Alcohol Effects On Liver 2

meredith: hello, everyone, and welcome tocellular healing tv. this is episode 112, and we have dr. pompa here, and we have avery special guest today, dr. jason fung. we’re going to talk about obesity, diabetes,fasting. dr. fung has a lot of expertise in these areas. before we jump into the conversation,i’m going to tell you a little bit about him.dr. jason fung earned his medical degree at the university of toronto, where he also completedhis internal medicine residency before heading to the university of california at los angelesfor his fellowship in nephrology. he currently practices as a kidney specialist in toronto.during the course of treating thousands of patients, it became clear to dr. fung thatthe epidemic of type 2 diabetes and obesity

was getting worse. the prevailing dietaryrecommendations to reduce dietary fat and calories were clearly ineffective.he founded the intensive dietary management program to provide a unique treatment focusfor type 2 diabetes and obesity. rather than focusing on medications, this clinic focuseson dietary changes that are simple, yet effective. in march, 2016 – just this month – greystonebooks will publish dr. fung’s first book, the obesity code, which explores the underlyinghormonal imbalance that leads to obesity and recommends effective strategies that addressthe root cause of weight gain. i know you and dr. pompa are really in alignment on alot of different areas. we’re so excited to have you on the show. welcome, dr. fung.dr. fung:thank you very much. thanks for having

me.dr. pompa:yeah, dr. fung, we’re grateful that you came on the show. our viewers arejust – they’re already educated about a lot of the things that you say, not thatit takes away from it by any means. it just excites me when i see a doctor who breaksout of the norm, so to speak, and ends up crossing into something that we both knowis the answer to a growing epidemic of why people can’t lose weight, why people havehormone challenges, diabetes, thyroid conditions. these conditions are costing our country,the world, greatly financially and taking people’s health, and yet we’re throwingmore medication at it. we’re throwing even the dietary changes that are recommended,low-fat, low-calorie diets. i love that in

your bio, that you said that frustrated you.between the medications and the low-fat, low-calorie diets, wasn’t the answer. with that said,how did you go from there – obviously, you had medical training, and that’s your background– to where you are now with believing what we believe?dr. fung:it’s actually quite a interesting journey because it – i went through medicalschool, and i went through specialist training. for the first about seven or eight years ofmy practice, i was just treating people the same as most doctors. weight loss was notsomething i thought about, really. i didn’t deal with it much. i told them to go see somebodyto exercise a little more, eat a little less, look at the food guide, or whatever, nationalfood recommendations.

it really was around the mid 2000s that thingsstarted to get interesting for me. what happened, of course, was that the atkins diet was verypopular somewhere around the 2000s. a lot of studies got launched just around that time,and they all got published somewhere around 2006 to 2008. they started appearing in thenew england journal of medicine, which is really the top medical journal in the world.what was really fascinating was that these diets were doing much better than our conventionalrecommended diets. the people who did these studies, a lot of them did them with the expectationthat these atkins dieters would do a lot worse, and here they were, doing much better, notjust in terms of weight loss, but in terms of their entire metabolic profile. that waswhen i started to think about nutrition a

lot because here’s a kind of very interestingparadox. as i started to look deeper and deeper intothis sort of thing, you realize that a lot of these kind of hand-me-down nutritionalbeliefs, they’re really just not true even from the very, very basics of what we knowlike calories in, calories out, which is something that we’re taught from kindergarten, almost.it’s all about calorie balance and all this kind of stuff. it’s just all wrong and justfascinating to me that we could get to this point where we are.dr. pompa:absolutely. dr. fung:one of the biggest diseases thatis affecting us, the entire premise of treatment is completely incorrect. that’s just unbelievablethat that could be the case. it’s actually

really interesting because if you look back,and i think that where we are comes from a kind of mistaken treatment paradigm. we’restuck in this 19th century paradigm, where infectious disease was the major – in the20th century, late 19th century, it was all infectious disease. that’s what’s killingpeople. we went through a period where we had theseantibiotics, and penicillin, and great medicines. infectious disease just really got treatedvery well. we got into this treatment paradigm of one disease, one drug. we approached thesediseases of the 21st century, which is obesity, type 2 diabetes, and all its attendant diseaseswith the same paradigm. what drug can we give for this? it’s the wrong approach.dr. pompa:yeah.

dr. fung:these are dietary diseases, and therefore,we need to fix our diet and use dietary strategies, such as fasting, that we talked about thathave been around forever, and use these strategies to attack the root cause of the problem, whichis all dietary, instead of saying, “oh, here’s a new drug for this.” you lookaround, and that’s all doctors talk about. “oh, what’s the new drug for obesity?”i’m like, “that’s totally the wrong approach right from the get-go.” we don’tneed a surgery for obesity. we don’t need drugs for obesity. we need to [00:06:43] diet.dr. pompa:that translates into even diabetes, and thyroid, and heart disease. of course,there’s a time and a place for a medication, but again, if you don’t get to the cause,then what are you really solving? you’re

not solving anything.dr. fung:exactly. that’s the whole point of my book, the obesity code, was what’sreally causing weight gain? i wanted to actually call the book the etiology of obesity. etiology,for those who don’t know, is a medical term meaning, “what’s the cause of it?” itwas too medical, so they nixed that title and said, “no. you can’t use it.” thatwas really what my original title was because i really wanted to say, “what is the causeof obesity?” if we get that question wrong, then we get everything wrong. the real problemis that our understanding of what causes obesity right now is too many calories. it’s allthis calorie balance, this calorie paradigm, and it’s crazy. the calorie understandinghas only been around for 50, or 60, or 70

years.two hundred years ago, people didn’t have bomb calorimeters. nobody measured the calorievalue of foods, and nobody had obesity. it’s not like people were – you look at 1930,1940 america, people are not starving of hunger. it’s not that there was no food. there wasplenty of food. there was just no obesity. that’s what we really have to know. evenfast forward, like 1960s. how many people are really dying of hunger in new york city?almost none. yeah, there’s some soup kitchens and so on, but it’s not like the widespreadfamine that you would see in biblical egypt or something.people talk about this whole thrifty genes and all this sort of stuff as if people arestarving in 1960s united states. that didn’t

happen, and yet there had no obesity. we hadto find out what caused it. i think that, really, we started with the wrong thing, withthe calories paradigm, that it’s a caloric imbalance rather than a hormonal imbalance.that’s where everything kind of fell off the tracks. now, all our strategies are dealingwith calories, but calories aren’t the problem. dr. pompa:i couldn’t agree more. if youlook at the diabetes association diet, low fat, low calories, exercise more, and matterof fact, replace all your fats with margarine, man-made fats. oh, and use artificial sweeteners.that’s the diet that they’re still [00:09:32] dr. fung:yeah. yeah.dr. pompa:even when they do focus on, “okay, let’s get to the diet,” they get it wrong,doc, because this – i believe this stuff

comes – it gets locked into government.i always have a saying that, “once something gets into government, you almost can neverback it up.” dr. fung:yeah.dr. pompa:it’s like this low-fat, low-calorie message is something that if you turned yourtelevision on this morning, i promise you they’ll talk about a low-calorie, low-fatrecipe of some sort. dr. fung:yeah.dr. pompa:every media outlet still talks about this faulted science, this junk science. wheredid it come from? now that it’s here, here we are. you said a key point, and i want youto expand on it. you and i both believe that the inability to lose weight or sudden weightgain, this is a hormone problem. i always

say, “look, we know that we could talk aboutfood. we could talk about diet, but more specifically, this is a hormonal problem today.” talka little bit about that. how did we get here, and what do you mean by “hormone problem?”dr. fung:yeah. if you want to prove causation, what you need to do is basically give peoplewhat you think is the causative agent and see if it causes it. that’s what we do allthe time. when we prescribe insulin – so the major player here is insulin. when yougive insulin to people, people gain weight. that’s the bottom line. whether you thinkthe mechanism is this or that, it doesn’t matter. when i prescribe insulin to people,people gain weight. when i give drugs, such as sulfonylureas,which are diabetic medications, which also

raise insulin, they gain weight. if i dealwith the diabetes by prescribing something such as metformin, which is a different diabetesdrug that doesn’t cause that insulin surge, then they don’t gain weight. here you havea direct correlation. anybody who’s ever taken insulin or any family members, and everydoctor already knows this, you give insulin, people come back and complain about their20, 30 pound weight gain. dr. pompa:their glucose is better. that’swhat they think. the doctor goes, “yeah, but look, your glucose looks better. yourblood looks better.” they’re going, “i’m gaining weight, and i still don’t have energy.i still don’t feel well.” dr. fung:absolutely. that’s absolutely thewrong thing to do because the patients know

it already. that’s what i always find funnyis that the patients always come back, and they always say things like, “doc, you’vealways told me that i need to lose weight to control this diabetes, yet you give mea drug, and i’ve gained 30 pounds. how is that good?” you say something like, “oh,well, you have to because your glucose is too high,” or something like that. theyalready know. there’s something going wrong here. they’regaining weight, which leads them to take more insulin, which is going to make them gainmore weight, which is going to lead them to take more insulin. that’s what happens.that’s exactly what happens. they’re in this downward spiral. they’re just gettingworse, and worse, and worse. what we’re

doing is actually making it worse. that’sthe real problem. the thing about type 2 diabetes is that it’sreally a disease of insulin resistance. that’s the actual disease. the problem is our treatmentis based on lowering the blood sugar. we’re treating the symptom, and we’re not treatingthe disease. in fact, the disease does nothing but get worse. if you look at the typicalhistory and the actual history of what happens, people get started on medication, then theyget more medication, then more, then insulin, and then more, and more. their diabetes isnot getting better with treatment. it’s getting worse with treatment.dr. pompa:absolutely. dr. fung:even as the blood sugars are gettingbetter, the diabetes is getting worse. it’s

like alcoholism. if you take a couple shotsof alcohol, those shakes go away, but it doesn’t mean your alcoholism is getting better.dr. pompa:yeah. dr. fung:we’re treating the symptoms, butthe disease is getting worse. that’s the real problem with the way we approach type2 diabetes and the related problem of obesity. it’s really a hormonal issue. once you understandthat – and this is what i get into in the book. if you look at low insulin, for example– if you take away insulin – like type 1 diabetics, their insulin levels go verylow. what happens to their weight? you would predict if insulin is the majorcausative agent, that their weight should go way down, and that’s exactly what happenswith type 1 diabetes. the type 1 diabetics

actually know this. there’s an entire eatingdisorder called diabulimia, where patients will deliberately under-dose their insulinlike dangerous, like crazy. their sugars go up. they might get ketoacidosis. they couldkill themselves. they do it because the weight comes way down. that’s the whole issue.when you give insulin, weight goes up; when you take away insulin, weight goes down. clearly,we have a causative relationship here that you don’t see in calories. if you thinkcalories causes weight gain, you can give calories and see if they will gain weighton the long-term basis. they’ve done these deliberate forced feeding studies where peopleovereat. you gain weight for a little bit. there’s a few very famous ones done in the‘60s, where they actually took college kids,

and they said, “just eat a lot of food becausewe want you to gain weight.” this guy, dr. ethan sims, he had actuallytried to do it in rats. he gave a lot of food, but he couldn’t force these rats to gainweight. he thought, “okay, well, can i do it with humans?” all the college studentsthought, “oh, yeah. no problem. piece of cake.” what was fascinating was that thosecollege kids just couldn’t gain weight. it was incredible. you’d force them to eat,and then they would eventually just stop. then you couldn’t force them anymore.then he went to the jail, and he got a bunch of prisoners, and he forced them to eat aspart of an experiment, which is quite funny. he watched them. he’d make sure that theydidn’t exercise more, and he’d force them

to eat. some of these guys were eating 10,000calories a day, and some of them, their weight went up. as soon as you stop forcing themto eat, their weight just came right back down to its original.that’s interesting because if you’re saying that calories is what causes weight gain,but yet you give calories, and it doesn’t go up, then you don’t have that causal relationshipthere. the same works on the flip side. dr. pompa:that’s right.dr. fung:if you think that calories causes weight gain, take away calories, you shouldsee weight loss, but you don’t. we all know this, right?dr. pompa:yeah. absolutely. dr. fung:studies of caloric restriction arecrazy because the failure rate is 98%.

dr. pompa:you know where people get trappedin to where they believe it? i always like to say this: if people cut calories, there’sthat beginning phase where they actually lose a little weight. i always say women, the mostyou could possibly lose is about 10 pounds, and then men, maybe a little more when theycut their calories way down, but what happens? the complicated hormonal metabolism startsto drop, as well. then the weight starts to come back on, or when you cut calories, youjust can’t do that. you can’t just push food away. i always talk about this on othershows. eventually, you start to eat again. two ways, it fails. either your body says,“no. okay. we can’t just cut calories. we’re going to eat again.”ultimately, your metabolism goes lower and

lower so ultimately, you never lose weight.you really never lose any weight long-term, but people hold onto that little short, littleblip when they see themselves cut calories, and they see their weight drop slightly, probablywater, some fat, some muscle, probably mostly muscle. the point is they see the scale godown, so they think it works, doc. dr. fung:yeah, absolutely. every single dietstudy has shown this same thing. you see the very bottom at around six months, sometimesnine months, and then it always goes up. every dieter knows this, of course. at six months,what happens is that you start to plateau, so you double up your efforts. you cut calorieseven more, and for a while, it works. again, you plateau, and then you start feelinglike crap. you’re feeling cold, and you’re

feeling hungry, and you think it’s all yourfault. the problem is exactly what you said. the studies are very clear on this. when youcut your calories, your metabolism goes down. you start with 2,000 calories in and 2,000out. you cut it to 1,500. you lose a little bit of weight. great. then your body justreduces it to 1,500 calories. dr. pompa:exactly.dr. fung:now, because you’re only burning 1,500 calories, you’re not – you’recold. your metabolism’s slowing down. the other thing that they have shown is that yourhunger hormones go up; your satiety hormones go down, so you’re actually hungrier, notbecause you have no will power, but you’re actually hungrier because your hormones aretelling you to gain that weight back. you’re

hungrier, and your metabolism has slowed down.that’s kind of a double whammy that you’ll never get out of.what happens, of course, is that you’re at 1,500 calories in, 1,500 out. you’refeeling like crap. you feel it’s not worth it. then you go up to 1,700. still less thanyou used to take, and the weight starts coming back. itâ goes right back up, and now yourmetabolism’s at 1,700. you feel like crap. your weight goes back to what it was, andthen everybody blames you for failing the diet. that’s the super-unfair part aboutweight loss is that all these dieters get blamed when we know exactly what’s happening.we know that it will happen for sure, and the weight loss –the studies of weight lossshow that 98% of people fail.

one, why would we ever give advice that hasa 98% failure rate, and two, it’s so unfair that when people fail, they get the blameinstead of the advice getting the blame. nobody ever says, “it’s because your stupid ‘eatless, move more’ advice was really bad. we knew it was bad, and we knew you’d fail.”nobody ever says that. people say, “oh, you fell off your diet.” it’s bound tohappen, and that’s the real problem. if you understand that what the issues isis really a hormonal issue, then you can say, “well, now what we need to do is look forways not to cut calories because it’s not a calorie problem. what we need to do is lookfor ways to lower insulin because that’s the real issue.” that’s what the strategiesare, and both you and i use them all the time.

cutting out a lot of the sugars, and the refinedgrains, and the intermittent fasting is the main strategies. those are strategies aimedat lowering insulin, not lowering calories. dr. pompa:you know, doc, when i entered 50years old, of course, everyone in this country has the adage that, “the older you get,the fatter you get.” i can tell you, at 50, i am leaner with lower body fat, withmore energy, better brain than even when i was in my twenties. how is that possible?i’m very, very insulin sensitive. wait. i’m very hormone sensitive because of thethings that i practice that you just said. i intermittent fast every day. by the way,at the end of my day, yeah, i probably eat less calories than everybody, but i promiseyou this, never once do i go, “oh, i’m

going to eat less at this meal.” quite theopposite. i make sure i eat to full every time i eat.when we look at these studies that people live longer when they eat less, we think thatpeople in okinawa are just simply pushing food away and eating until – it doesn’twork that way. the innate intelligence in the body goes, “i’m going to lower mymetabolism. i’m starving. i’m starving. i’m starving.” my body knows it’s notstarving because i’m eating big, full meals. however, i take 18 to 20 hours in betweenmy dinner and my next meal day. that makes my cells very, very hormone sensitive andobviously, insulin. when you look at my hormone levels, they’revery, very low. however, my cells hear them

very well. i see two parts to this. insulin– and i want you to discuss this – obviously, insulin’s connection with the cell, whichwe know inflammation and everything americans do are driving that sensitivity to becomeless and less, and obviously, too many carbohydrates, driving glucose and insulin, making it lessand less to be able to hear the hormone. also a liver issue. the liver plays a big rolein this liver problem, fatty liver. discuss those two things because people are goingto say, “okay, what are the strategies that i can get my cells hearing insulin and lowermy insulin?” dr. fung:yeah. i think that’s the key ideahere, and the fatty liver actually – and insulin resistance are very, very intimatelytied. the idea is that insulin sensitivity

and insulin resistance is very important becauseinsulin is the major driver of obesity. one of the things that causes the insulin to stayhigh all the time is insulin resistance. if you have insulin resistance, then your bodynormally produces insulin to kind of overcome that resistance.dr. pompa:our viewers and listeners, when we say this word, “resistance,” folks,we’re talking about the cell not being able to hear insulin well. the receptor to insulinis blunted, and there’s multiple reasons, inflammation being one of them, but it can’thear the message. therefore, you need more and more of the hormone, insulin in this case,to get the message in the cell. okay. i didn’t want to lose people on the “resistance”word.

dr. fung:yeah. that’s absolutely right.i actually have a different thought about what causes insulin resistance. if you lookat insulin resistance or resistance in general, you can look at, say, antibiotics, and say,“what causes antibiotic resistance?” the body has a natural tendency to homeostasis,which is that it has a comfortable state. if you move out of it, yeah, it’ll kindof move back to that comfortable state. if you subject the body to constant barrageof a hormone, any hormone, it will develop resistance. if you, for instance, take a drug– you can use nicotine, or you can use alcohol, or marijuana, or any of these drugs – thefirst time you give it, it has a great effect, whatever it is. you get very high or whateverit is. if you continue to use it constantly,

what happens is that that effect goes down,and down, and down. dr. pompa:dr. fung, can i give my examplethere? not to interrupt you, but i have to give the example. this is the example i alwaysgive, and meredith’s laughing because she knows what i’m going to say. i have fivekids, doc. i always say it’s like yelling at your children. when you first start yelling,it works. they go, “oh,” and they start listening. then you notice that you’re yelling– you find yourself yelling louder and louder, and they’re listening less, and less, andless. by the time you’re screaming at your kids all the time, and they don’t even hearyou anymore. [00:25:05] of what’s happening with hormones.dr. fung:yeah. that’s right.

dr. pompa:more and more insulin, we’re challenginginsulin, at first, it works. then it starts working less and less, and then more and moreinsulin. that’s the analogy i love to give. dr. fung:i love that analogy, actually, becausethat’s exactly what happens in the body. it’s not just for insulin, but it’s everyhormone you can think of, even drugs. dr. pompa:every hormone, every hormone.dr. fung:if you keep giving it all the time – it takes two things. it needs persistentlevels and high levels. if you’re yelling with insulin or whether you’re yelling withcocaine, or marijuana, or whatever it is, your body eventually stops responding to it.that’s a natural, protective mechanism. it’s not used to these high levels, so ithas to resist it. if you take the example

of antibiotic resistance, you can – thisis a situation in a lot of hospitals, where the antibiotics that we use are simply noteffective anymore. if you want to know why, it’s because weuse too many antibiotics. that’s the idea. the natural response, though, is to use moreantibiotics, just like more yelling. that’s not the answer. that’s actually the wronganswer because you can see that, to use your example, the more you yell, the less responseyou get. exactly. it’s a vicious cycle because you yell more, they respond less, so you yelleven more, and they respond even less. the actual answer is to use much less. insulinis the same. insulin resistance is actually caused by too much insulin, not only too high,but persistently high.

dr. pompa:absolutely.dr. fung:as you use insulin all the time, then your body becomes less sensitive to it.as you become less sensitive to it, or become more resistant, your body produces more insulinto overcome that resistance. that’s exactly the wrong response. you want to use less.you either have to cut down the amount, the level, or the persistence of those levels.that’s what the intermittent fasting does. it provides you with that long period of verylow insulin. that means your body stays insulin sensitive, and that’s the key.dr. pompa:that’s right. dr. fung:if insulin resistance is what’scausing your high insulin level, it’s not your diet anymore. this is why people whohave been obese for 20 years have a lot of

trouble losing that weight. it’s a time-dependentphenomenon. this is what people have to understand. it’s the insulin resistance that is keepingyour insulin levels high, but the answer is not to give more insulin, just like in diabetes.the answer’s not to give more. the answer is to give much, much, much less.this is the thing: if you believe in calories or even if you just believe in carbohydrates,if it’s all carbohydrates or if it’s all calories that drives obesity, then it shouldbe the same whether you want to lose weight and you’ve been overweight for 15 yearsor if you’ve been overweight for 15 days. you should be able to lose weight the same.dr. pompa:absolutely. dr. fung:everybody knows it’s not the same.the guy who’s been overweight for 15 days

drops it like that. the guy who’s been overweightfor 15 years has a hell of a time because they’ve been going around that insulin resistanceinsulin cycle – high insulin, insulin resistance cycle for so long that they need to get thatfixed. that’s why the intermittent fasting is really such a powerful method because it’snot simply the diet. now, you’re dealing with – the diet isa major factor in keeping insulin levels high, but it’s the insulin resistance. that’swhere we’ve gone off the track. if you go back to our dietary habits in the mid-‘70s,there was actually two major changes. one, we went to a very low-fat diet, which wasa mistake because the fat has a lot of calories, so we said, “you should cut your fat,”and all this kind of stuff. everything kind

of knows about that already.the second change that nobody ever talks about is that we went from an average of three mealsa day, breakfast, lunch, dinner. i grew up in the ‘70s. you tried to have a snack,and your mom said, “forget it. you’re going to ruin your dinner.”dr. pompa:absolutely. dr. fung:now, we’ve gone, in the mid-2000s,to an average of five to six meals a day. you look at your kids, and they’re all breakfast,snack, lunch, snack, dinner, snack. that’s normal, and that’s the average. that’sinsane. now, we’ve actually set into motion the exact two things that we need for insulinresistance. we need high levels, which we’ve done that with very high insulin foods likerefined grains. we’ve cut out the fat and

eat more bread. that’s the base of the foodpyramid was the bread. dr. pompa:that’s right.dr. fung:the second thing we did, which is what you need for resistance, is the persistenceof those levels. now, people say, “you got to eat the minute you wake up. breakfast isthe most important meal of the day.” dr. pompa:absolutely.dr. fung:eat five, six times a day, constantly snack, so now, you’ve got not only the highlevels, but you’ve got the persistently high levels. now, you have set the stage forinsulin to be high, insulin resistance to be high, and you’re a sitting duck for obesityand type 2 diabetes. the answer is to do what you do, which is give your body a break.you think about it. suppose you’re in a

dark room. you go out in the sunlight, andyou’re blinded. it’s so bright. after five minutes, it’s normal. that’s thething. when you are in the dark and you suddenly get that bright light, it’s got a huge effecton you. if you then go back in the dark, the next time the bright light comes in, it’sgoing to have a huge effect. that’s what our body does. it keeps, not just insulin,but all hormonal levels very low. you can look growth hormone. you can lookat parathyroid hormone, melatonin. all the levels are practically undetectable. thenyou get a burst, and then that’s it. then they go back down to very low levels. that’sthe way our body is designed. if you sit in the dark and you get that bright light, greateffect. go back to the dark, and then next

time, bright light, you get great effect.if you simply give that bright light all the time, it just loses all its effect, and that’swhat we’ve done. instead of insulin goes high and then low, and then high, and thenlow, we just keep it high all the time. dr. pompa:absolutely. that’s a great analogy.dr. fung:that’s the problem. dr. pompa:yeah. that’s a great analogy.the five, six meals a day thing, again, it’s one of those things that people do it at first,and they go, “oh, that helped.” they lose a little weight because their cells have zerohormonal ability to burn fat for energy. when they eat more often, they’re not burningas much muscle. they get a little spike in their metabolism a little bit, and they go,“oh, that kind of worked.”

long-term, you’re dying sooner. i alwayssay if you want to age faster than anybody, raise your glucose and insulin continually.that’s what you do. guess what? the best way to do that is eat five, six meals a day.that’s [00:32:27] aging prematurely. dr. fung:yeah. that’s the whole thing withthe mammalian target of rapamycin and autophagy that we talked about. the biggest stimulantto autophagy, which is kind of this cellular cleansing process, is not eating. it’s actuallythe protein. the protein actually stimulates this – stops us from clearing out theseold, damaged, subcellular organisms. people knew.the funny part, i think, is that people have known this for thousands of years. if yougo back and look at all major religions, they

all have periods of fasting, all of them,prolonged periods of fasting, 40 days and 40 nights.dr. pompa:bingo! dr. fung:it’s crazy that they knew this.dr. pompa:doc, look at the cultures that live the longest. the hunza people and all thesepeople, they say it’s not even what they’re eating to why they’re living so long disease-free;it’s the fact that they’re not eating for so many times of the year, whether theyrun out of food, whether the seasons change. in the hunza period, they call it starvationspring. it’s like those fasting moments in the timepeople were eating was completely different then. they didn’t have access to food allday. food was precious. they would go out

hunting all day. they wouldn’t eat but maybeone, two meals a day. that’s basically what we’re emulating when we’re intermittentfasting. we’re emulating what cultures did for thousands and thousands of years and livedlong doing it. when we hear these studies of eating lesscalories and living longer, it really, doc, should be eating less often and living longer.would you agree with that? dr. fung:absolutely. nobody in history hasdecided to calorie-restrict by eating small, frequent meals. the much easier thing to dois to cut out a bunch of meals. why would you want to cook, and clean, and prep sixtimes a day when you could do it once a day? isn’t it make a lot more sense from a logisticalstandpoint?

the other thing that’s crazy, and i seethis all the time because we do a lot of fasting in our clinic, as well, is that people comeback, and they say, “you know, i didn’t think it – i thought it’d be terrible,but it’s actually really, really easy.” once you get into that mode of not eating,you don’t – there’s no inertia there. the inertia is not to do it. it’s kind oflike my son. you can’t get him into the bath, but when he’s in the bath, you can’tget him out of the bath. dr. pompa:i like that. yeah.dr. fung:same thing. when you start eating, it’s just really hard to stop. if you startby not eating, you might as well just ride that until it’s time. it’s a lot easier.dr. pompa:look, the last two days – i always

pick one day a week where i fast for 24 hours.i go dinner to dinner. the other days, i’m typically doing between 18 and 20 hours. theday before yesterday, i was so busy, i went on and on in my day, my day, my day. i realizedit had been 24 hours, and i didn’t eat. i didn’t eat all day. yesterday, the samething. i went two days where i didn’t eat for 24 hours. the day before and yesterday,i went 24 hours, and i wasn’t hungry. i never thought about food. i had pure energy.my brain worked good. oftentimes, when you eat, the blood rushesto your stomach. your parasympathetic nerve system kicks in, and you [00:35:58] that sluggishdown. it’s like when i’m at my busiest, and i need my brain the most, i simply don’teat. matter of fact, how many hours do you

go? what’s your intermittent fasting schedule?dr. fung:i typically go 24 hours a couple times a week, although it really depends.it depends on how busy i am. when i get really busy, i really just do it a lot more becauseit saves me 45 minutes at lunchtime. dr. pompa:it’s massive, the amount of timeyou have when you’re not eating. my son didn’t eat yesterday. he was like, “dad,i didn’t realize how much eating bogs me down.” i’m like, “yeah, exactly, son.”dr. fung:not just that, but people worry about not having energy and this whole – there’sa whole thing that, “i won’t be able to concentrate.” it is really funny that peoplethink that. it’s pretty obvious that if you don’t eat, your brain actually worksbetter. if you think about it, you had a giant

thanksgiving dinner. are you really supersharp, or are you sluggish on the couch watching television? it’s pretty clear that eatinga lot doesn’t really make you mentally very sharp.on the other hand, when you say that someone is really hungry for something, they’rehungry for power, hungry for this, hungry for that emotion, does it mean they’re sluggishand have no energy? no. when you’re hungry for something, it means you have a lot ofenergy, and you’re willing to do what it takes. that’s what the body does. it actuallyfuels you. they’ve done so many studies on this fasting.it’s been well established for 50 years. your noradrenaline levels go up; your growthhormone levels go up, and your metabolism

doesn’t go down. you’re actually moreenergetic. at the beginning of the – everybody worries about this metabolic slow-down thatyou see with the chronic calorie reduction. you don’t see that with the fasting becauseeven though you could fast for four days, and the resting metabolic rate at the endof the four days is actually 15%, 14% higher than it was at the beginning. your metabolism’sactually revving up. what you’ve done is you’ve switched energy sources from foodto fat, and that’s all it’s doing. that’s all it’s doing.dr. pompa:yeah. it is the opposite. most days, then, you’re eating one to two meals a day,and you’re going – how long do you go in between?dr. fung:i rarely eat breakfast. i eat breakfast

on the weekends now, but –dr. pompa:one day a week, i call it my feast, where i actually purposely eat more, again,emulating our ancestors. i purposely, on saturdays, eat breakfast, lunch, and dinner. i try toeat more. by the way, it’s hard for me. dr. fung:actually, i find the same. on theweekends, i find that i’m not actually hungry, but i do eat because my family is there, andi usually eat breakfast. there are social things that go along with it.â it’s nice.this is what i say about fasting. you really have to find what fits into your life. whatfits into my life may not fit into somebody else’s life. on saturdays and sundays, it’sa little less busy, so it’s nice to enjoy that time in the morning and have a littlebit of something with the kids and stuff – with

my wife and the kids. i like that, so i havesomething. i find that oftentimes, i’m not hungry, but once i start, i can eat a fullbreakfast. that’s what i mean that sometimes, it’s just easier to go right through.dr. pompa:absolutely. dr. fung:i do, but monday through friday,i almost never eat breakfast anymore. it’s really easy because then when you skip lunch,you’ve gone 24 hours. some weeks, i wind up doing it four out of the five days. again,it’s mostly because – it depends on my work schedule. when i get really busy, theni know that those are days that i’m going to – it’s not worth it for me. the bodygets so used to it. it gets so easy to skip that meal that it’sfar more precious to me to get that 45 minutes

or an hour and get home a little earlier.it’s far more precious to me than eating something. it just doesn’t matter that much,whereas that 45 minutes is hard to get back. that’s every day, monday, tuesday, wednesday,thursday – that’s three, four hours of extra time that i have to do stuff. on daysthat it’s not that busy, then i’ll eat more, but again, it depends a lot on social– dr. pompa:i think we’re emulating feastand famine, and i think there’s benefit to both. i believe the fast reminds our bodiesthat we have plenty and to burn fat. i think it makes us more of a fat burning machine.when the body says, “hey, we’re not starving, here,” it’ll burn its fat with ease. thebody, i believe, can create some blunting

of the insulin receptor if it thinks it’sstarving, and that’s not a good thing because it’ll want to hold on. i believe that oneday or two of feasting is a really good thing, and the fast.here’s what i would ask, though. i would ask that, what do you say to the people whogo, “oh! i just can’t go without food. i get dizzy.” right, meredith? we hear thatall the time. “i get dizzy. i get” – but you and i know that eventually, the body shifts.i call it the desert island experience. if i put you on a desert island, you’d havethose days, but eventually, you could go with one meal a day or no food, and you would bejust fine. what do you say to that? dr. fung:we warn people ahead of time thatthe first few times that they do this, it’s

going to feel really bad.dr. pompa:absolutely. dr. fung:it’s the same for ketosis. peopletalk about a keto-flu and all this sort of stuff. as you make that shift in your metabolism,one, it takes a bit of time, but during that time, you have to understand that things are– it’s not abnormal [00:42:03]. if they do it twice, and the first one was kind ofbad, and the second one was kind of bad, they were really hungry, they would say, “oh,i can’t do this.” they give up. look. you got to give your body a chance.if you want to learn to play the piano, you don’t give up after two times. it’s like,“oh, i tried to play the piano twice, and i can’t play this beethoven piece.” that’skind of ridiculous, right? it’s the same

thing. you have to let your body get usedto it. we warn them ahead of time, even before they start it. most people do fine once theyget started. then they have to find their niche because there’s – it’s funny becausesome people feel great with the 24 or 36 hours, and some people find that they do way betterwith long fasts, like periodic five-day, seven-day fasts.dr. pompa:i agree with that. yeah. uh-huh. dr. fung:i say, “it doesn’t matter tome. if you like this, then do it. if you like the other, do it as long as you’re gettingyour results.” when people really have trouble, i actually have them sometimes – what iask them to do, and not all of them do it, obviously. i say, “what you should do isgo for a long period, like five or seven days.

that’s going to force your body” – that’skind of like the desert island. you’re forcing your body to actually do it.â it takes a bitof motivation, and it takes a bit of people who are willing to do it, but when they dothat, their bodies usually make that adjustment. you kind of force your body to say, “look,it’s not coming, okay? there’s no food coming. you better start shifting your metabolism.”then when it does, they find it much easier. also, if they’re kind of in that low carb– people who are eating a lot of low-carb, ketotoic diets, they actually do much better.they find the fasting really easy. it’s kind of a natural segue when they’re alreadyin that high-fat diet. they actually do very – they switch over very well. sometimes,the other thing is to switch them to that

diet first.dr. pompa:just take it in steps. that’s what we do. we switch their diet oftentimesto what i call a cellular healing diet, to, oftentimes, a ketosis, a more advanced cellulardiet, and then we start the fasting. you’re exactly right. it’s like these people thatsay, “i have hypoglycemia. i can’t do it.” oh. i have the cure. don’t eat. “what?that’s the – i can’t not eat.” it’s like, “no. just not eat.” day three, dayfour, magic happens every time. eventually, the body goes, “okay, i’mnot going to die, so i’m going to switch my dna. i’m going to turn genes off andturn some on.” all of a sudden, guess what. it starts utilizing fat for energy becauseit will not die. it will do everything to

survive, even burn fat. imagine that. it isremarkable, that adaptation that occurs in everybody. that’s why – you’re right– some of those longer block fasts are what you need to – eventually, every fast, theyget more and more efficient at becoming fat burners.dr. fung:yeah. the switch is easier so that even if they do feast, then they can veryquickly go back and start burning fat again. i tell them that that’s what we want thebody to do. fat is nothing more than stored food energy. if you’re constantly puttingfood in, it’s not going to burn the fat because it has no reason to.dr. pompa:yeah, absolutely. you know what? the body does get more and more efficientwith every restricted state, whether it’s

daily intermittent fasting or whether it’sblock fasting, more and more efficient. i believe that when we fix that cellular energyproblem, then we fix the majority of conditions that we’re seeing today, even brain fog,obviously, the inability to lose weight, whether it’s thyroid, diabetes, all these hormonalproblems. the cell becomes more sensitive to the hormones. the cell becomes more efficientat utilizing fat, which burns cleaner than glucose.everything starts to change. doc, we see it all the time. we are just so privileged tohave you on this show, and just that fact that seeing somebody doing what we do. i callthese things ancient healing strategies. all we’re doing is emulating, really, what ourbodies are genetically set up to do.

dr. fung:yeah. that’s what i say, too. sometimes,i call it the ancient secret because it’s been around forever. it’s a secret becauseeverybody tells you not to do it, yet it’s exactly what you need to do. we tell peoplethe opposite. “oh, eat all the time,” like that’s going to really work, right?dr. pompa:yeah. i have something that i call the 180 degree solution. what it means isif you just watch the media, read everything that everyone says about health, do the opposite,and somehow, you hit it right every time. “oh, eat low fat?” try high fat. “eatlow calorie?” forget about low calorie. eat until full. basically, every message thatcomes across is wrong. “fasting’s dangerous. fasting’s bad.” actually, fasting’sgreat. “eat a big breakfast.” don’t

eat breakfast at all. we can just continueto go through – “eat five, six meals a day.” try eating one.dr. fung:that’s what i said, too. i said i should call this the costanza diet [00:47:28]jerry seinfeld episode, where he did the opposite, and he did [00:47:34]dr. pompa:you know what’s funny? someone told me the – about that episode, whereeverything was opposite. i said, “i’m going to play that at one of my seminars,the costanza thing.” everything’s opposite. you know, we stand different, doc, but wehave a message that ultimately will – could end an epidemic. the healthcare crisis, it’snot a better insurance or government-controlled program. it’s what you and i are talkingabout. it’s what we’re doing in our clinics

and teaching doctors to do. this is it.this is the answer, and it stands 180 degrees opposite of everything people are hearingfrom their doctors, from the media, from the government. we just got to get more of uspreaching this message, no doubt. promote your book, the obesity code. i actually lovethe name, doc, because the obesity code, i believe it is a genetic code, and we couldchange that code by the things that we’re talking about, like intermittent fasting.do you have a copy to hold up? dr. fung:oh, i don’t have one here. i shouldhave brought one. dr. pompa:everyone will remember the name,obesity code. i’m sure you could buy it on amazon, right?dr. fung:yeah. it’s available everywhere

now, so on amazon. it’s in the bookstores,so anywhere you go, you should be able to get it now.dr. pompa:listen, we appreciate your work. i’m sure we’ll have more requests to haveyou back on and continue some of these conversations. meredith, let me turn it over to you because– meredith, matter of fact, she just got done doing a four-day water fast herself lastweek. dr. fung:wow! amazing.dr. pompa:meredith, let me turn it back over to you.meredith:oh, thanks. yeah. it was my first water fast. i had done some broth fastingand fasting on whey water, but i’d been a little intimidated by the water. i foundit to be much easier than a lot of the other

fasts that i had done, so i’m excited todo a longer water fast. i do intermittent fasting daily. practice a lot of what youguys preach, of course. i had a lot of different questions, but just– we’re coming up on the end of the hour, so i know we don’t have much time. i’mjust kind of curious, as a kidney expert, what you have to say as far as fasting andelectrolyte balance. i know that that’s something that people ask a lot about. i tookelectrolytes, kind of a concentrated electrolyte balance, when i was doing my water fast. iwas wondering if you could speak to that a little bit.â for alternate daily fasting and shorter periods – so i kind of break it at around 24, 36hours, i generally don’t worry about it.

now, i measure it all the time in my – inthe lab for our patients because people are worried about it, but it just about neveris an issue. there is only one electrolyte that many people are deficient in, which isthe magnesium. that gives, sometimes, a lot of muscle cramps. not very dangerous, butit gives a lot of muscle cramps, and people don’t feel so well. that is the one thatmany people are deficient in, but it’s not really due to the fasting. they’re justdeficient in it anyway. a lot of type 2 diabetics are deficient init, so we do have some strategies for magnesium replacement. that’s the only one that iactually find quite a bit of, but i find it before we even do the fasting. the fastingdoesn’t really make it any worse; it certainly

doesn’t help. i just about never have aproblem. now, you have to be a little bit more carefulif people have advanced heart disease or advanced kidney disease. i don’t use it for advancedkidney disease just because there is a little bit more problems with it. yeah, i don’treally worry about the electrolytes. i measure them just to make sure that people are stayinghydrated and all this kind of stuff. measure their kidney function, make sure they’redoing okay. other than that, i don’t worry about it. for long-period fasts, like a weekor more, then i’ll have people take a general multivitamin, and that’s about it.dr. pompa:yeah. then it’s enough to replace – we just have people take some sea salt,simple as that, which maintains – helps

maintain the electrolytes. yeah. no, that’sgreat. great question. meredith:thanks, dr. fung. we so appreciatehaving you on today. just to kind of finish up, i wondered if you had two or three takeawaysfor our audience if they wanted to start to implement some of these strategies.dr. fung:yeah. i think the main takeaways, in terms of weight loss, is one, first ofall, understand that this is a hormonal imbalance and not a caloric imbalance. if you understandthat, then you know how to fix it. if the problem is too high in insulin, well, yourstrategy is, “how am i going to lower it?” one, you don’t want to eat foods that reallystimulate insulin. that’s mainly the sugar and the refined grains, so bread, and pasta,and all those things that used to be on the

bottom of that food pyramid. that’s onething. that’s the ‘what to eat’ question. the second question is really when to eat.again, if you understand that insulin depends on both the high levels, but the persistenceat those levels, then you want to have long periods of time where your levels are low.you want to do some intermittent fasting. it doesn’t have to be long. you could do18 hours a day. lots of people do that or even longer. twenty-four hour periods, maybetwice a week is another popular strategy, or you could just do long periods, like sevendays once in a while. that will work just as well.these cleanses like beyonce does, the master cleanse, which is – you have a little bitof funny stuff with lemon juice and so on.

essentially, it’s a fast. you could do that,too. whatever it is that you want to do, you want to break that insulin resistance becausethat is one of the key problems that you can’t just deal with in terms of the ‘what toeat’ question. there’s always two questions: what to eat and when to eat. both of thosequestions, in order to be successful – and i think that’s why a lot of diets fail becausethey only talk about what to eat. we’re mostly in agreement. nobody says youshould eat white bread anymore, even the low-calorie people or low-fat people. nobody says, “oh,yeah. go eat a lot of white bread.” nobody says that anymore, right? we’re more orless in agreement on what to it. it’s the ‘when to eat’ question that we’ve reallygot wrong. the six, seven times a day, it’s

all wrong. we have to really get people thinkingabout that more and saying, “well, if you understand that it’s about too much insulin,now figure out what to eat. figure out when to eat and implement the strategy that worksbest for you and that fits into your life.” it’s not going to be the same for everybody.some people say, “oh, i do this and this. i do 18/6 every day.” they say, “is thatokay?” i’m like, “well, are you losing weight?” “yeah, i’m losing weight steadily.”then that’s great. there’s nothing wrong with it. now, if you start to plateau, thenyou’ve got to change it up. other people won’t do so well on that strategy, and i’llchange it up. again, you have to find what works for you in your life. again, it’sthe fasting – if you’re eating dinner

– if you like to eat dinner with your family,and then you start doing these three-day fasts or five-day fasts, and it’s disrupting yourfamily life – i had one guy who used to not go to a socialevent. he’d usually get together with his buddies for lunch every day, and he’d notdo that because he was – that’s not the idea. the idea to fit it around – you haveto fit it in. dr. pompa:absolutely.dr. fung:don’t cut yourself off because you’re doing the fasting. it’s part ofyour life. fit it in because there’s lots of opportunities to do so. that’s the keyto doing it. find what works for you. find the strategy that works for you. there aregeneral guidelines that i lay out, but i don’t

use prescription so much because everybody’sso different, right? dr. pompa:great. thank you, doc. we reallyappreciate it. what a great alignment we have with you and your message and ours. awesome.thank you. dr. fung:thank you.meredith:thank you so much, dr. fung. thanks, everyone, for watching. it was an awesomeepisode, jam-packed with information. dr. fung, we’ll have to keep in touch and maybehave you back on the show in the future. dr. fung:all right. thank you.meredith:check out his book, the obesity code. it’s out now, march, 2016, so check it out.his website is intensivedietarymanagement. all right, everyone. we’ll catch you nexttime.