasn't on a strict keto diet. Fasting enabled me to be in a state of ketosis enough to lose almost a hundred pounds at the end of the day, so you can absolutely be in ketosis without being so rigid with a diet. You would just have to fast more.

How fasting and keto go hand-in-hand is that we know insulin is a problem. Our previous diets, your overall insulin is very high, to a level of toxicity within the body. That toxicity has created a condition called insulin resistance within our bodies. Following a ketogenic diet prevents your body from producing too much insulin and too much of anything that's good for us is bad for us in excess. Just because insulin is good if our bodies produce insulin, if our bodies don't, then we have type 1 diabetes and that's potentially life threatening. Having our bodies produce too much insulin is also a really bad thing.

It's about having the right level within the body for it to function properly, so eating a ketogenic diet prevents those levels from going too high, the insulin level from going too high, which is great. You're not adding any unnecessary insulin into your system. Your body will produce insulin in response to what you eat and it produces the most insulin in response to consumption of carbohydrates. Depending on how sick you are, it does the same thing with protein, but it produces very, very little insulin in response to dietary fat. It's almost negligible.

When you eat a diet that's high in fat, moderate protein, and low in carbs like a ketogenic diet, then your body's really not adding any unnecessary insulin to the system. It's very minimal what it adds, so that's great at keeping your levels in a healthy range. A lot of us have gotten to the point where we have damage from having high levels of insulin for a long time and just eating ketogenically does not always fix that damage in everybody. In people with mild damage, it solves the problem. You don't have to do any fasting or be extreme. A lot of people think that they need to fast for seven days. That's not true, so you don't have to be extreme. There are some people that do have damage. They've developed metabolic syndrome, for example, or they've put on an extreme amount of weight and really can't get it off very easily at all.

A lot of people come to my program with Jason when they have been keto, like really strict keto, and it's still not enough. They've made some progress, but they haven't gotten there. That's because their body has left over damage that was a result of these high insulin levels. The fasting actually fixed that damage, so this is where the keto diet can go hand-in-hand with the fasting. The keto diet prevents the problem from accelerating and prevents the problem from coming back, but it's the fasting that can actually fix the problem in people with insulin resistance or more severe insulin resistance. For someone who's 24 and you gained 20 pounds in university and is otherwise healthy, probably just doing a ketogenic diet and cutting out snacking would be good enough to get them to a healthy place.

A question that I like to ask every guest is what is a day in the life of Megan like when it comes to your eating? Can you tell us from the time that you wake up and the time that you go to bed, what hours do you eat? What hours do you fast? What are you eating inside those eating windows? Let's talk about yesterday, for example.

Yesterday was a bit of a not normal day because we had some snow. We had a snowstorm and our schedule didn't go as planned. I guess today would be a more normal day.

Tell us yesterday. Still tell us yesterday, even though it was normal.

Yesterday, we didn't get to go grocery shopping, so we had very little food in the house and it was an eating day, so we wake up and we work out every morning. We either hit the gym or, if it's not a gym day-

You hit the gym in the fasted state?

Yeah, always, so usually about 16 or 18 hours fasted. Yesterday, we had some bacon. We were out of eggs or we would've had eggs.

What time did you start eating yesterday?

We woke up at 4:30 and our first meal was at 8:30.

Okay.

So we were up for four hours before we ate.

Okay. Then when did you end your eating window yesterday?

We usually eat within about half an hour, so it was more of a I had a bacon, avocado, and MCT oil and typically, I would've had a couple of eggs, too. We just didn't have any. Then later on in the afternoon, around 2:00, again we eat within about half an hour, 45 minutes. It's how long our eating window is. I had a small steak, about four ounces of steak and four ounces of salmon. We had some broccoli and I had a salad with avocado oil on it.

Okay. Then did you eat dinner?

No, we didn't. On my eating days, I just eat twice. I always try to have my second meal before 4 p.m. and that's it, so just breakfast [crosstalk 00:21:14].

So your eating window is usually from like 8:30 to 2:30?

Usually. Saturday nights is usually the only exception and sometimes on Sundays, but Monday through Friday, that's what do we do.

You like to eat in a six-hour eating window?

That's correct.

Me too. Me too. What's funny is I actually, my eating window that I like to eat in is usually 12:00 to 6:00 or 1:00 to 7:00. Sometimes I'll do 11:00 to 5:00. Lately, I feel like I've been doing 11:00 to 5:00 just because by 11:00 I'm starving because I wake up really early and work out in a fasted state, so by 11:00, I'm usually like okay, I'm ready to eat. Today, I was so hungry this morning. I woke up at 4:00, was at the gym at 5:00, and was done at 6:00, but by 7:30 I was really hungry. I was like I'm making today I'm going to have breakfast and lunch and then I'm not going to eat dinner tonight, so that's funny that I did that. I don't normally do that.

You said you do normally 8:30 to 2:30, six-hour window, and then you on Saturday nights, you will make an exception and eat dinner. What does your eating window look like on Saturdays?

Usually we sleep in a little bit, so we don't eat our first meal until around 10:30 or 11:00. We're old people now, so we usually eat [crosstalk 00:22:45].

Yeah, you're so old. What did you say, you're 35?

If it's just my husband and I, we usually go at between 5:00 and 6:00 we'll go out for dinner to a restaurant in the area. If we go out with friends, they don't like to go out as early, so I usually try to ask for 6:30 or 7:00 and just let them know that we wake up really early because we do and we're more productive in the morning, so why not just roll with your body chemistry and physiology and wake up early, so usually 6:30 or 7:00.

Yeah, well, we would be in perfect ... I would hang out with you all the time if you lived closer because that's exactly when I like to eat. My friends joke with me all the time because sometimes like at 4:45 in the afternoon they'll call me and they'll say, "What are you doing?" I'm like, "Oh, I just finished dinner," which that's not normal for around here. I want to really talk, dive in deep about intermittent fasting because it's the backbone of our show and we have all kinds of guests that come in. We talk about thyroids and hormones and gut health, but today, I want to really get back to the basics of intermittent fasting. I want you to debunk five of the most common intermittent fasting myths that we hear all the time. Myth number one is intermittent fasting will cause my metabolism to slow down because my body will think that it's starving.

That's not true because if you have excess body fat on you, all excess body fat is is stored fuel for your system. You're not going to get into starvation mode unless you have no excess fat to fuel on, so a lot of us aren't malnourished, especially here in North America. We tend to be a little over nourished, so all your extra body fat is plenty of fat to fuel on. I fast professional athlete who are like 7% body fat and they still have extra fat to fuel on, so you're not going to get into starvation mode. You're not malnourished before entering a fast, so your fasting is not going to malnourish you in that sense.

Also, when you fast, your body produces counterregulatory hormones as part of a stress response to being in a fasted state and a lot of these counterregulatory hormones work in your favor. One of them is noradrenaline, which causes the body to produce quite a lot of adrenaline and adrenaline actually increases your metabolic rate. There's a lot of great research out there that's come out since 2016 that's compared caloric restriction versus alternate daily fasting. It was one particular study and they assessed two groups, two populations, one that did calorie restriction and one that did alternate daily fasting. The alternate daily fasting group virtually had no change, no clinically significant reduction in metabolic rate, but the calorie restriction group saw clinically significant reduction in metabolic rate. That was a randomized controlled study, which is the gold standard of all medical research, so it is very different.

You wouldn't fast someone who is definitely in a malnourished state who had no body fat, but your body fat is just extra fuel that you didn't burn because you fueled your body with more food and more food and more food energy. If you've got extra body fat, it's pretty safe for you to fast and those counterregulatory hormones, noradrenaline, and the production of adrenaline is going to keep your metabolism intact.

Okay. Great. Myth number two intermittent fasting is bad for my blood sugar. If I don't eat sugar every couple hours or eat something, I will see my blood sugar drop and I will pass out and feel weak.

If you eat sugar, you cause your body to produce a lot of insulin. Then your insulin's job is to help metabolize that sugar that you have, so you eat a lot of sugar and your sugar spikes and your insulin spikes. Then the insulin has to get rid of the sugar from the blood, which drops your blood sugar levels back down low. The easiest way to avoid those highs and lows is to cut out the sugar so you get nice, stable blood sugar levels across the board. If you're someone who's experiencing this now, you probably want to cut out the sugar for a few days before you try to fast.

It's not just sugar. It's also those carbs, too, or anything that you eat, really. Not anything if you have fat, but if you had even a sandwich that had bread and turkey and whatever, your insulin is going to come into effect, so it's not just sugar. When people think sugar, a lot of times they think a cookie or candy or stuff like that.

Yeah, absolutely, so potatoes, rice, pasta, bread, corn, all of that has exact same effect. They're all carbohydrates. They're all glucose and glucose is a sugar, so carbohydrate starches are just long chains of sugar molecules linked together. When you're fasting, you force your body to normalize and having these periods of highs and lows is a result of the carbohydrates, so the sugar that you consume.

Awesome. Myth number three, when I'm following intermittent fasting, I can eat whatever I want, as much as I want, as long as it's in my eating window. Can you respond to that?

Isn't always the case with every individual. We do have some people who don't eat very well when they do eat, but they can essentially out fast their bad diet. They're still eating really poor stuff. The fasting will help keep control of the insulin levels, but it can't fix the damage that that bad food has to your body, so it's not always the case. There are very few people that have metabolic syndrome that can really eat anything other than a ketogenic diet. Even with lots of fasting, they can't out fast even a good diet, let alone a bad diet. They need to be on a strict ketogenic diet in order to make progress and as they get healthier, they can follow a more liberal low carb diet and maintain good health. That's not the case the bad fats, the bad sugars in these foods, especially fructose and high fructose corn syrup are just terrible, so you can still cause a lot of disease. There are very few people that can out fast a poor diet. Just like you can't out exercise a poor diet, you can't out fast a poor diet either.

Awesome. Myth number four, it's not safe to work out while intermittent fasting. I need to eat before working out.

That's not true at all. I just wrote a blog post about this the other week that you can find on our website. Your body needs electrolytes and hydration before you fast, so you don't need to get the hydration and electrolytes from food. You could have a cup of broth. You could have a glass of water with a pinch of salt in it. All your body needs is the hydration. What you're getting from the food is the water from the food. Food has water in it. Natural foods have a tremendous amount of sodium in them, too, like broccoli's got an incredible amount of sodium it it, so you don't think of these things, but food has those electrolytes. An avocado has got so much potassium in it, more so than a banana or two bananas. That's where the benefit comes from. You could have bone broth. You could have, again, water with some salt. You could have some pickle juice. That's what you need for a successful workout.

Most patients, like I've worked with over 8000 people across the world doing this and I work with a lot of professional athletes, some who will train very intensively in mixed martial arts and do a five-day water fast. They're drinking water. Instead of eating food for their water, they're actually drinking water and they're adding salt to that water rather than getting the salt from the food and they're perfectly fine.

Yeah. Have you ever tried those Nuun, like N-U-U-N, those Nuun hydration electrolyte tablets that you can just stick into your bottle of water? Do you like those or is there a specific brand of electrolytes or do you say drink SmartWater? When you're talking about the electrolytes because I think those make a big difference, what's your favorite go to for the electrolytes?

We're really big in our program on real food and real in general and not really supplementing with anything. We'll encourage our patients to take Epsom salt baths. That's about as out there as we go, but literally, if you keep your sodium levels happy, your potassium and magnesium stay fine. Most of these electrolyte supplements on the market, they have too much potassium in them in order for you to get the right amount of sodium, so we just focus on the sodium in our program and make sure people take salt, so either bone broth or just salty water or pickle juice and that's good enough. A lot of these other things, too, have other sweeteners in them.

The best one on the market though and I'm not affiliated with this company in any way is Keto Chow has some fasting drops. They actually consulted us. We don't get a penny, but they wanted something that was good quality and that actual fasting experts would recommend. I'm not affiliated with them. I get no royalties or sponsorship fees from them. They were smart. They asked. They asked well, why don't you recommend any of these other ones and how could we make our brand different.

If you were going to supplement with something, I do like the fasting drops. What I like about them is that they were so wiling to make ones without potassium in it because potassium is very dangerous and people don't realize that. Too much of it's very dangerous. Too little of it's dangerous. There's always people out there that are telling me like, "Hey, Megan, I've got to eat like five bananas a day. Where else can I get my potassium from?" I'll say, "Well, what disease do you have that makes you have such low potassium levels?" They'll say, "None." I'll ask them, "Well, what is your potassium level?" They say, "I don't know." So why the heck are you seeking out potassium?

Well, let's talk about that because that's funny because honestly, I would say for me personally, if someone asked me for whatever reason, I think I have in my mind that I'm low in potassium and the reason why is because there's a couple things that if I'm not feeling well, like right now, let's say I just wasn't feeling well and someone said to me, "Chantel, you're not feeling good. What can I get you?" I'd say, "An avocado," and I would eat an avocado, which has tons of potassium and it would be a game changer. I'd feel so much better. Coconut water fresh from like a Thai coconut, which coconut water has a lot of potassium. For me, it was just one of those things that I was like anything that I was craving, like if I looked at what I was craving, it was always a potato or a avocado or a banana or coconut water. As soon as I would take one of those things, I would literally go from not feeling good to feeling almost like a new person. In my mind, I was like man, I must be low on potassium.

A lot of people get low in potassium because they're actually low in sodium. Your body will hold onto all of the sodium it's got and it will lose potassium. It will waste potassium because every time you go pee, you have to urinate out something. If your sodium levels get too low, your body starts wasting potassium and magnesium to hold onto that little bit of sodium that it has. I would definitely go get your potassium levels checked out because there are people who genuinely have low potassium levels and that's something that needs to be addressed. I think it's the electrolytes, probably sodium in most cases, where people aren't getting enough salt and then they become potassium and magnesium deficient as a result, whereas if they had just supplemented with salt in the first place, they wouldn't have become potassium and magnesium deficient.

Most people are really terrified of salt. They don't use enough of it when they cook. I went to a cooking class once and my husband said, "Why does restaurant food taste so much better than food that people make at home?" Said, "Because we use salt and we're not afraid to use salt in the kitchen." A lot of it goes back to salt. You are getting some sodium in avocados and other potassium-rich foods, as well. I wouldn't disagree that potassium definitely probably makes you feel better, but you're probably not getting enough sodium in the first place.

On the other hand, there are conditions that cause people to have very low potassium levels and it's always good to have your electrolytes tested by a doctor. My mother, I encouraged her to eat potassium-rich foods because she has one of those conditions. I don't. My potassium is actually slightly too high, so I eat potassium-rich foods, just not a whole bunch of them. It's really different for each individual.

Awesome. Back to these Keto Chow electrolyte drops. I just pulled it up online and it says on here concentrated sodium, magnesium, potassium, trace minerals from the Great Salt Lake. Are you saying that some of the Keto Chow electrolyte drops don't have any potassium in them?

Yes. You can special order them from the company. I know they'll be out for mainstream sale soon, but you can always have them special ordered from that [crosstalk 00:37:34].

Let me repeat back what I heard you say. My mom's a counselor, by the way, so I'm always like, "Now, what I heard you say is ..." That's what she always says. What I heard you say is is that you prefer people to take the electrolyte drops that don't have the potassium in it?

Unless your doctor tells you you need to get potassium and you check those drops with your doctor.

Tell us the reason one more time of why you prefer the one that doesn't have the potassium.

Yes, because if you don't know your potassium levels and you start taking way too much of it, you could develop a heart condition or have a heart attack or stroke.

Got you. All right. Let's jump right into the listener questions. This first one is Joyce in Colorado. She says, "I was listening to a doctor on another podcast recently who mentioned that he does intermittent fasting for half of the year every year from January to June. He didn't give his reasoning why, but he said he's been doing this for many years. This was the first time I've ever heard of a regimen like that and I'm assuming since he was a doctor there was some sort of reason for it. Do you know any benefits of this intense intermittent fasting for a short portion of the year and then normal eating for the rest of the year?" Joyce in Colorado.

Okay. I think everybody's different and we fit fasting into your lifestyle, so perhaps for that doctor, January to June is a more slower time of year for them. I know a lot of people that I work with that are Jewish. They have a lot of feasting from like September into the end of December, so they don't really do a whole lot of fasting at that time of year. Myself, I usually spend a lot of the summer traveling for work, which is great, but I go all over the world and I want to eat lamb in Amman, Jordan and I want to experience the local cultures in a low carb way, of course, so I want to eat, so I tend to not fast very much in June and July. By January, February, March, which are slow months, there's no work travel usually, and I'm at home, then it's really easy for me to fast.

I find this is very similar with patients that I work with depending on their cultures. In Toronto, we have all four seasons of the year and people tend to fast a lot in the fall and the winter, but not as much in the spring and the summer because in the months of springtime comes around, they want to go out. They want to meet up with friends and what do we do? We meet up with friends and we celebrate our communities around food. People tend to do a lot more fasting in the fall when kids are back to school and everyone is back to work and in the wintertime, as well, so I think it's just sort of a seasonal thing, what works with people's cultures or lifestyles. Again, I don't do too much fasting at all in July and August because of work travel, but I do a whole lot in November. I do a lot in January and February and March because that's what works for my schedule.

Awesome. All right. This next one is from Judy in Calgary, which I don't know where that is, but she said, "I love your show, but I feel like I have listened to different people and different people have recommended different supplements and I've loved all the different people you've had on the show, but I keep adding a new supplement every time I listen to a new show. Now I'm on 14 different supplements and I think this is too much. I feel like I'm getting out of control with too many supplements. How many is too many and is there one that I should be taking for sure and how can I dial this number down?" Judy in Calgary.

Well, I don't really know what your bloods are. Before we recommend any supplements to any patients, we check their lab results because I just don't know. Some people have Vitamin B deficiency, but sometimes people have Vitamin B levels that are way too high, like Vitamin B12 levels that are through the roof, so you wouldn't recommend a Vitamin B to them. Some people have magnesium deficiency, some don't. Most of North America has magnesium deficiency, but some don't.

It's taking the supplements right for you, so I'd go get your blood work done at your doctor's and have these things checked out that you are supplementing with. You can get zinc levels checked. You can get this checked or that checked. I once was convinced I had zinc deficiency, so I started taking zinc and I felt a hundred times worse. Then I got my zinc levels checked and they were really, really high, so they probably weren't high to start with. We really encourage our patients to just eat real food. Eat real food. Get your blood work done periodically, so we know what's going on. There's a place for supplementation and there isn't a place for supplementation. Here in Canada, it's sunny today, but we're not outside because it's cold, so we take Vitamin D. I don't take Vitamin D in the summer. Why? Because I'm outside all the time in the summer and I'm getting plenty of Vitamin D, so why would I supplement it and give myself too much?

Really thinking of things in perspective, I don't eat a whole lot of fish in my diet. No health reason, just personal preference, so I supplement with krill oil in my diet because I don't eat it. It's really specific. My husband, who eats lots of fish when I'm not around, he doesn't need krill oil because he's getting plenty of those nutrients from food.

How many supplements do you take per day total?

Right now, I take Vitamin D and Vitamin K2 and that's all that I take. I'm only taking Vitamin D because it's the wintertime.

Now, let's talk about the Vitamin K2 because this is a little bit of a controversial vitamin. Can you talk about that a little and can you talk about the bitters, the apricot bitters, the apricot seeds?

Yeah, so I don't know too much about apricot seeds or bitters. I was at a retreat and they were talking about bitters and that improving digestion, which is great, so I'm not an expert in that. I'm a fasting expert. In terms of sorry, what was the first thing? I guess [crosstalk 00:44:31].

Well, let's talk about Vitamin K2 because the things that have a lot of Vitamin K2 would be like egg yolks, cheese, dark chicken meat, butter, so if you're not eating a lot of cheese or eggs or chicken, dark chicken meat, those are things that are good in Vitamin K2.

Yeah. I only eat some of those foods. I don't eat all of those foods because I'm a notoriously picky eater and even when I do eat eggs, I'll have one of them at a time because I don't digest them very well and it's usually on the weekends more so than throughout the weekdays. For people who don't eat a whole lot of Vitamin K2, Vitamin K2, what it's supposed to be is like a transit director within the body, so making sure that your body utilizes the calcium that you intake properly, the magnesium supplements or the magnesium from the food that you take properly, and make sure that your body directs Vitamin D to the right places, so it's like a traffic controller.

A lot of people have these pulmonary calcifications, so the calcifications in their arteries and that leads to heart disease and it's life threatening. How did the calcium end up in those arteries in the first place? Well, Vitamin K2 is something that's supposed to direct calcium, like when it comes into your body, go to Megan's bones. Go to Megan's teeth. Make Megan strong. Go to where calcium is supposed to be. Don't get stuck in Megan's arteries. Vitamin K2 is this traffic controller for things like calcium and magnesium and Vitamin D to make sure that they're used efficiently by the body.

There's a lot of people, too, who have a hard time processing Vitamin D, so when you're exposed to it, you want to make sure that you utilize what you have very efficiently. K2 is this important traffic controller within the body, so you can get it from your diet and if you're not getting it from your diet as regularly, it's always great to supplement with it.

There's different kinds of Vitamin K2. It's MK-7 that you want to be looking for. Talk to your doctor about recommended dosages. Most people take somewhere between about 180 to 280 milligrams a day, but talk to your doctor. Make sure you don't have any conditions or any medications that say you can't take any Vitamin K-related items and make sure it's a great supplement for you because it can be great to make sure that those nutrients get to the right places.

Yeah. With the apricot kernels, basically what the debate is is that the apricot kernels they say is really good for cancer. There was a study done on this people called the Hunzas. They said that these Hunzas ate a lot of apricot kernels and so someone did this big study and said oh, these are so good for you and these apricot seeds have a lot of Vitamin B17 in it. It's kind of this controversial thing that says okay, well, these Hunzas ate massive quantities of apricot seeds and they never had cancer and that sort of thing. That's what made me think of it when we were talking about the vitamin.

Okay. We have two questions from the same person here. It looks like these are both from [Tarin 00:48:21] in Bedford or this one might be from anonymous. I can't tell if these are both from the same. Okay. Let me start with this one. This is from Tarin in Bedford. "I've been doing the keto diet for the past couple months and since then, I've joined several Facebook groups of people who are doing the same. I've noticed several comments when people are talking about a specific food item or recipe. Well, they say such and such is low carb, but it's not keto or some people refer to their personal diets as low carb, but not keto. Can you explain the difference in low carb and the keto diet?"

It's really different for everybody because there are some people that can eat like 20 grams of carbs and that kicks them out of ketosis and there are some people that are healthy enough metabolically that can eat 100 grams of carbohydrates and they can be in ketosis. It's really individual specific and I think that's where a lot of people are misguided online. What I can eat in a day in terms of carbohydrates and get ketones of three is very different as a healthy individual now than I could when I was an unhealthy individual. I can eat about 80 more grams of carbohydrates a day and get ketones of three than I could when I was sick. It really varies from individual to individual, so it's very specific.

We have different ranges. When people consume 20 grams of carbohydrates or less, we call that ketogenic, which means it's very extreme in the sense that it's very low in carbohydrates. Hey, that's what I had to do for a couple years, actually, in order to get great health. People who consume between about 50 and 20 grams of carbohydrates we call that moderate low carb and somewhere between about 50 to 70 grams of carbohydrates you call that liberal low carb. Over that, we typically call it higher carb diet or a high carb diet.

Again, it varies for individual. If I were to go out and eat 90 grams of carbs in french fries, I would get kicked out of ketosis. If I go eat 90 grams of carbs from cauliflower, broccoli, Brussels sprouts, avocados, olives, eggplant, I'm not going to get kicked out of ketosis. It's really carbohydrate specific. I think people are trying to label things, but it's really tough to label because we're all each so different. You're going to find that when you're sick, you can barely tolerate any carbohydrates, but as you get better and you heal, you can have great ketones and be in a great state of ketosis with more carbohydrates, just the right carbohydrates in the fibrous, non-starchy carbohydrates. You'll be able to tolerate those a lot better.

Awesome. All right. Jenna in Connecticut. "I've been consistent with intermittent fasting for three months now and I can't believe the results I'm seeing, not only with my weight loss, but with my mental clarity and energy. Six days a week I eat in a six-hour window. It's typically from 12:00 to 6:00. The only exception is my morning coffee. I found some flavored Keurig cups that don't appear to have any calories or sugar, but the coffee says coffee and other natural flavors. I'm not someone who likes to ask questions that I can easily find on Google, but I've literally spent hours finding the answer for this online and haven't come up with any conclusions. It's not just one Keurig brand cup brand either. I noticed this trend in other natural flavors with no explanation. Will these flavors break my fast and hurt my weight loss even if they appear to be calorie free?"

So for someone who doesn't drink coffee, no. A lot of my patients have Keurigs and natural flavors are well, who knows? It's actually really mind boggling what the FDA and Health Canada permit to be labeled as a natural flavor, so personally, I tend to stay away from waters that are naturally flavored, teas that have natural flavorings in them or coffees. That's my own personal preference because I don't know if they're truly natural or if they're very funky things. I have lots of patients who drink coffee with natural flavors, tea and water also with natural flavors and it doesn't seem to hinder or slow down their process in any way.

All right. Perfect. This is Heather in Virginia. "I recently started working out with a new trainer who's insistent that I eat four to five meals a day. I try to explain to him that his way of thinking is extremely old school and that our body doesn't need to eat all day long, but the problem is he is absolutely chiseled and in shape and he is the expert and I'm someone with a lot of weight left to lose. From everything I've learned from this podcast and your book, I truly believe I shouldn't be feeding my body all day long and that I need to give it time to rest and digest. Not only that, I don't have time to be prepping all these meals each day. How should I explain to him in a way that will be respectful and he will accept? I want this help with my workouts, but I simply don't agree with his way of thinking." Heather in Virginia.

I think she makes a good point because let's say she's ... I don't know how heavy she is, but let's say she's 60 pounds overweight and he's eating every couple hours and is chiseled as a rock. She's going to him going, "No, I don't think I should eat." I'm just trying to picture this. She's saying, "I don't think I should be eating every two hours," da, da, da, da, da. I bet he's responding by, "Not to be mean, but look at you and look at me. I'm as chiseled as can be with doing meal preps and eating every couple hours, so you should listen to me." I'm just guessing.

It's different because they obviously lead different lifestyles and they probably eat very different carbohydrates, too. Not that she's eating bad carbohydrates now, but she probably ate bad carbohydrates that got her to the place where she is at today, whereas this guy, his carbs are probably sweet potatoes and things that aren't as bad, not fructose or high fructose corn syrup, which is the biggest culprit, not lots of highly refined and processed foods. Also, she's probably not being fit 12 hours a day, seven days a week for her job and being completely active, so this guy is probably eating better quality carbs and he's moving nonstop all day long and he's probably very active in his personal life as it it, whereas most of us aren't.

My personal trainer, he's working out all day with people and himself and I go to the gym for an hour. Then I come home and I sit. I sit answering emails. I sit doing interviews. I sit writing books. Or I go to the clinic and I sit while I see patients. I'm not being active. I'm being extremely sedentary. I might walk my dog later today for 30 minutes. That's about it. A lot of us got sick from drinking the sodas with high fructose corn syrup and eating a lot of the processed junk food that was all sweetened with high fructose corn syrup. That causes damage in the body, so it takes a different approach to actually fix that damage and if we're not being as active as this guy is and chronically burning off everything that we're eating, we're never going to get there. That's the biggest difference.

Okay. Awesome. All right. This next one is from Judy in San Diego. "If I want to do a longer fast, let's say I want to do five full days, there's no way I can do it without having at least like some green juice with no fruit, lemon in my water, and cream in my coffee. Are you okay with this?"

Well, that's not really fasting because the green juice, not so much the lemon in your tea, but cream in the coffee, all that's going to cause insulin to be produced. If insulin is a fat-trapping hormone, you can't trap fat and lose fat at the same time. That's the bottom line. If you're producing fat-trapping hormone, you're not going to be losing body fat. Your body is going to actively be trying to store that body fat. It's a place to start. Everybody has to start somewhere with fasting. When I started, I drank a ton of broth, an insane amount of broth, but then I didn't eat anymore. My fasting muscle got stronger and I could fast without it and soon as I stopped it, I lost a lot more weight.

What is the longest that you've gone on a longer fast, like instead of just doing like a 18 hour, 24 hour, what's the longest amount of time you've gone?

11 days.

Did you do complete water fast, nothing else with it, or did you black coffee or anything like that?

I just did water for it, so flat, mineral, carbonated, boiling, cold. It has many different ways you could have water and I had salt and I would have Epsom salt baths daily.

How often do you do those longer fasts?

I typically do ... 11 days was sort of an off one to try. I do five to seven days about four times a year. I think of it as seasonal cleaning for my body and it's good if you do it while you do your seasonal cleaning because then you're busy and distracted when you're fasting.

Yeah. I agree. I think that ideally, the water fast is just so powerful, but if you, like you said, are building that muscle that you can still see tons of benefits by doing it with a green juice that has no fruit and just lemon in your water and broth. You're still going to get so many benefits by doing that, as well.

It's a starting place. If you think of fasting like a muscle, doing it with green juice is sort of like stretching. You're not going to build a lot of muscle mass or burn a whole lot of body fat, but it's something. You're getting moving. You're getting your system moving. When you get strong, like when stretching becomes easy, then you want to take it to the next level, so you always want to be challenging yourself. If you lose the challenge, then the less effective it's going to be.

Yeah. Awesome. Well, thank you so much for being on our show. I want you to talk to listeners about you guys offer a great community both on Facebook and live question and answers and different forums, as well as individualized coaching. Can you just talk about I guess you guys use IDM as your slogan for the Intensive Dietary Management Program, but tell us what IDM offers and where they can go to find out more about you and Dr. Fung.

Yeah, absolutely. You can go to the IDM website at www.idmprogram.com. There's a ton of information about our programs there. We have two main programs. We have a monthly membership subscription site and when you enroll in it, you can pick from your own program. It's a self-guided program. You'll have me giving you a weekly lesson and you can binge watch. You can do all the weeks at once, but there are 64 weeks, so there's a weekly lesson with a quiz and some actions to get you started. Then there's community support. There's a great forum. There's group fasts. There's daily Q&A's. There's a live meetup. We're having a live meetup later today at 4:00 with 90 of our members. I'll be organizing the event, so people can ask me their questions live. We offer continuing fasting education, so we talk about the latest and the greatest in the science behind fasting and nutrition. That people pay for monthly. It's $39 a month and you can cancel your membership at any time.

If you're someone who's been trying this and really struggling on their own and wants some more support or accountability, we have our personalized coaching program, where you get to work with one of our therapeutic fasting experts that myself and Jason have trained. They will coach you either one-on-one or in small group sessions to help you get personalized advice for you. They review your labs and offer you some dietary recommendations from your lab results, too, so they could guide you on potassium supplementation and magnesium supplementation and whatnot from the labs.

That's awesome. Well, Megan, thank you so much for being on here and I know that you have a little special for a few people about the monthly membership for their first three months. Talk about that.

Yeah, so if you'd like to try it out, you can enter in a coupon code that we'll pass along to Chantel and it will get you 50% off for your first three months in the program.

All right. We will put that on our Facebook page, so go to that and check that out. Well, thank you again and congratulations. You look absolutely amazing and congratulations on all your weight loss. You look beautiful.

Thank you, too, Chantel. Thanks for having me. Happy fasting. Bye.

All right. Bye. Have a good one. Thank you. Bye-bye.