Welcome to the high performance health podcast with your host Angela Foster, the show where we talk about everything you need to break through limits and achieve a high performance, mind, body and lifestyle.
You're getting into the Christmas spirit, it's all getting very exciting. We're definitely getting excited in the foster household. So over the next couple of episodes, I thought what might be a good thing to do is to give you some clips from our very popular episodes over the last 12 months that you've enjoyed listening to so you can go back and have a listen. And I've what I've tried to do is to thread together the relevant information for you. And in this this episode today, what I've done is put together some clips for you from my podcast with Dr. Carl Guillot, Dr. Nicola Conlon, Dr. Joseph Antoon. And Dr. Stacey Sims around what intermittent fasting is how how long the fast needs to be to stimulate autophagy and why a 16 hour fast is often misconstrued to do that, how supplements like creatine can really help to upregulate energy and the amount of progesterone that crosses the blood brain barrier. How to really enhance your mitochondrial health, your energy and also stimulate ATP production and optimise NAD for longevity. So if you've been thinking about how can I really get the longevity benefits of exercise of fasting of taking certain supplements then this episode is going to break down those pieces for you. So in this first clip, I'm talking with Dr. Kyle Gill it about how lifestyle prescriptions are more powerful than any supplement. And we're talking about the effects of zone to exercise on sex hormone binding globulin, and he explains how many people struggle with to low levels of sex hormone binding globulin so they can't actually hold on to that androgens, or estrogens. So we talk here in this paper about the importance of maintaining weight and why rapidly weight loss particularly around menopause can increase your risk of things like dementia. We also dive into creatine, which as you know, I'm a huge fan of it's such a great supplement, and specifically how creatine can help regulate an enzyme known as five alpha reductase, which can help with the amount of progesterone that crosses the blood brain barrier, which really helps to calm you and enhance GABA production. And we know that in perimenopause, we have that increased sympathetic drive in women. And so this may be something that can really help you. We also talk about the effects of creatine for helping with mitochondria, and NAD and ATP optimization. How easy do you think it is? Or Should women I guess? And is it always a bit of a controversial question, isn't it? Do you think it's possible? I mean, it must be possible because we had women do this multiple times previously. But in today's current environment, we're seeing such significant hormonal disruption. You probably don't see them in your practice, because people who have problems will be the ones coming to see you. But how common Do you think it is? And how easy is it to make that transition through menopause without symptoms without needing anything?
PCOS all the different axes of PCOS, of course, there's a lot of different axes, which maybe we get into as well. But I would say the prevalence of that is around 30%. In the population of most developed countries, most people that have it don't know and most people tend to have a fairly mild case. Infertility is extremely common. And sub fertility is even more common. I would say at least 50% of couples, whether it's male factor or female factor, or third factor where it's combined, at least 50% experience some degree of sub fertility in developed countries for varying reasons. A lot of it is things like metabolic syndrome and sleep apnea. And then even rarer diagnoses like hypothalamic amenorrhea, or premature ovarian insufficiency, those are becoming much more common as well. Adrenal Fatigue is another one, or just adrenal relative subclinical hyperplasia. And then if you I certainly count, thyroid hormone pathology among that, that is, of course becoming more and more common,
super common. And what about like the transition through to menopause. And if you if you've got a woman who is managing her stress, she's physically very active. She has been looking after her metabolic health. Maybe she didn't have any of these problems previously, she's had a regular cycle. Are there many women who can then make that transition without having you know vasomotor complications and all the other things that we hear and see
In general, the better you're able to optimise your estrogens and androgens without the ovary, the better your transition to menopause. However, even if you have an optimal profile, it does not necessarily mean you will be symptom free. And even if you are mostly symptom free, it does not mean that you should not consider optimising your hormones naturally, or even somewhat naturally. So, again to use DHEA as an example, because it's a supplement in the States, or because it's relatively easy to get some people consider that hormone replacement therapy and some people do not. Some people consider synthetic estrogens and progestins. Like contraceptive pills. Some people consider that hormone replacement therapy as I do, and some people do not. So thinking about doing something with your hormones, I would say 100% of females should do, and they should do it earlier rather than later. So if you're considering it, a time to get lab workup and look at your baseline levels and use the accurate precise biomarker would be yesterday rather than today. Another thing to think about with oestrogen signalling is that there's two different oestrogen receptors and various things can affect them. There's also many oestrogen related receptors, for example, there's oestrogen, oestrogen related receptor alpha, and that one cholesterol binds to. So cholesterol is actually a hormone in and of itself. It's a ligand or it binds to that receptor. And there's also one people might be more familiar with oestrogen related receptor gamma. And that's what BPA or Bisphenol A binds to. Okay,
I want to get into that Shea to do with sort of environmental issues and disruptors and mimickers. And just a moment, but when we're looking then sticking with what you were saying there in terms of testing, So how often should women be testing their hormones? Is it like an annual workup? Or more often than that? And at what point should they then be thinking about because there's this theory of this sort of critical window, particularly with things like brain health? What do you advise women at what stage should they be checking their hormones in an ideal world, and when they should be then be looking at potentially introducing hormone therapy?
A good rule of thumb as a baseline, of course, you can always do more if you want to optimise things, but to get ahead of the eight ball and use true preventive medicine, then once a year, up to about the age of 40. And ideally, twice a year over the age of 40. Of course, you would want to follow how you're doing subjectively. So if you're starting to have menstrual abnormalities, like if they're spacing out, which we call a ligament area, then you want to be a little bit more proactive with that, especially if you haven't had a min season, say, you know, six months, you would certainly want to get a workup because if you do need to start or tweak something, doing it as early as possible is going to be by far better efficacy.
Okay. And one of the things I see women in the early stages they seem to to struggle with the most is rather than the cycle lengthening, it seems to be shortening, and actually they're getting heavier bleeds, and they seem to have effects where they're producing less progesterone. In that scenario, is that a place where actually they should be thinking about optimising and maybe taking hormones at that point, or using maybe natural things that can support because I know, you know, many instances, a lot of doctors will say actually we can or functional medicine doctors will talk about using things like maca and things like that, to try and sort of optimise levels until there's further disruption.
And just curious on your view.
Yes, depending on the patient, each one of those things could work for patients with really severe symptoms, the and that have a congruent hormonal profiles, but the chance that you can optimise with something, for example, just maca, is certainly a lot less likely than for someone with mild symptoms, that has mildly suboptimal hormone profiles for that individual. Something like maca might be a lot more reasonable. When you look at hormone productions progestins for example, progesterone pregnenolone, five alpha and three Alpha progesterone. Those drop much more quickly than estrogens. So usually oestrogen is the last hormone to drop during the peri menopausal time. So a lot of women do start progesterone Of course there's risks and benefits to starting any medication or hormone. But often that is what we see. In general. If your FSH is not suppressed, and the units might be slightly different in the UK, but if your FSH is still below around 35 or 40, you should certainly attempt not to start any oestrogen until it climbs higher and higher. There are exceptions of course, at what
level would you spend start to look with oestrogen therapy?
As far as like a hormone replacement therapy with oestrogen Yeah, if you are no longer having menstrual periods, that's another one. Another good one to see. Because even if you're, let's say your FSH is 70, but you still think you're having very frequent menses, perhaps that's an like endometrial hyperplasia, or even an endometrial carcinoma. Worst case scenario. So you want to make sure that you're no longer having endometrial bleeds or menses and then looking at the FSH above, above 50 would be quite safe when those criteria are met.
And this next clip you're going to hear from Dr. Nicola Conlon, who's the CEO and founder of New Cheeto. She is a molecular biologist, specialising in the study of cellular ageing, whose goal is very similar to mine to help us age well and achieve optimal life experience. And in this clip, we talk about the critical role of NAD for energy productions and how can it 11 nad levels are impacted by lifestyle and ageing. Dr. Nicola explains that there are positive actions we can take to boost NAD levels and help to increase our health span alongside our lifespan so that we can live as healthy life for as long as possible. And optimising NAD is super important, not just for longevity, but also for energy levels. And as Dr. Nicola explains, you can take all the situations that you want to but if you don't have enough, NAD, they won't be activated. So what that means is, even if you're drinking copious amounts of things like matcha, green tea, you might be adding raw cacao to your smoothies and taking resveratrol. Without any D, you won't actually get the full benefit.
Yes, absolutely, I can give you a bit of an NAD one or one to begin with. So NAD, I sometimes refer to it as probably the most important molecule that you've never heard of. And that's because if you didn't have any ID in your body, you'd literally be dead within 30 seconds, because it plays some really critical roles within ourselves. The first one is that it's incredibly important for energy production in our cells. And this is because NAD is part of the Krebs cycle, which is a cycle within mitochondria, which are the energy powerhouses of ourselves, which actually make cellular energy. And without NAD ourselves literally couldn't do this, the pathway wouldn't actually work. So that's one really important role for NAD which has energy production. The other side is that NAD actually acts as a kind of signalling molecule in the cell, where it senses the levels of energy in our cell and then causes reactions which allow our cells to react appropriately to the levels of energy in the cells. So when we have high levels of NAD, it actually signals to the cells that cellular maintenance and repair needs to be switched on. So lots of pathways are activated that keep ourselves in good health. And when NAD levels are low, that means the cells kind of got a lot of energy. And it doesn't really need to be as resourceful and energy. So your cellular maintenance and repair can kind of be turned down. So these fluctuate fluctuate in levels of NAD in the cells kind of control cellular maintenance and repair being switched on and switched off. So they are the sort of key things that NAD is really known for, and really important for.
And my understanding is and I think you share this research actually on your website is that it's sort of half every 20 years. So and when is that from so for example, my I've got teenage children, and younger one they presumably are there NAD pathways are working really super well. And the salvage pathway which we can come on to in a moment, when does this process start to begin? Like when should people start to think about this?
From research that's been done, it seems like it declines from birth. So by the time you're age 20, you've kind of got half half the amount of energy that you had when you were born and in various different tissues. So that's quite significant to think that, you know, by the time we're 20, it's half that's going to half again, that's going to half again. And what you see in tissues from humans and all sorts of mammals is that it does significantly decline. So it's like an exponential decline where you know, it's half and half and it On half and again, and this is a real problem, because this NAD decline that we actually suffer with age is actually being found to reduce or first of all our energy levels because I'm at a country can't function as well, without NAD. And also, it means that these beneficial maintenance and repair pathways in the cell are also getting turned down. So if they're getting turned down, damage is accumulating within the cells. And this sort of manifests as the signs and symptoms that we associate with ageing. So it's thought that this decline in NAD with age does actually play a big role in our experience of ageing. And when we
look at the boy who are doing things like intermittent fasting, which can help to regulate that pathway, there's a sort of differences. So I think we have people listening that, that do intermittent fasting, putting aside kind of the female menstrual cycle, and whether women should be fasting, as long as we think more generally, is there an optimal period of fasting on a daily basis, or an intermittent basis that we should be looking at to try and seek to up regulate that pathway?
I think what's known is that any level of fasting really is going to start to actually increase your NAD levels. And that's because basically, NAD is acting as the link between some of the pathways that sense and energy stress, which at the end of the day, is what you're trying to create with fasting, and then the downstream pathways that are activated. So when you fast, so you know, say you've gone for 1216 hours. Without food, what happens is something in your cells called a NPK, is activated. And that's like your cellular energy sensor. And that almost goes off like an alarm saying, Okay, there's no energy coming into the body, we're going to have to make sure the body's resourceful, and it's not wasteful. And it holds on to whatever energy and resources that it has. So a NPK actually up regulates NAD levels. And then this rise in NAD is sensed by the cell. And that is what activates multiple downstream pathways. So anything that you're doing, it's been to sort of create an energy stress in the body has been found to positively impact NAD levels. So that's everything from intermittent fasting and calorie restriction to exercise. So exercise is a well known way to actually boost NAD levels,
doing kind of high intensity interval training, for example, has been shown to regulate that pathway. And so I think for people listening, they we just came off actually, in my membership, metabolic flexibility month, and quite a few people there were tracking their flexibility with the lumen device, for example. And that device will actually sort of give you an indication if you've moved fully into fat burning mode, and you've depleted liver glycogen, then the recommendation that's made is if you're going to go and do a high intensity interval training session, you're probably going to have better output if you pre load with a little bit of carbohydrates to fuel that session. But when we're looking at this from activating those pathways, and a NPK, it would seem that actually going and doing that exercise in a fasted state would be creating more positive stress in terms of hormetic stress on the body to regulate this further.
Yeah, absolutely. And personally, that's what I do. I do all my exercise in a fasted state in the morning. And you know, in that way, you're sort of prolonging and emphasising that NPK activation and a NPK that actually activates critical enzymes within the cell that actually produce NAD. So you're fundamentally altering the cell's ability to actually make more NAD and have it available to activate the beneficial downstream pathways.
And yeah, it's interesting, because that's what I do as well. I like to go and do it fostered for that reason. And I think the other thing I wanted to share, which I've heard you talk about before as well, and that you could go into for listeners is this is something that the body generally has what it needs, right, but it just it needs to activate that pathway itself. There is a little bit of interest, and we can talk about that in the moment in terms of bringing outside nutrients in, but it has a mechanism for recycling. Could you just explain that before we go into things that are complementary to to help there?
Yeah, absolutely. So a lot of you know, NAD has been a popular thing within the scientific field for quite a while now. And but the science is really changing in terms of what we understand about NAD production, and also decline in the body. And one of the major things that's changed is our understanding of First of all, how our body produces NAD and why it's depleted and it's been fun. I found that the major way that our body actually makes NAD is actually by recycling it. So it has a pathway called the salvage pathway in most cells, where when NAD is actually used by the body, so when it's used by enzymes and pathways, and it actually gets broken down into some of its fundamental components, which are called precursors, and the main precursor, which NAD gets broken down into, is something called nicotine amaze. Now, in young cells, they have this amazing capacity to be able to recycle that break down product that nicotine amide, straight back into useful NAD again, and this is called the salvage pathway. And the majority of our NAD is actually made in this way when we're young. And if you think about it, it makes complete sense. Because NAD is so critical for the body, why would the body want to rely on having to have some sort of external nutrients to make this NAD it needs to have almost a failsafe mechanism to be able to continually supply the cell with NAD no matter how much it's using. So when we're young, and it is used up, it's broken down into nicotinamide. And the salvage pathway, literally salvages it and recycles it straight back into fresh NAD that can be then used again for all the repair the maintenance, the mitochondrial function, and keeps getting recycled. Now the issue is, is that it's been found that our NAD levels mainly decline, because this becomes dysregulated with age. And the salvage pathway in older cells simply doesn't work as well. And the reason is, is because the main rate limiting rate limiting enzyme in this pathway, an enzyme called nampt, actually declines with age. So if you take a sample of someone cells who is older, you will find that they simply do not have as much of this nampt enzyme. So what that means is in older cells, where they are using up the NAD, and breaking it down in the waste products, nicotine or made, it's just not getting recycled. So cells are using it and using it. But it's not getting replenished like it should be. And that's a really important thing to bear in mind when you're looking at, you know, restoring NAD levels or trying to impact NAD in any way. And just to emphasise how important that pathway is. Remember, we were just talking about how faston and exercise all increase the production of NAD. Well, the way they do this is by directly increasing levels of this enzyme nampt. So all the beneficial effects of exercise, fasting etc, are happening, because they're increasing the ability of ourselves to use the salvage pathway.
Interesting. So we're kind of and actually, it's interesting is that because if you learned ancestrally, we would have actually had to be doing by necessity, a lot of these things right, and food wouldn't have always been super readily available, and definitely not the processed food that that we have an abundance of at the moment, we would have also had to work quite hard and exercise in a fasted state to get it. I always think like, even when you look at things like nature's sweeteners, right, we wouldn't have eaten tonnes and tonnes of honey, because it's actually really hard to get ahold of, and you're gonna get starting to get it and have to climb, sort of it's quite interesting. And we would have been like cold swimming or bathing right in a in a lake or a river and having that cold exposure, we wouldn't have had central heating to keep us warm. So presumably, we actually would have been a lot better at activating those pathways naturally than we are today when a lot of people are in a highly fed state most of the time.
Yeah, 100% agree. And something that I say all the time, is that if you want to make sense of ageing and ageing biology, just look at it through the perspective of evolution, everything an agent starts to make sense when you look at it, of why we've evolved to be the way we are, you know, all the pathways, all the things that go wrong with age, and it's all because we've evolved, you know, to live more like our ancestors, and then suddenly we've had these huge lifestyle changes and you know, the last 200 years, it's really, really short timeframe. And in terms of evolution and how our bodies can evolve and change. Our bodies aren't designed to live the way we're living today. They're designed to go with long periods without food. They're designed to be you know, hunting down food and using a lot of energy and actually really go in in a state of energy stress, where the cellular repair, you know, recycling autophagy DNA repair, things like that are activated to keep ourselves in good health, but unfortunately, you know, we just click a button on apps on our phones and order some food and don't have to move and so ourselves aren't having the chance to go into this energy stress state, which is activating, you know, NAD production and activating all the beneficial downstream pathways.
Yeah, it's very interesting, isn't it, and also really had exposure to I guess to things, more things like wild plants that are growing, which again, have these hormetic compounds within them, right things like resveratrol, which I want to, I want to come on to in a moment, I think the other thing as well is when people are eating a highly processed diet, presumably they are then using more NAD and their pathways are not working as effectively. So they will, they will be ageing at a much faster rate. As opposed to if you took two individuals, somebody who is highly sedentary at work, maybe travels by car to the office, gets food orders delivery, eats most of the day up until they go to bed, probably is quite stressed, doesn't sleep very well versus somebody who is fasting, or going out for a morning walk or moving around through the day eating an abundance of kind of plant based diet and things like that are going to look quite different. internally.
Yeah, absolutely. That you know, you can almost bet they will have lower NAD levels. And that's for two reasons. Firstly, the things that they're doing in their lifestyle is ultimately going to cause more damage, more chronic inflammation, more oxidative stress, all of which are things that need repair. And that repair is driven ultimately a lot by NAD. So they're going to be having a higher demand for NAD in their body, which means it's going to get be getting used up. At the same time, they aren't putting that stress on their body, they aren't activating those pathways that are actually promoting it. It's salvage and recycling. So you've almost got the perfect storm where you've got this increased demand. And at the same time, you've got a decreased production and recycling. So ultimately, levels four, and you tend to see that not only in people with you know, poor lifestyle choices, especially younger people or poor lifestyle choices, but naturally as we get older This is is generally what's happening. And you know, you could take a fit, healthy 60 year old and they could have you know, alright, NAD levels, they will have lower, but due to their lifestyle practices, they could have quite good NAD levels. And you could take a 30 year old who's you know, overweight has metabolic disease and prediabetes things from having a poor lifestyle, who's probably got just as low NAD as you would expect in it in a healthy, older person. So lifestyle massively impacts NAD levels, you know, metabolic syndrome, if you look at people's samples, who have some form of metabolic disease, whether that's diabetes, fatty liver, and they are characterised by low NAD levels, and also low nampt levels, that enzyme that that's critical for the salvage pathway. And there's a lot of evidence to show that some of these diseases can actually be really reversed or made significantly better by actually elevating NAD through some quite simple mechanisms. So the sirtuins are, they always go hand in hand and are mentioned with NAD. And that's because the sirtuins are a group of longevity proteins or enzymes that basically they sit like at the top of a cascade at that switches on a lot of downstream beneficial pathways. And that are involved in longevity. They're involved in repair. They're involved in basically you name it if it's good for ageing and longevity, the searcher and somehow are involved. The weight the reason that they are linked to NAD is that they are absolutely critically dependent on NAD to function. So the sirtuin ism is essentially an enzyme and it needs a fuel to power the enzyme and NAD is that fuel. So what you find is that when NAD levels decline, the reason that all that cellular maintenance and repair gets switched off is because there's not enough NAD to switch on the sirtuins which are then coordinating this cascade of beneficial pathways. And conversely, when NAD levels are high, there's an abundance of NAD which means there's abundance of fuel for the sirtuins they're getting activated, lots of the repair and pathways etc. And genes are getting switched on and you get these longevity and ageing benefits. So that's where search winds
motion on that transit the students so because we can, we can have searches and activating compounds in our diet right and a lot of people have heard about things like this To set diet and things like resveratrol and for Seaton and Mike matcher, and things like that, that they can start having, but if that NAD salvage pathway is not operating correctly, then you could be consuming lots of serotonin enhancing compounds, but actually not making a difference. Presumably, you've got to have both.
Absolutely. So you can take all of resveratrol in the world. But if you've got no NAD, it's absolutely pointless. And,
yeah, so you could be really overweight, eating a highly processed, drink Matcha Green Tea all day long.
I'm gonna have absolutely no, you might get a benefit. Yeah, exam. It's not gonna work on that pathway properly?
Absolutely not. So they act on a different site. They sort of work on it in a different way to benefits the search wins. But ultimately, sirtuins cannot perform their chemical reaction that they perform. Without NAD, it's absolutely critical.
Okay, interesting. So it really is a combination of nutrition, supplementation lifestyle, that magic starts to happen. Before we come on, then to the supplementary aspect. I know that circadian rhythm also plays a part here. Can you explain that?
Yeah. So NAD is heavily involved in regulating your circadian rhythm. So actually, if you think your circadian rhythm regulates, you know, your sleep wake cycles, your hormones, your metabolism, everything and, you know, peaks and troughs in this 24 hour cycle. If you measure NAD levels, NAD also goes up and down and peaks and troughs in the circadian way. But it's sort of slightly offset from your circadian rhythm. And that's because levels of NAD actually switch on and off some of the, basically the the pathways that, for example, manufacture melatonin, and switch on some of the pathways that are your hormones and your cortisol and other things that are involved in those rhythms throughout the day. So as you get older, if your NAD levels are declining, and you're not having that, you know that that pronounced fluctuation in NAD levels throughout the day, that then also goes on to impact circadian rhythms because it means that the NAD is not driving some of the pathways that switch on and off the melatonin production and everything else. So you can also see suppression in the you know how pronounced those rhythms are as well. So what you find isn't that people who actually have youthful levels of NAD, their circadian rhythms stronger than in people who that have lower levels of NAD. That's when it starts to get torn down. And then people have sleep issues and other issues associated with that.
Now, when we're looking at longevity, a common misconception is around how long it actually takes to get into autophagy. And the myths around a 16 hour fast being long enough. In this next clip, you'll hear from Dr. Joseph Antoon, who's the CEO and Chairman of the Board of L neutre. And he's also a member of the Forbes Business Development Council. He's an expert in longevity and health who fasting and nutrition and specifically shares how to enhance autophagy and enhance your longevity. And in this clip, you'll hear us talk about fasting periods. What works, what doesn't. And we'll also talk about the impact on women's health and hormones and how you can use something known as molecular fasting, which is a protocol that's been developed by Dr. Valter Longo.
Yeah, that's, that's a fantastic question. And probably the question I get asked the most because there's a big confusion into how many hours should I do? What happens if I do 1216? If I do? So let's let's best answer the question. Let's go back and say, Hey, what are the types of fasting and what happens to the buddy when you fast and we classify fasting is two categories. Today, there's a category called intermittent fasting, which is any fast below two days. And there's a category called prolonged or periodic fasting, which is any fast that goes above two days. And why the cutoff of two days. Most people by the second day, or between the first hour fast to two days to 48 hours. We lose weight, I mean the fastest candidate deficit and you have reserves in your body fat. You have glycogen and you have the liver that can crack this what we call the gluconeogenesis. So you have three defence line when you don't when you're not eating, you have enough reserves again, the liver, glycogen and fat to compensate for the calorie deficit. In the first 48 hours. A typical person has enough reserves to cover for that period. When he crossed the second day. The body's telling the cells Hey, I'm not eating and fasting. I had some reserves there depleting fast. Therefore, you should start eating what's inside of you and use and start rejuvenating, and start enhancing the way you operate. This is the process called autophagy, or self eat, and won the Nobel Prize in medicine and physiology in 2016. And again, it happens for most people, there's no set clock, some people get into it. And the first day if they're exercising, creating extra calorie deficit, or if they're thin, they don't have a lot of reserves, but on average, and some people go through it on day three, because they have a lot of reserves, they have low metabolic rate, etc. But that day two is where most people would start getting into, from what we call the metabolic stage of fasting to the cellular stage of fasting. And then your practice rejuvenating cells of your body, which is a very important process for longevity, because you're biologically when you tell the cells, hey, eating your waste, detox, fix what's inside, you're asking, asking itself to be biologically healthier or biologically younger. And therefore, it's an important healthy ageing practice. And if you have certain health conditions that can benefit from such rejuvenation, we can talk about that later, then it could be good intervention for for these for this purposes. The intermittent fasting phase, which is less than two days is mainly a metabolic intervention, you're you lose weight, you're spending, you know, calories, you're not ingesting calories, you're spending those and therefore you lose, you lose weight, you spend calories, which is great for many of the diseases we're facing today, or the health conditions we're facing today, whether it's a blood pressure induced by overweight, whether it's blood sugar, and diabetes induced by overweight, etc.
Interesting was thank you for clearing that out. Because I think a lot of people do get confused. But what you're saying is autophagy begins for some people at around 24 hours, particularly if they're doing other things, but the complement it like exercising. But for other people, it will be around two days, so a 14 hour fast.
And that's that's big news. Because if you listen to most podcasts and YouTubers, they'll tell you, you get an artificial and 16 hours of fast. This is why most people practice 16 hours of intermittent fasting, thinking that they're gonna get autophagy. Very, very, very rarely, you get to autophagy in our 16th. I mean, imagine, every day you eat, you sleep, you go to work, and you have your breakfast. And if you skip breakfast, suddenly in four hours, the stress is so big, then the cells have to eat themselves. It doesn't happen this way. Now, if you run the marathon in the morning, and our eight to 10, you rent for you know, 1015 kilometres marathon, and you're thin, you don't have a lot of reserves, maybe at our 16 you practice a little bit of accelerated autophagy. May be, but But most people above 90% of people will require at least one or two days to deplete that initial defence line, which is fat, glycogen and liver. And then it's such a big crisis that the cells have to practice autophagy hopefully that's clarified,
what you're saying is we need to completely deplete the liver glycogen during this phase, and then we would be depleting muscle glycogen, presumably as well.
Yeah, I mean, you don't need to deplete it all as much as the acceleration if it's if your body is losing those very fast is when they tell the cells Hey, you gotta start participate, you got to start chipping in and eating what's inside of the cell. You don't need to deplete all of it. The body goes to glycogen glycogen is very fast. A waiting for I was I called fat as your savings accounts, right? Fat is like oh, okay, I have money saved on the site. Glycogen is your checking account, you can quickly jump and get glycogen. And deliver is your credit that when you ask the bank for credit, and the bank is saying, Okay, I'm gonna give you a little bit of a loan. And it's exactly the same. So you tap into your savings and checking account first, and then the savings account. So glycogen first then you go start tapping into fat while delivery is doing lipogenesis and supporting, adding more credit.
Because when I was speaking to I don't know if you've come across the device lumen speaking to them, I've used that and measured like am I burning carbs am I burning fats? And what their research was indicating was that once you get to a score on the carbohydrate, the carbon dioxide ratio respiratory ratio is putting you at a level one you are at 8% Plus in fat burning mode. So now they say we know that liver glycogen has now been depleted. And you can utilise that to look at how you might feel around workouts. So at this point, my understanding was liver glycogen has gone down and if I was to work out in that state like and try and lift heavy weights, I may be in a pro catabolic state rather than an anabolic state if I want to Great muscle mass, because now when my body has depleted glycogen from the liver, the next thing it's going to do is try and take it from the muscles, but it will at the same time draw some amino acids. And therefore, for the purposes of that workout, actually pre fueling may be the answer. But I also understand the for longevity, it might be better to do that so long as to stick to work out in the fasted state, so long as that the workout is kept quite short. And that I then load up again quite quickly afterwards with some protein and carbohydrate.
Yeah, so So glycogen is is is either in different organs of the body, including your right muscle and liver, what I was talking about is Neo gluconeogenesis, producing glucagon. Talking about the glycogen of liver, glycogen is the first line we're exactly agreeing, firstly is glycogen, the liver ships and faster but to form new new to, for the liver to practice new book of Genesis, the buddy taps into glycogen first before before adding the credit with
God. So then the and this process of gluconeogenesis is, I understand is partly why some people may struggle to sleep, because actually it invokes a degree of cortisol, which has this sort of inverse relationship with melatonin. So if you're if your cortisol is going up, you may struggle a little bit to sleep because your melatonin production isn't quite where it should be. And
partially how fasting work, it's the stress people think, is a calorie deficit. There's only one angle, probably the most important angle of how fasting works is stress is by stressing the body. I always give the example of if you're a CEO of a company, you need a million dollars to operate. Any low calorie diet will give you say, $800,000, you can cope with that state, you have enough money in the bank, executive fat and the glucagon and you can adjust to it. But if I give you $0 Instead of a million dollar, that only you're you're in the big deficit, but it's such a big stress that that CEO of the company has to restructure the company and this is autophagy. So this stress induced restructuring is exactly what happens to the body. And stress elevates cortisol is way bringing the cortisol up as within fasting there and growth hormone by the way as well. This is why fasting helps the muscle the fasting is yes, you're tapping into glycogen and muscle but actually fasting increase growth hormone as well and the muscle tone is high is like one of the ways that athletes are incorporating fasting into their training is to play on this duality of let's cut fat, protect the muscle, eat protein after fasting and train the muscle and you get it cycles of rejuvenation and cycles of muscle enhancement.
A conversation around fasting and longevity for women in particular would not be complete without hearing from the amazing Dr. Stacey Sims. And so in this last clip you're going to be hearing about how fasting affects women in particular more physically active women, and why Dr. Sims believes that you should be pre fueling your exercise, including why exercise actually Trump's fasting for autophagy in most cases, particularly for women and women's health and balancing their hormones. Dr. Stacey Sims is a forward thinking international exercise physiologist and nutrition scientist who aims to revolutionise exercise, nutrition and performance for women. And she's directed research programmes at Stanford University and the University of Waikato focusing on female health and performance and pushing the dogma to improve research on all women. Fasting, which I know is a controversial topic. It's really interesting because I was, I was interviewing Dr. Joseph Antin, I think, who is the CEO of prologue. And what he was saying, just really dovetails with what you say, because he was like, well, they obviously are all about molecular Paston right at that company. And the research is really good that they've done, but he's like, there's no point you're not stimulating autophagy by fasting for 16 hours. So there really isn't a point to doing it. And depending on how overweight you are, it could take what they found is and the reason they made it a five day molecular fast was you may only get one day where you're really stimulating overall autophagy so it seems like
you're really not doing a big myth
because everyone is obsessed with it. And it's funny because even though I know all of this, the more you're surrounded by on social media, the more you kind of get competitive with it and think oh, yeah, but I've been fasting this long, even though, you know, isn't really doing that. And exercise is stimulating autophagy anyway, but can we pray this up for people? Because
yeah, for sure. I just wrote an article on intermittent fasting versus time restriction today for for magazine. So it's all fresh in my head. Cool. So first of all, we talked about fasting, you have intermittent fasting and you have time restricted eating. So time restricted eating is what first came out. And when they're looking in the 40s, around the war, we need to have some calorie restriction and they're like, Okay, well, let's really just make an effort to educate people not to eat after dinner, and then they can have breakfast, and then we'll have a slight calorie restriction during the day. But time restricted eating really is eating according to our circadian rhythm. So we wake up, we need food, our brain sees light, it's time to eat, our body can handle it, and then it's starting to get dark, we don't eat when it's dark. That's time restricted. We talked about intermittent fasting, which also often gets, you know, the terminology gets intermixed. Intermittent Fasting is what all the buzz is where we're having, like the warrior, where you have a four hour eating window, a 12 hour eating window, or an eight hour eating window or alternate day fasting. And this is where it gets really confusing, because intermittent fasting is interesting, because you either have with calorie restriction in your eating window, or you eat whatever you want within that eating window. And when we're looking at the research that's been done on people, it's primarily obese, overweight women, sedentary women or obese, overweight, clinically sick men, that then that's been generalised into general population. And the primary aspect of intermittent fasting is weight loss. Then they're like, Oh, well, we'll see these other kinds of, of, you know, health benefits of toffee G and increase oxidative capacity within the muscle that are cardiovascular output, all of these kinds of things. But when it comes right down to it, it's calorie restriction. So there's a really good meta analysis that came out. And another clinical study that just came out maybe three weeks ago, comparing the tube, and people are doing slight calorie restriction in it with better weight loss and better cardiovascular outcomes and better endocrine health than people who are doing all this crazy intermittent fasting time restricted windows, we look right down to the data as well, we're looking at men versus women. All the stuff that you hear about with intermittent fasting with the toffee, G and parasympathetic drive, and blood glucose control, and better insulin control is all male data. Because when you look at women, it's not there, there isn't anything to support it. For women, we see the complete opposite, we see a downregulation on a genetic level. So we're looking at gene adaptations to food restriction. For men, we see a five time increase in gene responses to preserve the mass and to preserve testosterone. But for women, we see not only no upregulation of genes to preserve fertility, we see a change to stop fertility, we see a downregulation of thyroid we see a downregulation of luteinizing pulse, we see a blunting of kisspeptin, which is responsible for appetite and appetite control. And we see in women instead of blood glucose control and better insulin sensitivity, the opposite. So when we're talking about all this intermittent fasting stuff that's being put out there, but toffee G becomes the one at the very bottom, because people don't really want to talk about that, because it's not there for either sex unless you really start getting into the long ration stuff. But when you start looking at exercise and exercise data, you start exercising, and it's a huge stimulus to create toffee G in the brain and the cardiovascular system. We also know that exercise promotes the aerobic exercise promotes the growth of brain tissue, and resistance training increases the growth of the nerve growth factor within the brain. So exercise in itself has more robust data to support longevity, and support all the things that the buzzwords of intermittent fasting support. But the evidence is there. And the adherence to exercise with slight calorie restriction is so much better. And the outcomes are better than someone who's trying to do all these crazy hours of time restriction. Because the hunger really beats up people. And the idea of I just I can't do anything until noon. Because I have I can't bring my best timing. And then if we're trying to fit our training in and it's in that fasted window, like we've talked about earlier, it's really devastating to women regardless of age, because our bodies revert to using lean mass first, instead of using carbohydrate and fat. Interesting, I'll
just say, and so, I guess, for women that are exercising that autophagy that stimulated through exercise, is that regardless of whether they go and do the workout in a fasted state So I know we've just been talking about pre fueling workouts in different ways. Is there any benefit to actually going and because I've heard people talk about stimulating more NAD and the salvage pathway and things like that, if you go and exercise in a fasted state, is there any benefit in men and women
and women now, because from like a pure biological standpoint, when it comes down to our environment and food availability, biologically, the male is completely different than the female, biologically, food inaccessibility. And low nutrient density increases the fertility aspect of the male species, because the whole thing is, if there isn't any food, I'm gonna die off soon. So I need to be able to reproduce to keep the species going. But not only that, because there's lack of food and lack of food availability. We know that in the female aspect of species from biological standpoint, that there's a downturn or fertility. So the the male species has to increase fertility to be able to impregnate at sub fertile female aspect for survival of the species. So it all comes down to that biological aspect. It's interesting. Yeah, very interesting. Bodies are completely different.
Completely different. And is that true, though? What about when women have transitioned through menopause? What about says, Is there any benefits to fasted exercise
that? So this is where we started looking at the very sparse research that's out there. So you'll have physicians who are like, yes, you should do fasted training to lose that body fat and yes, you should do a ketogenic diet because it helps with the abdominal adiposity. But when we look again, back down to the molecular mechanisms, women are already maximally fatty acid adapted for burning fat at during exercise. There's no reason to do fasted exercise or the ketogenic diet, because again, it's a stress on the body that increases cortisol and women who are postmenopausal already have a higher level baseline. And we also have a greater or women also have a greater systemic inflammation, especially the early menopausal years that postmenopausal year so about the first five to six years after that one point, time and menopause, the body is still undergoing this transition. So if you start adding in the fasted training, it increases the stress and it backfires. So then you have an increased signalling, for putting on more body fat because the body's like, Hey, wait, I'm going through all this craziness. I don't have these hormones. I'm trying to reset and relearn. And I know that I have increased protein for fatty acid use in my mitochondria. So why are you trying to do this to me? So, in the small amount of research that is out there on postmenopausal women and exercise, fasting is not recommended.
I hope you enjoyed those clips. If you want to go back and listen to the full episodes. The links to each of the episodes with these doctors are in the show notes below this episode. Thanks again for listening, and I'll see you next week for another podcast episode.
Thanks for listening. Remember to review and subscribe, you can grab the show notes, the resources and highlights of everything Angela mentioned over at Angela Foster performance.com You can also snatch up plenty of other goodies including the highly helpful Angela recommends page which is a list of everything she personally recommend to optimise your mind, body and lifestyle.
