Zero Live #4: 3 Ways to Boost Fat Burning

In our fourth session of Zero Live, Dr. Naomi Parrella, MD, and Nicole Grant, RDN, answer questions from Zero Members about how to boost fat burning and more.

Video

Transcript

Dr. Naomi Parrella, MD: (00:53)

First, you’re gonna burn glucose, then you burn glycogen. And if you fast long enough or you boost your fast with exercise, you are going to burn through that glucose glycogen and begin burning fat.

Dr. Naomi Parrella, MD: (01:09)

And depending on how you refuel, you are then refilling the candle and you might refill it all the way back up or just a bit. But that determines how fast to fat burning it takes, right? Depending on what you eat. And we’re gonna talk about that, um, today. So before we do that, um, we’re also gonna do a little bit of review about insulin, but I’m going to go to the next slide and we wanna just kind of give you the overview. There are many ways to boost fat burning, and today we’re gonna talk about these three. Number one is about getting insulin levels low to burn fat. Number two is how to accelerate the rate of your fat burning to make it faster. And then number three is how to refuel wisely to maximize your fat burn and make it easier to burn fat in the future. So let’s start with boosting fat burn with fasting.

Dr. Naomi Parrella, MD: (02:10)

So this is where we’re going to talk about a previous mini medical school event, uh, that we talked about on one of our previous, uh, webinars. And I just wanna go through why insulin is important here. So if your insulin spikes high, you turn off fat burning. If your insulin is low, you turn on fat burning. And so the simplest way to get insulin lower is by fasting. And fasting allows insulin to get lower. So let me do a quick mini medical school on blood sugars and insulin so that we’re all on the same page. Your body runs on fuel and we’re gonna use glucose. Your body has to have a regular amount of glucose in the bloodstream, and it’s about one teaspoon. One teaspoon fuels. The body lets you play, lets you heal, repair, do all the things you need to do, and that’s what’s circulating in your bloodstream at any one time.

Dr. Naomi Parrella, MD: (03:12)

If you have a sort of good level of glucose, it means you have enough fuel. If your blood sugar was your glucose, it goes very, very high. You are no longer burning fat, right? We just talked about how high insulin turns off fat burning. When that happens, your body is going to start storing all the extra sugars in the bloodstream. So how high does the sugar have to go? Well, if you know it’s about one teaspoon for a normal level, one and a quarter teaspoons is a poisonous level, that’s the level that we would call type two diabetes because it poisons every single cell in the body causing blindness, kidney failure, heart attacks, strokes, cancer, nerve damage, depression, anxiety, dementia, and so on. So the most important thing to understand is we’re using fasting for multiple reasons, but one of the first things that happens is it starts letting that insulin come down so you can get into that fat burning state. So our first tip number one is you wanna allow yourself to fast so that you get that insulin down. And so you’re gonna aim to fast for about 12 to 18 hours. Now Nicole, did you wanna share some of the information around this?

Nicole Grant, RDN: (04:38)

Sustainable daily fast? On average, our Zero users are able to get into their fat burning zone between that 14 to 16 hour space. It varies a little bit based off your height, weight, age, and other factors. Um, but with some fast, you know, fat burning and fat boosting techniques, we can shift that one way or another. So our lifestyle changes in addition to fasting can kind of shift this time to fat burn. But a great general tip is to aim for that daily fast of 12 to 18 hours and you’re gonna be putting your body in a, in a good low insulin state to help promote that fat burning process.

Dr. Naomi Parrella, MD: (05:27)

So I think the key here is to get that candle to burn down, you gotta get that insulin low and then you can tap into that fat burning level at the bottom. Awesome.

Nicole Grant, RDN: (05:45)

So…

Dr. Naomi Parrella, MD: (05:47)

Go ahead.

Nicole Grant, RDN: (05:48)

Oh, uh, that’s fine. I was just gonna talk a little bit about boosting fat burn with exercise and would love your inputs too, uh, Naomi, but let’s, uh, one of the ways, so I mentioned we can shift that time to fat burning. One of the best ways we can do that is through exercise. And we want to strategically place this exercise within our fast. So fasted exercise, it helps speed up that depletion of glycogen that we, that Naomi talked about in the, in the candle burning analogy. Um, and so we wanna make sure that we place it during that time that we’re fasting. And there’s a variety of different exercises that we can turn to depending on our fitness level, depending on what we’re comfortable with. The simple answer to this question of what can boost my fat burning? Any type of exercise that you can do and you’re comfortable doing. So I would choose one that fits right with your lifestyle, with things that you enjoy doing, and find a time within your fasting window whether it’s right when you start your fasting timer. So maybe it could be in the evening or at nighttime, or it could be first thing in the morning when you wake up, you know, glycogen levels are pretty low coming off of that sleep where you probably weren’t eating. So find that time within your fasting window and we can get a great boost into your fat burning zone. Anything else to add?

Dr. Naomi Parrella, MD: (07:23)

Um, no, I think that’s exactly it. So again, it makes that candle burn faster. So when you add in the exercise, you’re gonna burn the, uh, candle faster. It also is gonna help your insulin get lower. So again, you can get to that fat burning state, uh, much faster. So exactly I think one of the challenges in this space is some people have difficulty understanding what counts as exercise. And again, as we have listed here, there’s lots of different options. So some of my patients will come in and say, you know, I wanna exercise and I use to exercise, but I have knee pain, or I’m extremely uncomfortable. I have, you know, some reason that I can’t, uh, find the time or have the um, strength to do that. And there might be some limitations. So again, there’s all sorts of different ways you can do this and um, that would be really, really important is just to understand what is it that you can do, even if it’s just getting up from a chair, it might be getting on a bicycle, getting in a pool, um, just stretching your arms overhead. There’s so many different things. So it can be chair exercises, but a lot of options.

Nicole Grant, RDN: (08:34)

Exactly. And the additional tip that we would like to add is how quickly does this boost my rate to fat burning? And so this varies on the intensity of the exercise, um, and the duration. But on average, for every minute that you do some sort of exercise, you get a one to two minute boost towards your fat burn zone. So that’s pretty awesome. Um, so a 30-minute zone to walk, which is walking at a faster pace where you can still hold a conversation, but it’s a little bit tricky. That might boost your time if that’s 30 minutes to one hour. So definitely encourage any type of movement to really get that, that one to two minute boost per minute of exercise.

Dr. Naomi Parrella, MD: (09:25)

One tip over here also with regards to exercise is initially it can be a little bit difficult because your body is getting, is sort of building the machinery to be able to do the physical activity. So even if it’s really hard early on, some people find it, it sort of gets easier sort of in a stepwise process where suddenly they’re like, oh wow, this is so much better. And um, so, uh, stick with it because your body is then ramping up to be able to tolerate more and be able to do more. So it’s really fun. Feels great. Alright.

Nicole Grant, RDN: (10:00)

Alright, I’ll, yeah, I’ll talk a little bit about boosting fat with nutrition. Um, so when we think about eating, so within our eating window, we, unless you’re on a ketogenic diet, you’re typically eating a blend of carbohydrates, proteins, and fats. Carbohydrates are a source of glucose. So looking back at that candle analogy, glucose is that top part. So we’re putting glucose in our body from the foods that we eat, which is a normal process, but it is something to consider when we are thinking about flipping that switch and eventually depleting that glucose so we can get down to glycogen, eventually fat burning. So we wanna think about different dietary influences for boosting this fat burn. And for us, we highlight three. The first one’s looking at your baseline nutrition intake. So this is what you’re doing on a typical day, um, what you’re, you know, doing most of the time what your plate and your daily intake generally is.

Nicole Grant, RDN: (11:06)

We look at it from a carbohydrate specific, um, kind of perspective and we look at four different types here. So the first one is our ketogenic diet, and this is very minimal carbohydrates, zero, maybe 5% or less of your calories or coming from carbs. And the majority of your fuel is from proteins and fats. So that’s the lowest, lowest one. Then we have a step up around low carbohydrate diets, and this is when you’re still having some carbohydrates, but you’re probably a little bit more conscious about where they’re coming from. Maybe they’re lower glycemic options, whole food sources, maybe it’s about a fourth of your plate that is carbohydrates and the majority of your calories are still coming from proteins and fats. The next one up is a balanced plate. And this is as it’s described, balanced in its protein, fat and carbohydrate content. So about a third of your plate is each macronutrient. Finally, we have the high-carbohydrate diet, and this is about half your plate or more being carbohydrates. You’re typically having carbohydrates at each meal. That would be considered our high carbohydrate.

Nicole Grant, RDN: (12:29)

When thinking about boosting our fat burning, we start at the balanced plate. So this is kind of a neutral zone. When we start moving down towards low carbon ketogenic, we’re decreasing the amount of glucose that we’re intaking. And so that actually boosts our, um, our time to fat burn ’cause we have less of that to burn through when we go the opposite direction. When we go up to high carb, we have a little bit more carbohydrates to burn through, so that can slow the fat burn a little bit. And this is taking into account that baseline nutrition. So something to think about, something that we ask, um, in your, your onboarding. Um, so that will kind of give you this baseline fat burning target. And then they can also change based off your daily inputs. But this is your baseline. The next two influences are around your fast starter meal, and this is the last meal you have for the day before you click that start button on your fasting timer.

Nicole Grant, RDN: (13:35)

And there’s two things that we wanna look at here. The first one is the quantity of carbohydrates on your plate. So still that, that kind of concept around is it a more of a ketogenic type of meal? Is it a low carb meal balanced or high carb meal? So the quantity, that portion of your plate, how many carbs are there? And then we look at the size of your fast starter meal as well. And this is based on calories. So we have small, medium, and large, and you’ll see this in our app, when we ask you to log your meals, we ask you the type of meal that you have and then all size. So a small meal would be about 200 calories, which might be a small snack type of thing. A medium meal is about 400. And just to give some context there, that’s maybe a six ounce piece of chicken breast with a cup of broccoli, teaspoon of olive oil, you know, maybe half a small sweet potato that’s about 400. And then a larger meal is about 800 plus calories. If you have a smaller or moderate meal that’s gonna boost your fat burning time, a larger meal, it’s probably gonna slow it down a little bit. So those are some key takeaways to think about when we’re looking at nutrition and boosting our fat burn.

Nicole Grant, RDN: (15:03)

Right? So I think the biggest tip here is to really be strategic about your fast starter. We have our baseline nutrition and that can shift over time, but what can you do on a day-to-day basis to boost your fat burning from nutrition, be a little bit more strategic about your fast starting meal. Absolutely. Anything to add, Dr. Parrella?

Dr. Naomi Parrella, MD: (15:31)

Um, no, I think that is really, you, you totally nailed that. So that was fantastic.

Nicole Grant, RDN: (15:41)

Right.

Dr. Naomi Parrella, MD: (15:42)

Alright, so what we wanna do now is shift over to the live q and a session. And I think we have a lot of questions that we get and we’d like to make sure that we answer as many of them as possible. Some of them are submitted ahead of time, so I’m just gonna pull that up here. So what I’ll do is, uh, I’ll read off some of the questions that we received already. And meanwhile, for those of you who are live with us today, put in your questions into the chat so that we can see them and then we’ll be able to go through and answer them. So first question, this is a big one, what do you think about the Washington Post article about intermittent fasting and risks to your heart?

Dr. Naomi Parrella, MD: (16:30)

So just recently at the American Heart Association Conference here in Chicago, there was a poster that was presented and it was not peer reviewed. Um, it was an observational study, so really not cause and effect. Um, and it was looking at if, uh, different fasting windows or different, uh, eating windows and assessing risk of cardiovascular death. And what ended up happening was there was a lot of headlines that came out from that. And so we know these results are gonna be really interesting to look at because we don’t have all the data, right? This was not a peer reviewed, um, set of information. It was an observational study. Again, no cause and effect. And they used a food frequency questionnaire, uh, which actually they used a 24 hour food recall actually. And so they asked people, what did you eat in the last 24 hours?

Dr. Naomi Parrella, MD: (17:24)

Two times? And based on that, they made generalizations about what the individuals were eating and, um, and then they followed them. Um, what we found is in addition to the fact that, uh, we, the data needs to be scrutinized because nobody has, uh, reviewed that, we also found that, um, in the group that less that, uh, they showed. So the results of the presentation were that individuals who were eating for less than eight hours outta 24 hours were found to have 90, they reported 91% increased risk of death from cardiovascular disease. And, um, again, you know, we’re very curious and we wanna understand what the evidence shows and we don’t have that yet. Um, but what we found was those, that group that was found out of the 20,000 plus individuals who were, uh, looked at, there were about 414 people between the years of 2003 in 2018 who were eating less than eight hours of eating.

Dr. Naomi Parrella, MD: (18:36)

So this is like the 16 eight or more fasting, uh, windows, 10% of them were more likely there were a 10% more likely increase in those individuals being smokers. We know that smoking leads to increased risk of cardiovascular disease anyways. We also saw that, um, there was not any information about what the individuals were eating in between. They’re fast. So we have no idea what nutrient quality was. And when we think about the time period of 2003 to 2018, um, I’m actually not aware of anybody who was doing specifically intermittent fasting because that wasn’t really a thing at the time. So I’m not sure, uh, what the population was doing the eight hours of not eating. And we, we just don’t know. We do know that there was a higher percentage of people who were smoking. Um, so basically we’re still waiting to find out what the results actually mean because we don’t have enough information yet. Nicole, did you have any other thoughts on that study or…

Nicole Grant, RDN: (19:46)

Yeah, I think those are presentations. Yeah, those are great points, right? Yeah, it’s not, it’s not peer reviewed yet. Um, as a dietician, I would love to see the data around what these people were eating. And like you mentioned, you know, they probably were not being intentional fasters, I could see a lot of them, you know, busy schedules, lower access to food, um, you know, maybe there was other reasons why they weren’t consuming more than one meal or more a day. So there’s these varying con factors that we gotta think about. Um, and I just kind of go back to the research that we do know, right? So there is a lot of research around fasting and positive improvements in total cholesterol, triglycerides, LVL, there are some positive markers there, um, insulin too and, and how we manage our blood glucose, that’s definitely tied to cardiovascular health as well. So, um, you know, kind of gotta look, take a, take a step back and look at all of the research and what we know and, you know, not, not focus on just one thing that we still are learning about.

Dr. Naomi Parrella, MD: (20:54)

Yeah, it’ll be very interesting to see what the data that they have looked at actually looks like. So again, you’re right, those, there’s such strong evidence for lowering insulin levels, lowering blood sugars, maintaining weight or losing weight, uh, that’s fat mass and maintaining lean mass. So I agree, I think this will be really, uh, curious to see what comes from this. alright. So, uh, let’s go to the second question here. So it’d be great to understand what aspects of the app or data you can enter and how they affect how quickly you enter fat burning. So this was stuff that we sort of started talking about, Nicole, I think you started talking about this and we have some, um, other visuals that we’ll show later. But, um…

Nicole Grant, RDN: (21:45)

Yeah, so I think in addition to the pre fast meal and the exercise, we kind of have this day-to-day input that can shift it. We also look at your baseline characteristics. So on onboarding, we ask your age, your height and your weight. And so this determines your RMR, your resting metabolic rate. And so this is kind of what we calculate you to be burning in terms of calories per day, and that can translate roughly to the amount of glycogen that you have as well. So we look at these baseline characteristics along with your habitual, you know, baseline, we, uh, diet baseline, and then we also look at your activity level. So if you’re sitting behind a desk all day and kind of are living in a more sedentary lifestyle, that will push your time to fat, delay your time to fat burning, whereas maybe you have more of an active lifestyle. Maybe you have a job where you’re on your feet and you’re moving consistently. We do take that into account as well. So we have our baseline characteristics, which, you know, can shift over time, but then more importantly, we like to look at those day-to-day things that you can really focus on, which is fasted exercise and being strategic about your pre fast wheel or your fast starter.

Dr. Naomi Parrella, MD: (23:12)

Yeah, I think this is where the lifestyle, um, information becomes really, really important. And if you’re tracking, you can start seeing the connections and, uh, will show some of the things that you can do with the app later on with, uh, some of the options of what you can monitor. But I think this is very, very, uh, important. What I find really compelling is the amount of data that Xero has collected around this space, being the first fasting app, so that there’s a lot of data that we’re building algorithms off of to help people really fine tune and understand their personal fat burning zone, right? That’s like, you know, how long is it gonna take you specifically with the data that you, uh, share with it? And there’s information that if you have an Oura ring or an Apple Watch or, um, you know, it’ll connect that information. So it’s really nice to be able to do that.

Nicole Grant, RDN: (24:09)

Yeah, there’s been hours and hours and hours of research and you know, the product team working on this to really make it a personalized approach to you, which I absolutely love. I think nutrition and lifestyle, if we can personalize it to your unique situation as much as possible, I am all for it. So kudos to the science and product team on this one.

Dr. Naomi Parrella, MD: (24:33)

I know, totally. alright, awesome. Um, let’s see. How does Zero specifically contribute to fat burning and overall weight loss compared to other methods or diets? That’s such a good question. Um, alright, Nicole, did you wanna start with that?

Nicole Grant, RDN: (24:54)

Sure, I can start with that. So Zero fasting first, right? We started with fasting, and fasting, as we talked about, gets us into a low-insulin, fat-burning state. So if you can start with just one thing, start with our fasting timer, that’s, you know, kind of the core of what we do, but over the years we have also realized that these additional lifestyle factors do make a huge impact in our health. And so we combine fasting with other healthy habits that are known to impact fat burning. We mentioned nutrition and exercise. We also track your sleep. We also track your stress, your mood, which can all contribute to our health and our ability to burn fat. So we, you know, we kind of built this product around a full lifestyle change, and having an app is almost like a nutrition coach or something like in the palm of your hand because we personalize it, we have education. The mere act of tracking and holding yourself accountable has been shown to shift habits and behaviors over time. So I think it’s pretty cool how we’ve kind of developed this over time to just be a really behavioral tool in shifting health and, and ability to burn fat, lose weight, and all of that good stuff.

Dr. Naomi Parrella, MD: (26:21)

Totally agree. So, um, you know, I’ve used Zero in my clinic in multiple different ways. And so when people come to the clinic and they say, I wanna perform better at my work, at my sport, at my, um, in my life and or, um, I wanna lose weight and feel better or reverse disease, there’s so many different lifestyle factors that act together, and everybody has a different, they’re in a different stage of life. They have different, uh, needs and different complicating factors in their life. So sometimes you wanna start with just being able to fast, for example, not even fasting all foods, but it might just be, I’m just gonna fast from sugar, right? And that might be really low hanging fruit for somebody like that is easier than maybe some other habit that they might currently not be able to activate on. But as you start layering on different behaviors and they become habitual where you start feeling good about it, it becomes easier, uh, to add on new things.

Dr. Naomi Parrella, MD: (27:27)

So it’s a way of tracking and collecting better and better and more optimal habits and building them into your repertoire. The other thing that I think is really unique is, yes, you can just like use a stopwatch or whatever, but if you are understanding the why behind what you’re doing, it’s easier to do it for long term and you need to, um, allow yourself permission to sometimes fall off track life happens, right? And have a tool that you know, you can just go right back to and it’s going to guide you right back into things. So many patients will come in and say to me, you know, doc, I am just, I just need to be more consistent. I’m not a hundred percent all the time and I don’t have any patients who are a hundred percent all the time, right? So part of life is there’s sort of the on and off, and sometimes we fall off and we’re not doing exactly what we want it to be doing.

Dr. Naomi Parrella, MD: (28:27)

So to have a tool that you can come back to has your information, you know, it’s gonna sort of remind you of the factors that help you and help you get back into it. And it’s familiar and becomes much easier to resume what you were intending to do from the start much faster. So it just makes the path a little bit easier and a little bit faster to get where you’re going. So I find that to be the most helpful is starting to build a tool that just by opening the app, you’re like, oh, I’m back on. This is my ritual. I’m back into the game, right? So that’s how I like to use, um, Zero to help with the fat burning and overall weight loss. So…

Nicole Grant, RDN: (29:09)

I love that just to, yeah, add to it. I talk about this all the time with my patients as well as there’s always something in life that’s going to throw you off your routine. There’s a vacation, you get sick, the stressful job situation, whatever it might be. You need to have a reset routine. I think it’s, we’re gonna fall off, but how quickly can we get back on? And usually we need a tool or a routine to help pick things off again. And like you said, picking up your phone, clicking that fasting timer is such a simple way to have that almost like trickle down snowball effect to those other healthy habits. So I just wanted to add my little 2 cents there too.

Dr. Naomi Parrella, MD: (29:51)

Yeah, totally. I love that term. I use a reset ritual, but reset routine, that’s exactly it. Like you train yourself to be able to quickly, you know, get back in it. And so it feels really good to have that tool right at your hands. So I really like that a lot. alright, anything else on that?

Nicole Grant, RDN: (30:11)

Think that’s good for now?

Dr. Naomi Parrella, MD: (30:13)

Okay. Um, I think we’re on number five. What are easy ways of burning fat besides aerobic exercises that are harsh on your knees and back? alright, that’s a really great question. Um, did you wanna start with that?

Nicole Grant, RDN: (30:33)

Yeah, I think it’s finding, you know, feel, finding what feels good. Um, there’s definitely some low impact exercises that would be potential good starting points. So I’m a big fan of yoga, stretching, Pilates, things that you can lay down beyond a mat. There’s not a lot of resistance or kind of force on those knees or those joints. So something along those lines where it’s low intensity, low impact. There’s also ways to get zone-2 exercise in that doesn’t require walking. So if walking is too harsh on your knees or your back, swimming is a wonderful alternative. You can do a doggy paddle, you can do something very light and easy. You can do water aerobics. That is a very, um, joint friendly type of exercise. There’s, you know, light strength training that we could potentially work in using bands or very low weights, two or three pounds to start, or even your body weight.

Nicole Grant, RDN: (31:40)

Something as simple as getting up and down from a chair, which I’ve heard you talk about. DR is a great place you’ve started with some of your patients who are having these, these problems. So those would be some ideas to start even. Um, household chores, standing more than sitting, we, there’s this term called meet it’s non-exercise activity, and that all adds up as well. So if you’re able to stand for a couple minutes, even while you’re watching TV, and then sit down and maybe rotate, you know, there’s all different levels that we can incorporate exercise in, but those are some initial ideas.

Dr. Naomi Parrella, MD: (32:20)

Yeah, absolutely. This is like an area I’m, I’m very, uh, passionate about having been a trainer in the past. But, um, one of the things that’s really cool about the pool, if you have access or you can go to a lake or a beach or whatever, and you can get in water that’s a little bit colder than your body’s temperature, the amount of work your body has to do to maintain body temperature is a lot of work. And so even if you got in the water and just sat there, you would still be burning a lot of fuel relative to not being in the water. So just, you know that alone. So people will say, well, I don’t know how to swim even if you just get in and walk across the pool, right? That would be acceptable, and that would be really, really great because you’d get not only the walking through the pool, but you’d get the temperature regulation that your body has to work on so much.

Dr. Naomi Parrella, MD: (33:15)

And any parent who’s taken their kids to a pool or a beach will know their kids sleep really well later because they’ve just burned so much fuel to maintain that body temperature. So it’s super, super cool. The other thing to know is movement is not just about getting into fat burning, it’s about being able to do life, right? So the more you move, the better it is, and the less you move, the less you’re gonna be able to move. So the most important thing is to be able to get your body, to get you where you wanna go, to be able to reach for things, to be able to open a book, whatever. So you wanna use your body, and one of the ways the body knows and gets signal to regenerate and heal and thrive is when you move your body because it stretches your fascia like the saran wrap that surrounds all of your bones and muscles.

Dr. Naomi Parrella, MD: (34:09)

Um, you know, it keeps you in your shape. And when you move, your fascia moves and stretches. And if that’s more flexible, it’s more comfortable to move. And there’s nerve endings that go from all of your fascia, which is all over your whole body, and it feeds into your brain and it tells your brain, I’m moving, uh, this is where I am, this is what I need to do. There’s things going on over here, and your body then is signaling to the brain that you’re moving. And when you move, that’s a signal that you need to be alive, that you need to regenerate, that you need to heal. So again, it’s not just for the fat burn effect, but it, you combine that with fasting. So with fasting, you’re letting your body sort of clean house, you’re giving a signal it’s okay to clean house, and then as you move, you’re actually telling your body, because I wanna be able to do more things. So clean up and build better than before, right? So this is why I feel so strongly about the exercise component. So there’s a lot of ways you can do this again, even if you have knee or back pain, which many of my patients, um, experience. And as you start moving and the fascia gets more flexible, it becomes easier to move without that discomfort, even if you haven’t had the surgery or injections or medications. So definitely, um, to think about that. alright. Uh, anything else to add?

Nicole Grant, RDN: (35:40)

I think that was great. Thank you for sharing. Okay.

Dr. Naomi Parrella, MD: (35:43)

Um, when is it better to do exercise before breaking my fast or a few hours after I start fasting?

Nicole Grant, RDN: (35:55)

I know everybody wants more information than just exercise when you’re fasting, so I’d love to expand on that a little bit more. I think there’s three things that we want to consider when picking our timing. First one, schedule and logistics. When can you actually do it? The second one is to think about your goals. Uh, do you really wanna optimize fat loss? Do you wanna optimize strength? Do you wanna optimize endurance? So thinking about why you’re doing the exercise. And then third, whether or not you like exercising on an empty stomach, I think that can have a little bit of an influence there as well. So we’re thinking about schedules. If we kind of throw that out the window and we think about the goals here, the goals for fat loss and muscle gain, I would encourage those to potentially shift it more in the morning.

Nicole Grant, RDN: (36:53)

So we’re likely gonna be in a lower glycogen state, so that’s gonna help with the fat burn. And then in the morning, or maybe late late morning closer to that first meal, that’s when you’re about to refuel. So that’s gonna help with that muscle gain. So you’re gonna get that protein, you’re gonna get that little bit of an insulin spike, which at that time is good. It’s a moderate insulin spike to help put that glucose and that protein into the muscle for growth. So I think for those two, the fat burning, fat loss and the muscle gain, morning-ish time is probably gonna work if we’re considering a 12:8 feeding window. Again, there’s a lot of factors and variables that go into this. If we’re thinking of more endurance, perhaps a late, you know, afternoon, evening, once your fast has started, you might see better performance during endurance.

Nicole Grant, RDN: (37:52)

Um, you have a little bit more fuel in the tank, you know, you’re maybe able to push yourself a little bit further there. Um, one consideration I would say about evening exercise is just make sure that it doesn’t impact your quality of sleep. We have seen that some higher intensity interval training or higher intensity exercise too close to bed can actually impact the quality of sleep. So I guess that’s another little caveat to kind of consider. Um, so again, it’s, it’s a blend of preference, a blend of goals, and finding what works best for your personal schedule and situation. Anything else to add?

Dr. Naomi Parrella, MD: (38:33)

Yeah, no, I mean, I think that’s, that’s exactly it. So whenever you’re willing to exercise, that’s a great thing. Again, because you’re signaling to your body, there’s two parts, right? You wanna break up the sitting so that you’re interrupting the sedentary and you want to be exercising. So the exercise, which is the more, uh, like the zone 2, the high-intensity interval training, uh, strength training, those things will be really great, like in the fasted window. And, and I really don’t have any more to add in that space. And again, just remember, even if it’s in the middle of your day and it’s not your fasting window, that’s okay too. Just make sure you’re signaling to, your body will have different effects, um, and that will also be beneficial. So there’s no bad time to exercise there. It’s all good. So, um, alright. I do wanna make sure we answer some of these live questions and also, uh, get to our summary and our call to action .

Dr. Naomi Parrella, MD: (39:34)

But, uh, so I wanted to answer one of the questions. This comes up all the time in my clinic, so I wanna make sure we hit on this. The question is from Marta. I’ve been fasting and I haven’t lost any weight. I follow a low carb diet. What could be the cause or causes? Um, there is so much here. So I think between Nicole and I, we’ll be able to have a lot of, uh, information here. One of the things that, um, you know, there’s multiple reasons. This could be number one, the fasting sometimes takes time before it starts working, right? So you have to start burning down that candle, and then if you build it back up a little bit, it, but you’re still not in the fat burning zone, right? It might take a few, sometimes like a week, two weeks before you get into that zone.

Dr. Naomi Parrella, MD: (40:26)

It can be related to hormones. And that can be from either high stress, which leads to high cortisol, which leads to high blood sugar, which leads to high insulin, and then again, turns off fat burning. High cortisol also can be, um, occurring for other reasons. And a similar thing to cortisol is a medication called prednisone. So there’s certain medications that can cause people to, um, gain weight or grow their fat cells, not intentionally. So people will come in and they’ll say, I don’t know what happened. I’m like, ravenous. And it’s not that I’m hungry for broccoli, right? I’m, like, looking for stuff that I know isn’t gonna work for me. Um, so those are some things in addition, sleep. So if somebody has sleep apnea that’s not treated appropriately, then it basically is like you’re not getting oxygen adequately through the night, raises the stress hormones in the body again, and it makes it very easy to gain weight and actually also remodel the heart and other things.

Dr. Naomi Parrella, MD: (41:31)

So those are some, uh, really important factors. Then again, looking at overall, this is where I would be checking labs, and I would wanna understand what’s the metabolic profile, because maybe there’s something here that can be adapted. Low carb may or may not be the right answer depending on what’s going on, and the fasting window might not be working with your metabolism. So if you’re sleep deprived, you’ve got high stress in your life, um, you might be on certain medications, those can all impact as well. And then again, hormonal changes. And I see a ton of questions about menopause in women’s hormones, and we’re actually gonna do an entire webinar on that. So I’m gonna hold off on answering those today. Nicole, do you have anything you wanted to add here?

Nicole Grant, RDN: (42:21)

I love everything that you said, and I take a similar approach of kind of taking a step back, bird’s eye view, kind of checking the boxes of, okay, where’s stress hormones, cortisol, how’s our sleep, what’s our exercise looking like? Sometimes fasting and nutrition is enough, sometimes it’s not. Um, so we have to look at other things as well. Um, yeah,

Dr. Naomi Parrella, MD: (42:47)

One last thing, um, uh, is about fat, fat cells and hydration, which is how, how much fluid do you have in your body? The human body needs a certain amount of fluid to survive, right? If we don’t have enough water or fluids, we’re gonna dehydrate, we’re gonna, you know, not be able to survive. So the body has a very, very primitive way of making sure that you’re going to be able to survive several hours without drinking water, for example. And if you are not drinking enough fluids and you tend to run dry, then your body is going to have to hold on to extra fat because that can then get burned to release water into the body and rather than, uh, absorbing water and carrying around water all the time, right? That gets very heavy. If you’ve ever carried buckets of water, that’s very heavy, so your body could absorb a bunch of water and just hold onto it.

Dr. Naomi Parrella, MD: (43:54)

And we see that with heart failure or liver failure or kidney failure, but if you have a healthy body, your body’s gonna get pretty smart. It’s gonna be like, okay, it’s really heavy for me to carry around these buckets of water so that this person stays hydrated. So instead I’m gonna convert that to fat cells, because fat is very lightweight, it’s easy to carry, and it doesn’t require a lot of fuel to carry that around. So then when you burn the fat, you release water, that’s one of the components, and that’s a way of staying hydrated. So again, even just staying hydrated makes a lot of difference. And some patients will come in and they’re like, I just started drinking water and I started losing weight. So, you know, it’s so bizarre because it doesn’t, you know, it doesn’t really sound like a big deal, but it’s a big deal. So another thing to just pay attention to.

Nicole Grant, RDN: (44:46)

Love it, love it. Yeah. And it helps with hunger cravings. So hydration is definitely key. .

Dr. Naomi Parrella, MD: (44:54)

Absolutely. Um, alright, um, Nicole, did you wanna pick any questions out of here? I, I’m not sure if I’m looking in the right place.

Nicole Grant, RDN: (45:04)

No, let’s take a look. I…

Dr. Naomi Parrella, MD: (45:10)

Let’s see…

Nicole Grant, RDN: (45:13)

One question we have, is there a gold standard blood sugar level that marks being in a fat burning zone?

Dr. Naomi Parrella, MD: (45:22)

That’s such a great question. So, uh, not really. Um, so here’s what happens. Your body is going to try to maintain glucose, which is the blood sugar, so it’s gonna try to maintain it 70, 80, 90, right? It’s gonna maintain it in a certain range. And when the sugars start dropping low because you’re burning ’em and you’re using them, then your body shifts over to glycogen, which is the stored glucose, and it breaks that down and dumps sugar into the bloodstream, right? What we’re doing is to get into fat burning, that means you’re burning fat into ketones, and that’s a little bit different. So, um, that’s about the insulin. So in medicine, we use blood sugar as a proxy to kind of guesstimate what the insulin is doing in the weight loss world. So this is very confusing for a lot of people because they’ll say, I know what my insulin is, and then they tell me their hemoglobin A1C or their blood sugar, but insulin is different. It’s the hormone that tells your body which fuels to use. And it basically is a growth hormone. It’s a storage hormone. So if you have high insulin, you store, if you have low insulin, you burn. So that’s just a very simple way of thinking about it. So rather than a specific blood sugar, as the blood sugar goes down, you’re gonna start burning fat because the insulin then comes down. So it’s about the insulin. So if you wanted to know, you would want to know what your insulin is doing,

Nicole Grant, RDN: (47:08)

Just to add a little something too. It’s not a very easy marker to look at, but you could check your ketone levels. There are finger stick cricks out there that you can look at your ketone levels, and that gives you a little bit of a sense of, you know, are we generating, um, our own like fuel source? So ketones are all an alternative fuel source. When glucose and glycogen are low, we need to start pulling from our fat stores, and our liver creates these ketone bodies. So you could be checking finger sticks, there’s a breathalyzer as well that can check those. Again, not as accessible, but it is one marker that you can look at. The cutoff there, 0.5 and above is nutritional ketosis. And so when you’re hitting that marker, you can be pretty sure that you’re burning some fat at that point.

Dr. Naomi Parrella, MD: (48:02)

Yeah, and I’m gonna answer this. Uh, there’s so many good questions here. I like when I answer all of them. One of them is about shift work. I work in night shift, so this is typical. I work in night shift for two years now, and since then I’ve been gaining weight. I’m gonna put it that way. And, uh, is a long night shift the cause of this. And the answer to that is that it very well may be right. So again, it’s about hormones and shift work is one of the, um, one of the best tools to address weight with shift work is actually fasting. That’s actually one of the best ways. So, um, again, it’s gonna depend on the, uh, eating windows, what you do for eating, it’s gonna depend on whether you get adequate sleep or not. And there’s also evidence to show that our insulin sensitivity to foods is different at different times of the day. So again, if you, uh, eat late in the middle of the night, for example, it makes it easier for your body to store those calories, even if you’re walking around and doing things. So, um, it’s just the way the circadian rhythm goes.

Nicole Grant, RDN: (49:23)

Yeah, that’s great. So yeah, if you’re working, I’ve had, I’ve worked with the nurses before who may be working a seven to seven, and they’re sleeping from eight to two, so I encourage them to consume their food within the daylight hours as much as possible. So right when they wake up, start eating, maybe they have a six to eight hour eating window and then half of their shift they’re gonna be fasting. But that does better align with circadian rhythms, as you mentioned, Dr. Crow.

Dr. Naomi Parrella, MD: (49:55)

Yeah, and, and the challenge with that is, of course, when you’re awake overnight, you get hungry. And especially, you know, if you’re in the healthcare, uh, setting, a lot of wonderful patients with good intentions will bring in donuts to support the team. And you know, that that really, uh, boosts that insulin. And again, remember, if you are eating foods that spike insulin, it’s gonna make you hungry very quickly because you turn off fat burning. And so now your body is gonna be driven, like it’s gonna be driven to eat more. It makes it hard to not eat if you’ve started your, uh, you know, shift, for example, with something that’s very high starch or sugar. So just to understand that, because that does spike the insulin. So, um, we’re running down on time, so I wonder if we should go to our 10 tips.

Nicole Grant, RDN: (50:47)

That’d be great.

Dr. Naomi Parrella, MD: (50:48)

Zero users.

Nicole Grant, RDN: (50:51)

Yes.

Dr. Naomi Parrella, MD: (50:54)

alright. I think, do I have those? I think I do. alright. Okay. Now we are at the 10 Zero Member tips and tricks that you have shared with us, and we’re just gonna share ’em real quick. Number one, get a scale that measures your fat mass and muscle mass so you don’t make fasting decisions merely on weight alone. Number two, during my eating window, I start off with vegetables or a big salad, then have proteins and fats, and then if I’m still wanting something, something sweet. Number three, working out while in a fasted state of 14 to 16 hours helped me lose 23 pounds in three months. Woo-hoo. Adding a sugar free fast cycle has helped me burn fast seven to 45 days.

Dr. Naomi Parrella, MD: (51:48)

Uh, number five, hunger will come but will quickly go away. Understanding the waves. I love that. Number six, when using my Zero up Timer, if I am close to the next hour of fasting, I will push through. Number seven, keep busy and active when fasting and time flies and you don’t think about food. We love to play pickleball for two to three hours. Number eight, fast overnight and exercise first thing in the AM before breakfast. Number nine, I like to focus on the positive visuals. The green ring is fulfilling to see when you hit your marker. And number 10, being consistent in avoiding night eating. Those were our 10 tips that, uh, people shared with us. And so I think we’ll get to our summary.

Nicole Grant, RDN: (52:44)

Yes.

Dr. Naomi Parrella, MD: (52:53)

Now Nicole, how do you feel about answering a few Q&As after the summary for anybody who wants to stick around for like, after hours?

Nicole Grant, RDN: (53:01)

Oh, we can do a few of those. I think that would be great.

Dr. Naomi Parrella, MD: (53:04)

Alright, so to respect everybody who’s just plugged one hour into their day for to spend time with us, we’re gonna go through these, uh, Zero Live takeaways and then we’ll stay a little bit longer and answer some additional questions in the Q&A, um, afterwards. So again, here’s our takeaway. We talked about this candle and we talked about the fact that you gotta burn through this glycogen level to get to burning fat. And the important thing as we advance this slide is to remember that the low insulin is what allows fat burning to turn on. And so then you’re burning down, right? Fasting for 12 to 18 hours. You can kind of think of it as it goes through the glucose glycogen layer and gets into the fat burning. And the fat burning layer is the biggest layer, right? So that’s where you’re gonna have almost infinite energy. Another way that you’re gonna be able to boost that fat burning and again, make it go faster, is you’re gonna use that fasted exercise that’ll get you into that fat burning much faster. And then by reducing time to fat burn again, Nicole taught us about baseline nutrition, being smart about your fast starter so you can optimize your fat burn, the carb quantity and the meal size. So again, if you just take this one screenshot, right, this is the thing that just kind of summarizes everything that we talked about today.

Dr. Naomi Parrella, MD: (54:30)

Anything to add, Nicole?

Nicole Grant, RDN: (54:32)

I think that’s a great summary. Thank you.

Dr. Naomi Parrella, MD: (54:35)

alright, so now, um, should we talk about the rest of the, uh, monitoring components? Yeah. Okay. So we wanna actually give actionable tips. So right now, here’s what we would recommend. If you wanted to take action immediately, build and solidify one habit. So we have this Zero app here, and you can see all the different things that you could choose to focus on. And again, this is gonna be the way we start taking action. So if we’re used to getting moving, like moving, right, which is what we talked about a lot today, getting moving while you’re, uh, fasting is gonna boost that fat burning mode. And you can see on the screen, you can actually see the difference of how quickly you can get into that fat burning zone for yourself. And this is where it’s really, really helpful to have it connect with anything in your Apple Health kit, any of the information that you wanna log, anything you put in, it’s gonna help fine tune so that you know, when you get into that fat burn zone.

Dr. Naomi Parrella, MD: (55:50)

And again, one of the most fun things about being a human is we like to collect things and we like to monitor progress and see that we’re moving forward. So that’s what we wanna do with the app. And unlike some things that we do in our life where you’re dinged, if you don’t do something here, you get to collect your wins. And so you can track the streaks in your app and we like to track things like what you’re eating or active minutes, the sleep hours, the mood weight, blood sugars, ketone levels. So there’s different ways you can self-assess and learn over time, time and again, like we talked about, if you step away and you’re doing something else with your life and you forgot to take care of yourself for a bit of time, you can always just open the app and come back and see what’s been working for you in the past. And it’ll be so much easier to get started because you have that visual. And it’s really fun to come back and start, uh, seeing that the time in between when you’re off track will get shorter and shorter and you can get back in control much, much faster.

Dr. Naomi Parrella, MD: (56:57)

The other thing that we really like and we’ve recognized here in the webinars and with, uh, people writing in is, you know, if you tap into the power of Zero Plus, you can really like, have all of the fun that, uh, together. And so we want you to be sharing your best tips with the Zero community. And you have, as you’ve submitted these tips that we share, and we wanna get better and better at collecting and sharing collectively across our whole community. You can motivate others by posting your progress. And we’d be thrilled if you tagged it with at Zero Longevity, hashtag start at Zero. And then again, we want to see you back here again because over time we’re gonna get to know what is it that you need and how can we help. So these are the things that, um, we’re learning from you.

Dr. Naomi Parrella, MD: (57:47)

And so we’re super excited when you share any of your information with us. Um, and the questions too, with Zero Plus and with Zero, you’re gonna see that there’s a lot of resources and support. Um, the science of fasting is really fun to get better and better at. So some of the stuff is gonna sound really basic after a while, it might already sound very basic, and then you can level up your knowledge so that you get smarter and smarter about how to take care of yourself and what you’re doing. You can also message our support team and they will be able to answer you and help take care of you. Um, and then of course, follow and tag us on social media and we’ll be thrilled to be connected ’cause we’re really, um, interested in making this a community where you can turn to for everything fasting and health and, uh, longevity. So awesome. Now this says thank you and for those of you who wanted to, uh, just be for the hour, we’re, we’re good with that, but we’re gonna stay around and answer some questions. So these are after hours. alright, Nicole, were there any questions that you wanted to start with or, I have one that I’m kind of excited about.

Nicole Grant, RDN: (59:16)

Yeah, you go first. I’m okay. Excited to hear what it is.

Dr. Naomi Parrella, MD: (59:19)

Yeah, so Susan has a question about she had gastric bypass more than two years ago, and she was wondering if intermittent fasting can be successful to help get off another 30 pounds. And I love this question because, um, you know, obviously there’s, there’s always more stuff that we can learn about this. So when we take care of individuals who’ve had gastric bypass, intermittent fasting can be helpful if you use it appropriately. So the number one most important thing with gastric bypass is to make sure that you stay hydrated, you take your vitamins and you also eat enough protein. So this is where, uh, individuals who’ve had gastric bypass are wildly successful, much more if they go to regular visits with their dietician, their registered dietician or, and or go to support groups where it reminds you of the things that you wanna keep track of. So intermittent fasting can be very helpful and I often use it first just as, um, I usually don’t do more than 12 hours, uh, at, at the beginning at all, um, because you’re gonna be eating a lot less. So anybody who’s had gastric bypass, you’ll wanna connect with a provider who understands about the, uh, nutritional needs. But then it’s really, really fun because, uh, you’ll learn all the different ways you can tweak as you continue on your journey. Nicole, did you have other thoughts on that?

Nicole Grant, RDN: (01:00:58)

I love the combination of fasting plus proper nutrition. Like you said, it is really vital to get enough protein to get enough micronutrients. Things are passing through your system more quickly. So we do still need to allow enough time in our eating window to have those nutrients that our bodies are, are, they’re necessary for optimal function. So, you know, uh, an 18 plus hour fast may not be so appropriate, but 14, 16 something you would work out with your healthcare practitioner, as long as you’re getting enough of those vital nutrients and hydration, of course, um, I think that would be some key con considerations to keep in mind.

Dr. Naomi Parrella, MD: (01:01:48)

Yeah, for sure. Um, there’s a question about

Speaker 3: (01:01:52)

Question, Nicole. Would you mind turning off screen share?

Nicole Grant, RDN: (01:01:57)

Of course.

Dr. Naomi Parrella, MD: (01:02:05)

Alright. Alright. Yeah, so there was a, let’s see, I just lost the question. Um.

Nicole Grant, RDN: (01:02:13)

I have one for you. It’s kind of a fun one. Okay. Um, someone asks this about the books, books behind you, any regarding intermittent fasting or any recommendations that you have. We love all those books.

Dr. Naomi Parrella, MD: (01:02:28)

My fasting books are probably upstairs. Um, there’s a lot of great fasting books out there and I think we’ll put them in the chat, the ones that we would recommend. But of course there’s the, you know, individuals who sort of, their names scream, uh, intermittent fasting or alternate day fasting. Um, and so whether it’s researchers, physicians or um, chiropractors, different individuals will be using it. So we’ll post those, um, afterwards so that we can make sure people get access to some of those.

Nicole Grant, RDN: (01:03:07)

Great thanks. There’s another one about the hip. If you are perimenopause and you don’t enter the fat burning zone, in the app until 20 hours into a fast.

Dr. Naomi Parrella, MD: (01:03:26)

Yeah. So that’s a tricky one because again, that comes back to the hormones. And so we talked today about how you can boost fat burning. And again, one of the things that I would be very curious about, we see this a lot in individuals who’ve done very low calorie diets in the past, where their metabolism is already a little bit like trying to protect you from going into that very low, uh, calorie state where it’s not gonna have enough fuel. Um, we’ll talk about the perimenopausal and postmenopausal hormonal balance at our, I believe it’s our next webinar. Is that correct? I think um, on women’s hormones. But you can again, do exercise. You can decrease the amount of, um, sugars and carbs. Alcohol has a huge effect. A lot of my patients will be saying, I’m just having a glass of wine every night. Well, we’re finding that that stops the ability to burn fat for many individuals, sometimes for up to three days. So I think this is a really, really important, um, area to look at as well. And then again, um, if sleep has been disrupted around the perimenopausal period, that can also impair, um, fat burning and medications. So some people take medications to treat their perimenopausal symptoms or their hot flashes, and that can also interfere with, uh, that weight loss.

Nicole Grant, RDN: (01:04:54)

Yeah, sleep can be such a challenge. Yeah. One thing we talk about with our eating window in relation to sleep is to have a large enough gap so that we’re properly digesting food. We’re allowing our glucose levels to return to baseline along with insulin. So bodies are prepared to be in that rest and digest stage. So we always recommend at least a two hour gap, if not more. So two to four hours. If you can start that fasting timer, say your bedtime’s 10 o’clock, 8:00 p.m. at the very latest, is the last time that you’re consuming food, if not a little bit earlier. And that can hopefully help, help with quality of sleep. Um, yeah, I think for sure. Yeah, fasting definitely can be a great tool during this time, as long as you’re still finding enough time to get that proper nutrition in.

Nicole Grant, RDN: (01:05:51)

Especially going to more of the post menopause stage where protein becomes even more important. Bone mineral density, there’s certain considerations that we need to address through nutrition and getting proper nutrition. So finding a timeframe of your eating that allows enough of those nutrients. So probably at least two meals a day, especially to hit a protein goal. Most women could use north of a hundred. You know, I know that can seem like a lot, but it’s almost impossible to sit down and eat a hundred grams of protein in one meal. So two meals, something like that might work. But still incorporating fasting that works for you.

Dr. Naomi Parrella, MD: (01:06:36)

Yeah, absolutely. Thomas asked a question, um, some claim that fasting causes gallstones or kidney stones, any truth to this, and if yes, any way to minimize that risk? So that’s a really great question, and we get a lot of, uh, concerns about gallstones. Rapid weight loss or significant amounts of weight loss can lead to gallstones regardless of how you do it. So that’s something that is, um, not uncommon. And um, also there’s certain medications, some anti-obesity medications also that can, uh, increase the likelihood of kidney stones. And of course, by losing weight can cause more gallstones as well. So that’s very, very, uh, real. But it’s not about fasting, it’s about losing weight. Um, minimizing the risk. Well, depending, uh, some people will be trying different kinds of medications, um, to try and improve that, but, um, we haven’t really seen, uh, much evidence, high quality evidence that shows you can really minimize that risk. In most of the time, people aren’t willing to take the medications necessary, um, because you don’t know if you’re gonna be one of the individuals that’s affected or not. Uh, so you might be able to change your diet, however, so that you can minimize the risk. And Nicole, you probably have some dietary recommendations you make, especially with the different kinds of kidney stones or gallstones that are out there. Yeah.

Nicole Grant, RDN: (01:08:06)

There’s definitely some correlation between high amounts of added sugar, processed carbohydrate intake, and increased risks of some of these disease states. I would definitely say hydration is a big thing too, properly hydrating, especially your kidneys, you wanna keep things flowing. Um, so yeah, I think those are two, two general areas that I like to focus on.

Dr. Naomi Parrella, MD: (01:08:32)

Yeah. And, and there’s a question about, um, can someone explain better, what is insulin resistance when my insulin is high? It’s resistant. Question mark. I love this question because this is a topic I talk about all the time. So insulin resistance. So remember we talked about insulin, and I’m just gonna again, quick go-through. Your body runs on a certain level of blood glucose, and that’s blood sugar. So I’m just gonna use the term sugar. In that level of sugar your body is expecting to have regularly, very high levels, like we talked about earlier, is poisonous to the body. And so the body has a defense to try and protect you from being poisoned from very high sugars. How do you get high sugars? It can be from stress, it could be from medications, it could be from drinking juice or sugary beverages. It can be from eating a lot of starchy carbs.

Dr. Naomi Parrella, MD: (01:09:24)

It’s often what we put in our body that leads to the higher blood sugar. That higher blood sugar. If you, for example, eight in excess of what your body can tolerate over time, you’re gonna keep spiking that insulin. So the insulin keeps going up and it doesn’t have time to come down if you’re not doing any fasting, right? Which is why we love fasting. But if you don’t allow that insulin to come down. So a classic example is somebody says, I start my day with some toast and then, um, or cereal, sugars and carbs. So the sugars then plum pump up in your bloodstream, your insulin goes up. Now you’re like, okay, I’m, you know, it’s an hour later, I’m a little thirsty and have a little orange juice because it’s good for vitamin C. Don’t do that. Um, but let’s say you were to do that, then you would pump up the blood sugars again.

Dr. Naomi Parrella, MD: (01:10:15)

So the insulin stays high and goes a little bit higher. Now if you’re snacking throughout the day and nobody has, you know, green beans sitting on their desktop, but there’s tootsie rolls, there’s some kind of candy or something, right? That’s very easy to access if you take those foods, and again, it causes the blood sugar to go up over time, your insulin stays high and the body starts ignoring things that stay high. The body likes cycles. It wants you to have high and low or stable at a healthy level. But if your insulin is chronically high, your body is gonna start ignoring it because you cannot shove anymore into the fat cells. Your body’s trying to make more fat cells to absorb more of the extra sugars. And after a while, your body starts ignoring the insulin. That’s really insulin resistance. It means the insulin is no longer as effective.

Dr. Naomi Parrella, MD: (01:11:10)

So your body has to start pumping out even more insulin. So what you end up finding is even if somebody is fasted until they fasted frequently enough with enough consistency that the body learns to get back into fat burning, that insulin will stay high. And then it’s like you just can’t tap into fat burning. You might experience what people call low blood sugar where you feel really shaky and unwell because you have this very high insulin. So that means your sugars are being pulled outta your bloodstream and you’re gonna be really hungry and you’re not gonna have enough fuel. So your sugars are gonna drop. You’re gonna go seek out some food or lie down and take a nap because you’re feeling so unwell. So if you pay attention and you see that your fasting insulin, that’s 12 to 14 hours of not eating, you can have, you know, uh, water, you get your blood work done, you get a fasting insulin level.

Dr. Naomi Parrella, MD: (01:12:08)

If that stays high at 12 to 14 hours, you have insulin resistance. And high is really eight and above, even though the lab will say that’s a normal level, that’s actually normal for the US population that has metabolic dysfunction, but it’s not a healthy level. So what you wanna do is start introducing intermittent fasting and paying attention to your physical activity and all the things we talked about to start bringing that insulin down. And the really fun thing is insulin starts responding and coming down pretty quickly. So it’s a wonderful marker, uh, to just kind of see, oh, okay, this is why it’s so hard for me right now. I feel like I’m, you know, doing all the right things, but I might not be burning as much fat as I thought. ’cause my insulin is still high. I am training my body to bring it down. And that’s what fasting will do for you. It will allow you to do that. And you can kind of track and over time you learn, oh, this is how long it’s gonna take me to get back into fat burning because you’ve been tracking it on your app.

Nicole Grant, RDN: (01:13:11)

That’s great. That, that reminds me of, um, a question I’ve had like before around why am I hangry? Yes. And it’s, it’s almost like what you described, high insulin levels not enough glucose. So we’re using that glucose up and then we’re so reliant on glucose as our fuel. We can’t tap into our own fat stores. So we’re in that emergency state, like, I’m so hungry, I’m so moody, I need to get some fuel fast. So I think, you know, that’s maybe one subjective way to know that you’re not in fat burning and yeah. You know, you might have a little bit of insulin resistance going on.

Dr. Naomi Parrella, MD: (01:13:54)

Totally. And that’s reversible. Mm-Hmm. . So this is something I don’t know. And many, um, providers might not know this as well because we didn’t know that in the past when I was in med school, they did not say, you could reverse this. This was like, oh no, it’s a one way street. It’s not good. It’s just you’re just trying to slow down the, you know, the, the going down the tubes. But that’s actually not true. We know, and patients have taught me, actually, Dr. P, you’re wrong. Like, look at me, I’m amazing. Right? And they, they blow my mind, right? So we learn from other people and you can be inspired to know, you know, when you see other people do this and they turn it around. So, um, and then I just wanted to like, my mind is a little bit blown right now because I just saw Susan in the q and a, just posted that in conjunction with quality food and exercise. I’ve lost over 60 kilos in 16 months. Congratulations. That is…

Nicole Grant, RDN: (01:14:49)

So cool. Wow. Great job. Super.

Dr. Naomi Parrella, MD: (01:14:52)

Awesome. Um, oh, here’s a good question for you Nicole. Mm-hmm, um, does sweet fruit like banana apples, et cetera, increase glucose and slow fat burning?

Nicole Grant, RDN: (01:15:05)

Good question. Yes. Fruits do have carbohydrates and carbohydrates are broken down into glucose. Different types of fruits have different amounts and they fall differently on the glycemic index. So the glycemic index is a test that we have used that shows how much your blood sugar will spike in response to a food. So lower glycemic index means less of a spike, higher glycemic is higher. So things like berries are gonna be on the lower glycemic index. They’re coupled with more fiber, it has a little bit less sugar per volume, whereas mangoes, unfortunately grapes, there’s some of these higher glycemic ones that just pack a little bit more sugar. Not saying this is a bad thing, fruit is definitely, definitely has good properties. We should be eating fruit, but we just have to maybe be a little bit mindful of how we do it. And I always say to have fruit with something else. So have fruit with some fat or some protein. So apples and peanut butter could be a great example. Or, um, a handful of grapes with a few slices of cheese so that that protein in that healthy fat is going to slow down the absorption of that glucose into your bloodstream. So there’s less of a spike and less of an insulin response in, in relation to that fruit.

Dr. Naomi Parrella, MD: (01:16:36)

Totally. I think we also, um, know that, um, processed foods are not as good. So a lot of people tell me, yeah, but I have apple juice, so I’m having my fruit. Of course that’s just sugar water. So, um, you know, to Nicole’s point, the fiber is super important with the fruit. So Absolutely. Um, we have another question about cortisol levels. How can you balance it, especially when you work at night, this person says, I work at night, so I think this is a major factor, stalling my weight loss. I’m awake all night during the day and I can hardly get six hours of sleep. What can you say to this?

Dr. Naomi Parrella, MD: (01:17:24)

That’s really rough. First of all, six hours is really, um, challenging. There’s so many things that I wanna say about this. Number one, let’s just go with the cortisol. Cortisol is again that stress hormone level and that can be in response to working long hours, not getting enough sleep. It could be in response to being highly stressed about work or about things at home or, or health or so many, we just read the news, right? There’s a lot of reasons, uh, cortisol levels can be high. So I wanna answer how can we bring that down? Again, there’s gonna be multiple answers here. So maybe, uh, Nicole, you and I can, like, share some of the different ways that, um, we bring cortisol down. One is going for, for example, a gentle walk or some kind of rhythmic activity, even if you’re in a rocking chair or just kind of like, you know, rocking back and forth.

Dr. Naomi Parrella, MD: (01:18:23)

That’s, that rhythmic activity actually is very soothing to the physical body. And you can see that when you take a baby who’s really stressed out and you just kind of rock or you know, sort of jostle the baby a little bit very gently, that’s a very soothing activity. Sleeping. And if you’re able to get some sleep, that would be very, very helpful as well. Nature exposure, we know getting out into nature is super helpful in just, you know, having a little pause and space. Things like removing the stressors. A lot of people forget to think about that, right? Just disconnecting from the digital world for a little bit. Spending time with a loved one or somebody who you can really share your, um, share time with and connect with. That could be a therapist, it could be a coach, it could be somebody you know from the Zero community, right?

Dr. Naomi Parrella, MD: (01:19:14)

It can be friends, family, but where it’s a mutual connection and you feel taken care of and supported. It can also be as simple as, um, making sure you hydrate, um, and finding what it is that is, uh, re releasing for you. Music works very well as well. And you can watch a child. If you play some music that a child likes and can be, uh, very calming, the child will stop and listen. Same thing happens to adults. So, you know, sometimes I look at children and I see, oh, what’s, what works to calm them? Sometimes it’s just slowing the pace down and pausing and saying, let’s take a little break here. And that can really make a big difference. So even if you’re working a very high-stress job and you’re go, go, go, somebody might say, I go swimming or I run, or I do some rhythmic activity to try and release that cortisol level. Or I talk with somebody, an advisor coach, you know, whatever. Or, um, again, some, some of your senses, the more senses you engage, the much better that can be for allowing your body to de-escalate. So the sounds, the smells sitting in a warm bath, you know, being around a body of water, being in nature, things like that. Nicole, any thoughts on that?

Nicole Grant, RDN: (01:20:31)

Those are great examples. I think exercise is a common one that people do use to help de-stress, but I say for those who are maybe shift workers, high stress jobs, we anticipate cortisol being higher. We wanna be careful with the intensity of our exercise. Mm-hmm. So exercise is a stressor to some degree. The higher intensity you go the more of a stressor it is. So in these patient populations I tend to recommend avoidance of high intensity and instead we do low intensity. So walking a nice calm bike ride, you know, a hike in nature or something like that. So I think being mindful of how we move our body, which can definitely help us relax, but we also don’t wanna overdo it there. And then fasting, if we can do a consistent fasting schedule to some degree that can help align our circadian rhythms and all the hormones in our body are on these circadian rhythms. So better alignment with one type of rhythm. So a fasting and feeding schedule can definitely help align those other rhythms such as cortisol, you know, that is a pattern in our body and so we wanna kind of get back to a quote unquote normalized pattern.

Dr. Naomi Parrella, MD: (01:21:54)

Yeah, absolutely. Um, any other questions that you’re seeing?

Nicole Grant, RDN: (01:22:02)

There was, um, one more if we’re talking about insulin. Yeah. Um, we have a patient, uh, this person is a type one diabetic on an insulin pump with a CGM. Does this affect my fasting and weight loss? My pump CGM is a closed loop system keeping my A1C down to 6.5. Any thoughts here?

Dr. Naomi Parrella, MD: (01:22:29)

That’s impressive. Okay, so this is really great. So with type-1 diabetes, it means that for those who don’t have type one diabetes, it means there is not enough insulin in the body, sometimes zero, that the body naturally makes. And so, um, unlike type two diabetes, which is an advanced insulin-resistant state with very high insulin levels, type one diabetes has low insulin at baseline and they need to have a little insulin through their pump and what we call that the basal insulin. And then any time there’s any kind of food that causes the blood sugars to go up, then that, uh, closed loop system will push a little bit of insulin for the blood sugars to be maintained at a certain level, which would be safe for that individual. ‘Cause again, if you just have no insulin, you would just drain off all of the fat cells and you’d have no fuel left on your body.

Dr. Naomi Parrella, MD: (01:23:25)

‘Cause you can’t store anything in a, uh, build or absorb. So that’s why you’d need to have the insulin. So with type one diabetes, the amount of insulin does matter. And so again, you might, uh, look at and work with your dietician and your endocrinologist or your person who’s taking care of your type one diabetes, and if you have less foods and um, uh, drinks that cause blood sugars to go up, like the ultra processed foods would be a classic example, or sugary drinks. If you have less of those, you will need less insulin, which means your baseline weight will be a little bit less than if you have more of those foods. So it’s really about titrating or bringing down the kinds of, uh, the baseline sugars. So you need a little bit less insulin, but you would never wanna stop it completely because if your sugars go too low, then you know that that can be actually deadly. So we don’t want to do that.

Nicole Grant, RDN: (01:24:34)

Yeah, great points. Um, yeah, you definitely can lower the amount of insulin that you need. You definitely need it, right? But working closely with the dietician who specializes in diabetes care, they can help you gradually reduce your medication along with the changes in your diet. So when I recommend doing it without working closely with your doctor and dietician on that, but it definitely is possible like you, like Dr. Parrella said, minimizing those added sugar, processed carbohydrates, ultra processed foods that will have less of an impact on your glucose and insulin needs.

Dr. Naomi Parrella, MD: (01:25:14)

Yeah. One last thing. Um, I know a lot of people talk about fasting and muscle and so there was a question here, no issue with fat and I do intermittent fasting for muscle gain, but observe muscle depletion. Uh, what’s your advice? So this is a really great question because fasting is, um, it tells your body to recycle things right and, um, burn fat. So again, if somebody’s trying to get some more cut so you can, you know, lose a little bit more fat tissue, that can definitely be helpful. It’s what you put in and how you stimulate your muscle, that’s gonna determine the muscle gain. So it’s the foods and nutritions in between the fasts that will matter. Again, you have to have sufficient protein. You have to actually, um, put stress on, you have to load the muscles to be able to build muscles. There’s also a lot of conversations about how to build muscle right now, and it’s, it takes effort. So you have to have adequate protein and you have to have a stimulus for your muscles to grow, meaning you have to use them. Nicole, do you have any thoughts on this space?

Nicole Grant, RDN: (01:26:29)

Yeah, I’d look at the timing of exercise in relation to your fasts. So if you do like fasted exercise, I would put that weight training workout right before your fast breaker and then your fast breaker should have at least 30 grams of protein, if not more. Um, some of the research has shown that’s a great threshold to really stimulate your muscle protein synthesis and you can even do more. You know, we’re learning that there’s really no cap on the amount of protein that you can consume, and the more you consume, the more it stimulates that muscle growth. So I would, I would do that. Some people do find that weight training within their eating window is also helpful because they have a little bit of fuel before to really amplify their energy and their ability to hit harder weights and then they would have their protein afterwards. But I’d say fueling after the workout is probably important along with everything else you’re doing in the eating window, as Dr. Parrella said.

Dr. Naomi Parrella, MD: (01:27:35)

Yeah, exactly. alright, well we’ve gone 30 minutes over. Um, I appreciate everybody sticking around and hopefully we’ve answered a lot of questions. Um, anything else, Nicole, that you would like to add?

Nicole Grant, RDN: (01:27:51)

Just wanna say thank you everybody for joining and hanging with us and I look forward to the next one.

Dr. Naomi Parrella, MD: (01:27:59)

Yeah, absolutely. The next one is coming up in April, and I also wanna just give a shout out to the little squares at the top of the screen here for, um, Rich, Bea, and Nick who all helped make this happen. Um, this was a big team effort, so, and also Marissa, who’s not actually on, uh, at this time as well, helped us with the slide. So we have a big team that are here to take care of you and help you be successful. So thank you all so much for joining and we’ll look forward to seeing you in the first week of April. Bye-bye.