The 2 Best Strategies to Burn Fat Fast! Guest: Dr. Jason Fung

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1 The 2 Best Strategies to Burn Fat Fast! Guest: Dr. Jason Fung The purpose of this presentation is to convey information. It is not intended to diagnose, treat, or cure your condition or to be a substitute for advice from your physician or other healthcare professional. Dr. Mueller: Hello, health heroes. And welcome to another session of the Forget Weight Loss Forever Project. I'm your host, Dr. Rudy Mueller, and you are learning from the experts. We are guiding you through the steps to find the underlying causes to your health and weight loss struggles with the goal of teaching you how to implement solutions that help you get real results. We are giving you the tools to help you knock the pant sizes off, but more importantly to optimize your environment so that you can reach your full human potential. Let's welcome the next expert, Dr. Jason Fung. He is a medical doctor, and kidney specialist, and the author of the recently released book, The Obesity Code. He is an amazing physician and doctor. What is the definition of a doctor? It is a teacher. That is exactly the reason I asked him to join us for this project because he takes very complex medical topics and makes them more easy to understand. Dr. Fung, thank you for being such a great teacher and for helping us today. Dr. Fung: Thank you very much. Thanks for having me Rudy. Dr. Mueller: So, Dr. Fung, what got you into the medical field and then eventually getting into nephrology? Dr. Fung: Well, I guess I always wanted to be a doctor. After medical school you have to choose your specialty. So, to me, it was the most interesting field, was the kidneys. So that's kind of where I went. I went to University of Toronto 2016 Slimitless, LLC. All rights reserved. 1

2 for a bit, and then I went to University of California, Los Angeles where I finished my training. And it s interesting because sometimes they ask, Well what does the kidneys have to do with weight and type 2 diabetes? It s usually because the type 2 diabetes, which is very closely associated with the weight gain and obesity, is by far and away the biggest cause of kidney failure. So that's really where it kind of aligns, kidney disease, and also weight, and type 2 diabetes. So that's kind of how I got into this entire field. Dr. Mueller: So you always knew you wanted to be a doc. So being an expert in this field, what do you see as being the biggest problems, or dogmas, that have really led industrialized nations like Canada, and the U.S., to experience rises in the occurrence of their citizens being overweight and obese? Dr. Fung: I think that the problem is that we fundamentally misunderstand both obesity and type 2 diabetes. Because if we understood what was causing it, then we'd have a good treatment. That's what I talk about a lot on my blog. And the video series that I have which is called, The Etiology of Obesity, which is really, what is the underlying cause of obesity? That's the one question we never actually really think about very hard. And the reason we don't think about it, is that we think we already know. Everybody tells you it's too many calories. You eat too many calories and you're going to gain weight. But it turns out that calories are not really the right measure of food. Because we've all done it. So if you think that calories cause weight gain, then if you reduce calories you're going to cause weight loss, right? And that sounds pretty reasonable, unfortunately it's not true at all. Really the proof is in everybody who's ever done a diet, where they've tried to restrict their calories. It actually just doesn't work at all. You lose weight for 6 months, perhaps. Then all the dietary studies show that after the 6 months you start to plateau and then your weight gain kind of comes right back on. And everybody assumes that it's because you're falling off your diet that the calories are sneaking in there somewhere. I actually don't really think so. I 2016 Slimitless, LLC. All rights reserved. 2

3 think it's because the diet just doesn't work. So, you can prove this experimentally as well because if you take normal people, or even overweight people, and you simply restrict their calories. And you measure their energy expenditure, their metabolism, what you find is that when you restrict their calories by 30%, given enough time, what happens is that the body reduces its metabolism by about 30%. So what's happening is that calories in goes down, but so does calories out. So then in the end you don't lose any weight. The problem is that, if you normally eat 2,000 calories a day and you cut it down to 1,500, your body, which normally burns 2,000 calories a day, then only burns only 1,500. So even though you stick to that same diet, you don't lose any weight. And that's because the body has adjusted to what you're doing. The thing is that this is not some abnormal situation. This is the normal situation; the body doesn't want to die. So it adjusts. That's homeostasis. That's the way it's supposed to work. Because think about it for a second. If people tell you that, Oh, just cut 500 calories a day, you ll lose a pound a week. Well, does that mean that over 100 weeks I'll lose 100 pounds? In 200 weeks, I'll weigh 0? Well, obviously not, right? So at some point and it turns out that it's right away your body adjusts to it. Because it's smart and it doesn't want to die. So if it senses that you're having less energy going in, it's going to reduce your energy. So you're going to be cold. You're going to be tired. Everything is going to function a little bit more slowly because you're only burning 1,500 calories. And that's exactly what we see with these calorie reduced diets. Everybody who tries to just eat what they normally eat, but portion control and cut down your portions, that's what happens. And we have long term studies that show exactly that this is what happens Slimitless, LLC. All rights reserved. 3

4 Dr. Mueller: So it's not just that they're over exercising, getting fatigued. It's the fact that they're taking in less energy and fuel, so therefore they have less energy. Dr. Fung: Exactly. And that's the key to understanding. Is that your body is able to adjust its metabolism up or down as much as 30 or 40%. You can do the exact opposite experiment. You can actually overfeed people. So you tell them to eat and you're trying to make them gain weight. And they've done some famous overfeeding experiments. And what you find is the exact opposite. You actually can't make people gain weight as quick as you think they will, which is kind of funny. They did this experiment in the 1960's. They took a bunch of college kids and said, You know, we're going to do this experiment. We're going to give you a lot of food and then we're going to make you gain weight. And actually very few of them were able to gain the weight and keep it on. In the end, what happened was that when they went off of the forced feeding, they actually just lost all that weight and went right back to their original weight. Then they went to prisoners and tried to make them eat. And some were eating like 10,000 calories a day and barely gaining anything because the body actually increases metabolism to burn it all off. So you see that when you try to just adjust what you eat, your body also adjusts the metabolism. And that's one of the reasons why it doesn't work. And that's the whole thing. So we've done these big experiments, like the Women's Health Initiative, where they've cut calories. I think it's about 350 calories a day for like 7 years. When you compare it to a group that didn't diet, there was basically no difference in weight loss. So even though you've cut 300 calories a day for 7 years, you still were the same weight as the person who never dieted, which means again, it just goes to show you, that this kind of caloric reduction as primary, reducing calories is the main thing you need to do, is completely wrong Slimitless, LLC. All rights reserved. 4

5 And the thing about it is that everybody knows it. The only reason that we think it works is because everybody keeps saying it works. But for anybody who's actually done any kind of calorie reduced diet, they know it doesn't work. Everybody knows it doesn't work. Dr. Mueller: That's definitely not sustainable. Dr. Fung: It's not sustainable. I mean people have done it. In studies they have sustained 300 calories reduced for long periods of time. And if you're strong willed enough you can. It's just that you won't lose any weight because your body will now burn 300 less calories a day. So you'll still be in an equilibrium. But you'll be eating less. You'll be tired. You'll be cranky. And that's exactly what happens on most diets. So it's not that people stop dieting, it's that the diet stops working, right? And this is the thing, we always blame the patients for not following it, but in fact it's the advice that's wrong. If you look at actual studies of what the success rate is of these calorie reduced diets, the success rate is about 2%. So significant weight loss over 2 years is about 2% of people. So 98% failure rate. I don't know why anybody would accept this as the standard advice yet, this is our standard advice. Watch what you eat, cut down your portions, count your calories, right? We have calorie labels, we have this is this many calories, and so on. It's the wrong measure. It doesn't work. And that's what people need to understand. It s that they've looked at this entirely incorrectly, and that's why we fail to make any kind of dent in this obesity epidemic is because we're all worried about calories. And that's not the right thing. Dr. Mueller: The dogma has been around for so long. Calories in, calories out. Eat less, exercise more for weight loss. It's been around way too long and the fact is, from what you just said, and citing a few different studies, it doesn't work. Not only does it not work long term, but it just doesn't inherently make sense Slimitless, LLC. All rights reserved. 5

6 So what should we be focusing on instead of counting calories? Which is a huge relief that we don't have to do that, because that can be a cumbersome process. What should we be focusing on? Dr. Fung: Then what you can do is say, Well, if that doesn't cause obesity, then what does cause obesity? That's what you need to know in order to actually treat the disease is what's causing it. Because if you don't understand what causes it, you can't really treat it very rationally. So if you look at the hormone insulin. Insulin is a storage hormone. So when you eat, your blood sugars go up, your insulin goes up. So you store some of that food energy in your body. And when you fast, which means you're not eating, so like at nighttime when you're not eating, your insulin levels go down. And you start to pull energy back out from what you stored during the day. That's what happens normally. So if you continuously give insulin, then it seems that you will gain weight. And we know this because the truth is that I can make you fat. I can make anybody fat. I just give them enough insulin, and enough time, and they will gain weight. We know this for a fact. Anybody who's taken insulin, or anybody who knows somebody who takes insulin, knows that the main side effect of insulin is weight gain. So if I can make somebody fat, that means that that's what's driving a lot of weight gain. So if you look at insulin, now you have to look at it from a different angle. You have to say, Well, insulin is what makes people gain weight. So if insulin is what makes people gain weight, then what we need to reduce is the insulin. It's not about reducing calories. It's about reducing insulin. What's the best way to reduce insulin? There's no pill that does that for you, and that's the thing. One of the things that people had recognized very early on is that refined carbohydrates and sugar stimulate a lot of high glucose and also stimulate a lot of weight gain. It's not by coincidence because both of them drive up insulin levels. So if you take sugar, if you take white bread, or a lot of pasta, 2016 Slimitless, LLC. All rights reserved. 6

7 your blood sugars will go up, your insulin will go up. Now if you constantly eat. It's not enough to have a single spike of insulin, and then back down. But if you're eating constantly throughout the entire day, which is what we've told people to do, right? Eat constantly throughout the day. Now you're constantly stimulating insulin. And if you're constantly stimulating insulin, that's what drives weight gain. It's just as if I gave you an insulin shot. There are also drugs that raise insulin. And if you give a drug that raises insulin, you get weight gain. And there are drugs that lower insulin. There's only one right now, and it causes weight loss. So you see that from a mechanistic standpoint that what really drives weight gain is not calories. What really drives it is insulin. Then you can think, How do I get insulin down? Now you can design a rational approach to weight loss. So if it's refined carbohydrates that really causes insulin to go up, then cut down on your carbohydrates. Turns out that protein also can stimulate insulin quite a bit, as well. Therefore, you shouldn't overeat protein. You can't eat no protein, so therefore what we do for a lot of people is use low carbohydrate diets, high in natural fats. So it sounds funny to eat a high fat meal, but that's exactly what we tell people to do. Dr. Mueller: So when you're talking about carbohydrates, what would be a low carbohydrate diet? How do you measure a low carbohydrate diet? Dr. Fung: You can measure by grams, but really what you're interested in is more what the effect on insulin is. There are tables, and there are websites, that you can go to which will tell you what the glycemic index of a carbohydrate is for instance. And you can base it on that, but it's a little tedious. Essentially if you start sticking to whole, unprocessed foods then the insulin effect is far lower. So where you get the highest insulin effect is foods that are processed Slimitless, LLC. All rights reserved. 7

8 So for example if you take wheat. If you take the wheat berry, you've got a lot of other stuff in there. You've got protein. You've got fat. What you do when you refine that into flour is that you throw everything else out, and you just take the carbohydrate. So instead of a natural food that our bodies have evolved to handle You can take a food such as sweet potato, which is sweet, and has a lot of starches as well, but the effect on the body is not the same because that has all the other fiber, and all these other fats, and nutrients, and stuff that come with it. Whereas the flour is really only that part of the wheat berry that is the carbohydrate. We take it out, we refine it, refine it, refine it. It's different. They're not the same thing. So if you eat a lot of beans, that's a lot of carbohydrates too, but again, they're not the same. Beans have a lot of something called amylopectin. That's a type of starch that it comes in, but there's three forms. So wheat is amylopectin A, which is very quickly and easily turned into sugar in the body. And amylopectin C, which is what beans have, they actually are very poorly absorbed. And that's why you get a lot of gas when you eat the beans. And it doesn't have much of an effect on the glycemic index. You can measure grams of carbohydrates, but there's really, in the end, each food is an individual. It's got its individual nutrient profile how much fat, how much protein. But if you want a general rule, stick to whole unprocessed foods and you'll probably do fine. It's not the carbohydrate that's really toxic. It's the refining process where you throw everything out but one thing. What happens is you overeat that thing. And for us it's the sugar, for instance. So instead of eating one whole apple, which has lots of fiber, and fiber tends to counteract the effect of the carbohydrate. The insulin doesn't spike as high; the sugars don't spike as high. If you take one apple, yes you get sugar, but if you just take the sugar and the juice, now you're running into trouble. So you might take 5 apples and juice them, throw out all the pulp, throw out all the fiber, all the pectin, all this other stuff that makes it an okay food that 2016 Slimitless, LLC. All rights reserved. 8

9 our bodies can handle. And you just take the one thing, and you just don't take the juice from 1 apple, you take it from 5 apples, that's where you start to run into trouble. It's the balance of the food that's off. So sticking to whole, unprocessed foods is a general rule to good health. The thing is if you look at the insulin response to those foods, they're much lower than when you take the refined food. So if you look at glycemic index for instance, and you look at unrefined carbohydrate versus a refined one, there's a huge difference. Cornflakes, and white bread, and sugar. They're all very high. Whereas when you go with things like cauliflower, broccoli, carrots and that sort of thing they're much, much lower. Dr. Mueller: So this is the process of creating high fructose corn syrup is along the same lines. We're breaking that down. We're processing it. We're taking out all of these other ingredients, such as the fiber, possibly the proteins, and then distilling it down into the sweetest form. And making it the most affordable sweetener, so then it gets added into all of these different processed foods. So inevitably, by avoiding these processed foods, we're avoiding these types of sugars that then create that spike in insulin, which then can drive fat gain. Dr. Fung: Exactly, exactly. So the thing is that people have always known this, right? So you can take a food such as a carbohydrate containing food. For instance, the Okinawan eat a lot of sweet potato. This is a traditional Okinawan diet. Now, they're eating all kinds of Americanized foods. But if you have them, and it's a high starch diet, it's high in sweet potatoes. But if you look at them from 30 years ago, there was no obesity. There was no diabetes, that kind of thing. But you compare that to somebody who just eats a lot of sugar, they will get all those problems. So you know it's not the food. It's not the carbohydrate. We have to get away from talking about percentage carbs because they're all different. They're not the same thing. You really have to talk about foods and which foods are making you fat because people have known for hundreds of years that, yes, if 2016 Slimitless, LLC. All rights reserved. 9

10 you eat candy, you're going to get fat. You're not going to get fat eating broccoli. You could eat 2,000 calories of broccoli and I doubt very much that anybody's going to be able to gain weight eating pure broccoli. It doesn't happen. And that's the thing about the calories argument that's been so destructive, is that they're saying that 1,000 calories of sugar is the same as 1,000 calories of salad with olive oil and vinegar. It's not even close! It's not even close. But yet you have doctors going out and saying, Oh, you can have dessert for dinner because they're both 1,000 calories. You know, the effect on the body is completely different. If you take 1,000 calories of Frappuccino, your insulin will go through the roof. Your glucose will go through the roof. If you take 1,000 calories of a spinach salad with nuts and olive oil, your insulin ain't going nowhere. So to say that a calorie is a calorie is completely and utterly incorrect. It's actually very destructive to say things like that. Dr. Mueller: Well, it seems pretty obvious. But you're right. When look at this from this advice of decreasing your food intake, or from a calorie standpoint. Dr. Fung: Yeah, because they've been confused that calories are the main issue. Calories is not the main issue. The main issue is the insulin effect. So what are those effects of those calories on your insulin? If you take 1,000 calories of Frappuccino, your insulin shoots through the roof. Therefore, it will eventually make you fat. We all know that. You take 1,000 calories of broccoli salad; your insulin goes nowhere. It's the same amount of calories, but the metabolic effect is completely different. So to say a calorie is a calorie, it s just been out there so long, it makes people not understand the issue. The thing is that you have to understand that obesity is not a caloric imbalance. It's a hormonal imbalance. We've imbalanced our insulin. There are periods where our insulin is high, and periods where our insulin is low. That's what they have to understand; is that it s all about the insulin Slimitless, LLC. All rights reserved. 10

11 Now, if you can understand that, then you can design a program to say, How are we going to change that? So low carbohydrate, high fat, unprocessed foods, because unprocessed foods are much lower in terms of spiking your insulin. And then we use a lot if intermittent fasting, as well since fasting is the most efficient way of lowering insulin because really, all foods generally raise your insulin levels, even protein. People don't understand sometimes that the protein, especially the meat proteins, can raise insulin even though they don't raise the blood glucose. Dr. Mueller: How does that happen? Dr. Fung: It's a bit complicated, but the insulin goes up at the same time the glucagon goes up. So it's effects tend to negate each other, but excess amino acids can also turn into sugar in the body. So it can be fattening in some cases if you overeat protein. It can be difficult. Dr. Mueller: Okay. Dr. Fung: One thing that doesn't is fat. But very few people eat fat alone. If you eat pure olive oil, your insulin actually doesn't go up very much at all. Or if you eat pure butter. This is why we have people who do these things like Bulletproof coffee, which is very popular these days. What you're doing is you're just taking almost pure fat, and then using that as a kind of hack. I don't like it because it's not a natural thing to do. But it's kind of a hack because you're getting a lot of calories, yet you're not having much of an effect on your insulin. Therefore, people say it just keeps you full because you've taken all those calories. But yet it's not fattening because you're not stimulating the insulin. I understand that it works. Lots of people swear by it, but to me it's not a natural thing to do, so I don't do it myself. But if people want to do it, and they enjoy it, then I say sure. I understand why it works, and if you like it then, go ahead, go for it. That's the thing, if you understand that all foods are potentially fattening, unless you go pure fat which is rare, then the way to lower your insulin the 2016 Slimitless, LLC. All rights reserved. 11

12 most is through intermittent fasting. If you eat nothing, then your insulin levels will fall to the lowest possible. Dr. Mueller: How does elevated insulin levels drive fat? Then I d like to then dive more into the intermittent fasting. Dr. Fung: This is where I think a little bit more research needs to come in to. The exact mechanisms are not entirely clear. A lot of people say it's because insulin is a fat storage hormone. So if you have a little insulin, you can store a lot of fat. That's not quite entirely true. I mean, it's a nice story, but I don't think it's entirely true. Obesity, essentially, is a disease of the brain. The control of your appetite, the control of everything, lies in the hypothalamus, which is a part of your brain that controls how much you eat. So it makes you hungry, or it makes you not hungry. So it integrates all the signals that are coming through your body. So if you have a lot of fat, for instance, it will produce leptin and make you eat less. But obesity must be controlled somewhere in the brain. But what is it that controls that signal to eat, or not to eat? So for a while there was a lot of excitement about leptin. Leptin, it turns out, it wasn't really the end answer. In obesity there is a lot of leptin resistance. We know that insulin causes weight gain. That we know, because we've done it. We give people insulin, they gain weight. Therefore, you know it's a cause and effect. So wherever it happens, it must happen somewhere in the brain. So there's some people who think that insulin's main action is to block leptin at the hypothalamus. That kind of makes sense to me, but the experimental proof of that is still lacking. From a practical standpoint it doesn't matter so much because when you lower insulin, you lose weight. So how it works is not as important as understanding that it works. That's the bottom line. Dr. Mueller: We're taught about the problems today is the advice that we give and we as a collective, as being the majority of physicians give is to decrease the calories, watch what you eat. And then to turn on metabolism, or 2016 Slimitless, LLC. All rights reserved. 12

13 to speed it up and I put that in air-quotes is to increase the frequency of eating. What you're saying is the complete opposite of both of those. Increase the food intake, but more importantly than the quantity, it's the quality of the food that you're eating. And then you're saying fasting, which is what I understand as decreasing the frequency of eating. Dr. Fung: Exactly. So there's actually two things you have to be concerned about in terms of weight gain. It's really what you're eating, but it's also when you're eating. We never forget about this sort of question of frequency in anything else. Say you're talking about how much money you make. The salary. You say, Oh I make $100. It's like OK, well that could be good if you make $100 an hour, or it could be bad if you make $100 a week. Which is it? Right? That's important. So it s the same thing. It's the number of calories times how often you take those calories. There's a whole question about the meal timing, and whether or not it's important or not. We think for some reason that if we constantly stimulate insulin by eating 6 times a day -- so one of the things that you can measure, is from the NHANE survey, which is a large survey of Americans. You can look back at 1977 and you can see that the meal frequency, which is defined not as just a meal but also snack times, so eating opportunities in 1977 was about 3 per day. Breakfast, lunch, dinner. That's it. Boom. Nothing else. Now, if you go to 2005, the average range is somewhere between 5 and 6. This is the average. So we've almost doubled the number of times we eat. It turns out it s something like this. Breakfast, snack, lunch, snack, dinner, snack. So the thing is that if you are constantly stimulating insulin, you're constantly telling your body that you need to store some of this energy. So what's normal is that you eat, insulin goes up, you store some of this energy for later for when you're not eating. That's called the fed state. When you're feeding. The fasting state is the exact opposite. Insulin levels fall, you take energy that you stored away, and you pull it out, and burn it for energy Slimitless, LLC. All rights reserved. 13

14 So if you go from a balance. 3 meals a day 12 hours of feeding, 12 hours of fasting, you've got a nice balance there. But we don't do that anymore. We eat the minute we get up, and then we never let our bodies rest. We never go into the fasting mode. We're always in the feeding mode. From the minute you get up, to the minute you go to bed, you're eating. You're always storing energy. So now you've gone from 12 and 12 kind of balance 50/50 balance and you're doing hours in the fed state and like 6 hours in the fasting state. That's not that hard to understand why we're gaining weight. The other thing is that the constant stimulation of insulin leads to insulin resistance, which leads to higher insulin levels, which is a whole circle that keeps going round and round even if you think about it generally. In the 1970's, obesity was a lot less of a problem and they only ate 3 times a day. So I don't know if you remember, but in the 70's what would happen when you came home and tried to get a snack, your mom would slap your hand and say, You're going to ruin your dinner. And now it's like, Oh please! Eat a snack! That's insane! Why would you think that eating more would make you lose weight? That doesn't really ever work. But somehow over the years we've decided that we have to eat all the time to lose weight, which is the exact opposite. You ask a 5-year-old child how you're going to lose weight, they'll probably say, Skip a few meals. And you know what? That's worked because now you let your body go into the fasting kind of mode, which is a normal thing by the way. It should be done every day. And you're letting your body pull out some of that stored energy. In fact, the very word breakfast is to break your fast, which implies that you should be fasting every single day. Dr. Mueller: I love that. Dr. Fung: That's what we used to do. So that's the thing about what we do. We have to catch up a little bit. So we add periods of fasting. If somebody fasts And we have people who do a day at a time, or even longer. But if you 2016 Slimitless, LLC. All rights reserved. 14

15 don't eat for a week, do you think you'll lose weight? Dr. Mueller: Most definitely. Dr. Fung: Well, of course. So what's the problem? There's only two problems. One, is can you do it. And that's where we help people with it. Because it's not fun, and it's not easy. The other question, is it unhealthy? It turns out that not only is it not unhealthy, it's actually got huge, huge benefits to your system. You get these benefits because you're letting your body clean out of all the excess sugar, and excess fat that you've stored over the years. That's really basically what it is. People have known this forever. They've called them different things, but they've always been something like a detoxification, a detox, cleansing, a purification. It's all the same idea. You just drink water, or tea, and let your body kind of clean out of everything. And you've got to understand that this is a natural process. This is not something unnatural. This is the way our bodies are designed. Think back to the caveman days. It's not like they had a refrigerator and ate three times a day otherwise they'd die. Their bodies had the ability to store energy for times when you didn't have anything to eat. And when you didn't have anything to eat, your body would eat its own fat because that's what it is. Fat is just stored food. You're eating the food that you stored away. What's wrong with that? There's nothing wrong with that. That's the way we're built. The problem is that we don't do it. There's a lot of people who don't want you to fast. All the food companies, all the pharma companies, and so on. It doesn't make any sense. Dr. Mueller: So from a standpoint of seeing this success, not only in your practice, but if it's been going on since the Paleo days, are there specific areas in the world that continue to practice fasting? Dr. Fung: Well, there are a lot of people who do fasting. And if you looked at 2016 Slimitless, LLC. All rights reserved. 15

16 all the cultures of the world, there are supposed to be periods of fasting. But in most Western cultures, they've been really denigrated, so to speak. If you look at Buddhism for instance, they very often fast from 12 o clock noon, until the morning the next day. So almost an 18 hour fast every day. Muslims, of course have the holy month of Ramadan. Again, it gets changed over the years. Ramadan, for instance, is you can t eat from sunup to sun down. Unfortunately, now people kind of binge before the sun comes up, and binge when it goes down. Which kind of defeats the whole purpose of the cleaning and the purification. Even things like the 40 days of Lent, very rarely do people do that. You're supposed to fast once a week on Fridays. Then it was fish on Fridays. Now very few people do that anymore. You can see that these things have been a part of our culture, but over the years in the modern century it's been cut down a lot. And no surprise, we're seeing a lot more of the obesity and the type 2 diabetes, which are the diseases of course, which would be most impacted by these because you're cleaning out that excess sugar. You're cleaning out all that excess fat. So you're going to get better. But people used to do these long fasts all the time. 7 days, 40 days even. Those were not abnormal in the past. Now it's so abnormal that people don't know how to do it anymore. And that's what we help people with. Dr. Mueller: People are scared about doing it, too. They think that you re starving yourself. That's definitely the thing that I hear the most when I start to recommend this type of thing to patients is, I'm going to be starving myself, and helping people understand that's not the case. Dr. Fung: The starvation is entirely different. Starvation is the involuntary absence of food. When you don't have anything to eat, and don't know when it's coming like those starving kids in Africa that s starvation. That's not healthy. Fasting is the voluntary withholding of food for various reasons. It's a completely different situation Slimitless, LLC. All rights reserved. 16

17 And the other thing you have to understand is that fasting is if you are significantly malnourished, yes, you should not be fasting. If you're a child, if you're pregnant, if you're breastfeeding. In those cases, yes, you should not be fasting because your body needs nutrients. But the thing is that the obesity, the type 2 diabetes, they're essentially situations of over-nutrition. We have too much sugar. Therefore, the best treatment is to get rid of it. Everybody thinks they'll be tired, for instance, but that doesn't happen because the body switches from burning food, to burning fat. Your energy level should stay the same. And that's what the studies show. It stays the same. You might be hungry, but you shouldn't be tired. You can do all your normal activities because you're simply accessing the fat that you stored away. It's something that does take some time. The first couple times you do it, it's going to suck. It's going to be hard. They talk about these things in the ketogenic diet. They talk about this ketoflu, or keto-adaptation, and it's essentially the same thing. As your body tries to switch from burning sugar to burning fat, there's about a 2-, to 3-week period of time where, if you've never done it, you really feel lousy. That's because you're not burning sugar because none of it's coming in. And your body's not really used to burning fat, so you feel not so good for about a couple of weeks. Then after that, after your body gets used to burning fat, that's it. Remember fat is just stored food. It's not there for looks. It's there for when you don't have anything to eat. So if you never not have anything to eat, you'll never burn it off. Think about it this way. Imagine that you have a refrigerator and a freezer. The freezer is the long-term storage. You put food into the fridge, and put food into the freezer. But after a while, you find that you have like 10 freezers full of food. But every day you go out, you buy food. You put it in the fridge. Go out, buy food, put it in the fridge. And as soon as your fridge gets a little low, you go out and buy some more because, hey, your food is getting low in the fridge. How do you think you're ever going to use up that food in the freezer? 2016 Slimitless, LLC. All rights reserved. 17

18 Well, you never will because you've always got food in the fridge. It s the same idea. If you always have sugar hanging around in the form of food, or stored in your liver, you re never going to burn your fat. There's no reason to. But if all of a sudden you decide, okay, I'm not going to go the store and get food. What's going to happen? Well, your refrigerator will go empty. Then what's going to happen? Are you going to starve? No. You're just going to take the food out of the freezer. Dr. Mueller: I love that analogy. Dr. Fung: Because it makes sense. It's just stored food. That's how it got there. But you ve got to get rid of all the food in your fridge. It's essential. If you just simply buy a little less food, then you'll just eat a little less food. That's all that happens. So when you eat a little less, your metabolism goes down to match. You still don't burn off the food in your freezer. That's the thing. Dr. Mueller: So what I hear you saying is that fasting can come in different shapes in sizes from the duration that we do a fast, to the frequency that we're doing a fast. And so when you're working with patients and you're talking to them and you've gotten them to feel more comfortable about attempting a fast, what are some of the recommendations that you go by to help them slowly introduce this process so that they can start to clear the glucose? So they can start to clear the insulin, and start to activate all the stuff that's in the freezer, the fat as energy? Dr. Fung: You can do anything. It comes in all shapes and sizes. The fact is, that the fasting, really you can go as long or as short as you want. Typically, you can do 1 of 2 ways. You can break into it easily. So start with say, skipping breakfast. And then skipping breakfast, and lunch, for instance. Then doing the full day. Some people like to go in gently, and some people like to just go in, boom, right away. There's no right or wrong answer. The first couple times you do it; it's going to be bad anyway. So some people like to get it over with Slimitless, LLC. All rights reserved. 18

19 It's like going in the pool. Sometimes some people like to wade in, and some people like to cannonball right into the deep end. It s the same idea. You can do it either way, and you can do it as long, or as short as you want. Typically, it depends. If we have older people, or if we have people who are very leery, then we'll go very gently. We'll say, Okay. Start with skipping breakfast, 3 times a week. That's usually not hard for people to do. Then you simply move it up. Then you say, Now you can skip breakfast, and lunch. And that's a 24-hour fast. If you eat dinner, then skip breakfast, skip lunch, and then go right through till dinner, that's a 24-hour fasting period. If you do that twice a week, you'll actually do a lot of good over a period of time. If you need faster results, then you can go longer. You can go the full day. So you go breakfast, lunch, and dinner, and then you can start going multiple days. You do have to be careful. You have to talk to your physician, especially if you're on medications that have to be adjusted, for instance. But that s why we like for older people who are on medications, who have any medical problems, we like to go slowly. Because if they kind of just skip breakfast, then they get their system used to it. Then they go breakfast, and lunch, and get used to it. And then the medications, they're able to adjust, and everything, and it's a bit more gentle process. But we do all different kinds. You have to be prepared, again, that the first couple of times is going to be quite difficult. And that's where people often fall off the wagon. When they don t get the support. So people have tried it and then somebody inevitably comes up and tells them, Oh you can't do that! You're going to go into starvation mode! Then they stop doing it and we have to tell them, No, it's okay. We've done it. We've done it for hundreds and hundreds of patients and we've seen a lot get better. Other times we'll have - we're different in that I see patients that are quite severe, and I supervise them personally, and so on. We do longer ones, but 2016 Slimitless, LLC. All rights reserved. 19

20 only under strict supervision. We check their blood work. We have them check their sugars all the time. I personally manage their medications. Those ones I would definitely leave for somebody who knows what they're doing and is familiar with that. But starting slowly is a great idea. Build it up, and then do it on a consistent basis. Dr. Mueller: The common one that I'll recommend initially is the 12 and 12 as you indicated before. With only 3 meals, trying to reduce the snacking in between. And then go to the more popular one, or the one that I see talked about more than any other is the 16 hours of fasting and 8 hours of feed time, I guess you could say. Where you re really not eating the entire 8 hours, but cutting down to 1, 2 larger portion meals in that period of time. Is that something that you would consider as intermittent fasting? Dr. Fung: The 16-8 is good. I don't really consider it fasting. Some people call it time restricted eating. In that you're still eating. In fact, you could eat 3 meals, but within that 8 hours. But the idea is the same. It really is a very gentle form of intermittent fasting. We try to get everybody on that, so we tell people you should try to skip breakfast on most days. That automatically puts you into sort of a 16-8, and then you can kind of add from there. Everybody says breakfast is the most important meal of the day. It's not really. It's a meal of the day. But it's not the most important. Dr. Mueller: Especially when the quality of that food tends to be mostly processed carbohydrates in the Standard American Diet. Dr. Fung: Exactly. So if you think about breakfast. It's the meal that breaks your fast. But there's nothing that says you have to break your fast at 7 in the morning. You can break your fast at 12 noon. There's nothing wrong with that. The problem, as you said, is that breakfast, everybody s in a rush. So what do we do? We get a slice of toast. We get cereal. All highly processed 2016 Slimitless, LLC. All rights reserved. 20

21 carbohydrate-heavy foods. We're not eating the traditional bacon and eggs. Once in a while we do. It s a real treat because most people are rushing out the door, getting your kids to school, and rushing into work. Forget it. Simplify your life. Just have a cup of coffee. Have a big glass of water. Have a cup of green tea and wait to break your fast until noon time. In a sense, that breakfast meal is important, but you can do it at 12 noon. There's nothing wrong with that. I tell people, think about it this way. When you eat, you're storing food. When you're sleeping, you have to pull some of that food energy out. By skipping breakfast and giving yourself an extra 5 hours, from 7 to 12, where's your energy going to come from? It's got to be pulled out of your body because you re not eating. So you're giving your body a bit of extra chance to burn off that food energy. That s it. So 16:8 is a great thing. And we try to use that as a baseline for a lot of people and kind of layer on from there. It makes it very easy because if you're used to skipping breakfast and having, going lunch, dinner kind of thing, then doing a 24-hour fast just means skipping lunch every once in a while. You work through lunch. That's it. That's a 24-hour fast. If you do that twice a week, hey, it's like the 5 to 2 diet or whatever. There're very similar to that. By skipping breakfast as a baseline, it makes that very easy. You re lengthening your daily fasting period. Shorter fasts, of course, you generally do more often. If you do a 12-hour, 14-hour fast, you should be doing that every day. That s just normal. If you re going to go to the 16:8, you could do that every day, or like 5 days a week, and you'll probably get benefit. And then when you start going to the 24-hours, you might do that 2 to 3 times a week. You see, you go longer and you typically do it a little less frequently, depending on what your goals are. Dr. Mueller: Great. I really appreciate your time. I appreciate you debunking the common myths such as the calories in, calories out. The myths that a lot of our physicians are recommending still today is the decreasing the food 2016 Slimitless, LLC. All rights reserved. 21

22 intake, and increasing the frequency of eating and really getting at some of the underlying issues here specifically, from a hormonal standpoint, insulin being the main driver of fat storage and then how to implement different strategies, such as food intake being low carbohydrate, higher fats, and decreasing the frequency of the eating to be able to help interact, and decrease the insulin levels. Now, Dr. Fung, is there anything right now that you re working on that you d like to tell the listeners about? Dr. Fung: I've got my book, The Obesity Code, which goes over a lot of this. Trying to understand what the causes of obesity are. You can also get more information on my website which is Our program is called, The Intensive Dietary Management Program. So that's the website. And I do a weekly blog, and there's also links to our lectures on YouTube, and so on. So there's a lot of information there on obesity, on fasting, on type 2 diabetes. I'm also writing a book with Jimmy Moore that should be coming out in November of 2016 dealing specifically with fasting. That should be an interesting project, as well. Dr. Mueller: Great. Dr. Fung, thank you for shining the light on the dogma that is the calorie in and calorie out. That we have, as industrialized nations, have become more obese because we're more gluttonous. We can't control our appetite, and that we've become more lazy. We're not exercising enough, taking the blame off of people who are overweight. It is not your fault. There are other underlying issues at hand here. And one of the biggest ones is how your body responds to sugar, carbohydrates with its glucose and insulin. Each person is just a little bit different. Dr. Fung, thank you very much, also for giving us a real solution in intermittent fasting. So, now that you know more about this. Now that you have some tools, I 2016 Slimitless, LLC. All rights reserved. 22

23 encourage you to begin the change in your life now. Add more tools to your hero tool belt by bringing this information home with you. Click the link beside or below and purchase this interview. And share it with your friends, your loved ones, your family members so that we all can reach our full potential. This is Dr. Rudy Mueller saying live happy, live healthy, and affect others positively. Thank you so much for listening Slimitless, LLC. All rights reserved. 23

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