Fasting is everywhere in the news and is transforming how we think of health and longevity. Today we speak with one of the true pioneers in the field.  Megan Ramos is the NYT Bestselling Author of Life in the Fasting Lane. She is also CEO and Co-founder of The Fasting Method with Dr Jason Fung. She’s a world-leading expert on therapeutic fasting and low carbohydrate diets, and has guided over 10,000 people worldwide. 

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Robert Lufkin  0:01  
Welcome back to the health longevity Secret show and I’m your host, Dr. Robert Lufkin. Fasting is everywhere in the news and is transforming how we think about health and longevity. Today we speak with one of the true pioneers in the field. Megan Ramos is the New York Times bestselling author of life in the fasting lane. She is also the CEO and co founder of the fasting method with Dr. Jason Fung. She’s a world leader and expert in therapeutic fasting and low carbohydrate diets and has guided over 10,000 people worldwide in the process. Thanks again for your support of this video podcast. We appreciate any reviews that you provide, which help us to spread the word of the work that we do. As a thanks for your review, we will send you a copy of one of our most popular guests book, the path mastering the nine pillars of resilience and success by Dr. Steven siter off to receive it, just email a screenshot of your review along with your name and us address and include the title the path to male m a i l at Robert Lufkin We’re sorry that we can only ship to us addresses at this time. And now, please enjoy this conversation with Megan Ramos. Hi, Megan, welcome to the show.

Megan Ramos  1:39  
Hi, Dr. Luskin. Thank you for having me today.

Robert Lufkin  1:42  
Oh, thanks. Please, please call me Rob. If you want I’m I’m so excited about having you in the on the show today. I’ve really enjoyed your book Life in the fasting lane. I recommend it to anyone out there. That’s it’s a New York Times bestseller, I think and it’s it’s an excellent introduction to some of the topics we’re going to be discussing today. And if people want a deeper dive on that, it’s I can’t recommend it highly enough. So So today before we before we jump into fasting and talk about all the all the questions there that we have, maybe you could just take a moment and tell our audience a little bit about how you came to be interested in such a fascinating area.

Megan Ramos  2:33  
Yeah, I was ground zero guinea pig back in our clinic in Toronto. When we first started, I from a very young age had a keen interest in preventative medicine. My mom is what we call a very medically interesting patient. So whenever she’s in the hospital, they love to bring rounds of students to sort of review her chart and ask her questions. And so I had this medical mystery at home. And it just always seemed like they were really treating her symptoms. And she suffered for a really long time because of it. And she was so fortunate to come across one doctor who is committed to discovering the root cause. And when that happened, her life was able to improve a lot but unfortunately, she lost years she developed so many other chronic conditions along the way. So as a result, from a young age, I had a huge interest in preventative medicine. And I started working in this nephrology clinic this kidney clinic when I was a teenager, 15 years old. My dad’s friend was the big nephrology director and a big doctor guru in the area and I wanted to learn about medicine. This guy’s kids wanted to learn about law. So they swapped kids for the summer, because my dad was a lawyer and had a law firm downtown. And that’s how I got into kidney disease. And I just fell in love with the program there because they focus so much on preventative medicine really tried to catch kidney disease earlier and lifestyle interventions. I’ll be it sort of the standard traditional ones calorie restriction diets eat plenty of grains, more of the Canadian foods guideline or American food pyramid. And so we know that doesn’t work. But I didn’t know that at the time. And I really just love that it wasn’t all about slapping medications on and managing symptoms. So I hung out there for years. And then at 26 I got super heartbroken. It just seemed like all we were doing was the managing people till they died. And with kidney patients, you see them all the time they become friends, they become family, you know, they celebrated graduation after graduation, they celebrated life monuments with me and I got so sick and tired of watching people I love die. And then around this point, my personal life kind of collided into my professional life as a kid I was super skinny. But I had fatty liver disease. I was diagnosed at 12 and PCO So at 14, and the doctors and specialists just kind of rolled their eyes oh, she’s so thin. It’s kind of weird that she has these conditions, she’ll just grow out of it, you know, keep her active.

And I was always tired. But I was so worried for my health, I stayed active. I was a competitive swimmer, I play basketball, play field hockey, played soccer, just because I said, that’s what the doctors said I need to do. So I don’t become sick, like my mom and other family members as I get older. But I just I barely had the energy to survive all of that activity. In hindsight, I now know that I was I might have been skinny on the outside, but I was very fat. On the inside, I was a little sack of fat, with not very strong muscles, or even strong bones because I would always slip fall break or risk something like that as a kid. So at 26, I thought, okay, you can end up like one of these patients, you can’t end up like your family, you got to really follow every guideline to a tee. So I got like the most fancy dietician in Canada paid an arm and a leg, I was super fortunate. So working out with a trainer. And the end result was like a 60 pound weight gain and the development of type two diabetes for my 27th birthday. So I was just brokenhearted. And I was working in the clinic one day and one of my colleagues said, you know, Dr. Fung thinks that he can reverse diabetes, by starving people. And like all of the research team started to giggle a little bit. And I’d worked with Jason now since I was 15, or 28. And Jason had some ideas that were out of the box. And that were always very simple, but they were always very right. And I so I’ve been around a lot longer than my colleagues to see all of Jason’s funds philosophies kind of unfolds. And I knew better than to to laugh at laugh at off. So fortunately, a day later, I was staying late to Philip K support forums. And I heard Jason giving a talk to a bunch of patients in what we call the Education Center. And that talk was specifically on fasting. And he just invited his patients to come for extra education. And I just sat there and I watched in the back of the room. And I was like, Oh my gosh, this is so simple. But it’s so accurate. It’s so right. What are we doing, I went through like 1000 different emotions in the span of 45 minutes, like, oh my gosh, we’re killing people professionally. There’s so many people suffering, people are losing parents, they’re losing arms or losing limbs or losing children. And it doesn’t need to be this way over something so simple. And oh my gosh, me and my family. And I went through the whole spectrum of emotions in that time. And I talked to him afterwards. And he said, you know, a friend of his had started fasting for religious reasons. We’re from Toronto, so most diversity in the entire world. So it was really not uncommon for us to have patients who fasted especially around Ramadan, so many people would fast. And Jason said his friend inspired him like not only did she lose weight, she improved her hemoglobin a one C. And Jason said, you know, around the same time we were dealing with the Ramadan patients, and that they were always a huge pain in the rear end, because you had to come in and lower their medications before Ramadan started, or they were gonna have issues. And then you had to see them, you know, a month afterwards because all of their numbers would go back to not necessarily being great because they’ve returned to eating all the time and eating the wrong foods. And foods even during Ramadan are not necessarily the best foods, but there is a lot of fasting from sunrise to sunset. And Ramadan changes depending on the time of year. So when you’re in a place like Toronto, there’s daylight for four hours when it happens during the summer time. So those are ended up being quite long grew fast compared to when it happens in November, December when there’s not very much sunlight, the faster a lot shorter, seven, eight hours.

And like everything just kind of clicked. So Jason said, you know, there’s gotta be a reason why other than spirituality, that every major religion in the world and throughout human history, there’s fasting and like, how do we even survive in the first place? So we started with me as a guinea pig. Jason wanted to start with patients, but all of the senior nephrologist are like you guys have nuts. And I said, Well, I can do it. I’m not a patient. And it became senior nephrologists would come to me saying, Hey, Megan, you’re looking great. Like not only are you losing weight, but you’re looking healthier, which sometimes we’ll see people lose weight, but they also look like they’re losing their health. Because their bodies you know, functioning on calorie restriction everything their systems are slowing down their brain fog. Nothing’s working, right. I was losing weight, but I was driving and they said do you mind posting your lab test results in the staff room? Because we’d love to follow you along. And then one day the big director chief called me and he’s like, this woman needs to lose 30 pounds and in about a month or two months, Max or she’s gonna lose her opportunity for a transplant. So he’s like I’m waiving the right PFLAG she’s yours, do what you gotta do. And then we started seeing patients in the clinic. And Jason wrote some popular books, we wrote a popular book. So we decided to move our practice online, so we will be better able to help people who couldn’t come to Toronto and get the information and the support that they need.

Robert Lufkin  10:21  
Wow, what a what a great, what a great story and that about Ramadan, playing a role in that, that that’s fast, fascinating. Well, maybe just to start off what what is fasting? And what why is it so helpful? What’s happening with fasting?

Megan Ramos  10:41  
Yeah, so fasting, at first, it was the total opposite of starvation. So Starvation is when you don’t know when your next meal is coming from, you’re very nutrient deficient, you don’t know if you’re getting nutritious foods. It’s it’s unpredictable. And it’s something forced upon you, when you are fasting and you are electing to fast you are in control of it, it is a voluntary voluntary act, and you define the parameters and hopefully are able to define the foods that are coming in. And in our society, especially here in North America, a lot of first world countries, you know, we’re we’re over nourished in the sense that we’re eating an abundance of food. So fasting gives our bodies a break to help burn off some of the excess food energy that we consume. So I love to use this analogy I, you know, and, and 2022, we have all these luxuries of modern lifestyle. So we get up in the morning, we get in our cars, we drive to work, we sit at work, we’re not really burning tons of fuel like we would, in sort of ancestral times, we have to walk to work or your your life would be to go hunting hunter gatherer that would be your work and maintaining your families. But imagine that there’s some sort of mandate that you must buy an entire fuel tank worth of gasoline every day, but you’re only driving a few miles a day. But if you don’t buy that fuel tank with some gas, if you don’t buy that 15 gallons worth of gas every day, the government’s gonna find you a lot of money. So you’ve got to buy that gas, but you’re only driving maybe three, four or five miles a day, you’re not going to deplete that fuel tank at all. So what ends up happening? Well, you don’t want to get fired, right. So you’ll go buy gas canisters, and you’ll have to fill those up. So you get your korta in a 15 gallons a day. But then what happens? Well, your car becomes full of gas canisters, you have to go to your house, your garage becomes full, then you’ve got to put them inside of your house, you’ve got to put them in your backyard. And then there’s this toxic zone, because you have all of this fuel. Now, when you’re fasting, you’re fasting from going to the gas station, and you’re forcing your self to utilize those canisters, and to start to deplete the canisters that have accumulated and cause this toxic environment that you’re in. So, you know, we don’t have any imposed rules that we must eat some like eat X number amounts of food a day. Although our guidelines recommend that we necessarily eat from some from time we wake that’s the time when you go to bed, you know, six small meals plus a bunch of snacks is the recommendation. It’s like we’re we are at the end of the day filling ourselves up with an entire fuel tank of fuel. But we’re not really driving ourselves that much. So our body’s got to store the excess fuel. And Insulin is the hormone that’s produced to help us either get that fuel into the cell to be used or get it into storage. So Insulin helps create that gas canister. And then we end up building these high levels of insulin in the body because they’ve got so much fuel that we need that insulin for because we’re told to eat sort of the wrong foods, the ones that things like processed and refined carbohydrates that are completely dependent on insulin to either get into the cell or to be stored as fuel later on. And so we ended up with this toxic level of insulin in the body that causes all kinds of inflammation causes all kinds of disease, like type two diabetes, causes growth in the body’s like PCOS. And we it’s a growth hormone. So this toxic level of insulin that’s produced in result to our dietary habits, which again, are imposed on us by the government, they are the guidelines, they lead to so much disease. So when you’re fasting, you’re not producing any excess insulin because you’re not eating the excess stuff or storage. And you’re actually able to lower those toxic levels of insulin in your body because you’re going to be emptying the canisters so you empty the canisters of hassle, but simultaneously, the insulin levels get to go down. And that’s kind of the beauty of fat Seeing your diabetic patients that have to, of course, check their blood sugar levels, so they’re fast. And they’ll have to adjust their medications on, especially on their fasting days and certain cases. So they’ve got a monitor and they’ll say, you know, Hey, Megan, you know, why is my blood sugar levels still 141 I’ve been fasting now for like 24 hours, well, your body’s going into that refrigerator, you know, those those gas canisters is that extra slice of pizza you ate at that hockey game, it’s an extra piece of birthday cake you had when your colleague turned 40, as an extra donut you had in the morning when traffic was really bad and you got into the office. So our bodies really emptying our internal refrigerators, cleaning it out. And as a result, we are able to get this healthy hormonal balance and reduce inflammation and really reverse disease for disease prevention later on.

Robert Lufkin  15:55  
So so that that’s important concept. What you’re saying then is fasting, I mean, I get that fasting, if I eat less, I’ll lose weight. So it’s great for obesity, but, but what you’re saying is that it’s it’s much, much more than that much more powerful. And it’s influencing these, these hormones you mentioned, like insulin and inflammation, and many other factors that that help with with chronic disease as well. So the fasting is is actual actually healthful beyond just weight loss and fewer calories. There are actual other benefits to it. I I’ve heard some people say that ancestrally that fasting that in in humans, maybe prior to agriculture 12,000 years ago or so that as hunter gatherers that fasting was was was pretty much the default state. How do you do you think that’s true with humans?

Megan Ramos  17:04  
Yeah, it absolutely is check that our human history. A few years ago, I was giving an interview to a news outlet, I believe that was out of Dallas, Texas. So Dallas and Toronto have very different climates through some parts of the year. And it was the dead of winter. And this woman who was interviewing me was doing her due diligence and being devil’s advocate, and saying, like you could this have been possible throughout human history, and I’m looking outside my window at Toronto. There’s literally nothing like animals are in hibernation, there is no there are no plants growing. I would have to trek far and wide to a climate where I would have access to these things at this particular time of year. We had to hunt are a big part of our evolution. Our job, you know, was to go hunt and gather and find food. We wouldn’t wake up in the morning and go to our caveman cupboards and pull it or cavemen cereal and our caveman bagels and make breakfast before we would go out looking for animals looking for plans, whatever is in that geographic area that people had that they could eat and they could consume for food fuel. It was our number one drive to do so we were almost always in the fasted state. And our food is very different than what food was back there. At least in the supermarkets. You know, moving from Toronto to the Bay Area. In the last two years, I didn’t have all of the resources. I’m like a fourth generation Torontonian I know the grandchildren of my farmers back home. But here it was different. So I had to go to the supermarket a couple of times when I first moved to like learn the lay of the land and how to source food and the supermarket so like barely like 10% Real food and the entire supermarket and then that real food is is even good quality years is just sprayed with nasty pesticides, herbicides and all crazy GMO stuff. And it’s just so mind blowing to me that like this is this is what food is nowadays. A good friend of mine. His name’s Nick Mahler. He’s sort of a citizen scientist. He’s a scientist, but in the medical field that what we call a citizen scientists in the UK, and we were having dinner in London before the pandemic with a famous rugby player who was trying to rehab and reduce inflammation after surgery. And we were talking to him about this. He was very interested. And Nick said, you know, water is also scarce it throughout human history and those very ancestral times, but you don’t necessarily see people turning on faucets every time they see what and sticking their head under and just drinking until they internally drown. But we’re doing that with food because food nowadays has been so designed to be addictive to cause these strong hormonal responses that lead to Addictive patterns these neurotransmitter responses like dopamine That leads to these addictive patterns. So they’re like you people can eat into oblivion nowadays. So not only has our access to food like now there’s an app, I can have food delivered to my door in like 10 Minutes or Less being in a major city area. But the foods also designed very differently than what it was that we ate back then back then we would eat real Whole Foods, people who do follow a more of an ancestral dietary plan, paleo, low carb, real food keto, real food, because those diets can be done without real food. It’s amazing what you’ll see at Costco nowadays. But through a real food approach, and individuals feel satiated, I can get to the point where even I might be having a little bit of something like sweet potato at a meal, but I can’t finish it all. And you can leave food on your plate. Like most people in North America can’t imagine leaving food on the plate at a mealtime. But you can get satiated to a point where you’re not overly uncomfortable, but you’re comfortable. And you can leave food on your plate when you’re eating these real foods. And that’s those are the foods we had access to throughout human history. So they go hunter gatherer, they would have these energy retrieval systems. So being able to store fat, and then in a fasted state, being able to activate our sympathetic nervous system, produce these counter regulatory hormones that enabled us to liberate this stored fuel fat and to use it, and they will be able to find foods and then eat them until they are associated, and then you know, be able to be able to move on. And sometimes food was more in abundance. And sometimes they’d have to go days weeks, perhaps even longer periods of time, depending on their geographic location and time of year and season and whatnot. So it’s very different our lifestyle, our access to foods, the type of foods that we have available now are affecting humans in a way that they haven’t human history.

Robert Lufkin  22:03  
Yeah, yeah. Well, I want to talk about the types of foods that the choices we make in the foods when we’re not fasting. But before we do that, a couple other questions about fasting. So we’ve seen We’ve talked it about fasting is a benefit beyond just restricting calories for weight loss, or they’re actually these these hormonal these inflammation benefits of fasting? So simple, basic question, I guess, how long do I have to stop eating before it’s considered a fast? So what’s the what’s the current thinking on the optimal length of fasting these days?

Megan Ramos  22:40  
Yeah, so I would say it’s definitely not a one size fits all approach. There’s some really awesome data out there about 14 hours being a good mark for some disease prevention, especially for some more female hormonal related cancers, breast cancer, in particular, Dr. Don Lemon from Oregon, oh, no, we lost her from the Bay Area. We lost her from Berkeley and politics to Oregon, but she’s a gift there. Love her presentations. She has a book called The End of one. And she talks about that 14 hours being so great, especially for women at some disease prevention, especially in female related cancers. We found that 16 to eight hours of daily fasting is great to help a little bit of metabolic disease, great to help that, you know, 10 pounds of that freshman 10 pounds that you never quite lost, and for maintaining very good, very good health. Once there, though, is metabolic disease. There’s, there’s disease, and you’ve got to have a therapeutic plan to treat that. And I love what you noted earlier, like this isn’t just for weight loss. And if you think about it, that, you know, we have this weight, weight issue, we have this obesity and this metabolic syndrome, because it’s a medical condition. It’s not just a vanity condition. And we always you know, especially I’m I’m a woman, and I will tell you that when I got it’s a size four pair of jeans after losing that weight that I had gained. It was awesome. And I felt sexy and great and on top of the world and I loved every comment that came my way. But it’s really a health condition that causes it. It’s so it’s not just not just from from vanity. So we had a young guy in the clinic years ago. He’s just a couple of years younger than me. And he was like going to be going blind from his diabetes. He was on pounds of insulin. And there was always something work was stressful. They ordered and subs to work for lunch and he couldn’t say no, he went to watch the Toronto Raptors play at the bar with his friends ended up you know, just diving into the nacho plate. There is always always something and you gotta live your life to and you can absolutely hit fasting into your life but suddenly But Jason said that was so powerful to me. And that is, I hear Him say many, many things. And this is one that that definitely stuck with me it caused chills

was that if you had cancer, and if you are told, if you go to your cancer treatment three times a week, for six months that you will be free of that cancer, you could go on to do whatever your professional dreams were personal dreams, get married to the love of your life, have kids, if that’s what you want travel the world, if that’s what you want, you could do everything, would you go for those three treatments a week, and here’s a bonus, you can move those three treatments around, you don’t need to commit to always Monday, Wednesday and Friday. For example, if you’ve got a social thing on a Monday, you can go on Tuesday. And you can do it in any combination throughout the week. And the guy said, Of course, I would go and he’s like, this is not a diet, you know, you might see this on the cover woman’s world, you might see it on the cover of this or that talking about weight loss. It’s not a diet retreating your disease. This is a therapeutic plan. And you need to show up for your treatments. But the great thing about it is you’re only scheduling an appointment with yourself, you’re not dependent on other people, so you can fit it into your plan. So when we have people that have the metabolic conditions, and that need to fast for therapeutic reasons that have caused their, their weight gain or their metabolic syndrome and diseases like Type Two Diabetes, you know, we take therapeutic approaches. So for this, you know, we’ve worked with over 20,000 people now, since 20. In the last 10 years since 2000, in June 2012, we’re approaching a big anniversary, I guess, in a few days. So now. So we asked them to do three fasts a week that range from 24 to 42 hours is a therapeutic approach. And then of course, there’s different combinations. A lot of people with families or significant others at home partners who don’t fast, they like doing something like maybe 240 hour fasts a week. It’s it only then they’re missing two meals, or they’re trying to cook two meals for family in a fasted state as compared to three sort of separate days. And, you know, I took that approach. Myself, if I could do 340 twos, I would, but I would always do at least 320 fours. And I did give myself that flexibility to me maintain consistency with it. If I had a really low key social week, and I was feeling great and thriving that week, I do 340 twos. And if I had a busy social week, I tried to schedule in 320 fours, or if I was feeling really tired and rundown, maybe it was jetlag from a trip, I would do 320 fours and you can fit it in, but you just need to make the commitment to show up for your disease. And anyone can have the results that I’ve had, I had, you know, in six months, I lost over 60 pounds, I have not only maintain that weight loss, I lost another 26 pounds in the month of follow in the months to follow and I maintained it now for over 10 years that I reverse that fatty liver almost overnight. I reverse that PCOS I reverse that type two diabetes all within six months. So if I can do it growing up on a diet that primarily consisted of McDonald’s and Domino’s Pizza, and a roasted chicken chain in Toronto, pretty much like anybody can do it. I didn’t eat broccoli till I was nearly 30 years old. So you know, if I can make these changes that and they can come over over time and the fasting is great, because you know, for me, they are days I was like fasting like I’m like this is hard. My first fast was really tough. And your Jason said, Well, you could try doing some low carb I’m like I have not cooked in my life other than to boil water for pasta. You know, I was I was spoiled. I know I had access to ordering lots of food if I didn’t like what was being served at home, I could order pizza and I ate out all the time like I don’t know I don’t have these skills. And Jason’s like well you better start passing then because at least you don’t have to worry about it. And then over I will tell you like over the the years my diets been a real evolution and I’ve had to figure out what works best for me and you know, I crave brussel sprouts now like I used to create potato chips. It’s the craziest thing, but it took time. It took it took time but I was able to save my life through fasting because diabetes doesn’t wait diabetes isn’t wait for you to learn to love brussel sprouts more than potato chips doesn’t. It doesn’t wait for you to figure out how to calm yourself emotionally without diving into a bowl of popcorn or a cake.

It doesn’t wait for any thoughts stuff and I’ve seen firsthand how diabetes can destroy people. The amputations, the kidney failure, the dialysis going on disability, losing your eyesight, the cancers, diabetes doesn’t wait for that. And fasting is a really great strategy to get ahead of that as you work on the nutritional side of things.

Robert Lufkin  30:20  
Yeah, so it sounds like there’s a the begin fasting, it needs to be about 12 or 14 hours, I guess that’s maybe that’s the time that glycogen burns off sort of the short term storage and the fat and the muscle in the liver and the muscles of the glucose and then then after that, you’re burning fat, I guess. And, and that, then that’s when the benefits of fasting start to accrue. So I guess the next question would be, is there an advantage to going longer? Like you talked about you mentioned 24, you mentioned a 48 hour is longer better? Or did do we? Do we have any ideas? What, what’s your experience with that?

Megan Ramos  31:04  
If you probably can do an extended fast here, there, you probably should do about four seasonally, like when I will do spring cleaning. In our household, I will also do a bit of a longer fasts and it’s great because I’m so busy cleaning my household, I don’t have to worry about eating and meal prep. And I know Jason does about one longer fasts at the start of every year him himself. And so when the longer fasts, so what’s the deal with longer fasts? Well, for especially for metabolic patients, too, we don’t really see the insulin levels start to fall until around the 24 hour mark. So we really don’t so tell us insulin levels start to come down that we really start to see a lot of fat loss of these metabolic patients. And if you think of insulin is like the, the hormone that’s guarding all that body fat, and we’re trying to, we need to knock it down in order to burn that body fat to get at it and to deplete it from our system. So we found in these metabolic patients, that that’s really when a lot of the magic starts to happen. But it’s also around that point, sometimes a little bit earlier, sometimes a little bit later that we activate this physiological phenomenon called the toffee G. Now I’m, I’m only going to be 38 this year, at 18. I probably would have thought this is old, but I am aware of quite young in the in the big picture of things. So I didn’t finish school decades ago, although we’re, I guess we’re getting to that point.

I didn’t learn about it. So you know, in 2016, the Nobel Prize in Medicine was awarded to a Japanese physiologist for his work in this field of a top and Gene, what a tapa G is the cellular recycling phenomenon that happens in the body. When it’s activated, it will target old and damaged cells will then damage proteins. And it doesn’t create new stuff. But it takes apart the old stuff and puts it back together in a new and healthy cellular way. And why this is so interesting is it’s great for disease prevention. And there’s been a lot of promising research, especially about neurological conditions and cancer. So a lot of people are keen to fast because it’s such a powerful activator of a tapa G. There are other things very intense exercise is can activate it to pathology, doing a ketogenic diet that’s very, very low carbohydrate diet can activate a tapa G too, but this to a certain extent. And it’s not always feasible for people to have that intensive exercise, or to be able to follow a ketogenic diet based on their circumstances. I do what’s called a bit of a cyclical approach to ketogenic diet and in my own life. So I’m not I’m not anti yet, but fasting is a real powerhouse for toxicity. So depending on how metabolically healthy you are, it can start earlier in your fast or it can take quite a while to happen in your fast. But these metabolic patients with these high insulin levels, they’re at risk for a lot of gnarly stuff, you know, nerve damage due to their diabetes, we call Alzheimer’s disease and dementia like type three diabetes, which we were chatting a bit about earlier. And, you know, we really, you know, want to prevent these things from occurring. And autophagy is potentially very powerful at helping with some of the cellular healing the cellular recycling and preventing some of these diseases. So for these individuals, you know, we want to be additionally therapeutic. We’ve found pretty remarkable results with this, you know, once people surpass that 24 hour mark. So we typically have these therapeutic protocols that are or three times a week between 24 and 42 hours, or 248 hour fasts that people will strive to do the majority of the time for about six months, till they’ve made real headway with their disease. And, you know, it’s really you can’t go into a doctor’s office and just measure autophagy. And you’re kind of relying as a clinician to look for observational findings of it. And I’ll never forget Jason and I had one patient, Jason and I were both in the office and he was there. It was about five foot five. He had been in a terrible car accident, I was wheelchair bound, when we met him had gained tons of weight. And that day, he was on 165 pounds. And, you know, he wasn’t one of those stories. Yes, we got from a wheelchair to a walker to a cane with that weight loss. But he wasn’t going to the gym and pumping iron or climbing mountains and hikes or anything like that. I mean, he was in his late 60s. And he said, you know, Megan, Dr. Fung, you know, why have I lost 165 pounds at my height with my lack of activity, and I don’t have any loose skin at my age. And Jason, and I just kind of looked at each other. And I’m like, you know, I’m five foot three, and I lost 86 pounds at this point. And I don’t have an ounce of blue skin. And I just attributed it to, you know, being in my 20s at that point, because these people in their 20s are just invincible, right. So

I thought I was invincible, and that’s why I had such good luck. But then we started looking at their cases. And then we started talking to patients about more than their blood sugar’s more than the inches loss more than their ultrasound results. Skin takes are going C section scars are going other surgical scars were disappearing. And we’re talking not in not on 20 year olds like I was at the time, you know, and people that had C sections 30 years ago, their C section scars are going and we’re like, wow. Because these patients at the time, we were so green when it came to fasting patients that we were doing about 324 to 42 hour fasts with our patients. We were not doing any of the longer fasts at that time. And we were seeing all of this a tapa G happening, and the patients doing the Spass. So So I mean, if that’s what we are observing from the outside, like what is going on on the inside, that is going to be helping them live longer and thrive as they age and prevent disease. I mean, this is just what we can see on the surface level like, wow, what’s happening on the other side is going to be truly amazing. And Jason goes into a lot of detail about a tapa G in his book, The Cancer code he’s written so many, so many good books are really fortunate. I’m not that one. I know. He is. He’s proud of all of them. That one is a very his his baby. And he goes into a lot of detail, specifically about a toffee G and cancer. So I’d highly recommend that as a good read.

Robert Lufkin  38:00  
Yeah, that’s that’s a great book. You mentioned, ketogenic diets, and and several people are always asking me, someone will say, Hey, I’m in ketosis, I’ve got it down, I enjoy. I enjoy ketogenic foods, I don’t eat many carbs, I’m in ketosis all the time I check my breath, you know, whatever. What additional benefits, if any, will I get my fasting? Do I need? Are there any additional health benefits of fasting? Or is being in ketosis accomplish the same things?

Megan Ramos  38:35  
Yeah, no, it doesn’t. But with the metabolic patient together, you kind of give yourself the base tools that you need to really tackle this. So Rob, the majority of people that come to us nowadays, with all of the popularity of a diet like a ketogenic diet, they come to us and this is the story, almost every time I lost 50 of those 80 pounds, I can’t lose that last 20 to 30 pounds, maybe I’m broken, maybe I’ve destroyed my metabolism so much. Maybe this is as good as it’s gonna get. Or in terms of diabetes, the diabetic marker that many people look at to judge whether you’re diabetic or not, or the severity of your diabetes is something called hemoglobin a one C or just a one C for short. And people strive to optimize that by getting it sort of between 4.5 and 5.2. But you know, we’ve, we’ve, we’ve seen it over, you know, 1314, we’ve seen crazy, crazy high numbers where a lot of diabetic damage is happening. So we’ll have people come in and they’ll say, you know, we got it from say nine to 5.8. Why can’t we get it to under 5.2. And it’s important to remember that so insulin resistance is the root cause of of type two diabetes as the root cause of a lot of our obesity and then insulin resistance develops, after we’ve, you know, had this toxic level of insulin in our body that’s caused some cellular damage. So our cells become resistant to to our own insulin. And it’s important to understand that we don’t just develop that insulin resistance through eating a diet that’s high and processed and refined sugars. And that’s really what the ketogenic diet does, it minimizes processed and refined sugars and starches from your diet, so. So if your problem is too much insulin, we’ve got three, all of our foods made the three primary building blocks, carbohydrates, protein, and fat. And the society tells us see lots of these carbs in the process of refined carbs. So our diets very heavy in that, and when we eat those causes the body to produce a lot of insulin. Whereas when you eat a diet that prioritizes, healthy fats, moderate in protein, and long carbohydrates, like a ketogenic diet, you’re barely forcing your body to produce any insulin. So it makes a lot of sense it a ketogenic diet, if you have a disease of too much insulin, then when you eat the foods that you’re eating, you’re not adding more fuel to the fire, not adding more insulin to the body. But does it help you deplete the insulin that is there.

So we also get in the habit of just eating all of the time as well. So many of the people that come to us, they’re eating all these really great foods, but they’re just eating all the time. And even when we do eat energetically, whatever we eat is still going to cause some insulin production. So if your cup, the if you think of your body as a cup, and it’s full of water to the top, because you’ve got insulin resistance, even adding drops, so that you add a lot of drops throughout the day is going to start to overflow. So when you eat ketogenic Lee, you’re not adding more fuel to the fire, but we also develop insulin resistance by the chronic stimulation of insulin. So the chronic drops into that class, and this is what fasting really addresses. So when you have insulin resistance itself, insulin resistance causes the body to produce insulin, so it’s great through the diet, that you’re not adding more to it, you’re going to see some weight loss, you’re gonna see some health improvements, but the insulin resistance that you already have still gonna be causing the production of some insulin, you still get kind of stuck in this circle. Whereas when you start fasting, you really suppress those insulin levels very low, because you’re not eating, you’re not constantly stimulating insulin production, either on a large scale or small scale. And you’re giving your body and your cells a bit of a break. So you’re suppressing it for these longer periods of time. And that really helps break the cycle of insulin resistance. One way to look at it on a cellular level is when I met my husband met my husband in Orlando and an engagement party at the time for a friend for his brother actually, and my friend, and he was living in San Francisco, I was living in Toronto, so we dated for seven months got engaged 12 months, we got married, the first year of our marriage was long distance, because there was some immigration stuff. Before we could actually live together, and all of the older woman in my family started to giggle, the month leading up to him moving to Toronto, and they said, Boy is your relationship going to change because you see each other every two to three weeks for these little long weekends, that you get this big break from each other, you’re not doing life with each other quite yet. So it doesn’t matter how much they take you off, or you take each other off, you’re always going to be so happy to see each other absence makes the heart grow fonder. But when you’re in Toronto, you’re living together and 24/7 You’ve got a rude awakening coming sweetheart, and I just rolled my eyes on the at them. And three months later, I’m like, Oh, this is what they’re talking, talking about. And because of the nature of our relationship before we’d have three days together, so we do everything together. And we had to say okay, what are your hobbies going to be? What are my hobbies going to be? What time you know, how do we still have our alone time? How do we make this work? Because we need that break in order to thrive and that’s sort of the same thing you know, with ourselves. Our cells have developed insulin resistance because of overexposure and chronic exposure. And fasting rarely gives ourselves a break a chance to heal a chance to say hey, when insulin then is produced in response to having food or having a snack, the body’s like oh hey, you know I used to I used to like you you’ve gone away for a while let me work with you better now. So you know, we’re getting away from that over over and chronic exposure. When we are fasting and giving our bodies a break.

Robert Lufkin  44:53  
I have to admit I’ve never heard resistance explained In terms of a marital relationship metaphor, but it’s actually makes a lot of sense. That’s great. Well, well, Megan, you’re, you’re the CEO and co founder with Jason Fung of the fasting method. So tell us a little bit about that. That’s a way that people can actually from anywhere in the world, correct. They don’t have to live in Toronto or in the Bay Area to, to learn to work with you on this. Yeah. So what is the fasting method? Yeah, so

Megan Ramos  45:39  
there’s a few different ways that we try to make fasting information as accessible and supportive as possible. So we have an online community with large group meetings on various topics, fasting, nutrition and disease related, depending on what support you need, along with online courses, and a very active engagement with our coaching team and ourselves. And then for people who do need a bit more support or haven’t been able to navigate this, on their own are a little nervous to fast, they might have complex medical concerns. We do have health coaching, that’s very fasting and nutrition oriented. You know, at the fastest method, we tried to remain diet agnostic. But we definitely drive people towards a real food based diet, more of a Paleo approach. But carnivores are welcome. People who follow a more plant based approach are also welcome. And we’ll do our best to help you navigate what works for you, I would love to be a carnivore. Unfortunately, I have something called intermittent maple syrup, Urine Disease. So I do eat a little bit more plant based. But I’ve learned to make it work for me. I definitely I so enjoy my fatty steaks. I just have to be mindful of how much I have. So everybody’s welcome. You know, our we come first to unite over over fasting and then real food and we’re respectful. So we have our coaching program. There’s one on one coaching and there’s small group coaching for people that feel that they need a little bit more accountability, and they need the community to go through this with and we will be relaunching our telemedicine program this September. So we’re really excited about that. And more information about that can be found on our website the fastest

Robert Lufkin  47:41  
Yeah, the idea of having a community to work with other people is so powerful, and it’s great that you’re doing that if people are new to fasting, this is a great way for them to work with others that are going through the same thing. I’m curious, do you follow blood tests or check labs? Like do you do you use CGM with any of your patients or anything? Have you found those to be useful continuous glucose monitor CGM?

Megan Ramos  48:09  
Yeah so um, we love them in Toronto when we have a bit more power and they’re a lot more economical I wear index calm myself, but I got it from Canada at about a quarter of the price than they are here in the United States. And insurance back in Canada is also a lot more relaxed about it. If your doctor thinks you need when you get one and it will be paid for versus here, there are many hoops. So for those who work in our telemedicine program, they’re absolutely part of that program and laboratory tests are ordered through the telemedicine program. Our health coaches do look at lab results from a nutritional lens to provide guidance on fasting and nutritional protocols as well. I mean, you can order those as part of the health coaching program but there’s a company called get so well where you can actually do the tests yourself at home and submit them and you’ll get test grade tests like fasting insulin, a one C fasting glucose ICRP. So you’ll get some really solid stuff often big hurdles getting a doctor to order fasting insulin as arguably one of one of the tests that we should be keeping our eye on the most. So it’s a great it’s economical, the under $200 to be able to do this test, send them and get detailed results. So that’s one way through the health coaching but through the telemedicine program, the doctors do order are able to order lab tests. Back in Toronto, we tested everything we did imaging for fatty liver disease. We did bloodwork sometimes weekly, sometimes twice a week on our patients looking at certain things depending on their fat sync protocol. And these biomarkers are important because they provide some tangible evidence that things are happening on a more internal level that you might not always see externally. And so I would always make sure that people had copies of their lab tests. And CGM, I think is the most powerful tool in the entire universe. Even for me, I remember having a handful of berries on their own on a crazy day and just seeing my glucose and say, okay, know that if I have berries, again, they’re going to be part of a meal, I’m not going to eat them alone, they’re going to be consumed with fat and protein and additional fiber. So they’re extremely powerful at shaping behavior change. And that’s so important because we don’t necessarily will eat food. But we can’t necessarily always see the consequences, good or bad from the way that we’ve consumed it or the types of foods that we’ve had. So it would be awesome. If everyone you know, walking around would have a CGM, and they could learn, you know, proper, proper ways to consume foods. I may be if you’re always stressed out at the end of the day before bed and eating something and you see, you can actually see what it’s doing to your insides with the CGM, you’re more likely to try to find breathing or meditation practices or doing some yoga late in the evening to help you down regulate your system rather than going to the cookie cupboard to down regulate your system. So I think for behavior change, biomarkers are critical. And the CGM is one of the most powerful ways. I’m super hopeful that in the United States, there’s such an epidemic, not that there isn’t in Canada as well. But I hope they become more economical people who are not severe diabetics, I hope insurance will start covering it for people who want to be well people who want to prevent disease, or reverse early diabetes as well, because it’s there’s some companies new just census one where they’ll they’ll really work to help you get them and at a slightly cheaper rate. But it’s still atrocious. It’s really save for the more wealthy individuals here when we could all benefit. So there’s companies coming out and a levels coming out there a Bay Area company can sign up on their website for information. But I think in the next next two or three years, we’ll start to see some more economical and easier to access forms a CGM. And I think if you can get one you probably should.

Robert Lufkin  52:32  
Absolutely I couldn’t agree more with a CGM is in my, my personal hope is I can’t wait until Apple and Android integrate the Raman spectroscopy fleet glucose monitoring on the watches, which they’ve teased a little bit they filed patents on it. But you know, it’s just a matter of when it’s going to come out. But think about that, if everybody had it on their watch. And we’re getting glucose feedback, how that would affect their choices in their their lifestyle choices, their diet choices, their fascinating choices, it would just would expand people’s consciousness about that it would be so valuable. Well, Megan, how can people find find out about what’s the best way to get in touch with you? We’re gonna put it in the show notes. But for any of our audience who’s listening only on audio, maybe you could just tell us now.

Megan Ramos  53:26  
Yeah, so the our website the fastest And there’s links to all of our social there. And then sort of me more specifically, you can find me on social platforms using the handle Meghan J. Ramos.

Robert Lufkin  53:40  
Great. And Megan, thanks so much for spending an hour with us today. This has been wonderful and welcome to California. And thanks so much for the work that you’re doing in this area and helping so many people find find better health with with fasting. Thank you so much.

Megan Ramos  54:02  
Thank you so much for having me, Rob and happy fasting.

Unknown Speaker  54:07  
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