The Power of Fasting - Doctor Jamnadas

 

I've been pretty excited about talking to you for a number of months now ever since i saw some of your youtube videos so first of all thank you for making time to come onto the show. 

It's a pleasure for me i'm honored actually and i've been watching your shows too,  amazing. 

Aku sangat bersemangat untuk membahas ini denganmu selama beberapa bulan, sejak aku melihat beberapa video YouTube mu. Jadi pertama-tama Kuucucapkan terima kasih telah meluangkan waktu untuk datang ke acara ini. 

Ini merupakan kesenangan bagiku, sebenarnya kumerasa tersanjung. Aku juga telah menonton acaramu, yang sangat luar biasa

Well I think there's a lot that we're gonna share, a common view. And I want to unpick a lot of that to start off though you were cardiologists you're very proactive about promoting the benefits of fasting with your patients. And i guess across society as a whole. 

So right at the start of this conversation I wonder if you could outline what are the key benefits of fasting that you have seen in your patients?

Aku rasa ada banyak hal yang akan kita bagikan, seperti kesamaan pandangan. Aku ingin memilih banyak hal untuk memulai meskipun kau seorang ahli jantung. 

Kau sangat proaktif dalam berpromosi manfaat PUASA 

• bagi pasienmu, 
• dan masyarakat secara keseluruhan.

Jadi di awal percakapan ini, aku ingin tahu apakah aku dapat menguraikan manfaat utama puasa yang kau lihat pada pasienmu yang mengalami trauma

You know i've been a cardiologist for 30 years. And i've tried everything but when i tried fasting, I started seeing changes.  

• People began to LOSE WEIGHT, 
• people's BLOOD PRESSURES came down 
• DIABETES got reversed 
• the progression of CORONARY ARTERY disease went down.

You see I had the benefit of seeing patients from day one. So I saw that they were having a second angioplasty, another heart attack in two years, five years. I saw the numbers going down on those whom I was able to get them to lose weigh, through a FASTING PROGRAM. And I tried lots of programs they didn't seem to work, but fasting did so 

• decreased BLOOD PRESSURE 
• decreased DIABETES  
• RE-HOSPITALIZATION 
• LV (Left Ventricular) FUNCTION seemed to stay GOOD which means that heart muscle function continued to do well 
• PATIENTS MENTALLY also seem to be doing better. 

So fasting gave me not just this benefit, but a lot more, also my patients didn't end up in the hospital with FRACTURES or FALLS and had stronger muscles and mentally. They were better so I started seeing that just generally patients were doing better. Your doctor's tell me, how come you're adopted your patients? don't end up in the ER (Emergency Room) with acute heart attacks.

Aku sudah menjadi ahli jantung selama 30 tahun. Dan sudah mencoba segalanya, tetapi ketika kucoba dengan berpuasa, aku mulai melihat perubahan pasien, seperti

• mulai menurunkan berat badan,
• tekanan darah pasien mulai turun
• diabetes menjadi terbalik membaik
• perkembangan penyakit arteri koroner menurun.

Bahkan aku mendapat manfaat dari menemui pasien sejak hari pertama. Jadi ketika melihat mereka terjangkit angioplasti kedua, yaitu semacam serangan jantung yang terjadi dalam dua tahun, lima tahun terakhir, kulihat angka2 menurun padanya yang berhasil menurunkan berat badannya, melalui program PUASA. Aku juga mencoba banyak program yang tampaknya tidak berhasil, tetapi puasa berhasil (misalnya dalam)

• penurunan tekanan darah
• penurunan diabetes
• re-hospitalisasi  
• Fungsi lv tampak tetap baik yang berarti fungsi otot jantung tetap baik
• pasien secara mental juga tampaknya menjadi lebih baik.

Jadi puasa tidak hanya memberiku manfaat ini, tetapi lebih banyak lagi. Pasienku tidak harus dirawat di rumah sakit, karena patah tulang atau terjatuh. Bahkan mereka memiliki otot dan mental yang lebih kuat, lebih baik. Jadi aku mulai melihat bahwa secara umum kondisi pasien lebih baik. Doktermu memberitahuku, Kenapa kamu coba2 hal baru terhadap pasienmu.. takutnya berakhir di UGD dengan serangan jantung akut lho..

 

With all these benefits I saw with fasting. With all these you know quite different benefits that you've just outlined for us. Why is it do you think that very few medical doctors are promoting fasting with their patients? 

Of course as you've demonstrated 

• It has huge benefits, 
• It's very effective 
• It's also kind of free of charge

So why is there such a resistance among you know like our profession to recommend this as a treatment. 

Dengan semua manfaat PUASA, yang bisa kulihat. Dengan semua itu, aku bisa mengetahui manfaat yang sangat berbeda, yang baru saja kau uraikan tadi.. 

Mengapa menurutmu sangat sedikit dokter yang menganjurkan puasa kepada pasiennya?

Tentu saja seperti yang sudah kau tunjukkan, 

• manfaatnya sangat besar,
• itu sangat efektif
• itu juga gratis

Jadi mengapa ada penolakan di antara para dokter yang seprofesi untuk merekomendasikan PUASA sebagai pengobatan? 

It's a tough sell and It takes time you see you're only as good as getting into your patients brain, can you get in there? and make them make those changes? and that's a tough one.

Yeah because all you're doing is you're giving them the advice 

• there's no tools for me to give them, 
• there's no tablets to give to them

They've got to make that effort and all I got to do is get into their brain change, the way they think. And if they get convinced that yes doc.. is telling me something that resonates inside me, and I'm  gonna make that change. Then they'll do it. 

Ini berbicara tentang hal yang sulit. Butuh waktu untuk menyadari hal ini kecuali ketika kau sudah bisa mempengaruhi pasienmu. 

Bisakah kau masuk ke otaknya? dan membuat mereka melakukan perubahan tersebut? tentu saja itu sulit.

Ya karena yang kau lakukan hanyalah memberi mereka nasihat

• Tanpa ALAT untuk kuberikan kepada mereka
• tanpa OBAT untuk diberikan kepada mereka

Tetapi mereka harus melakukan upaya itu. Dan yang harus kulakukan hanyalah mengubah otak mereka, cara pandang mereka, cara mereka berpikir. Jika mereka yakin bahwa 

Ya dokter memberitahuku sesuatu, kemudian merasuk ke dalam diriku, menggema dalam diriku, dan aku bertekad akan melakukan perubahan itu. 

Nah jika demikian baru mereka akan melakukannya.

So the trouble is that most of those doctors are too busy. We're actually taking care of disease processes, rather than prevention. Here we're really talking about a lifestyle change, and that's the hard part about fasting, and talking to someone about fasting. Physicians find it very difficult to talk to them about that, because you can just tell them that okay these are the benefits. That's not good enough. It takes much more than that it's a deeper dive into the patient's lifestyle.

• How do you wake up in the morning? 
• How do you feel in the morning
• What are the main issues in your life? 

Jadi masalahnya adalah kebanyakan dokter itu terlalu SIBUK. Kami sebenarnya fokus mengobati penyakit,bukan melakukan pencegahan. Di sini kita benar2 berbicara tentang perubahan gaya hidup, itulah bagian tersulit dari puasa.  

Berbicara dengan seseorang tentang puasa, dokter merasa sangat sulit melakukanya, karena cukup memberi tahu mereka bahwa oke, inilah manfaatnya. Itu tidak cukup. Dibutuhkan lebih dari itu, yaitu menyelami lebih dalam gaya hidup pasien.

• Bagaimana kau bangun di pagi hari?
• Bagaimana perasaanmu di pagi hari
• Apa permasalahan utama dalam hidupmu?

So it's not just about fasting. It's about your relationships, 

• who are you 
• what's your life all about?

All that affects your diet because see fasting is also about it's much more, it's about your whole life. It's about 

• who do you think you are? 
• And can you empower yourself to do it?
• or are you just a slave to your day-to-day routines, and advertising? 

So to get somebody to fast, you really need to change the whole outlook on who they are. 

• You are not your habits, 
• you are not even your body 

You are something that can change everything. There's a separate part of you besides your body. Even your mind there's a separateness, there's an awareness inside you. 

Jadi ini bukan hanya soal puasa. Ini tentang 

• siapa kamu sebenarnya?
• bagaimana kehidupanmu?

Semua itu mempengaruhi pola makanmu, karena bahasan PUASA juga tentang itu, bahkan lebih dari itu juga tentang seluruh hidupmu. Ini juga tentang siapakah kamu sebenarnya? Dan bisakah kau memberdayakan dirimu sendiri untuk melakukannya? atau kau hanya menjadi budak rutinitas sehari-hari? dan hanya penamoilan saja?

Jadi untuk membuat seseorang berpuasa, kita benar-benar perlu mengubah seluruh pandangan tentang siapa mereka sebenarnya.

• Kau itu bukan kebiasaanmu,
• kau bahkan bukan tubuhmu,

Kau adalah sesuatu yang dapat mengubah segalanya. Ada bagian terpisah dari dirimu selain tubuhmu. Bahkan pikiran Anda pun ada keterpisahan, ada kesadaran di dalam diri Anda.

And if I can get into that awareness, then I can empower you. And if I can empower you, then I can make you fast. So doing this whole thing, it's not easy for most physicians. And you know even people are dedicated to teaching people about diet. It's a hard sell and i think that our approach has to change our approach. 

I first look at patients and I have to empower them to say you know 

• you are more than what you think 
• you are you can do it 

Your videos on youtube have been going viral, for a number of years. Now and you know i've read a lot of the comments, and I've watched a lot of those videos. And I think what one of the many things people deeply resonate with you.

Dan jika aku bisa masuk ke dalam kesadaran itu, maka aku bisa memberdayakanmu ya. Dan jika aku bisa memberdayakanmu, maka aku bisa membuatmu cepat. Jadi melakukan semua ini bukanlah hal yang mudah bagi kebanyakan dokter. Dan tahukah Anda bahkan ada orang yang berdedikasi untuk mengajari orang tentang diet. Ini adalah penjualan yang sulit dan saya pikir pendekatan kami harus mengubah pendekatan kami.

Saya pertama kali melihat pasien dan saya harus memberdayakan mereka untuk mengatakan Anda tahu

• kamu lebih dari apa yang kamu pikirkan
• kamu adalah kamu bisa melakukannya

Video Anda di youtube telah menjadi viral selama beberapa tahun. Sekarang dan tahukah Anda, saya telah membaca banyak komentar, dan saya telah menonton banyak video itu. Dan menurut saya, salah satu dari banyak hal yang sangat disukai orang-orang terhadap Anda.

And your message about is this real passion to help people. And this real passion to empower people. And I want to sort of dive in there a little bit because you are you know a very well respected cardiologist. 

• You literally go into people's hearts. 
• You put in stents, 
• you do all this kind of stuff in some ways 

You know as life-saving as putting a stent in someone's heart potentially can be you know it's slightly disempowering isn't it it's kind of like well i've got to rely on the skill and ability of my doctor to be good at what he does, to be sharp on the day to have slept properly the night before right those all these things are out of my control as a patient whereas pretty much everything you're talking about and we're going to go through in detail today it's about putting the patient back in control of their health and i guess i would argue their wider happiness as well. 

Dan pesanmu adalah semangat nyata untuk membantu orang. Dan semangat nyata ini untuk memberdayakan masyarakat. Dan aku ingin menyelaminya  lebih dalam karena kau adalah seorang ahli jantung yang sangat dihormati. 

Kau masuk ke dalam hati orang, 

Kau memasang stent, 

Kau melakukan semua hal semacam ini dengan beberapa cara yang Anda tahu bisa menyelamatkan jiwa, seperti memasang stent di jantung seseorang.

Kau tahu itu sedikit melemahkan, bukan? itu semacam baik-baik saja aku harus mengandalkan keterampilan dan kemampuan dokterku untuk menjadi ahli dalam apa yang beliau lakukan. Untuk menjadi ahli pada hari itu agar dapat tidur nyenyak pada malam sebelumnya, kan, Semua hal ini di luar kendaliku sebagai seorang pasien, padahal cantik semua yang kau bicarakan dan akan kita bahas secara mendetail hari ini adalah tentang mengembalikan kendali pasien terhadap kesehatannya. Kurasa juga akan memperdebatkan kebahagiaan mereka yang lebih luas.

Absolutely and that's the thing that the patients have to take responsibility. Because the medical profession, the way it's set up right now. We just we're not in a position to do that. We have to you know 

• We don't have enough resources. 
• We don't have enough time 

so what we can do is we can educate patients. And we can throw light on the issues that have brought them to where they are now. And show them how they can get out of it.

• Show them, 
• empower them,
• and educate them,

so that they make their decisions. And when they make their decisions they will do it. And then it's self-empowering. It feeds back on themselves, and says…

look i was able to do this and i didn't think i could do this and so that brings us to that issue. 

That there are so many layers of onions that we can peel off. And fasting is the one that really seems to me to open up aspects of their lifestyle which they would not have otherwise looked at. 

Because fasting does bring in lots of issues into their life. It opens up the introspection into their life. It's what's going on, what's driving these things in my life. And that's what I like about fasting, it's so different imagine. If i just give them a diet and say okay you're just gonna eat this, okay they don't eat that. That's it but in fasting it's self-control it's deeper thinking about the habits. And all the other things that we're going to talk about.

Benar-benar mutlak dan itulah hal yang harus ditanggung oleh pasien karena profesi medis sudah diatur saat ini, hanya saja kami tidak dalam posisi untuk melakukan itu. Kami harus tahu bahwa kami tidak memiliki sumber daya yang cukup, kami tidak memiliki cukup waktu, jadi apa yang dapat kami lakukan adalah memberikan edukasi kepada pasien dan menyoroti permasalahan yang telah membawa mereka ke kondisi sekarang dan menunjukkan kepada mereka bagaimana caranya. mereka dapat keluar dari situasi tersebut dengan menunjukkan bahwa mereka memberdayakan dan mendidik mereka sehingga mereka dapat mengambil keputusan dan ketika mereka membuat keputusan, mereka akan melakukannya. Dan kemudian itu adalah pemberdayaan diri, ia memberi umpan balik pada diri mereka sendiri dan mengatakan lihat saya bisa melakukan ini dan saya tidak berpikir saya bisa melakukan ini dan itu membawa kita pada masalah bahwa ada begitu banyak lapisan bawang yang kita miliki. dapat terkelupas dan puasa adalah salah satu hal yang menurut saya benar-benar membuka aspek gaya hidup mereka yang sebelumnya tidak akan mereka lihat. Karena puasa memang membawa banyak masalah ke dalam hidup mereka, itu membuka introspeksi ke dalam hidup mereka, itulah yang terjadi, apa yang mendorong hal-hal ini dalam hidup saya, ya, dan itulah yang saya sukai dari puasa, itu sangat berbeda bayangkan jika saya hanya memberi mereka diet. dan bilang oke kamu makan ini saja oke mereka tidak makan itu itu saja tapi dalam puasa itu pengendalian diri itu memikirkan lebih dalam tentang kebiasaan dan semua hal lain yang akan kita bicarakan

Yeah in many ways fasting is you know really swimming against the tide of societal norms. Because we live in a society of abundance yet fasting is self-imposed scarcity. And you know we're going to talk about fasting from foods and the benefits for various different disease processes but also for promoting health and well-being. But you could take it a little step further couldn't you we're going to sort of link mind and body and heart all together well it's not just about fasting from food is it it's it's also we can take social media fasts we can take alcohol fast we can take caffeine fast even that term fasting it goes far beyond just food really doesn't it. 

Ya, dalam banyak hal, puasa memang benar-benar berenang melawan arus norma-norma masyarakat. Karena kita hidup dalam masyarakat yang berkelimpahan namun puasa adalah kelangkaan yang disebabkan oleh diri kita sendiri. Dan tahukah Anda, kita akan berbicara tentang puasa dari makanan dan manfaatnya untuk berbagai proses penyakit, tetapi juga untuk meningkatkan kesehatan dan kesejahteraan. Tapi Anda bisa mengambil langkah lebih jauh bukan? Kita akan menghubungkan pikiran, tubuh, dan hati bersama-sama dengan baik. Ini bukan hanya soal puasa dari makanan, tapi kita juga bisa berpuasa di media sosial. alkohol dengan cepat kita dapat mengonsumsi kafein dengan cepat bahkan dalam istilah puasa, itu lebih dari sekadar makanan, bukan

Absolutely you have so much insight into this you've just hit me onto something very important when we talk about our habits in fasting you know addiction really to eating and this pattern you also talked about digital addiction you almost just you didn't quite say it in that way but there is digital addiction there's alcohol addiction there's gambling addiction there's other forms of addictions and sugar addiction 

and all these things seem to go to that part of the brain. That gives us that reward so we're living in a society where it's all about the instant rewards and when you prime yourself in one area you can slip into other areas as well and that brings up this whole addiction thing that perhaps this pattern of eating that we've developed and this addictive pattern of eating every few hours all the time it's really an addiction it is an addiction and it it seems to give us that instant reward and doesn't really matter what you're eating but it's the fact that you're eating all the time and we need to get out of this so we need to really look at our whole life to say that look the dopamine centers are primed already from a young age and  yes we are addicted we're an addicted society. you know that the book that i just finished reading a few months ago um dopamine nation i think it's called fascinating insights that you know you prime yourself in one area and then you'll slip into another addiction very easy and i think that food is one of them yeah i am convinced that food is one of them so yeah no you're absolutely right it is it's a whole lifestyle and and i tell my patients that if you really want to come off your current eating habits we need to look at your whole life as well 

• are you addicted to alcohol 
• are you addicted to to caffeine 
• are you addicted to sugar 
• are you addicted to even digital media 

because it's just the way we're priming ourselves  and when they start looking to that they do see inside this oh my god he's right you know i am probably addicted to this pattern and i can get out of it

Tentu saja kau memiliki begitu banyak wawasan tentang hal ini. Kau baru saja memberitahuku sesuatu yang sangat penting. Ketika kita berbicara tentang kebiasaan kita dalam berpuasa, Anda tahu benar-benar kecanduan makan dan pola ini Anda juga berbicara tentang kecanduan digital, Anda hampir saja tidak begitu mengatakannya. memang seperti itu, tapi ada kecanduan digital, ada kecanduan alkohol, ada kecanduan judi, ada bentuk-bentuk kecanduan lainnya, dan kecanduan gula

dan semua hal ini sepertinya mengarah ke bagian otak itu. Hal ini memberi kita imbalan sehingga kita hidup dalam masyarakat yang mengutamakan imbalan instan dan ketika Anda menguasai satu bidang, Anda bisa masuk ke bidang lain juga dan itu memunculkan kecanduan yang mungkin adalah pola makan ini. yang telah kita kembangkan dan pola makan yang membuat ketagihan setiap beberapa jam sepanjang waktu itu benar-benar sebuah kecanduan itu adalah sebuah kecanduan dan tampaknya memberi kita imbalan instan dan tidak terlalu peduli apa yang Anda makan tetapi itulah faktanya bahwa Anda makan sepanjang waktu dan kita harus keluar dari ini jadi kita perlu benar-benar melihat seluruh hidup kita untuk mengatakan bahwa pusat dopamin sudah prima sejak usia muda dan ya kita kecanduan, kita kecanduan masyarakat. Anda tahu bahwa buku yang baru saja saya selesai baca beberapa bulan yang lalu um negara dopamin menurut saya ini disebut wawasan yang menarik bahwa Anda tahu bahwa Anda mempersiapkan diri dalam satu bidang dan kemudian Anda akan terjerumus ke dalam kecanduan lain dengan sangat mudah dan menurut saya makanan adalah salah satunya. di antaranya ya, saya yakin bahwa makanan adalah salah satunya, jadi ya tidak, Anda benar sekali, ini adalah gaya hidup secara keseluruhan dan saya memberi tahu pasien saya bahwa jika Anda benar-benar ingin menghentikan kebiasaan makan Anda saat ini, kita perlu memperhatikan pola makan Anda. seumur hidup juga

• apakah kamu kecanduan alkohol
• apakah Anda kecanduan kafein
• apakah kamu kecanduan gula
• apakah Anda kecanduan bahkan media digital

karena itu hanya cara kita mempersiapkan diri dan ketika mereka mulai mencarinya, mereka benar-benar melihat ke dalam ini ya Tuhan dia benar, Anda tahu saya mungkin kecanduan pola ini dan saya bisa keluar darinya

I've read that Book Dopamine Nation. I actually spoke to Anna Lemke, who wrote that just a few weeks ago on this show a great conversation i agree it's a it's an awesome book um many of us have heard of fasting we've heard that various religions have used fasting for years many of us depending on what culture we have grown up in may know that our parents or our grandparents would fast from time to time yet despite knowing that certainly in our current society, many of us aren't taking that next leap. 

Many of us think you know what i know i've heard you say before that you were a bit skeptical of fasting when you're at medical school many of us probably have thought in the past that oh yeah you know what did my grandparents know you know i'm not going to fast and what i'd love to do because i think you do it so well is really go through what happens in the body biochemically physiologically when we start fasting. Because i think for many people they're going to need that knowledge and that science to convince them that actually you know what maybe i should give this a go.

Aku sudah membaca buku Dopamin Nation. Saya benar-benar berbicara dengan Anna Lemke yang menulis bahwa beberapa minggu yang lalu di acara ini ada percakapan yang hebat. Saya setuju itu adalah buku yang luar biasa. Banyak dari kita pernah mendengar tentang puasa, kita pernah mendengar berbagai macamnya. Agama telah menerapkan puasa selama bertahun-tahun, banyak di antara kita, tergantung pada budaya tempat kita dibesarkan. Mungkin mengetahui bahwa orang tua atau kakek-nenek kita akan berpuasa dari waktu ke waktu. Namun meskipun kita mengetahui bahwa dalam masyarakat saat ini, banyak dari kita yang tidak melakukan puasa. lompatan berikutnya. 

Banyak dari kita berpikir kamu tahu apa yang saya tahu Saya pernah mendengar kamu mengatakan sebelumnya bahwa kamu agak skeptis terhadap puasa ketika kamu berada di sekolah kedokteran. Banyak dari kita mungkin pernah berpikir di masa lalu bahwa oh ya kamu tahu apa yang diketahui kakek dan nenekku. Anda tahu saya tidak akan berpuasa dan apa yang ingin saya lakukan karena menurut saya Anda melakukannya dengan sangat baik adalah benar-benar menjalani apa yang terjadi di dalam tubuh secara biokimia dan fisiologis ketika kita mulai berpuasa. Karena menurut saya banyak orang akan membutuhkan pengetahuan dan sains tersebut untuk meyakinkan mereka bahwa sebenarnya Anda tahu apa yang mungkin saya harus mencobanya.

Yeah no absolutely absolutely you know what fasting does it allows the body to do what it was made to do you see we eat eat eat insulin comes in puts everything into storage so you build up some fat and then you're supposed to live so when you live you now start utilizing your calories and you start burning the sugar when that goes out after maybe about four hours or five hours then the you know glycogen stores in your liver and then your muscles start breaking down start giving you the calories that you really need to burn so you can run do your day-to-day activities and all that. And when you run out of that by let's say about 18 hours or 20 hours and then the body says hmm i need to stop burning fat now that's what you're supposed to do that's why you put on fat in the first place that's why we have fat it's a storage and then you start burning that fat and therefore you start burning that fat so the fat comes out comes into your liver gets converted to some ketones perhaps and now you're making ketones and the ketones are being utilized for energy and then you go for your next meal again so the body was made to do this 

it was not made to just pile on pylon pylon all the time because that that results in increased fat stores which you'll never break down. So your body was supposed to do this from the from the design you're supposed to do this so the important thing is that when you eat, and you're taking calories your insulin level obviously goes up why because insulin has to get that sugar out of the bloodstream blood sugar must always come down. Because otherwise you get damaged from that high glucose level in your bloodstream. That's why we treat diabetes right because the blood sugar or the glucose rather attaches itself to proteins glycation end products and therefore these proteins become they become dysfunctional so insulin says i'm going to take the glucose out put it down into the blood into the storage first place it puts it into is the liver when the liver stores are full then it spills over into the pancreas. More calories coming there's more glucose then it goes into the muscles and it stores everything and from there into the skin and that's the way it was supposed to be. but now when we continue to do that we just keep piling it on piling it on we never get a chance to burn it down and we're supposed to burn it down. 

so the biochemistry of the body was made for feeding fasting cycles and this is the way the the other the bioengineering of our body was but we became dysfunctional because as food became more available we just kept piling it on and on and on and on. And that's the problem that we have today is exactly what you said excessive calories too frequently so our insulin levels stay high all the time so that's the biggest problem i found as a cardiologist you're eating all the time you're stimulating your insulin all the time insulin stays high stays high never gets a chance to come down and because your insulin doesn't come back down again you're always in a storage mode. This high insulin is the problem we've hormonally changed because we're eating too frequently we're not designed to eat that frequently insulin is supposed to go up then come back down again up and back down we stay up all the time so your body develops in a simple terms insulin resistance now the next time you eat you need even more insulin because just like wearing a jacket you first feel it then you don't feel it the body when it has high levels of insulin all the time it becomes insensitive to it and that's what's happening we are a hormonally modified human being now. We're becoming insulin resistant and this insulin resistance results in higher and higher insulin levels and that's the problem i found and i just want to digress a little bit i'll tell you how i came to this. 

In my practice what was happening is patients were coming in with 

• heart attacks 
• and hardening of the arteries 
• and angina 

And I said okay there must be a cause. And I look for it. 

And the cholesterol most of the time was okay 

• blood pressure was okay 
• they were not diabetic 
• and i see all this hardening of the arteries. 

And i'm wondering, Why so about 12-15 years ago, I started doing sugar tests on them. And I found that they actually had mild diabetes, what we call glucose intolerance or impaired fasting glucose. 

So the sugars were just slightly high, but not enough to make them a diabetic. So i said okay fine so i should put these patients on something to sensitize them, and make them better. And I put them on metformin and I got a lot of resistance from a lot of physicians in the community, plus patients but the outcomes were better they actually did better. 

Then I started doing insulin testing in my office, and I started doing this, when I read  some information  from a physician  who wrote a book on  insulin. And he got craft so it's called the craft test. So now what we do is we give them sugar water patients, and we measure the sugar levels going up, and back down again. And said okay it went up a little bit not too bad. 

But i looked at the insulin response and it was massive in these patients i took 100 patients. And i saw that they were making so much insulin and i said this is ridiculous why are you making so much insulin well that insulin resistance and then i linked the fact that it's the high insulin level that's actually causing the hardening of the arteries. Because the sugar levels are okay of course what happens is over time it's taking a gallon of insulin to bring your sugar levels under control eventually even that's not enough. So then the sugar level goes up and then they go to the doctor and say oh yeah sugar levels are high or your hemoglobin a1c level is high now you're a diabetic well guess what it's too late you already have all the hardening of the arteries you've done so much damage to your arteries you probably did it for 15 to 20 years. And that's the discovery and that's what really motivated me to make these changes in my patients to say that look you know i got to get that insulin level down.

And it is that high insulin level that really motivated me yeah to really do the fasting program because i said okay how am i going to get insulin levels down. how do i do that i don't have a drug so that's why look the whole thing comes down to insulin for me it was now as things happen i discovered more and more fun things that in this fantastic journey. But the bottom line is it was the high insulin level that really got me into this because i found that when i brought the insulin levels down my coronary artery disease atherosclerosis just went down. Patients did so much better and that high insulin level the only thing i know that really helps to bring that insulin level down besides metformin and a few other drugs really is fasting. yeah because when you don't eat guess what you don't make insulin that's it your insulin loss plummet and then the next time you eat you make insulin, but a much less amount because you're not sensitive. So this fasting i got into it through

this way not because i've i just wanted to make them reduce weight yeah not because i just want to reduce blood pressure it was really the insulin that got me into fasting then of course i discovered as time went on that my god the blood pressures were coming down and i realized that insulin is a vasoconstrictor it reduces nitric oxide in your blood vessels so therefore your blood vessels can't dilate now that brings me to hypertension that i said oh my god i was taught and you were taught that 95 of hypertension is essential and this very word essential there's nothing essential about hypertension you don't need it so should we explain to non-medical listeners what does that term essential mean when we say essential hypertension what do we mean by that which means we don't know the cause of it it's idiopathic idiopathic is another word we use which means we don't really know clearly what the cause is it's just something that just happens so this essential hypertension is not really essential you don't really need it and i found through my own experiences here that the fasting brought the blood pressures down and i said okay so what's the correlation it's insulin let's start reading more about insulin and sure enough when you give patients an insulin shot the blood pressure goes up yeah yeah take them off instantly come down

insulin causes nitric oxide depletion in the blood vessels nitric oxide by the way is a vasodilator nitric oxide is a natural endogenous product that makes your blood vessels dilate and then when nitric oxide goes down the basic can stick this is a dynamic state that you're supposed to have you walk into a cold room your vasoconstr constrict that means your blood vessels go down when you go into a hot room your vasodilator that's a normal response this nitric oxide is most essential in our body it is so important for blood vessels that in fact there was a noble price awarded for this nitric oil as you know so for the audience to realize that insulin when it comes down your nitric oxide production goes up and therefore you vasodilate appropriately your blood vessels are not imprisoned anymore and blood pressure started coming down i said this is amazing because for the first time in my life i felt that the patients were doing something that was actually bringing their blood pressures down i mean we always tell patients we have high blood pressure okay avoid excess of salt and go do some exercises and those are fine because they also can improve nitric oxide production but this was a very powerful one when i brought that insulin levels down on these patients through fasting blood pressures just plummeted and i had to actually take patients off blood pressure medications

yeah so yeah that's a huge thing that i found with insulin so fasting seemed to me the the best way to to really make the patient's blood pressures come down and i found that the weights came down the question is why did the weight come down well insulin in a bottom line for all your listeners insulin just is a storage molecule yeah puts everything in storage so when the insulin levels come down the storage padlocks are taken off so your fat can now be mobilized now there's of course i can go into all the enzymes that are involved and and the and the hormone dependent lipase et cetera et cetera et cetera but the bottom line is when insulin levels come down 

now your fat pads are available yeah for metabolism and i found that the fats just started coming off the patients and when i would look at these patients who do the fasting program look at them and they look great it's not like their faces are all you know the excess of skin hanging off or they have skin hanging off their arms no fasting patients seemed to lose weight in a more beautiful way they were actually losing fat but they were also losing the right amount of skin as well yeah because you see prior to this prior to this i used to tell patients okay you want to cut your calories to only 850 calories a day and you're going to have uh four meals a day each one is going to be this much and the patients would come back sure they lost some weight they would lose a lot actually sometimes but they would look terrible they would look absolutely terrible their faces their skin and and plus they were miserable because

they just never didn't feel good yeah eating small amounts of food frequently this advice that we gave patients previously that hey cut your calories down by eating four small meals a day or nibble throughout the day totally wrong in clinical experience they lost temporary weight they all would put it back on again she did it for years i did it for 15 years and i was sick and tired of it they would come back miserable saying doc my life's miserable i only eat this much and i just feel terrible i'm hungry all the time and i look at them they're sure they even look miserable and their skin was just so when patients were fasting they would come back and they were laughing they were they were so happy the mood was better and i said no why is this guy's mood so good he hasn't eaten for two days now and he says doc my mood is better than it ever was before i'm sleeping better as well and he empowered himself and i said no this is psychological 

he's just you know he was able to do it so he's feeling good about himself he says no dog i do feel good that i was able to do it and and i am self-empowered but also they felt better and then of course as i do the research i see that there are many substances that are produced during fasting and one of them is bdnf which is a big word for brain derived neurotropic factor what that really basically means is look when you are fasting does nature want you to just crawl into your into your cave and fall asleep and just just just just die no nature wants you to go out there find your kill or your prey or your find your berries or something so it actually makes your brain more alert and rejuvenates your brain and you actually now there's data to show that you can actually grow new cells as well in prolonged fasting so what happens is that you actually become more wide-eyed and bushy-tailed and that's what i saw with the patients too that they were they were so happy when they walked into my office you're walking to carriages office laughing and joking this is fantastic so and then so that's something and then i found that the the energy levels they just not only felt better mentally and and and their mood was better but they said that they moved around better so i said what does that mean this is where look my aches and pains went away i said come on i said yes i only lost 15 pounds so far but my joint pains are all gone no wait a second why is that why did the joint pains go you don't take off that much weight to take them off your knee well there's inflammation and i found that inflammation went down in this patient so i said okay so how do i measure inflammation so i looked at the crp levels on these patients and i found that the crp is a blood test and your audience would know that this is a test that we do to look for inflammation micro inflammation in your blood vessels and i found that they were coming down now you know how hard it was for me to bring these inflammatory markers down i mean you know we give statins and that does bring down cr people i found that these patients were fasting the crp's levels came down and perhaps a lot of the inflammation in the joints was getting better because the inflammation went down

so i said okay that's fine what else are you feeling i said well you know what my my stomach feels good too so wait a second come on guys i mean you're fasting and how can this be happening to you this is yeah less bloating uh my bowel movements are better um i'm not getting so gassy and i don't get that fatigue after eating you know i just i just feel so down of course they're not eating but when they do eat after the meal they feel so much better so they are eating after when they break the fast but they're feeling better their guts have better their joints are better their minds are better i just said oh god thisis crazy this is crazy so that's what really yeah i got so excited about fasting as you can tell though it's just it is amazing journey yeah it's you know what's incredible is hearing you talk about this with this incredible passion you know you have seen really really sick patients you've been inside their body you're obviously you know there was there was clearly a frustration at some point you know why am i keep doing this with all these patients they keep coming in what else can i do what you're talking about with fasting it's not giving more things to someone or you've got to add this into your life you've got to take more medications take more supplements go and go to the gym more right because most of the things we advise we're asking them to do more add more things in actually this is very very simple at its core we're asking them to do less we're saying actually don't cook um we'll get we'll get into the specifics but i'm just saying sort of 30 000 foot viewers it's kind of like well i'm going to save you some money you can eat less i want to save some time you don't have to cook this is going to help improve your sleep your cognitive function it's kind of it's very interesting it's something so simple that pretty much every religion has as part of its kind of culture and tradition yet it's so alien to us in the way that we currently live or as daughters the way we currently practice isn't it absolutely absolutely and you know on this journey they find out something about themselves yeah yeah i'm talking about what they find out they find out that they are not the hunger they are not the craving that they are something i mean i'm just going to say in first time i am something beyond my hunger i am beyond my body and beyond my habits i've suddenly realized that i am in charge that i don't have to have breakfast if i'm not hungry i don't have to have breakfast and now doc tells me that's good for me lunch comes around are you hungry or have you been a victim of just it's one o'clock so i have to eat so when the patients suddenly realize that gosh i don't have to eat because i'm not hungry of course if you're not hungry and now they're empowering themselves they realize that there's another part of themselves a real inner amnest my my awareness the the real me which is beyond my body beyond my feelings beyond my sensations and i have control over it now i found that that seems to empower patients more because you start them out first doing this this this dietary stuff okay learn how to just skip meals then all of a sudden it roller coasters and they themselves become so empowered they say whoa whoa whoa what have you done he says well you know doc you told me too fast i haven't eaten for 48 hours i said yeah but i didn't tell you i tell you 48 hours so what i'm saying is that it empowers them even more because they've realized yes i have control i have regained my control over my eating habits i don't `have to eat because it's uh one o'clock in the afternoon i have to go downstairs to the cafeteria to eat i don't have to do that if i'm not hungry and when i am hungry my ghrelin levels have gone up

they'll stay up for about an hour doctor me and then it'll come right back down and my hunger will be gone so now i'm empowering myself that yeah i can do it i'm going to wait it out for one hour i drink a glass of water doc told me to drink a glass of water and yeah sure enough my hunger went away i moved on yeah doc told me to keep my mind busy go and do your chores at one o'clock go do your shopping at one o'clock or pay your bills at one o'clock and your time will pass and before you know it you'll be back to work at two o'clock and you'll have no problems till the evening yeah so i think that self-empowering the patients this way they're taking control and they're looking back and they're getting positive feedback oh yeah i have regained control 

yeah so you know because compliance is such a big problem so when i did that the compliance with medications also improved because the patients just they they they took control yeah yeah yeah i mean there's so many things to kind of follow up on there you mentioned that actually when people fast they often get more energy and more mental clarity and this is very alien to as you say how most of us have been brought up and i think kids are still being brought up you have to eat regularly and i give an example from my own life which is my son is 11 years old currently and every saturday morning we try and do something called park run which is a five kilometer run in the local town 

now just to be clear i am not giving anyone medical advice with their children at the moment so this doesn't get misunderstood presents but i know my son i know his health well i know what he's capable of and we run at nine o'clock and my son loves food right he loves foods but actually he's realized that actually he runs better and feels better when he runs at nine if he doesn't eats so he said daddy don't need to eat i said no you don't want to eat that's fine right which is not what i would have been told at that age i can tell you what do we know you're gonna need to eat  so you've got energy for your run so on a saturday morning he gets up let's say at seven he'll probably have you know i'll probably keep reminding him stroke nudging him to have two glasses of water but then we'll go and do a run together at nine let's say nine till half nine then we nip to the supermarket

we come back and what i've started doing with him is i say to him i don't know how do you feel now you know you missed breakfast and he'll say often daddy actually feel really good like i could think really clearly so first of all kids get this stuff right and i'm delighted that my son is actually uh showcasing some of the stuff that you are talking about at the age of 11 i tell you i certainly was not i was very much eat from the minute you get up go downstairs i have your bowl of cereal and still be eating last thing at night but i remember just going to my room with big bowls of muesli and milk and just i was eating all the time so that was one thing i wanted to say um but the second thing i wanted to talk about was what you said about i am not the hunger i thought that was so powerful dr jam that asks because i think many people these days have forgotten what real hunger is and then if they ever experience hunger it's like i need to eat now because i'm hungry it's like well you could just sit with your hunger and see what happens so just a couple of points there and uh yeah i'd love you to share your sort of view on that absolutely now the experience with the sun is so empowering so he's he and all of us have realized there's a you know that we are a hybrid engine so you have your metabolism that's based on glucose and everyone needs to understand that sugar and glucose that is the the ultimate currency that we use to produce atp but there's another currency in the body and that currency is ketones so when everything's put into storage and you've depleted the glycogen in your liver because you've been exercising now then you need your fat stores that's another source of energy so when the fats kick in and your ketones start going up you will feel different when the ketones are in your body so that feeling of euphoria that feeling that the patients feel empowered and your sound feels so good after running on an empty stomach of course partly because of endorphins that are produced which is very good but the other product is this ketones we all make ketones we are supposed to make ketones the trouble is when we eat so frequently you turn ketones off we must all experience some degree of ketogenesis in our life in our day to day maybe at least two to three times a week you should become significantly ketone that does not really mean that you need to fast for three days or four days no look when we cut down on the amount of carbohydrates simple sugars and we we will go into ketogenesis sooner and sooner in a fast so that's adaptation you're adapting your metabolism if you're eating a lot of carbs and sugars all the time then stop eating you will start producing ketones maybe at 24 36 hours but if you already on a diet that cuts out processed foods sugars simple starches all the refined products now your body will start making ketones at a much earlier stage so maybe by about 15 16 hours also some people start making substantial amounts of ketones now those ketones when they are being used in your metabolism you will experience what your son experienced i feel great my exercise turns better my thinking is better so it's a different chemistry you're using in your body and i think all of us all of us need to go into some degree of ketone production because it has multiple other benefits to being ketone production and in ketone production there's a whole new biochemistry that's going on in the body which we need because one is anabolic what putting on on on all the time when you in the ketosis now the body is cleaning up and becoming efficient so it's another metabolism that we need to engage and we just don't engage enough of it and now on the fasting program is when i'm seeing that the reparative processes all kick in now i'm going to say this again the reparative process in your body is kicking in at a higher level when you are doing your fasting how do i say that oh actually blood pressure comes down joints seem to get better all symptoms seem to get better patients look better but now there's data showing that these patients live longer

less cancer as well and we know about the chemistry that is induced which one of them is called autophagy where the cells actually recycle all the inner parts to become more efficient and mitochondria recycle as well always called mitophagy so these autophagy and mitophagy which is recycling your biochemistry of your cells does not occur in a fed state it occurs much more when you in a fasting state so we supposed to have that we're supposed to do it that's what our life cycle was supposed to be yeah yeah it's  it's interesting as you speak you remind me very much of a conversation i had with dr william lee uh very very recently on the podcast who's done a lot of research into comparing food as medicine compared to drugs and dr lee talks about these defense systems that we have inside our body he's got these five he talks about these five defense systems and he talks about using food as medicine to support these defense systems and you know there are things like you know inflammation the immune system the gut microbiome uh stem cells dna and it's interesting he talks about what particular foods have been shown to support those various defense processes but also what you're talking about is the withdrawal of foods at prescribed set intervals also activates these natural defense processes that the body have got and i find that really really fascinating that actually what we're trying to do is support the body's natural defenses

we're trying to support that body's own natural resilience that's there if we and modern life kind of gets out of the way we're getting in the way and actually stopping this stuff from working but what you're talking about is let's get out the way and we're going to naturally kick all of these kind of different systems into gear yes all right now dr lee amazing so he talks about the foods that you want to to to consume to bring about these beneficial changes right and the mechanisms are immunity of course and stem cells as you mentioned and and and your gut microbiome which we know now plays a huge role in your day-to-day health now fasting impacts on all of them yeah exactly after you finish your fast and then when you have your meal you get you get stem cell mobilization so after a fast you're getting you're getting more stem cells mobilized from your bone marrow now what are stem cells stem cells will go into the circulation go to the parts of the body and they already have messages on them tagging them where to go what to do the body has immense internal signals so these stem cells go exactly and hone in exactly where they need to go and create the new cells and repair the body because maybe those cells that were senescent died maybe certain organs dysfunctional cells died and these stem cells move in and we know that we know this is stem cell mobilization occurs with fasting you talk about growth hormone growth hormone you want to increase your growth hormone

growth hormone as you know goes down after the age of 30 plummets really goes around growth hormone is responsible for muscle building and growth hormone production skyrockets when you're fasting because your body makes much more growth when you you more than taking shots so if you exercise in a fasting state you'll actually put on more muscle mass which is what your son is going to come back and tell you that dad i'm putting on more muscle in my fasting state when i exercise it then then if i exercise it's because of growth hormone so there's another immunity your immunity gets better when you're fasting during your fast your body is developing mechanisms to to strengthen itself and immunity does go up and we know that that certain foods people do the same thing but there you go now imagine the power if we joined all this together so eat the right foods eat the foods to improve your immunity as well and do the fasting as well this is just i think that the future is so exciting in this area where people like you and dr lee and come together and we're gonna we're gonna change things and say look we need to change what we're eating

we need to change the sourcing of our foods and we need to broaden our outlook look up the microbiome i didn't even talk about the microbiome just now so fasting does affect the microbiome yeah it does and when you know that that's a whole new area that's so dynamic in the the life of the half-life of of bacteria in the gut changes uh so we know that when we're fasting certain bacteria are gone and we know that the types of foods that we'd affect our microbiome but fasting itself also affects the microbiome yeah so i love fasting because it does have positive effects on the microbiome and we know that that's huge i never believed about the microbiome stuff until about five years ago but the data now coming out is so compelling for me yeah as a cardiologist in fact i just saw a patient yesterday and i advised him that he needs to be eating pro probiotic foods and fermented foods and he's like but doc i'm here for my uh my coronary calcium score which was so high

you know so it's just fascinating stuff yeah it really is and it's it's again it's that one thing [Music] fasting that's hitting so many different things isn't it it's reducing your insulin it's encouraging autophagy you know we've not mentioned really apoptosis yet it's encouraging apoptosis stem cell production growth hormone so many different things are being activated and actually if we could get a drug to do any one of those we'd be sort of shouting about it but but this one thing does all of them which is which is incredibly fascinating look i really want to understand because um i want to talk more about the science a bit later on in this conversation but in terms of getting really practical for people like if we if we compare fasting to let's say movements right so people if they want to move more they know they could start off with a 15-minute walk around the block you know they want to do a bit more they make it 30 40 minutes around the block uh then they might start jogging some people might want to do a 5k or a 5k walk or even a run a 10k some people want to do a marathon right so there's different grades of movement and so what are the different grades of fasting you know where can people start you know super super simple what are the benefits of that level and then how can people progress up depending on their state of health depending on their goals you know i think that would be quite a useful way at looking at fasting and making it really practical for people yeah right good great question so my general advice in my office and and all my nurse practitioners do the same thing with our patients is look the first thing you need to do is cut out all the sugars because if you go into a fasting with your regular diet pattern you can have a very nasty experience you're going to feel very hungry you're going to go through withdrawal from sugar you're going to feel terribly hungry sweaty you may even actually have worse symptoms so the first thing we're going to do is look we explain to the patients that your body is not supposed to consume so much sugar you know we consume about about more than 10 to 20 teaspoons of sugar a day in one form or the other so the first thing i tell my patients is look you need to get rid of all artificial foods sugar is manufactured sugar is artificial sugar is a poison for the body you need to cut out all sugar all processed foods processed foods anything that is made in a factory anything that has a barcode on it is suspect anything that's been pulverized anything that has been made into a powder get rid of everything you need to eat foods in their natural whole form and that's the first thing you do so forget fasting right now the first thing you're going to do is just change your diet i want you to eat whole foods so i have a chaat in my office that's the anti-inflammatory diet and it contains all the whole foods i said when you look at the food in your plate you need to be able to recognize it yes this is what this is this is what it is and this is a lot of meat and chicken and fish i said no problem as long as it is grass-finished meat organic chicken organic eggs and you can have some some turkey but you must have vegetables in their normal natural state and first thing you need to do is do that so get rid of all the bread all the bagels pastries all the things that are coming in a box spaghetti included pasta included i said look right now just get rid of all those things i want you to eat a natural diet so eat as much as you want but of the right food and i want you to do that for approximately two to three weeks no fasting right now no no fasting right now so that way they get used to that idea yeah that i'm going to first just change my diet and then after two to three weeks then i bring them back inside and i say okay so now that you've been doing this how do you feel is it dark i really didn't feel much now i said now you're going to learn to skip meals so step number two is skip meals wake up in the morning i'm not hungry for breakfast skip it come around to lunch have your lunch have your dinner next day uh have breakfast but skip your lunch the next day skip your dinner so learn to just skip meals and look you felt fine nothing bad happened you were perhaps a little hungry you got over it by drinking a glass of water drink lots of water during the day time so i do that for another two weeks or so see i'm doing it gradually just like your athlete you can't go to your 5k right now you first need to build into it so for a couple of weeks i make them just skip meals randomly then i sit down with them and say now this week five days a week i want to have only two meals and these two meals are going to be within six hours of each other so that you're going to have 18 hours that you're not going to eat at all and only drink water no calories in those 18 hours whatsoever you can have water black tea black coffee but no calories whatsoever and they say oh gosh that's great and they do that for about two weeks so for two weeks monday to friday two meals within a six hour window period so they're 18 hours they are fasting they do that for two weeks weekends i let them have fun because they're with their family so i said you can have breakfast you can have lunch dinner but no snacks in between so most you're gonna have on weekends is three meals on the weekends then they do that for another two weeks then i say okay now is when you're really going to start your fasting monday wednesday and friday i want you to skip that second meal also now you're only going to eat one meal on monday wednesday and friday that's it rest of the days during the week you're going to have your two meals weekends you can still have your three meals so i gradually get them into that and most of the time patients are able to do it this year when i go there when i try to make them go to once a day eating or time restricted feeding within a six-hour window from the get-go my failure rate is much higher so i make them do it gradually yeah yeah and then they self-empower themselves and then eventually i come to a three-day water fast which we can talk about yeah yeah the biochemistry of that i mean i love that you know i love chatting to fellow clinicians uh i love chatting to researchers as well i must be honest but clinicians like yourself you know you've got the real life experience not just what does the laboratory study say what happens in the lab now that you're dealing with real patients who are probably quite scared and you know that that sort of protocol you just took us through just to make it really clear for people you know what types of patients are you recommending this in you're a cardiologist of course you know you practice in america i don't know the exact differences on who gets referred to a cardiologist in america compared to here in the uk so my guess would be that people are you know sick on some level you know they've either got angina already uh maybe they've already got ischemic heart disease maybe they have already had a heart attack

you know you're obviously seeing those kinds of patients but then we can take it one step further which is that we know in america there was a recent study wasn't that well not that recent a few years ago now they're showing that maybe over 80 percent of americans are not in good metabolic health which is really quite incredible so i'm imagining pretty much all of your patients who come to see a cardiologist are already metabolically unhealthy or already having a degree of insulin resistance and therefore problems with their health and well-being so you know maybe help us through that a little bit because what i want to be really clear on someone who feels that they're in good health they're of you know a decent weight they don't have any health problems is that the approach that they should be doing as well are you specifically talking about patients who are already a little bit sick no what i'm talking about here applies to just about everybody in fact it's more than eighty percent i think it applies to more than ninety percent of it now of course the cohort that i see in my office are patients who already have coronary artery disease or they already have had a heart attack so those patients are kind of easy for me to to to convince that hey listen you already had a heart attack now you want another

one well you already have had two stents and then you're going to get the third one so you need to do this and i'm going

to put you on this program okay that's fine but then there's another cohort of patients who come to me and

i do a coronary calcium score and it's high but they're asymptomatic and

they've passed their stress test so let me just tell everybody who doesn't know about coronary calcium score because this is so important

and i'll tell you why really it's important so it's a ct scan low level radiation of

the heart and it looks at the amount of calcium buildup in your coronary arteries so it tells you you already have

atherosclerosis so there's no guessing that oh yeah you know your cholesterol your blood pressure your weight and

therefore your risk of having a heart attack in the next 10 years is such and such it's plugged into a formula no this

is do you have the disease yes or no do the scan yes you have disease do the stress

test pass my stress test why why did i pass my stress test whenever calcium in my arteries well you pass the stresses

because your blockage in your artery caused by the calcium is less than 70 percent

because it takes a blockage more than 70 to reduce the blood flow in it and then you may have symptoms or you may pass i

mean failure stress test can we just back can we just back it up a second for people like what is ischemic heart

disease what is atherosclerosis what is a stress test because i think there will be some people listening who

probably may not be familiar with those terms and i think it would be quite useful to sort of set that foundation if you don't mind

yeah yeah they're very important so atherosclerosis is the buildup of plaque

in the walls of the arteries and they occur everywhere in your neck in your brain in your legs but most importantly

in your heart so when the artery the walls of the arteries develop calcium in them it's atherosclerosis you

cannot get atherosclerosis without calcium actually you can't but very little most of the time there's a lot of

calcium with it so the calcium is a surrogate for the plaque buildup in the walls of the arteries

and that calcium buildup the atherosclerosis can cause two problems it can narrow your artery down on the

inside so the pipe becomes narrowed and therefore that causes ischemic heart

disease ischemic health lack of circulation lack of blood flow going down that artery therefore the muscle is

deprived of blood and the patient may experience pressure tightness heaviness in the chest particularly on exertion

that's called angina so angina chest pain is because of lack of circulation due to the plaque which

is picked up by the calcium and a positive stress test now positive stress

test stress test is where you exercise you or we use chemicals to assimilate and exercise

and it can tell us the consequences the consequences of the blockage is my

blockage more than 70 or less than 70 if it is more than 70 it may reduce the

blood flow in the muscle and will pick that up on the stress test the stress test can be a nuclear stress test or an

ekg stress test but now if your blockage is more than 70 you are

more likely to experience chest pain and the effects of the lack of circulation in the heart muscle and depending on the

location of that blockage and how much muscle is getting the effects of the lack of circulation your cardiologist

may opt to either put your medicines or if you're having very bad symptoms maybe even put a stent inside which we can

talk about but what i really want to stress here is that you can have a blockage

atherosclerotic calcium latent blockage that is less than 70

you pass your stress test you have no chest pain and those are the patients that i'm seeing in my office now because

they're coming in and they're getting the chronic calcium score which they would not have otherwise yeah because you go to your primary care physician's

office and they say oh yeah your stress test is good your cholesterol's fine your blood pressure's okay yeah keep

going and the guy gets a heart attack within a year or two years and so what happened to me well because you already

had the plaque you just didn't know it so the coronary ct scan that we do

low level looking for the calcium picks up the calcium in the walls of the arteries and quantitates it

on a score that goes from like zero to four thousand it's over 100

is significant between 100 and 400 is is very significant but over 400 is

critical that means you really have a lot of calcium in the walls of the arteries so these are the patients who

coming in they do the scan and i see that they have all this calcium in the walls of it now i turn

around to them and say did you know that you already have atherosclerosis you already got it

and we have studies that show that that coronary calcium is going to

predict whether you're going to have a heart attack or a coronary event or a stroke or even total mortality more accurately

than all the other blood tests put together so now i say now do i have your attention you already have see you've

got to motivate the patient and this is my this is my carrot look you have atherosclerosis now i want

you to do my program now i'm going to look for some parameters on your blood test i'm going

to see what's causing this calcium buildup and the patient said i'm fine i said yeah but you didn't just build this

up something is making your coronary calcium build up so let's find out what it is so i do a craft test i do a full

physical examination i'll do tests advanced lipid panel these are tests that i do in the office to see and then

i might even inquire into the gastrointestinal health i will do a

whole evaluation to see why this patient is building up this atherosclerosis and

part of the treatment program is going to be my fasting program which i think is the number one program for this so

those patients um are very happily motivated because i show them the chronic calcium score i said look

look at your picture this is it check it out you got this calcium another group of patients they come in

the 80 percent that you're referring to have metabolic syndrome so for the for the sake of the audience i'm just going to tell everyone what metabolic syndrome

is okay this is a derangement of your metabolism and basically it means that you're

you're overweight your body mass index is greater than 25 and you have

an increased abdominal girth all the weight is around the belly and there's actually a ratio that you can do

between the waist and the belly the belly is increased and then the hdl the cholesterol is low

the triglycerides are high and they have borderline high blood pressure

now when you look at all these numbers what's the common theme that comes to mind from everything i've already said

is insulin it's all about an insulin lowers your hdl increases your triglycerides

increases your abdominal girth because all the fat is down there remember what insulin does insulin puts all your

calories excess calories and frequent calories and because of the high insulin levels puts it well into the liver

pancreas and visceral gut and that fat is totally different from the fact that

you put on all over your body when you overeat you mean i overeat just eating a lot of fats and you know okay that's

different but the fats that are produced under the influence of insulin

by the liver de novo lipogenesis the new fats that are created the glucose has to

be converted into storage product the storage product is that fat that fat in the liver gets deposited in the liver

pancreas visceral gut is very inflammatory composition is totally different you do a biopsy of it you'll

find inflammatory cells in it that are producing tons and tons of interleukin-6 and neutron across bad stuff

so metabolic syndrome although you have these basic features when you do additional biochemistry on them you will

find that they have increased crp level which is a blood test for inflammation

and if you can do even further testing you will find that they have very high interleukin six or two minerals factors

and they have small dense ldl particles indicative of inflammation so these patients come into

the office for prevention or they sent to me because they have a low hdl

and and these are the patients that also do the the the fasting program so some patients are

motivated to go into my fasting program and lose the weight that way you see the weight by the way i gotta tell everybody

the weight is a side effect of the metabolism that's gone wrong yeah

you fix the metabolism the weight comes down as a side effect yeah it's not

really a weight loss program it's a metabolic program in which one of the side effects is that your weight comes

back down to the way it's supposed to be it comes back the way it was supposed to be so um so these patients come in and

and they get referred to me so i almost invariably do a coronary calcium score on them but even if the coronary calcium

score is not very high the metabolic derangements are going to make coronary calcium in the future and

i motivate these patients to start making the lifestyle changes by showing them that their metabolism is off now these metabolic tests are not being

offered by every doctor's office and and nobody because it takes a lot of effort yeah and the insurance companies

sometimes don't want to pay for it like the advanced lipid panel sometimes they pay for it sometimes they don't so what i did in my office i

developed a program where it's a cash paying if the insurance doesn't pay for it okay this is how much it's going to

cost you but get the test done it's a good investment and i have to show them that that it's going to change the life

yeah so but you're absolutely right that this metabolic derangement is it's not 80

it's probably more than that yeah yeah and it's very because i'm seeing it in children i mean i just the other day i

saw a mother bring in her 16 year old and i was like you know and i said you

i'm not a pediatric cardiologist but there you go she had all the derangements already at the age of 16. yeah this is this is so

it's so fascinating and i think you know i think i've read a study where they're saying nowadays atherosclerosis

starts in some children even under the age of 10 i believe you can see in some kids which is

you know you know clearly no one wants to be hearing that no parent wants that for their child we don't really want that

across society what i find really interesting is that the different groups of patients

who come in to see you you know they're proper the ones who've already got established heart disease and obviously

hopefully a lot of them will be motivated to go okay doc tell me what to do and i'll do it but you've also got

some who are probably coming in for prevention you know what's the state of my heart what's the state of my bloods

you know is there anything i need to do and the approach i can see is is

very similar but you also you know you're sort of encouraging them

to go all out and cut out all of the uh highly processed foods you know

you're saying all breads or pastas which which for many people is very difficult

now some people in the uk at least would call that quite extreme okay

now i also have used that approach successfully with my patients so i can i've absolutely seen the value of that

but i think it's worth talking about that does everyone need to go to that extreme and

I know a lot of breads these days are highly processed they've got about 10 15 different ingredients in they have a high glycemic index they spike our blood sugar whereas i know some of the kind of german breads uh like the rye bread sometimes and some of the uh like the in the uk at least the square-shaped german breads often can have a much lower uh sugar response so i guess what i'm trying to get at is all patients presumably say look i'm going to try it but they can't do the whole thing the way you would ideally want them to um you know are there some common obstacles are there some sort of common compromises you have to make with people when they can't go the whole way no no you're absolutely right i mean if you grew up on toast and white bread and it's gonna be very hard to do so it just depends on the stats now they're coming purely for prevention they're not overweight but they do have some family history it might be difficult for me to convince them that hey listen you need to cut out all the all the bread but clearly if they're overweight you know it's basically convincing the patient look you're overweight.

You have metabolic disease uh i can see some parameters here on the blood tests uh or you already have coronary calcium in your arteries and then explain to the the consequences of that that is not just that you're gonna get a heart attack you're also at risk of getting dementia when you grow older you're going to get proof of astro disease you're going to get renal failure such a big link between kidney disease and heart disease

I said so take a pic what would you want what do you want and cancers obesity is also related to cancer so sitting down and between myself and my staff explain to the patients that listen this is not just about about your heart this is also about your whole life this is a really a holistic approach this is gonna affect everything this is going to affect the way you're going to retire and what your retirement going to be like and are you going to be aware of your own retirement and you'll be able to think because alzheimer's is going off the roof too i mean we have a huge increase in the amount of dementia that's going on and i'm one of those who believes that much of that is also vascular it's all vascular i think everything here as old as your arteries you know yeah um so so what's your arterial age let's look at that and so i think that making these dietary changes and cutting out the bread yes you're absolutely right it's a difficult one to sell but at least even if they cut down or move to pump a nickel bread or or even sourdough bread is better because at least it has some benefit on the microbiome but at least make some compromises start start at least do something.  yeah and i think that that's that that's the key thing is motivating the patient to think more long-term also and not just think coronary artery disease everything that i tell the patients to do for their heart i tell them straight up front this is going to keep your eyesight this is going to keep you from getting dementia your renal disease this is going to help you from hopefully also decrease your risk of cancer joint disease back problems i mean name it it it it really has so many ramifications so yeah so again it comes

down to what we said right in the beginning of this talk that we have to motivate the patient i need to get into your brain

make a change in you so that you know that this is the right thing to do and then it resonates with you

yes this is right and then see the practical results of it and it's a slow process

gradual process but you know we've done this yeah we've gotten patients off blood pressure medication got them off

insulin you know the biggest achievements i've had in the last few years now is getting patients off

insulin and it makes me feel so good when i do that and all through this program they come in and already taking

25 units of insulin twice a day yeah and now they're on nothing and the a1cs are

so good yeah you you love it and i bet the patients love it as well don't they oh gosh coming off insulin coming off

blood pressure medications yeah coming off cholesterol medication you know how many patients walk into my

office and and there are tons of statins and and i do a coronary study on them

and the score is zero score is zero they have no coronary calcium and they're taking all these

statins and they're hobbling around with all these muscle aches and pains and i'll just stop the statin so that's

another thing you know empowering patients to know that you know there's no one treatment for all that yes your cholesterol level is a little high

and therefore you have to be on a statin i try to individualize the treatment for the patients based on

what's doing to your body you know you have you have a decent advanced lipid panel

and we can make some dietary changes here so that you don't get any more coronary cancer but you don't have to be

on a statin empowering the patients to do that as well yeah what what uh you know thinking

about your approach and because i've been using similar approaches with my patients for a number of years now and

i think we see a different subset because i'm a general practitioner and you're a cardiologist of course

there's a huge crossover given how common type 2 diabetes is how common metabolic

syndrome is and but it's interesting so you go before you approach any form of fasting you have a three week period where you

you know an inverted commerce try and clean up the diets you try and reduce the processed foods that they're

going to consume increase the whole natural foods which is just going to put them in a much better state for when you then

bring in your 18-hour fast so which i which is really interesting i 

take quite a softly softly approach i guess i always start with a 12-hour fast which some people wouldn't even call a

fast um but i think pretty much every human being should be able to go for 12

hours and every 24 hours without eating food and if you can't currently that's okay

but it would indicate that you are you know you have some sort of dysfunction some metabolic dysfunction somewhere

otherwise you would be able to because some people you know say i really struggle with that and i say okay it doesn't mean that's not a good thing for you it just means at the moment your biochemistry and physiology is not able to support that so let's let's work on that and get you to a point where you can and then yeah for the right patient i also increase it up gradually um so i find that super interesting

as as kind of just to notice a difference because there's no right or wrong is that there's just we're all trying to empower our patients and we're

all kind of biased i guess by our own experiences as to what we have found uh working with patients so i found that

really interesting also are most of your patients men and the reason i ask that is because

of course heart disease we hear a lot about killing men of course it affects women

as well um but also there is this question mark that many people have over fasting as

okay it kind of works for men but maybe it's not so good for women um i have my

own view on that but i i wonder if you could share some of your thoughts on that yeah so the first part was uh 12 hours

this is 18 hours um you know there's two things that i can concern about when

patients start fasting one is the withdrawal 

and i think that withdrawal is it comes in two shapes uh there's mental withdrawal that it's i'm a pavlovian

reflex i have to eat at eight o'clock in the morning i've done that for so many years the other one is a true

biochemical addiction at the level of the brain so

that really concerns me that that's why i do this period to come in because that gets them

rid of the addiction because i think addiction is a real issue right they addicted pavlovian wise but also

biochemically in the brain and some of them really do go through withdrawal symptoms and they say you know i felt

terrible i started sweating and i had this intense cravings and and and i said

god this sounds like heroin withdrawal and i think it's real so that's why i do this just skipping

meals and gradually getting into it but once how long does that take that's the question how long does that take and in

my experience i've been doing this six three weeks at the end of three weeks i can pretty

confidently say that the patients have gone through their withdrawals yeah and they're going to be now okay to take on

the 18 hours and that's why i do it that way and the withdrawals are very real because the foods have addictive

properties sugar is definitely addictive we know that we know dairy products have um caseomorphine um which actually

are addictive so you crave those things that you that that doc has told you to to skip the meals on and all that but i

think that after three weeks they're done and i tell patients it's not gonna be easy the first three weeks you're gonna get a lot of cravings you need

social support you need to your structure your life you need to do your shopping during the times that you're gonna be eating that meal otherwise you

keep your mind busy and you got to get your seven hours of sleep and so yeah so

what that the withdrawal issue is very important that's why i do this gradual stuff and then the answer to the second part

that women definitely women are not exempt from cad and heart disease and something that applies to you and me is asian women too did you know did you

know that the instance of coronary artery disease in indian women is actually higher than indian men

but it's just that they don't get diagnosed and and they don't seem to complain that much so they don't come to to to the

doctor's office but actually i've seen worse coronary artery disease in indian women in my office than in

indian men and in indians in general they have far more coronary artery disease than

caucasians so it's a huge problem so i think that women are are certainly

a population that is not exempt from coronary artery disease now the fasting programs in women there are some data to

suggest that they may not benefit as much as as men but overall i think that

what i've seen is that they also seem to benefit just as much um so i i don't make much distinction

between men and women they come in here i work them up the same way um i'm very aggressive with the women as well yeah

especially especially women from south asia when they walk in they've got my

antennas in fact any south asian that walks into my office my antennas are up because

they are what i call toffees you know they thin on the outside they fat on the inside and and they're

metabolically very deranged and there are specific things that i tell them

about fasting and dietary recommendations for their diet and the reasons

have to do with vitamin k2 as well which i'm finding absolutely fascinating yeah

so now i i very much appreciate that perspective thank you first of all for sharing that

you're seeing lots of coronary artery disease potentially worse in south asian women the south asian men i don't think that is commonly known i did not know that and actually i'm now thinking of people and women in my family i'm thinking why okay maybe instead of thinking about the the men we need to start thinking about the women as well in terms of you know prevention in terms of getting early screening done blood tests maybe you know coronary calcium score or you know whatever might be available to people um my experience of fasting in inverted commas because fasting can mean so many different things to so many different people is yeah i have seen some women with hormonal uh problems uh i'm not talking about necessarily insulin hormonal problems i'm talking more about kind of around the menopause let's say or estrogen progesterone sort of imbalance issues i found with some women uh it can be a bit challenging for fasting and some

women don't do so well but i've also found many women who thrive on it so i think a lot of the time people i've

noticed this on social media a lot of people trying to oh it doesn't work for women it's like well what do you mean 100 of women all the

time it's like you know and this is why i love talking to real life clinicians it's like well we see that not

everything works for everyone all of the time and we have to tweak our view depending on what we see and

you know when we make these kind of gross generalizations that are fascinating doesn't work for women

it's like well we put like let's say there's that subsection of women who who thrive on

fasting well they get put off they think oh it's not for me and it's kind of like well there's no

one-size-fits-all in anything and you see enough patience you kind of realize that there's very few although fasting

might be one of them i guess you might argue but do you know what i mean i kind of feel these days

we get too polarized on these things and it and we we just miss the kind of

nuance that's actually there oh no you're absolutely right and this is the new medicine we're going to

become more individual okay why is this lady not able to enter into my fasting

product she really needs to her bmi is 42 and she has all this stuff going on there may be other reasons she may have

so much stress in her life you know she may have financial problems that she can't buy the right kinds of

foods that i want her to buy she may be in a very dysfunctional relationships and that may be causing so many problems

for her she may not be sleeping at night a simple thing she may have undiagnosed obstructive sleep apnea which is why

during the daytime she has so much fatigue tiredness and she's never going to develop enough willpower to enter into my program until

i get her good night's sleep so maybe put a cpap on her for the time being and then see that oh yeah now she can abide by

the the principles of the fasting so you know it just means looking deeper into

the why weren't you able to do this that there are there are obvious factors why you cannot where's your willpower why on

don't you have the willpower let's look into this and we don't always find the answers to

everything but but i think that looking at them overall so sleep apnea is a huge issue by the way i mean yeah massive

problem that i find so often times temporarily i do put them on a cpap mask and say that you're going to have more

uh energy mental energy and clarity and and less neurodysfunctional during the

daytime and therefore you will be able to to abide by the diet but the goal is really

to lose the weight so that we can get you off the cpap eventually yeah so but back to the kind of therapeutic use of

fasting so you do this kind of three week program where they unprocess their diet

then you put them on this kind of 18-hour fast so they're having two meals a day over six hours and then for 18

hours they're not consuming anything sorry interrupts if you are enjoying this content there's loads more just

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conversation uh we must talk about any contraindications like insulin or blood

sugar medications at some point just to make sure that you know people who are listening who want to try stuff that

we've we've covered that but also i want to go a bit further because i know you have used

24-hour fasting with patients i know you have used three-day fasts and you have

also shared in previous conversations some very powerful statistics one in particular i

remember on a seven-day fast you shared a statistic a bit of research from boston in terms of what that does to

your lifetime cancer risk so maybe you could talk about some of these longer fasts and then practically how do people

start going about that yes yes so absolutely so at all times

they are supposed to take their blood pressures twice a day make sure that the blood pressure not going down to because they do not stop the blood pressure

medications right off the bat so all the blood pressure medication reduction will be done depending on your blood pressure

readings as far as blood sugar is concerned if they aren't oral agents i'll continue those oral agents while

they're doing the 18 hour fast periods even the 24 hour fast i'll keep them on

it and i will ask them to monitor their blood sugars now continuous glucose

monitoring the the little uh devices i only advise those on on

patients who are on insulin when i'm fasting them because i want to make sure that the instruments don't

drop off but when a patient is taking insulin and he does the 24-hour fast i drop the insulin

levels by half first i'm in insulin dosage by half and i monitor the blood sugars and then

when they go beyond 24 hour fast i stop insulin completely completely completely

i stop it completely because i don't want them to become hypoglycemic so oral agents i will continue

insulin i will discontinue if i'm doing more than 24 hours but i monitor the blood sugars very closely and then that

brings me to a little longer fast before i go to longer fest i make them do a 36 hour

fast so i'll make them do that once a week once a week means that

evening rolls around skip that meal also and then have yourself a breakfast treat

yourself with a breakfast the next day and that brings it to 36 hours so i make

them do at least one 36 hour fast for maybe you know two consecutive weeks and

then i'll take them to higher levels can i just kind of can i just clarify that so

the 36 hour fast the way you have found it most beneficial for most of your patients is what you

skip one evening meal to the next evening meal when when does that fasting time i know you can do it any way you

want but what have you found to work can we just clarify that yeah so the patients already are used to

having only one meal a day okay so then i'll say skip that one meal and then have the next meal when you're

supposed to have them that'll bring you to 36 hours so for most patients these days they're having the evening meals because it's more social having it okay

okay so they'll skip breakfast they'll skip lunch evening comes around they're supposed to eat and i tell them skip it

and go and have breakfast the next day that brings them to 36 hours i guess if they're already used to having one meal

a day then actually skipping that evening meal

is kind of i don't know just go to bed early as well you know sort of you know

it's yeah i like that so what stage do you take them from this two meal a day which is this uh you know this six hour eating

window you know you you do that initially for the 18 hour fast then you take them to 24 hours to you with just one meal a day

is that how you do it that's exactly how i do it and then they're doing one meal a day five days a week

weekends they're gonna have two meals they do that for two weeks and then i say okay you've been doing

this for two weeks now you've been having only one meal a day next few weeks

one day a week you're going to go to 36 and the way you're going to do it is you're going to skip that one meal also

and then have a breakfast the next day so i'll bring you to the and i want to see how you feel and most of them come back saying

i just missed the meal in the evening i watched the movie and went to bed so why am i going from 24 to 36

because i want to get them ready for longer fast especially if they tremendously overweight and they're metabolically deranged

what's the biochemical advantage between 24 and 36

at by 36 hours almost all of them will be in some degree of ketogenesis

so it's hard to know who's going to start spilling ketones at 18 hours 24

hours 30 or 32 hours it's hard to know that so when i prime them

then i'm finding that there's longer and longer periods of ketogenesis that means they go into ketone production at 16

hours so long as they made their dietary changes gradually got into this the ketogenesis

phase starts a little bit sooner at about 16 hours and the most motivated patients say that oh i want to know i

said okay if you want to know then go to the pharmacy and pick up some keto sticks and just test your urine and tell

me when you started spilling the ketones so after 24 hour fast

almost all of them are spelling ketones and when they're spilling ketones i know

what's going on with their physiology at that point i know that they're getting the benefits of some degree of autophagy

growth hormone bdnf production and mitophagy i know

that's happening because they're spilling ketones so spilling ketones so that's another motivating thing in the

patient who's showing me the interest and the ones i really want them to be yes give them the tool take this home

check your ketones that's what i find so fascinating so by 36 hours of making the ketones so

they'll do that for a couple of weeks where they now went to 36 hour fasts

once a week for two weeks now at that point depending on how motivated they feel and how well they

are doing now i'll go to more prolonged fasts and my favorite fast is the three-day

water fast and most of the i'm telling you greater than 95 of them when they've graduated

to this point where they've gradually gone and done all this they're able to do the three-day water fast with no

difficulty whatsoever and if they get cramps then i tell them okay

take a glass of water and put a pinch of salt in it and just just down it and you'll feel better but most of them

don't because they've adapted themselves if you go into a three-day water fast too quickly you're going to get more cramps but more importantly you're going

to go through what is known as keto flu and you just feel terrible and achy and just feel really bad so i do it

gradually but i must make them go to a three-day water fast i use it in that case i also use it in patients who are

able to lose weight but then they reach a plateau so now they're weighing 230 pounds and i

want them to have more weight loss so they've been doing this now for a month and they said look doc i just can't shed

any more weight now i've done everything you're saying and i'll put them on a three-day water fast and lo and behold

they'll start losing weight again so i use that in patients who have reached a plateau going to the three-day water

fast thank you for sharing that i think something i didn't want to bring up today um because

i know a lot of people and again we're all influenced by the online world or the patients that

we've seen or the online world that we inhabit and you know i spoke to david sinclair this

harvard professor who talks about aging in a very very profound and novel way

and you know when i put out that episode with david a lot of people are saying

look asking people to skip meals is very triggering for people with

eating disorders and i know eating disorders are on the rise uh massively all over

the world certainly here in the uk and in america so i think we need to be careful about

that uh i think it's worth me uh just flagging that here that potentially this advice is not for

people with eating disorders that's a sort of separate issue well i'd welcome your perspective on that um but also

you know is it possible that we take these things to extremes i guess there would be some people we

mentioned anna lemke's book before dopamine nation and um that we are all we're living in a world of addicts now and that you know

she mentions that the smartphone is the modern day hypodermic needle which i thought was a very provocative way but but i i actually

completely agree with her of talking about it that's health there's physical

biochemical health but there's also this kind of emotional health and our mental well-being

do you think as much as you love fasting do you think some people

they can sort of overdo it and get so addicted to kind of that feeling of

fasting and actually go to an extreme which potentially could become problematic i think you're right it can

happen fortunately i haven't seen it here with somebody i tell them stop now stop stop this is enough now you should

be eating two meals a day and you know i think that the pattern you need to settle down in

is for you i think that two meals a day in a six or eight hour window period may

be a nice thing for you to do chronically to maintain what you've gained the benefits that you've already

gained um then i haven't seen any patients who ignored that and continued to do the three-day water fasts on a

weekly basis or whatever or two weekly basis i haven't seen that but but you are absolutely right that there are some

patients who clearly have an eating disorder and they clearly have a type of addiction and they're going up at night

and then they creep downstairs and they're eating away five bars of chocolates and all this kinds of stuff and those patients clearly do need help

and i will not deal with those on my own i will supervise it but i'll send them to a psychologist that actually

specializes in addictions because they have to really spend time with that patient about addiction behavior and

it's not just behavior about the food there may be other issues that are actually triggering um because see you

you slide from one addiction to the other to the other to the other so so you can't take off this alone on its own

until you also take care take care of the sugar and maybe the the cell phone and other digital gadgets that gives you

the instant gratifications and and there may be even be other issues he may be a gambler for you know or have other type

of deviant behavior addictions so no you're absolutely so recognizing those with the

biggest problems and addiction is a huge problem and it's becoming more more

known now that uh the addiction is to not only sugar but it's also addicted to process food content yeah processed foods and the content of

processed foods um are very addictive yeah and i think that that's why you

want to change the the type of food that you so you're getting rid of all the addictive substances in the food the

addictive sugar in the food and then addictive behaviors in other aspects of your life as well yeah so so it's it's

really looking at the whole thing it's it's it's a huge problem it's a huge problem and yes we are an addicted

nation um yeah we and that's why it's making it so easier for us to become addicted to food later

on in life because it starts at a very young age and you're very getting addicted to gadgets um and instant

gratification i want to move on to the mental benefits shortly of fasting because i think there's a real important piece there that we touched on a couple of times in the conversation already before i do i sort of feel that that there's so much um divisiveness and you know frankly fighting about different diets that i think sometimes gets so unhelpful for the general public they see doctors who they admire saying this diet has got this evidence this is really good and they see another doctor who they admire say this type is really good it has all this evidence and i think and i know this from talking to patients and talking to the public that many people find this incredibly confusing i really like fasting for the right person in the right state of health i kind of see it as the great unifier in many ways because as long as you are metabolically able to do that fast you know whether you choose to eat meat and fish or whether you choose to be vegan if you are whole food primarily you're not having uh much processed food at all in your diets then you're still gonna get benefits from fasting right whether you're low carb or whether you're vegan and you know it's interesting that video that you did on fasting fasting for survival on youtube which is you know had millions of views i was reading through the comments just before this conversation dr jamadas and the top comments was it really i think encompasses everything that you stand for he i think said he was mostly plant-based and he started off following your advice with a whole food mostly plant-based diets i think he started off with 18-hour fasts he moved up to 24-hour ones i can't quite remember then he moved to maybe one three-day one every six months and he's documented his health journey over two years and it is utterly remarkable that you put out a video on youtube and you have completely empowered that guy to transform his life so first of all just i want to acknowledge you for that that's just one off millions of people who've seen that video and changed their lives so that's just incredible work that you're doing but what do you think about this concept that fasting could be the great unify no matter what tribe you belong to you can still get involved with fasting and yields and and reap many of those benefits yeah you're absolutely right um the various dietary programs that have come out have confused the public it's confused the physicians as well yeah i mean my patients come and say that i'm following this diet that diet and nothing happened and this one's too hard for me and and this one's too restrictive for me and it doesn't fit with my lifestyle i understand that i understand that fasting forgives you fasting in a sense forgives you for certain foods that that you may then consume and actually think about it this way also you eat that slice of bread after a fast your insulin response is totally different in the fasting state than in a fed state you're going to make less insulin for the same slice of bread in a fasting state so it's and the type of food that they consume so when i first started out i was years and years and years ago i'll say oh you got to be a vegetarian you got you got to drop all meats and being in united states how many patients are going to become vegetarian right so and then as the data came out and i started studying more and more i changed i decided that hey there's something wrong with this you know people should be able to eat an cestral foods and what they grew up with but the problem was processed foods when we take the foods and we process them we change them and all the additives that we put into and the way we grow our food or where we we we get our meats has changed so i said no no no this is not right when i studied non-vegetarian diets around the world how come that is low incidence of heart disease there are populations that eat only meat and only drink milk and blood or the populations that only eat starches and a lot of it and they also live long what's the commonality what is the commonality in all of them the common areas no processed foods no additives right no no sugar so they they all had simple diets so then i came up with my own plan and i said listen you what do you like to eat what do you like to eat so you want to eat red meat okay then eat grass-finished meat because that will have more nutrients in it the fats will be the right kind of fats you will not have all those omega-6s in there you you'll have more natural fats in there and if you're only eggs chicken so i let them do that and i said but you got to also introduce plants in your diet because you need the plants not for you yeah you're going to get some some water soluble vitamins etc into your system when you eat plants and but it's really for your gut bacteria so again i had to read a lot about the microbiome to understand that the fiber is hugely important very important and and so i tell eat your vegetables as well so this is my diet plan yeah it's not so restricted just stay away from anything that your great-great-grandfather wouldn't eat and no processed foods anything in a packet box barcode stay away from anything made into a flower and that's been a hard one

the flower one yeah also inside that's everywhere it's a huge huge problem i i love this um

you know i'm so enjoying speaking to you there's a real kind of there's just a beautiful energy there's

also this kind of real life practicalness that you know what it's like when these patients come in and

you've gotten your head the ideal thing but you got to work with people and their taste and their preferences and their culture and what they want and i

really do strongly feel that too many people these days on social media commentate they look at the science and

go oh this is what everyone needs to do it's like it's just not how it works in real life in my experience you know

people are different they've got different desires they've got different cultures different preferences so i

really like that you've mentioned all the kind of physical benefits the biochemical benefits when we have a

period of not taking in food a period of fasting but there's also something really

powerful isn't there like you have touched on several times

but what it does for you when you know oh i can go 12 hours without food i can

go 18 hours wow actually i can go 24 hours and i don't actually need

to put something in my mouth i think we shouldn't

undervalue just what that does for someone you know i think it's freedom it's freedom from a dependency on foods

addictive foods processed foods sugar it means that you can go about you're out on the train station or the airport and

there's no good food to have cool just don't eat take the flight don't eat it there's a real freedom which many people feel that

they are they're in chains i guess to the food industry and to their their hunger and their stomach so

you know can you speak a little bit about that and why you feel that's so important yeah i i love the the fact that you use

that word freedom because you know i said okay it empowers a patient but it is a real freedom it's a freedom that

that they know that what their behavior resulted in no

adverse effect and that they were able to overcome this which they never thought they could overcome so these

little hurdles that they're overcoming in their diet actually has huge repercussions in other aspects of their

life and really honestly it it percolates into the into the workplace into their family life um in

their social interactions uh with their friends um and i've seen that these people they just they just become more

more uh self-confident um and and i think it's because

we introduce terms to them like that's who you are

the real you so it opens up a new aspect of their

existence that there is a part of me that's separate and apart from my body and from

my mind and my cravings and my stomach and my feelings and and all these things and that's the real me and of course you

know this gets into some of that part that i have a huge interest in

which is who are you yeah yeah what you know who are you really um

where is the you uh and why can't you that that you

change uh your behavior of course you can because you need to change your identification so this is an

identification change that i see the patients doing they realize that they are in charge that that them inside them not the body

enough the mind is actually an awareness and amnesty and i am and that is huge

huge and i found that people who have done this program over the last few years they actually get work promotions

they actually become better supervisors they become just better family uh members and and

caregivers miraculous yeah one thing because it's showing them that yes you

are in charge look you can do it you can do it and they just self-empower themselves it feels so good

self-confidence just goes off the roof and i think that that that there's a you know i'm learning more about this um

but but i think it does boil down to to because that also brings me to stress management because

one of the things we do tell our patients is that you if you start getting stressed out during all this these periods where

you're getting into the fasting period you need to go out and do some some meditation we tell them and we show them

how to meditate and i have a very simple meditation technique where i just basically ask the patients to okay just

close your eyes and just concentrate on your breathing only and when a thought comes

let the thought go don't follow up on it because then another thought will come

in a few minutes don't follow up on it wait just come back to your breathing

concentrate on your breathing as the breath goes in and out and you will find that there'll be gaps

in between your thoughts that get longer and longer and longer and my patients have all said yes you're absolutely right there's blankness i said well that

blankness when you don't have a thought or when you're not thinking of something that's you that's

the real you and when you come out of this for 15 20 minutes you will realize that there is that you

in you and you can make up your mind about anything you can you can do anything it will empower you and you'll

feel less stressed out you'll feel less compelled you're less automatic you will be

you you will become as you said that word that you you'll have freedom you'll have freedom

and i find that fascinating so you see this whole thing i said this in the beginning that you

know fasting seems to open up those that onion into all different parts of your

life you know it's just amazing stuff i mean i love it i i just love it and um

if and when we have our second conversation i could see us going deep into who we are spirituality and

i i really do feel that's a missing piece in medicine like it's not just about telling someone what they should

do for their health i mean people don't really do what other people say in the long term in my experience they might do

initially to get them going but at some point it has to change

from being the doctor's plan to being my plan at some point it needs to be like they

go on your three week unprocess your diet uh sort of regime they start

fasting at some point maybe after a month two months three months

you want that self-empowerment piece where it's like yeah okay the doc's guided me but i know

what i'm doing now i want to eat this way i want to fast like this because i

feel good when i do it so i'm now doing it not because he told me to

but because i want to and i think that you know i you know i like you i teach doctors i i always talk to him

about this this is a really important piece of the puzzle another thought i had is

fasting is you know initially at least a difficult thing for many people to do and we kind of know that

when humans do difficult things whether it's fasting for 24 hours when

you find it hard or whether it's completing a half marathon when you know six months ago you can walk round the

block what it does for us in terms of who we are and our self-esteem and our

confidence it's very very powerful isn't it so i really love that you are bringing that

up also in the concepts of fasting we have to you you know that there's a huge

in health there's a huge component of your of your your your mental being and and your understanding of who you are

and your role in in in in your life and the people around you um so i one of my interests and maybe we

can talk about this on other occasions is is you know what are your relationships like especially with your

mother because that's going to tell you how long you're going to really live it's amazing or

you know when my patients are in the hospital how many people come visit them after open-heart surgery determines how

quickly they're going to recover from open heart surgery same surgery what's going on here so we can you know

there's huge repercussions on how patients healthy depending on their social and then how do they view

themselves in society and their role and and and the hierarchy in society and

that seems to also dictate uh outcomes in health irrespective of how much

healthcare provide uh facilities are available to them so there's all these other social

determinants of health that are extremely important and i think that we don't talk about that enough

and i think that that's something that we need to talk about because in cardiology besides my fasting my other aspect is is i do want to get into all

that with my patients to see that you know health is defined by

you basically metabolize your psychosocial

being you metabolize it into your body so be careful about your thoughts about who you are

and how you're interacting with the world and everything that's going around you because in an instantaneous moment

you're actually metabolizing it into physiology in your body yeah fascinating stuff and i have lots of data on that

lots of it well we are definitely going to have a second conversation because i think we've not even scratched the surface

of that uh just to finish off this conversation dr jammed us firstly thank you for your time i know you're a super

busy cardiologist this podcast is called feel better live more when we feel better

we get more out of our lives and i wonder if we're at the end of this conversation

you could share with your decades of experience as a cardiologist with all

the patients you've seen can you share with my listeners with my viewers some of your very top tips that they can

think about applying into their lives immediately after this conversation finishes

number one eat only natural foods in its natural

state number two eat infrequently

only when you are hungry number three sleep at least seven hours a day

number four find pleasure in your life and activities

so that you don't metabolize bad physiology from bad

habits so find happiness find pleasure in your life um and if you do these four things

you'll find your health will turn around completely dr jaminas you're incredible man you're

doing incredible work thank you for joining me on the show and i'll see you very soon no no thank you very much look

forward to it if you enjoyed that conversation with a real life working medical doctor i think you are really

going to enjoy this one this is probably the most effective diet that's ever been promoted on the planet this protects our

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