Podcast Episode 52 | September 28, 2023
Intermittent fasting is a health trend that has gone viral online. But what exactly is it and how does it contribute to wellness? Sandi welcomes intermittent fasting expert Cynthia Thurlow to discuss the ins and outs of intermittent fasting. Cynthia discusses the many benefits of fasting, as well as a few tips and tricks to get started. What's more, she and Sandi offer their unique experiences with intermittent fasting in the past and how flexible it can be for each person.
Cynthia Thurlow is a nurse practitioner, author, podcast host, and Metabolic Health and Intermittent Fasting Expert. Twenty-one days after a health hiccup, Cynthia was scheduled to give a TEDX talk about intermittent fasting. That talk went viral! Since then she has written a book, Intermittent Fasting Transformation, and created a 45-day program to help people begin their fasting journey.
Connect with Cynthia Thurlow
Sandi: Welcome back to Health Coach Talk. Today I am so excited because not only am I talking with a friend, Cynthia Thurlow, but she is a brilliant practitioner. She is a nurse practitioner, and she has an incredible book which I read when it was released. It is "Intermittent Fasting Transformation." It's a 45-day program that is very well-outlined, that is going to be helping you to reach your goals, whether that's losing weight, balancing your hormones, or slowing the aging process. Welcome, Cynthia.
Cynthia: Thank you so much for having me. I'm so glad that we are able to find time in our schedules to connect this morning.
Sandi: Yeah. Well, let's begin by talking about just what exactly is intermittent fasting. Does it differ from time-restricted eating for those who might not be aware?
Cynthia: Yeah, so intermittent fasting is just defining a specific time period in which we are not eating and a time period in which we eat. And that can look very different. There are lots of variations. You mentioned time-restricted eating or time-restricted feeding, and I think that they're very similar in terms of their outlook. There's usually a 12, 13, 14, 15, 16-plus hour timeframe in which you're not eating, when you're allowing your body to have a degree of digestive rest and other conferred benefits. And then there's a specific time period in which you may consume two to three meals.
And this goes completely contrary to all the advice that I used to give patients 25 years ago about eat to stoke your metabolism, eat every two to three hours, have lots of snacks in between your meals, because this is actually contrary to the way that our bodies are designed to thrive. We're designed to predominantly eat when it's light outside and eat the bulk of our food earlier in the day. And then as the day goes on, we're typically a little less insulin-sensitive.
And insulin is this wonderful hormone that helps with many biologic processes, but particularly in our modern-day culture, insulin is one of these hormones that is conditioned to be instrumental in regulating blood glucose or blood sugar. But if we're eating too frequently, if we're eating a lot of snacks, and many meals, and a very carbohydrate-dense diet, and about 50 percent of Americans...or Americans in general, 50 percent of their diet is carbohydrates. So, a lot of people are eating a lot of carbohydrates. Over time if you're eating too frequently, if you're eating the wrong types of foods, it can really wreak havoc on your health.
So, when we talk about intermittent fasting, it's helping men and women define a specific time period in which they choose to eat and in which they choose not to eat. And what I find for many people is that, when they get out of the habit of eating four to five meals a day and snacks in between, they feel a whole lot better. They have more energy. They sleep better. There's usually that side of weight loss or changes in body composition and then a lot of deeper scientific physiologic things that happen in the body. So, time-restricted eating and intermittent fasting really are speaking to timeframes. And for each one of us, it can look a little different when we choose to eat, when we choose not to eat, and everything in between.
Sandi: I remember those days of snacking. I used to leave groups. I'd have all of these tips like have food in the car. Never leave without food in your purse. Pack your snack. And doing that personally, like, "Oh, no, I'm leaving and I'm rushed and I don't have my snack to take with me. And what if it's over two, three hours and I won't have food?" So, I'm so glad that we got out of that, because it was overeating. But are there contraindications for fasting or time-restricted eating? Are there people who should not be engaging in this process?
Cynthia: Absolutely. And that's such a good question. I'm so glad that you asked it. So, number one, people that are still growing. So, children, teenagers. And if you haven't fulfilled your growth spurt, I have teenagers at home. I would never recommend that they are in these massive anabolic phases, that they fast.
I think it's also important to kind of identify if you're pregnant, breastfeeding, or trying to conceive. Probably not an optimal time. And I think this is... Unfortunately, I think there's a lot of misinformation on social media. I see a lot of fit pros that will fast throughout their pregnancies. They'll fast while they're breastfeeding. It's one of the few times in your life that you really don't want to put your body in a non-optimized way to support a fetus, or an infant, or toddler.
I also think about people that are just chronically ill that may not be aware of what their blood sugar is doing. Brittle diabetics. Anyone has a chronic health condition, I always recommend that you have a conversation with your healthcare provider, whether it's a physician, nurse practitioner, PA, etc., have a conversation to make sure that they may not need to be more involved in monitoring your blood sugar, your blood pressure. A lot of my patients, when they start fasting, they need alterations and medications.
And then lastly, I would say the other group that I'm very cautious about intermittent fasting with are individuals that have a history of anorexia, bulimia, or food addiction. And it's not to suggest that these individuals may have been far enough along in their healing journey, that they may be in a position where they could intermittent fast in conjunction with support from their clinical psychologist or whoever they're working with. But I do find, for some of these individuals, it can actually trigger some of those distorted relationships with food.
And so very much on a case-by-case basis. Of course, over the past 6 or 7 years, there's always exceptions, but it's typically an individual who is far enough along in their healing journey that they're able to integrate that, but generally, those are the kind of high points, the people that I think about are probably not in an optimal situation.
I would lastly add anyone that's underweight. So, you know, in our culture, which tends to be very thin-focused, thin-centric, there are individuals who just aren't even at a healthy body weight and they should not be restricting their food intake. They should not be restricting their protein intake. And so those are the people that I'm oftentimes cautious about. If you're someone that's got the dwindles and you're tiny and you're struggling to put weight on, you probably don't want to compress a feeding window, but for the average American, and I think right now 92 to 93 percent of us are not metabolically healthy. I just remind people that most of us do better with eating less frequently, but overall those are the general contraindications.
Sandi: Such good points. And I know my own personal example, I had been engaging in time-restricted eating. Generally, my eating window was 12 noon to around 6. I would stop eating, and our mutual friend, Dr. Gabrielle Lyon, we're having a conversation and she said, "No, for you..." And I'm underweight, and I struggle to get my macros regarding protein. So, then I shifted and now I'll have a protein shake, which I have right here nearby. And I will have that earlier. And then have lunch again, high protein and a high protein dinner. So, I could not get in all that protein compressing it into two meals with a narrower feeding window. And so at my age, at 73, that is so important for me to have those macros of protein.
Cynthia: No, and this is one thing that I always take the opportunity to really emphasize is that we need more protein with age and not less. Ironically enough, I'm interviewing our mutual friend in a couple of hours for the podcast, but it's important to be able to understand you need enough protein in your feeding window. So, if you can't get 100 grams of protein in a day, and for many people listening, they're like, "Oh, my gosh, I'm probably getting 50 or 60," that's the first thing to work up to. But ideally, we're looking for 1 gram per pound of ideal body weight. So, if you can't get 50 grams of protein in 2 meals, or if you're eating one meal a day, which I think is even more problematic if you're trying to really focus in on maintaining and building muscle, that the impact of sarcopenia starts in our 30s. It's not something that just impacts middle age people in their 50s and 60s and 70s. It's a process that starts at a much younger age.
So, your point about ensuring you're getting enough protein in and we want at least 30 grams of protein with each meal, that's important for actually triggering something called muscle protein synthesis. And I won't go down that rabbit hole, but it's important for people to understand we want to build and maintain muscle. Muscle is so important for insulin sensitivity. Remember, I talked about insulin earlier. And so when men or women are talking to me, I would say I'm a huge fan of intermittent fasting, but I'm not a fan of people having a very compressed feeding window where they can't get those macros in, protein being the most important. And it's not about, you know, the aesthetics piece, although having muscles is important. It makes us feel more confident, look better in clothing. It really is this organ of longevity.
And so I think that you bring up such an excellent point that, if you can't get the protein in in a six-hour feeding window, then it needs to be an eight-hour feeding window. If you can't get it in 8 hours, then it needs to be 9 or 10 hours. And actually, Satchin Panda, who's the expert about chronobiology and time-restricted feeding, he talks about 8 to 9 hours he thinks is the optimal feeding window for most individuals. And so I would echo those comments and say that I think for each one of us, it's a degree of experimentation. Do I get it right every single day? Absolutely not. Do I try to make up for it on days if I've been traveling or we just got back from a trip? And I was saying to my husband it's amazing how I'm so focused on protein, that when I don't get enough of it in a meal, I can definitely tell. I mean, I'm not as satiated. I definitely can feel that difference. So, yeah, protein-centric is really the way to go to be able to support our health properly.
Sandi: Speaking of support, health coaches can play a big role in supporting people to initiate fasting or time-restricted eating and also I think to play an important role in pulling back to not be so rigid. I see all the time people starting a plan, and it is often they get to the point where they are so strict, that is hampering their relationships, which is also contributing to poor health. So, how would you talk to somebody, for example, who's got a good eating pattern? Let's say they are wanting to stop eating at 6 p.m. after dinner, but now they have a social event, and the event may not start until 7. Dinner may not be served till 8. They might not be finished eating until 10. I've been to weddings where it's 10:00, and they're serving dinner. And I always have a conversation with my husband who thinks, if you don't eat, people are going to be staring at you. You are going to make them very uncomfortable. And so I wrestle with that, and I hear a lot of people do as well once they are establishing a time-restricted eating pattern. I wonder if you can comment on that.
Cynthia: Absolutely. And I think the key is flexibility. When we socialize, when we travel, we've had several weddings this year and to your point, the weddings, they're late in the afternoon to start. Meals aren't served until 8 or 9:00 at night. And I always say to my husband, "I will eat the protein. I will focus on what's important for me—vegetables and protein." I don't beat myself up about it. I feel like if you really focus in on the protein at these events, or you're just acknowledging this as a blip on the radar, you're going to have to adjust your feeding and fasting window.
I always say, let it go. Like, give yourself grace. Enjoy the event. If you drink alcohol, if you have a glass of alcohol, or you have part of the cake, or you indulge in some hors d'oeuvres, you can get back on track the following day. So, I think the most important thing is to give yourself grace and be flexible.
The rigidity piece, I don't like to see because it really speaks to a diet culture that can be very rigid like, "You must do this, and you can't do this, and you have to do this, and you must do this." And I remind people we're all human beings, and it's important that we allow ourselves opportunities, whether it's when we travel. We just got back from Europe, and Italians eat later than Americans do in many instances. And so we had dinner almost every night at 8:00 at night. And most of the other people there were Americans. The Europeans eat a whole lot later. And so to your point, I think that it's important for all of us to be flexible, to understand that it's okay on occasion if we shift our feeding window or we open our feeding window and it's wider or longer.
The other thing that I think is important is I typically, if I'm going to a party, going to an event, I never go hungry. I make sure that I've had something before I go because I will make much better food choices. Typically, that could be a protein shake. That could be that I'm having a small piece of fish or some leftovers the night before to make sure, if I show up at an event or a party and it's just carbohydrate and late and stuff, I don't feel a sense of temptation. I enjoy myself, I enjoy the social interaction, and then I kind of put it to bed. So, I think that there's a lot of ways to navigate social events without guilt, without beating yourself up, and acknowledging that it's okay. If you are eating a healthy diet 80%, 90% of the time, having one evening or one vacation where you indulge in things that you would not otherwise do or changing up your feeding and your fasting window, I think that that's important for us as human beings. I think that the rigidity piece to me always I find concerning when people don't have the ability to shift or adapt. That speaks to other issues that sometimes we do have to have an honest conversation about.
Sandi: Absolutely. That is so important. And, again, that is the role of a health coach. Not only can they help their clients to set goals around starting an intermittent fast dinner time-restricted eating plan but also provide that support and help them to find that balance where, if they do have an off day, to lose that rigidity to know that there is an opportunity to begin again and then celebrate those wins. And it becomes then a habit that those individuals are going to engage in, and it becomes their new normal. And so they can play a big role. You have an amazing program that you are initiating, and I'd love for you to tell our audience about this program. And I believe that came out of your book.
Cynthia: It did. So, 4 years ago, when my second TEDx talk went viral, this is the program that came out of... Suddenly there was a lot of tension. People wanted me to coach them through the process of intermittent fasting. And so IF:45 or Intermittent Fasting:45 is a 45-day program that I have honed in and perfected over the past 4 years that really helps individuals understand how to properly fast. And even if you've been fasting, there are so many tips and things like the protein piece. I mean, for people, that blows their minds. They're undereating protein, and they're wondering why they're struggling with trying to have a fasting regimen, helping women understand when to fast in their menstrual cycle, how to kind of lean into the lifestyle piece, the sleep, the stress management, the right types of exercise.
So, it's a 45-day program. It includes weekly calls with myself and other experts. I have a whole coaching program for IF:45. So, my coaches are in the program providing support to participants as well. And what I think is most important about this is it's really creating a community for people to express and share in a very safe environment and really allows them to learn the scientific principles of fasting and the direct application.
And because I've been teaching fasting for, gosh, now 7 years going on 8 years, I've now gotten to a point where we know exactly how to support people wherever they are in their journey. And the book is a nice accompaniment, but the program in and of itself is different than the book. So, I always remind people that we do provide the book as a resource and everyone has it. It's something to kind of look at as they're going through the program. But there's nothing better than getting real-time coaching, you know, for 45 days and beyond for individuals that move into another program that we offer.
So, IF:45 is the best program that's out there for supporting individuals that are interested in starting fasting, individuals who are seasoned fasters, people that are looking to take fasting because there are challenges, which are completely optional. Challenges that we utilize to... We use the term, you know, flexing your ability to see how much you can properly stress your body in a safe environment. Fasting is a form of hormesis, which is beneficial stress in the right amount at the right time. And we have really perfected the model for being able to do that effectively.
Sandi: And if you're a health coach and we have many health coaches in this audience, you could take this course and then you can support your clients through this program.
Sandi: So, this is an area that I think we often think about what to eat, but we don't think about when and how to eat. And that is just as important. And starting small like maybe stopping eating two to three hours after dinner and until not eating until the next day. So, those people who are tied to their midnight snacks, so to speak, would be a way to start.
Cynthia: Absolutely. And I think, you know, the biggest thing is that there are people out there, you know, coaches that are like, "I'd love to take the program. I myself am interested in intermittent fasting." We have people that start as beginners, people who are eating snacks and many meals and are struggling with blood sugar dysregulation, and energy issues, and stubborn weight loss resistance. And we walk you through. We take you through... Like, the first thing to do is to stop snacking, and that is ripping off one Band-Aid.
And then we're increasing protein and that's, you know, the next step. And so we really do work at a very basic level for those that need that degree of support all the way up to people who've been fasting and they're trying to figure out why it's not working well for them. So, you know, from my perspective, intermittent fasting is a great strategy, a great tool, and certainly there's a lot of good science around it, but the coaching piece, as your coaches know, coaching people through intermittent fasting is the way to be able to support those lifestyle changes in a way that makes it sustainable.
Sandi: That is so important. And I agree, starting with snacking. Years ago, I was eating all day long. I was working. And every time I would go into the kitchen or if I was at my office in the break room, I take another handful of nuts. Remember between clients, I was working as a clinical psychologist. And after every session, oh, I would take another snack and not realize how much I was eating just throughout the day. And particularly wearing a CGM, a continuous glucose monitor, was eye-opening to see that, what the difference would be if you are not snacking. And it's a good place for coaches to start. People can set goals around slowly withdrawing from that snacking behavior.
Cynthia: Yeah, and I think it's one of those things that, for many of us, I mean, we were conditioned to believe that snacking was good and then to have to find that degree of some people really struggle with the cognitive dissonance of, well, that can't possibly be true. But I can't tell you how many individuals, when they stop snacking, it really opens up their eyes. Like, I was never eating a good meal. I was grabbing and go... I was like, you know, all day long, just constantly eating these little mini meals. And when I sat down and ate 40 grams of protein, boy, did I feel different? Like, I wasn't hungry for 5 hours. You know, I had sustained energy. I didn't have this energy slump. I wasn't looking for, you know, a cappuccino or a frappuccino in the middle of the afternoon or a candy bar because I really had much better, you know, energy throughout the day.
And so I think that, you know, for so many people, that not snacking piece is both challenging but also very insightful. And I think when people master that, then they're like, okay, I can do this. Like, now that I took that snack away, I can absolutely do this.
Sandi: Yeah, and it doesn't matter what snack. So, in my early days, I remember in the '70s, snacking was a handful of M&M's. And then I transitioned many years later, snacking was a handful of nuts. I was eating a whole lot of nuts. And so getting back to two, three meals a day, health coaches can support people through that process.
Cynthia: Absolutely. Nuts are tricky, I tell everyone. You know, nuts and cheese get people into a lot of trouble because it's hard to moderate. Like, I always say I love salted macadamia nuts. It's one of my favorite, favorite things to eat, but I will measure out a portion, and I put the rest away because it's just so tempting. Like, you were saying that the other day you'd be snacking on nuts, and before you know it, you've consumed a healthy food, but so much of it that you're then not hungry to eat the protein or the vegetables or the other things that you probably really needed to be ingesting. But, yeah, nuts are tricky. They're definitely tricky.
Sandi: So true. Macadamia nuts are my weak spot as well. Oh, those dry roasted ones, they're salted. Those are...
Cynthia: Yep, salted. Give me some salted. Oh, goodness. It's a mess.
Sandi: Well, Cynthia, this has been such a great conversation. Where can people find you? Where can they learn about your program?
Cynthia: Absolutely. So, if you go to my website, so it's www.cynthiathurlow.com, you can get access to my programs, and we'll definitely give you a direct link so that they can find it more easily. Access to my podcast and then I'm active on social media. I always say Instagram, YouTube. We have a free Facebook group that's called Intermittent Fasting Lifestyle/Cynthia Thurlow. That is a free Facebook group that is moderated, so it's not pandemonium. We do actually moderate so that we make sure the right individuals who are supportive and have positive energy are there to support one another. But that's probably the easiest way to find me.
Sandi: And be sure to check out her TedTalk. It went viral, and it's a wonderful talk, so check that out as well. So, thank you so much, Cynthia, for being on the program today.
Cynthia: Absolutely. Thank you so much for having me.