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Episode 197:
Show Notes 


In the Real Health and Weight Loss podcast episode, Dr Lucy Burns and Dr Mary Barson, weight management and metabolic health experts, delve into the topic of intermittent fasting. They explore the physiological differences between fasting and chronic calorie restriction, debunking the notion that intermittent fasting solely revolves around reducing calorie intake. Instead, they emphasise the hormonal and metabolic benefits of intermittent fasting, such as reduced insulin levels, increased growth hormone, and enhanced autophagy.

Differentiating Fasting from Chronic Calorie Restriction: Drs Lucy and Mary explain that intermittent fasting involves periods of fasting balanced with nourishing meals, as opposed to chronic calorie restriction. They highlight the hormonal changes and metabolic benefits associated with intermittent fasting.

Benefits of Intermittent Fasting: The podcast hosts discuss the various advantages of intermittent fasting, including improved blood sugar control, increased resting metabolic rate, and cellular recycling through autophagy. They emphasise the importance of balancing fasting periods with proper nourishment.

Personal Fasting Strategies: Drs Lucy and Mary share their own fasting routines, emphasising flexibility and listening to one's body cues. They discuss different fasting methods, such as time-restricted eating and intentional fasting days, and underscore the importance of adapting fasting practices to suit individual lifestyles and preferences.

Mindful Feeding and Avoiding Bingeing: The hosts caution against the tendency to overeat during feeding windows following fasting periods, stressing the importance of mindful eating and avoiding bingeing behaviours. They encourage listeners to prioritise protein and nutrient-dense foods during feeding periods.

Starting Intermittent Fasting Gradually: Dr Lucy advises individuals to begin intermittent fasting gradually, emphasising the importance of listening to their bodies and avoiding rushing into fasting. She suggests waiting until one feels reasonably hungry before breaking the fast, extending the fasting window gradually over time. Dr Mary highlights the importance of ensuring that individuals are not pregnant, breastfeeding, or struggling with an eating disorder before starting intermittent fasting.

Hydration and Electrolyte Management: Both doctors emphasise the necessity of staying hydrated during fasting periods and discuss the importance of electrolyte balance, especially for those with increased electrolyte needs due to factors like physical activity or environmental conditions.

Listening to Body Signals: Dr Lucy emphasises the significance of paying attention to bodily cues and adjusting fasting practices accordingly, reinforcing the idea that breaking a fast when necessary is not a failure but rather a part of being attuned to one's body.

Flexibility and Individualisation: Dr Mary shares her approach to planning fasting days, highlighting the importance of flexibility and having access to suitable food options if needed, especially during workdays.

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Episode 197: 


Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.

Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.

Both (0:16) And this is the Real Health and Weight Loss podcast!

Dr Lucy Burns (0:23)  Hello, my gorgeous friend. How are you this morning? I am fantastic and I'm joined as always by the gorgeous Dr Mary. How are you, Dr Mary?

Dr Mary Barson  (0:31)  I'm very good. I'm recovering from a bit of a fright just before, I was still got bracing hot, right? I'm good. I'm fine. I'm ready. I'm ready to podcast. But I was walking around outside barefoot around my path to get a bit of sunlight and I came across a snake. So the one was either a little brown snake or a little juvenile Tiger Snake, and they're on the path woodshed and I saw it and I went into a massive, massive fight or flight response. In fact, I froze. I froze. And then the snake saw me little snake and it froze as well. I frightened it and it frightened me and we both froze, and we just stared at each other. And then I back away and then the steak slides off and then I grabbed the dog and came inside. So yep, have got got some adrenaline coursing through my body and got some increased counterregulatory hormones, they're definitely quite high.

Dr Lucy Burns  (1:29)  And a very appropriate use of the front and flight response.

Dr Mary Barson  (1:32)  Indeed, indeed, that's right, stop and back away from that. I also think that you know, as a kid growing up in Australia, we are taught this we're taught snake safety and that's what you do so you freeze and you back off. I know, my dad growing up in Canada was taught bear safety. And I don't think that my instincts would be quite so well-honed if I came across a bear, as perhaps he squats and he did have a couple of encounters with bears when he was a little kid. So they go yay, to everyone who told me what to do when you see a snake thanks.

Dr Lucy Burns  (2:08)  Yeah. Oh, I know. I know and in fact, you know, we do this a lot, don't we? You know, practice fire safety, fire drills, you know, if you're in the bush like we are, then you know, we have fire safety plans around bushfires and all sorts of things. You know, kids learn what to do in a house fire and they have their drop, what is it drop, roll. Stop, drop, roll or something like that. Stop. Drop. Roll. Thank you. Yes, this again, a 3-point plan is always good.

Dr Mary Barson  (2:39)  That's if you're on fire.

Dr Lucy Burns  (2:42)  Right. Stop. Drop. Roll. Yes, absolutely. 

Dr Mary Barson  (2:44)  Yeah the drop. Yeah. Yeah. 

Dr Lucy Burns  (2:47)  So yeah, it's always helpful to sort of almost mentally rehearse situations so that when they happen in true life, you know what to do. But again, like everything, it's all about balance, because you don't want to spend your whole life mentally rehearsing a snake. Never to say one, you know, oh, no, that would be unhelpful. Yeah, which I guess is why we, you know, at Real Life Medicine are always talking about balance.

Dr Mary Barson  (3:16) Absolutely, yes, balance is key, balance in all things. Not all things in moderation. But all things in balance.

Dr Lucy Burns  (3:27)  Indeed, indeed, which brings us to our topic today, which is something that we are asked a lot, which is great around fasting. So people want to know, all the things that we're going to cover in today's poddie, which is, you know, how do I balance my protein requirements with fasting? What's the difference between fasting and dieting? Do I lower my metabolic rate if I'm fasting? We thought we'd do some bit of myth-busting and then I guess, you know, who should fast, who shouldn't fast. And I probably could even rephrase that, to who could fast, who couldn't fast all of those things, as well as you know, some tips to help you if you're wanting to do some fasting to just make it a bit easier.

Dr Mary Barson  (4:17)  We spent time talking to our gorgeous people about why they perhaps feel like every attempt at weight loss has failed, why they have failed every diet under the sun. People come to us and we hear this a lot. You know, I've tried everything and I can only lose weight for a bit and it always comes back on and we spend time educating and empowering our beautiful people to understand that it's not them that's failed. It's the weight loss advice that they have been given that has failed them because no matter how it sort of packaged up and branded, almost all weight loss advice out there for the last few decades has focused around calories. This idea is that in order to lose weight you need to burn, you need to burn more calories than you eat. So you either eat less and/or move more and that is how you lose weight because we are simply just buckets of calories, and that's what you need to do. But this has a really, really false assumption at its core that makes this advice, extremely unhelpful damage. And in fact, it has failed, it has failed so many people time and time again. That core belief is the idea that the calories that we consume, and the calories that we burn, are independent processes. So we can burn as many calories as we want, regardless of how much we are eating and that if we eat less, we will just still manage to keep burning more, and it'll be fine. Yes, you feel hungry, yes, you feel tired. Yes, you feel miserable. Just keep going, just keep going because this is the only way to do it. But our fundamental truth here is that the amount of fuel that you consume, the energy that you consume, and the energy that your body will then expand, are intricately linked, intricately linked with complex hormonal processes, and they cannot be uncoupled at all. So if you eat less, particularly over a long period of time, your body will burn less and this is at the expense of your resting metabolic rate, at the expense of your energy, and really at the expense of your health as well. And then with that lower basal metabolic rate when you go back to not restricting your calories, this is why you gain all the way back on probably plus a little bit more and this is that whole yo-yo up and down diet roller coaster. So we tell people calorie is not the answer.

Dr Lucy Burns  (7:01)  It's actually really hard to unlearn that belief like it's such it for me in particular, you know, diet queen, it was such a fixed belief that the very first time I heard this, I just said, load bollocks, what a load of bollocks. Of course, you eat less, you gotta lose weight. Of course, you are and you know, I had a lot of evidence for that in my own journey, as I'm sure lots of you lovelies out there have to, when you do eat less initially, you do lose some weight and that's the trickery of it all the illusion because it doesn't stay off and that's the bit, that is not our fault. That's the bit with where we've been given the wrong advice, the wrong plan, the idea that you just need to keep eating less, less and if you're not losing weight, then you're doing something wrong, you're not exercising enough, or you're still eating too much.

Dr Mary Barson  (8:01)  It's not at all trivial is it because it it breeds this sense of failure and despondency in people if you truly believe this message, then you're going to internalise the fact that it's your fault, which is psychologically damaging. So it's bad for your body, that yo-yo dieting and the associated decrease in your metabolic rate and the damage it does to your metabolism. It's bad for your mind to know that you just fail and you fail and you fail with that predominant, you know, social paradigm that you fail, and it's your fault. So I hate this and this is a really important thing to unlearn and, you know, it can take a little while to unlearn and in the process of unlearning this, we talk about intermittent fasting as a tool, and people can get a bit confused. You know, what is the difference between intermittent fasting and calorie restriction? If you're telling me Dr Mary, Dr Lucy, that calorie restriction is the bad guy here. 

Dr Lucy Burns  (9:04)  Yeah, yeah. Yeah. And you know, even to rephrase it as what's the difference between intermittent fasting and dieting and looks like there can be depending on the motivation behind what you're doing, and the periods that you do either side of your fasting, you can certainly be accidentally dieting and using that fasting as a diet tool, and that's probably not going to serve you all that well. But you can do intermittent fasting that is part of health, that's not part of diet culture. It's a fine line. Okay. I'm going to say that this is not, you know, obvious and there will be people who will argue either way, there will be people who will tell you are intermittent fasting is just another form of dieting. Don't listen to anybody who says that. That's okay, they can believe that I can understand why you might think that but this is what we're going to explain to you, I guess today is why we don't think that intermittent fasting is part of dieting, if used appropriately. 

Dr Mary Barson  (10:13)  It comes down to that balance, you know, that balance, you balance your intermittent fasting with feeding yourself, you know, beautiful, delicious, nutritious food so that your body is really well nourished and I kind of think of it as a nourish and nurture. So you nourish your body with delicious real food and heal that hormonal root cause that is underlying, or being overweight and that excessive weight gain. You eat delicious real food that's naturally lower in sugar and naturally lower starches and you make sure you get enough protein and healthy fats, and you can eat delicious, delicious meals, and you nourish your body with those. And then you balance it with a bit of a rest, you rest your digestive system, you rest your body from feeding, and you have short stints of natural fasting and it's the balance between the two. And when you get this balance, right from a hormonal point of view. So just focusing at first on the physiology, intermittent fasting is very different to calorie restriction to long-term calorie restriction because it hormonally has a very different effect on your body, particularly when you are well-nourished with lower-carb, real food. When you just have a short period of time, when you're not eating, and we've designed to be like this, you know, humans have naturally designed to have periods but we don't eat for a while. You all these beautiful hormonal processes kick into gear, it's a metabolic switch that is essentially flicked. It's a reasonable metaphor to use and we go from being in a fed state to a fasted state. And in this fasted state, all of these beautiful different hormonal processes get switched on, we go from being catabolic, to sort of gaining weight, to anabolic, and during this phase, a really wonderful thing is our insulin levels are quite powerfully reduced. So intermittent fasting is a really useful, healthy strategy to break that cycle of high insulin. That is the main driver for excessive weight gain, but it's not just that. Other things happen, we get increased growth hormone and increased noradrenaline, which increases resting metabolic rate. So whereas you know, chronically, just eating less than your body needs day in, day out that chronic calorie restriction, our body responds by spending less energy by lowering our resting or basal metabolic rate. With short, sharp bouts of intermittent fasting, the opposite happens, we actually increase our resting metabolic rate, which is a beautiful thing. Additionally, when all of these wonderful healing processes are turned on, our body goes into this healthy recycling mode and we sift through old cells and old junky proteins and precancerous cells, and we break them down and we fix them and all these beautiful things happen in this fasted state. So you can see how it really is it's a nurturing, you nurture your body with this rest from food and you balance it by feeding your body as well.

Dr Lucy Burns  (13:38)  Yeah, absolutely. Which is the opposite of six small meals a day, I cannot tell you that three meals, three snacks that I did, you know, again, I did like neezy for a long time thinking that would be the key because, you know, in my head, I had this idea that I just needed a chef to cook for me and then it'd be fine. So lightning easy, three meals, three snacks that didn't result in long-term weight loss. Whenever I hear the phrase, low-calorie snack, my brain kind of goes Whoa, because at the end of the day, our body and again, you know, if you have a snack here and there, it's not harmful, but we don't need it. We don't need to snack. The snack food inches industry, aka junk food industry, has created this paradigm or this story that we need to snack in there and you know, they've got they've solved that, that terrible problem of snacking for us by providing us with, you know, a huge range of their options that line their pockets. But as humans, we actually, in general, once our metabolic hormones are balanced, we don't need to snack. So intermittent fasting again, there's no specific definition of what that means and it means It's different things to different people. And so I think intermittent fasting, we should probably go through the various definitions, and the ones that I practice and perhaps ones that you practice. But it's tricky because there was so, you know, the first I ever heard about this fasting business was the Five Two with Michael Mosley and again, when I heard about that, initially it was– I will five days of eating whatever you want and two days of 400 calories. And honestly, again, because I was dieting queen I thought – Oh I'll give that a crack. That was really hard. I found that really, really hard and I think because of my five days of eating whatever I wanted, and this was back in my pre-diabetes days, so clearly had high insulin so when it came to the 400 calories a day, I was hungry, really hungry, really hard. So that's one option but I prefer the what's often called time-restricted eating. So you eat within a certain window most days or some days or however, however you want to do it. Again, there are no fixed rules. So how do you like to do your fasting Miss? 

Dr Mary Barson  (16:20)  Yeah, what works for me is I naturally do most days will have a 16-hour eating window, just naturally, I wake up in the morning, and I'm not hungry for breakfast, I very rarely am so often won't have breakfast and instead, we'll have lunch and dinner, maybe another meal in there as well, it really depends on how I'm feeling. So that's like my normal feeding day I have two or three meals in a 16-hour window. And then I have intentional fasting days as well and for me two a week is good and in my intentional fasting days, I will just have a one-hour eating window. And so I fast for 23 hours or so and I do that twice a week with the extremely important caveat that if I just don't feel good, for whatever reason, it doesn't feel right for me, then I'll stop fasting or not eat because fasting is free, it's always there, and I'll listen to my body. Hunger, a little wave of hunger is fine, that's normal, we'll all naturally get a little wave of hunger at lunchtime, a bigger one at dinnertime and that's not necessarily my trigger to break my fast. If that happens, I might just have a glass of water or a cup of tea, and just see how I feel after that. Often I don't even get that if I'm busy and distracted. But if I get some, like quite significant hunger, or I feel a bit weak or something, my body's just saying, actually, you know, I'm not loving this right now. So I'll eat and that doesn't happen very often, but I will do it. And additionally, if something happens that really stresses me out. Like usually, in this case, psychological stress, quite typically with a diet like rural on call and you know, something big goes down. And you know, we're dealing with a really sick or injured person or patient, I find that understandably, quite stressful for me, personally, that I will always break my fast into I'll just have something to eat in those circumstances when my body's already quite under a lot of strain because of psychological stress. So that's how I do it. How about you, Lucy?

Dr Lucy Burns  (18:27)  Yeah, look, I'm a bit the same. I'm certainly not hungry in the mornings. Although interestingly, if I do eat in the morning, say like, you know, it's the weekend and we're going out for a cafe meal or something and I have something at 8:30 for example, I'm actually not hungry then for a long, long time. Like, it's interesting to me. Whereas when I used to eat cereal, for breakfast, hashtag zero for breakfast, I would be hungry about two hours later. So it's interesting that if you do eat in the morning, you will find that and again if you're really in tune with your body and your metabolic hormones are back to normal, then you will find that you're not hungry later on in the day. So yeah, certainly for me morning eating is not something that is easy for me to do, I can do it but it's not my preferred and I would rather have my meals in the evening. Now having said that, I do know that people who perhaps you know maybe if you're retired or you live by yourself or you haven't got that sort of family evening meal routine going, then a lot of people will have a bigger meal at lunch and maybe just something small at dinner. And technically that is you know, according to the papers, probably the best way to eat with your insulin levels because we do know that you know again, humans are diurnal creatures, we have a circadian rhythm, and that our insulin resistance, varies throughout the day, and it is a bit higher in the evenings. So, you know, there's some evidence around that. But having said that, we're also social creatures and so if our family or our friends or our tribe is meeting to eat at dinner, and you want to partake in that, then do that. Like you don't need to forego those meals. So it's really very flexible. But like you, fasting fits in with my life, not the other way around. I don't make my life fit in with my fasting regimen, I don't suddenly decide –oh I can't go out for dinner on Thursday night, because that's my fasting day. Like, that's not how it works. And I think that's a really sensible way to think about it. What I love is this idea that fasting, you know, has that benefit of, of yes, lowering insulin, again, balancing that with, if your insulin is very high, then fasting too soon will be hard, because your woodshed’s essentially shut and you don't have access to fuel. Once you're sort of down the woodshed open again, insulin comes and goes a little bit, it's a very powerful technique to really lower that insulin sort of longer term. So I love that. But I also love what you mentioned about the recycling of your cells and we call that autophagy. And I love autophagy because you're right, it's like a, it's so clever, you have the rubbish, you've got all this sort of stuff lying around that you haven't really got rid of yet, you know, off to the shop. Well, that's all our world cells, we don't need them, we can recycle them, reuse them, and replenish our stores. So this is really helpful when people get worried about their protein levels. Because again, as you know, we prioritise protein we don't, yes, you know, we're all about lowering some carbohydrates, but that has to be balanced with prioritising protein because proteins, you know, fantastic and we're basically recycling our own protein. So if you did extended and prolonged fasting, then you may have used up all your recycled proteins. So we've got to be again, mindful and balanced. But if you have got plenty of it, then you don't have to worry so much about that loss of muscle mass that we spend a lot of time telling people to make sure they get their protein. Can you explain Miss, a bit further about that for our listeners? 

Dr Mary Barson  (22:41)  Yeah, absolutely. So we love protein at Real Life Medicine and you know that there's fairly robust evidence that if you want to improve your health and your weight and your blood sugar control at everything, you want to prioritise the protein that you eat, and as a minimum rough target, we suggest people should aim to eat a gram of protein per kilogram of their body weight each day. But then we do also say that, hey, doing some intermittent fasting, once you've become fat adapted, and your body's able to naturally burn your fat source is a really good thing to do and it can leave people scratching their heads. But how can I eat, you know, 100 grams of protein and fast like, this is a very good question. So the short answer is that on the days that you are choosing to do some fasting, some lovely nurturing fasting, you don't really have to worry about hitting your protein target on those days, because your body does sift through in that beautiful fasted state, we go into this recycling mode and we're sifting through old damaged chunky proteins and cells, we're reusing them, and our body is getting the proteins that it needs from there. Also, when we are doing intermittent fasting, as opposed to chronically just eating low-calorie snacks all day, we get these hormonal changes, including this increasing growth hormone, which prevents us from having that lean muscle mass loss. So we don't really need to worry about that. Of course, it's about balance, we're not saying that you should, you know, do prolonged fasting forever. In fact, that is the opposite of what we're saying, but shorter periods of intermittent fasting balanced with days of feeding yourself are extremely good for you. 

Dr Lucy Burns  (24:23)  Absolutely. And I think it's, you know, again, what you said, what you eat in the fed state, so when your eating window is important, so people who do fasting but then just eat a salad with no protein in it or just a little bit of protein that's probably not super helpful. So again, when you are feeding you do prioritise your protein and your beautiful veggies and things that nourish your body. One of the things that I'm mindful of is that sometimes in that feeding window, so you finish your fasting and then people can feel a little bit it's out of control and I remember talking to one of my clients is that she kept saying to me, you know, I kept doing this fasting, and then I just fell out of control and ate everything in sight. So, which is, you know, really the definition of bingeing. So people will often talk about feeding and fasting, or feasting and fasting, you know because the world loves an alliteration. But what we want to do is think about bingeing and fasting and if bingeing is something that you're doing, or that your brain telling you to do, or that you're struggling with, then we don't recommend fasting. We say no, just wait. There's no rush. There's no rush. Like, we can just wait. So it's not that you can't do fasting, it's that you can't do fasting, yet. It's the same like you mentioned when you're very highly stressed fasting is a slightly, you know, it's a minor stressor on the body if you're already experiencing a lot of stress in your body and brain for whatever reason, then you probably don't need to add an extra layer to that. So fasting is not for you, yet.

Dr Mary Barson  (26:09)  Yes, I think an important story to be mindful of is this idea that because you fasted all day, then you need to make up for an entire day's worth of food in the one meal, or the two meals or whatever you choose to have that day. But that's, that's not physiologically true because if you can think about what's happening when you go into that fasted state, your body is just very happily getting the energy that it requires from your stored body fat, which is wonderful and healthy and that's what your stored body fat is there for, and so there actually isn't a calorie deficit, to use that word that you need to make up you've got all the energy that you need. You're just using it from your stored energy, rather than the energy that you eat.

Dr Lucy Burns  (26:57)   Yeah, and we often talk about that, don't worry, we often talk about, you know, the fat on your plate versus the fat on your body. And again, if you want to use that stored fat, well, we don't recommend people eat tons of fat. We don't recommend that people eat low-fat ever. But we also go you know, what, if you're wanting to burn some body fat, you probably don't need six coffees a day with, you know, half a cup of cream in each one. Yeah, that's right. I think you've written a great blog that's called Fat is Not Free. It's not. Bu again, which is great, which is fine and it's really again, just noticing if you've got a tendency because we do know that cream is easy to over-consume, again comes back to that, can you regulate it easily all of those sorts of stories, which are not about dieting, they're just about making life easy, easy for yourself. Okay, it's not restrictive if it's easier for you to have none than some, that's not restriction, in my mind, anyway.

Dr Mary Barson  (28:03)  We've discussed how physiologically, you know, intermittent fasting is different from chronic calorie restriction, but that there is a strong sentiment out there by it by many people that the reason intermittent fasting works is because it reduces calories. So it's still hanging on to that calorie and calorie out hypothesis. And I would disagree with that with like, maybe like a bit of an analogy, you know, if you are chronically you know, reducing your calories day in, day out and you may, over the course of a few days, eat the same amount of calories that someone who did maybe in a two-day window did some intermittent fasting. But it's really different between flicking between that fed and fasted state. It's kind of like, you know, you go outside and you get some beautiful sunshine, and your body is bathed in light and then at nighttime, you're having a little sleep in a dark room, you know, they're really quiet different. Whereas sort of the chronic calorie restriction is like you just spend all your time in a dimly lit room, you know, they're not identical. Yeah, they are very, very different.

Dr Lucy Burns  (29:04)  Napping. 

Dr Mary Barson  (29:07)  Yeah, that's right, that’s it. Yeah I’ve gone through napping, that's not what we want. So the benefits of intermittent fasting, really transcend any talk of calorie restriction.

Dr Lucy Burns  (29:19)   Yeah, absolutely and I think one of the things that is tricky because people, you know, again, you'll have people go, I think it was Jason Fung that said something along the lines of 50 calories is still fasting or something along those lines. But we do know that if you eat any protein, it does turn off the autophagy. So autophagy being the fancy name for recycling of your old proteins, which is helpful, very helpful. So you know cream has some protein in it. So it depends a little bit on what your aims are with your fasting as well. Certainly, my foray into black coffee started because I got to the point where I was ready to do some fasting. So I didn't start off like this and I didn't start my low-carb lifestyle off with black coffee and if you told me, I probably would have said– no, I'm not doing that was just a bridge too far and again, there's no rush. So I did the, you know, first bit, and then I got to the point where I went, you know what I'm actually just give this fasting like, sort of a proper go and so I moved to black coffee. And you know, lo and behold, I'm still alive, it wasn't terrible, and in fact, have grown to like it. So I think that if you want the benefits of fasting with autophagy, then we need to be mindful of the drinks that we consume during that time. And again, I think the tricky one is to get some cream in your coffee, and probably even bone broth because bone broth is often used because it has lots of electrolytes and so that can be helpful in fasting because we do need salt. But it does also have protein. So if you're fasting for your autophagy, so to recycle your proteins, then you're probably not going to do that if you're drinking bone broth. But if you're doing it, if you're doing it to lower your insulin, and really empty out those fat stores, then then that's probably still okay. Again, it's like there's no rules. This is just an experiment that you do yourself. 

Dr Mary Barson  (31:21)  Lovely Lucy, say we've got some people out there who feel like they're ready. They've been on a lower carb, real food diet, they're fat adapted, ready to take their healing journey to the next stage, how would you advise people to actually start intermittent fasting? What do you actually do?

Dr Lucy Burns  (31:35)  So first thing is, I always say to people, well, just make sure you're not pregnant or breastfeeding, because we don't really recommend intermittent fasting during those stages and assuming that's not the case, and that you're not, you know, accidentally covering up an eating disorder, then what we would be saying is that you go slow, there's no rush. So you can easily do it, you're the boss of you. So one technique is just to go, I'm not hungry this morning, I'll just wait till I'm hungry and again, depending on your lifestyle, you might be a teacher, and you might just wait till, you know, recess and to have your first meal. Or you might be an office worker, and you've got more flexibility, and you literally just wait till you're reasonably hungry, and you go. And sometimes people will do that. And they go – Oh, my God, I can't believe I just got to one o'clockand didn't even try that. Yeah, amazing, isn't it? So going gently with your body is by far and away the kindest, and usually the most effective for long-lasting fasting habits. Remembering our brain doesn't like things that are super, super hard and difficult, it will avoid pain, that's its job. So if you make your fasting really uncomfortable, then it's not likely to want to do it the next time. So I think the easiest way is just to extend out your resting window or your fasting window and shorten your feeding window tool, it comes to a point where you can decide how long you want to do it. Do you want to do 16 hours? Do you want to do 18 hours? Get to 23 hours? Sometimes you'll even get to the point where you go, you know what I reckon I don't even need to eat today. I might just wait till tomorrow. And you know, for us, like I can do 48 hours pretty easily, 72 is a push and then after 72, I don't recommend that.

Dr Mary Barson  (33:30)  No, we don't recommend you get into the realm of diminishing returns and increasing risks after that. What should we drink when we're doing an intermittent fast? Because we should drink definitely do need to drink. 

Dr Lucy Burns  (33:43)  Yeah, absolutely. And you need to drink more than you would normally because we actually get quite a lot of fluid from food. So people forget that. So we need to drink a bit more. What we want to do is, so obviously water, you know black tea, black coffee, they're my favorite drinks. Now then we're looking at electrolytes and again, people have different electrolyte requirements, and that just depends on their underlying physiology and what they're doing. So if you're out, you know, if you're a worker outside of the sun, then you're going to need you know, you're gonna sweat, you're gonna need lots of electrolytes. If you're a runner, you couldn't run fast and lots of people do, but you'll need to replace your electrolytes. So that's your salt, plus or minus magnesium. So, you know, you can just add salt to water if that's palatable enough for you. Personally, I find that hard I just get a bit dry wretchy, I don't know. Saltwater is not for me.

Dr Mary Barson  (34:38)  I can do it, I have no problem doing that Yeah.

Dr Lucy Burns  (34:42)  It's much easier for me to to just dip my finger in a little bit of salt. So I have a little bowl of salt like you would have sort of, you know, a fancy restaurant where they have the salt that you just sort of sprinkle on like flakes and I can just dip that in. Because sometimes what will happen is people will feel a little bit dizzy and they think they have low blood sugar. Way more likely they're having low blood salt and so when you have a little bit of salt, you suddenly feel so much better. You go, Oh, good. So yeah, that's basically how I do, I don't do anything extra fancy particularly just a basic 16, 18 or 20, up to 24-hour fast. After 24 hours, and I think you do need to be a bit more careful with your electrolytes and again, you can buy electrolyte powders if you want to make sure they don't have sugar. Okay, so we usually recommend Sodii as a brand, because it's got enough sodium, it's got enough electrolytes, whereas commercial ones that you can buy in the chemist are sometimes actually a bit stingy and they usually come with sometimes sugar or the sweeteners that are unhelpful to our body and colours and fillers and all sorts of things. And again, even with soda, you get to decide do you want to use a sweetener. People go sweeteners during fasting. The only issue I think with a sweetener during fasting is it might make some people a bit hungry. But if it doesn't make you hungry, just do that. Also, do you have a plain one if you want to do that? So that's really what I would do. What about you, Miss? 

Dr Mary Barson  (36:16)  Yeah, that's pretty much exactly the same and my as if I plan my fasting days to make sure that I've got access to my drinks. That's the only kind of real planning that I will do and I make sure I've got myself I've got my water, and I can make tea or coffee if I want to and I just think about that. The other thing I will do is a little bit counterintuitive, but say it is a work day and fasting when I'm working I actually find quite helpful. I work every day, but so it's the day where I'm actually working out at the hospital or clinical or something like that, I will actually make sure that I have access to food. Seems silly, but it is for that reason that if for whatever reason I want to break my fast I can and if it's this like tend to fish, nothing fancy to something that is there and I usually won't need it. But that is helpful for me as well. And it's helpful because if for whatever reason I feel like I need to break my fast or make sure I have access to something that's helpful. Rather than you know, the only option is you know, the bakery down the road. That's not helpful.

Dr Lucy Burns  (37:18)  Yeah, the biscuits in the tea room. So funny, isn't it? The power of suggestion just when you were talking about drinking, then I thought I'm thirsty. Drink. 

Dr Mary Barson  (37:24) My glass is empty I'm looking at my water glass guy. We have to wrap up this episode, Lucy because I need to go fill up my glass. 

Dr Lucy Burns  (37:34) Exactly, exactly. I know. I know and they're hilarious. Again, that just popped into my mind was a wiggle song. Something like gulp, gulp, drink some water and honestly, it was like this earworm. I had it in my brain for about three years gulp, gulp, drink some water.

Dr Mary Barson  (37:52)  So thank you Wiggles. We love you Wiggles. Yes, thank you. 

Dr Lucy Burns  (37:58)  Indeed, indeed. All right, lovely friends. So hopefully that's cleared up a few things around fasting, and gain, it's not imperative. You don't have to do fasting but also you don't need to be scared of it. You are the boss of you. You are your own compassionate scientist. You get to decide what you're going to do for how long and when and there's no medal for he who fasts longest. There is no medal. So if you decide you're going too fast, and for whatever reason, you need to break it. It is not a failure. It is just listening to your body and being in tune with it which is basically the whole idea of health.

Dr Mary Barson  (38:36)  Love it. Balance beautiful people. See you later.

Dr Lucy Burns  (38:40)  See you next week, lovelies, bye now.

Dr Lucy Burns  (38:45)  The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.

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