The Psychology of Hunger | Dr Jason Fung

13:10Dr. Jason Fung:The Hunger Code is really talking about trying to get to the sort of upstream ideas of what is causing this weight gain, right? If the problem is overeating, then you need to understand what is driving this behavior, right? Because nobody wants to be overweight or obese. So why is this happening and why here in America, right?

13:33Dr. Michael Gervais:I mean, it sounds funny to say it. I read that line in your book and I was like, yeah, you're right. Like, I don't know anybody that says, man, I want to be obese. That's not what, now I do think that there's some of my friends that they played sport, they stopped working out, they didn't change their eating habits, and they kind of like being big.

13:53Dr. Jason Fung:Yeah.

13:53Dr. Michael Gervais:You know, but that's one small segment of the population. But I agree with you that like nobody wants to look or feel unhealthy.

13:59Dr. Jason Fung:Yeah. So then why is this happening? Yeah. And this is the sort of focus. So, you know, there's a concept in logic called the three whys, right? So the idea is that if you really want to understand what's happening, you have to ask the question why three times. So if you were to say, well, why did the Titanic sink, for example? And you might say, because it hit an iceberg. And that's actually not the right answer. because if you're to say, okay, from that, how do you prevent future marine disasters? You'd say, don't hit icebergs, right? And that's not useful, right? You're not getting to the root cause.

14:33Dr. Jason Fung:That's why it's not useful, right? You're treating the symptoms, not the cause. So then the second why might be, well, why did the Titanic hit the iceberg? And it's like, they say, well, because the captain couldn't avoid, he couldn't turn the ship in time. So why couldn't the captain turn the ship in time? Because it was going too fast. And that's the real answer. So when you say, how do you avoid future marine disasters? The answer is slow down, not don't hit icebergs. If you stop thinking at that first superficial why, you get like a nonsense answer. Just like if you're to say alcoholism equals alcohol in minus alcohol out.

15:08Dr. Jason Fung:So the solution is don't drink alcohol. It's like, well, you're not understanding why people are drinking, right? You're not getting to that deeper reason. So when you say, okay, why is somebody gaining weight? And it's like, because calories in is greater than calories out. Well, sure, that's true, but that's not what I'm interested in. I'm interested in why calories in is greater than calories out, right? And the answer is because you're hungry. That's the only reason, right? We eat because we're hungry and we stop eating because we're full. So then you get to the third and I think most interesting question, why are you hungry, right?

15:45Dr. Jason Fung:Because if the problem is overeating, then you could think of the problem as overhunger. So why are you hungry? And there's actually three different types, at least three different types of hunger that you can classify. And when you go into the scientific literature, these are fairly well established. That's the sort of physical hunger, which is called homeostatic hunger, which is all about hormones and balance. And then there's the hedonic hunger, hedonic meaning related to pleasure. So we eat because we like to, right? It gives us pleasure. It makes us feel better. That's why you eat dessert, right?

16:19Dr. Jason Fung:It's not because you're physically hungry. And then there's a conditioned hunger because you can have, and you'll understand this, you can pair two things with conditioning. A whole field of behavioral psychology that you can now bring to bear on this conditioned hunger because it's a huge problem. If everything you do reminds you of food, food, you're going to be hungry all day long. So what do they call it? Food noise. Because everywhere you go, you go to the store, you go to the mall. Hey, you feel like eating. You go in your car. Hey, you feel like eating. You go sit in front of the TV. Hey, you feel like eating.

16:55Dr. Jason Fung:You go watch a sporting event. Hey, you feel hungry. It's lunchtime. Hey, you feel hungry. You go to the coffee shop. Hey, you feel hungry. So you're creating a lot of conditioned hunger, but there's ways around it. So you can't just say eat less because you never understood why they were eating too much in the first place.

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19:55Dr. Jason Fung:I think all three are, they're different, you know, because one is sort of physical. That one to me is sort of the closest to me because it's more biological than anything else. There's the emotional hunger. And I think that that one, I think, is probably one of the most important things that we talk about these days because it talks about two things are really important for hedonic hunger, which is ultra processed foods and food addiction. Those two topics, which I actually think are extremely important. Yeah.

20:24Dr. Michael Gervais:Before we go into the hedonic hunger, let's stay here for a minute because the ultra processed foods are problematic, but I think you're missing one. And I don't know what the literature would suggest, but there is eating out of boredom. Yeah. Yeah. And I know that that sits under the emotional category, but I didn't hear you talk about that. But can you first hit on the ultra processed foods and how that reshapes the idea of calories in, calories out?

20:48Dr. Jason Fung:Yeah, because the whole thing is that the way you process a food makes a big difference to eating behavior because we're not simply eating for that physical hunger. We're eating for emotional reasons, right? So there's the emotional eating, there's the boredom eating, right? So you're bored, you're looking for a bit of pick-me-up, right? So you eat because it makes you feel good. And that's the dopamine spikes and so on, right? So the whole idea is that if you process a food, you can still have the same calories you can still have the same number of carbohydrates and proteins and so on. But there's a lot of ways that you can change the food so that it changes the way we respond to it.

21:30Dr. Jason Fung:So one of the most important is the speed of absorption. So how quickly you absorb that food. Because the food doesn't go from the food into your bloodstream, right? It goes from food, it has to be digested, it has to go into the intestines, it has to be absorbed, which influences your hormones and neurotransmitters neurotransmitters like dopamine and then influences your weight, right? So if you make a food, and this is what they do for ultra processed foods, they make it, you know, super pleasurable. So you can talk about bliss points and salt and sugar and fat, but there's artificial flavors, artificial colors, because you know, when it looks good, right?

22:05Dr. Jason Fung:This is the whole debate around the lead-based dyes and how in the United States you get these super bright fruit loops and in other countries, are a little dull, but there's also texturizers, there's emulsifiers, there's things to make sure you have the right mouthfeel. Ultra processed foods tend to be very, very easily chewed. You need like half the number of chews compared to like regular foods. And when it gets down, it goes through the stomach much faster. So what happens is that you're basically mainlining this glucose because it's refined carbohydrates that tends to be a problem right into your blood because it goes through you so fast, but that's the processing.

22:43Dr. Jason Fung:It's not necessarily the carbs, calories, or whatever it is. And the speed of absorption matters because if you're thinking about addictive behavior, pleasurable behaviors, how quickly you absorb a molecule is very important. So if you think about tobacco smoking, right? You smoke it, why? Because the nicotine goes from your lungs directly into the pulmonary blood vessels. Same thing with heroin. You inject it directly into the veins. You don't eat it, right? You don't eat the nicotine. You can, you can get nicotine gum, but it's much less pleasurable. That's why you use it when people are weaning off.

23:18Dr. Jason Fung:You don't eat heroin. You sniff cocaine because it goes directly into the blood vessels, right? So when you've got this huge spike, you generate a lot more of the dopamine. You get a lot more of this rewarding behavior and it's the same with the food. So you're getting these sugar highs, but they're not normal sugar. It's not going in you slowly as you slowly digest it. say you eat a piece of fruit, an apple or something, right? It's going to take its time. So your blood glucose is not going to spike like this. It's going to take your time. It's slowly going to get digested. It's going to stick in your stomach for a while.

23:50Dr. Jason Fung:Then it's going to get absorbed.

23:51Dr. Michael Gervais:So if I eat two or three gummies versus an apple, equal number of sugar units for both, but they're not treated the same.

23:58Dr. Jason Fung:They're completely different. You can do better. You can compare apples to apple sauce. So you take the apple, you bake it, and then you puree it. So you don't add, you don't subtract. Okay. And it's completely different. The hormonal response is completely different. So you can measure how quickly it goes through the stomach, right? So for the apple slices, it's I think 65 minutes and it's like 44 minutes for the applesauce. So it's going through much faster. You can measure how many chews people take. It's like half as much, right? And you can measure how quickly the glucose goes up. It's like 30, 40 % faster.

24:32Dr. Michael Gervais:Yeah, that's great about apple and applesauce. So your point would be, if you're going to have applesauce, use it sparingly. Yeah. And do not be confused that this is the same as an apple, even though it says organic, pureed, no additives. Yeah. It's not the same.

24:46Dr. Jason Fung:It's the way you process it. So that's what people are focusing now on is you have to go past the calories, the carbs, all that stuff on the nutrition label. Ingredients, right? Because the apples and applesauce, identical, identical apple, right? But it's the processing that makes a difference. Why? Because it's sort of pre-digested. The applesauce is pre-digested so that you can sort of get through the digestion and into the bloodstream much, much faster. And that makes a huge, huge difference.

25:14Dr. Michael Gervais:It triggers something else. It does not satisfy the hunger response, right? And so can you walk us through the problem with that?

25:22Dr. Jason Fung:Yeah. So if you think about hunger, there's lots of ways that your body tells you when to stop eating. These are just called satiety hormones, right? So there's lots of them. So for example, there's GLP-1 and GIP, and these are well-known now because they're the focus of weight loss drugs like Ozempic, for example, or Munjaro. There's something called peptide YY, which is a response to protein. There's cholecystokinin. So what happens is when you eat a food, say you eat a steak or something, what happens is that the food contains calories, but it contains information as well as to what you're supposed to do, okay?

25:57Dr. Jason Fung:So when it goes down, then you activate all these satiety hormones. and therefore you're going to stop eating. So you can eat one hamburger, but you can't eat like 40 hamburgers, right? Why? It's the same hamburger because of the satiety hormones and they're very, very powerful. So the point is that if you speed up the absorption and speed this up, you're bypassing some of these satiety signals. One of them is the stretching of the stomach. So when you put food in and it sits in your stomach longer and it doesn't move out, well, you're going to feel more full. That's one of the signals to the brain.

26:30Dr. Jason Fung:It's called the baroreceptors, which is mediated through the vagal nerve. Well, ozempic slows down the gastric transit time. So it makes everything stick in the stomach a lot longer than normal. So you feel way more full after you've eaten. Oh, that's how it works. It works on multiple levels. It works actually directly on the brain as well. Causes a lot of nausea.

26:50Dr. Michael Gervais:Let's stay here for just a moment. There's a buzz. And I see people in media and in life that have been on ozempic-like or ozempic itself. I don't think they look great. So, you know, I know that it's designed for obesity, right? But when people are not obese and they want to lose weight, what is actually happening?

27:09Dr. Jason Fung:Well, part of the problem, there's a couple of concerns. A lot of people talk about this ozempic face, right? And it's quite, yeah, it's not a good look, right? And the reason is that you're losing a lot of subcutaneous fat. So when you eat the way people eat when they're in Ozempic, which tends to be very low in protein, because remember, there are certain foods like proteins and fats, which are very satiating because they release a lot of these peptide YY, cholecystokina, and GLP-1. If you eat those foods, you're stimulating GLP-1, but you've already stimulated it with your Ozempic. So therefore, you're going to tend to avoid these.

27:51Dr. Jason Fung:So that's why, for example, if you eat a big buffet, you know, they're really full, you can't eat another pork chop, but you could eat like some apple pie because there's not a lot of protein and not a lot of, you know, there's some fat, but it's a lot of refined carbohydrates, which don't stimulate the satiety response, right? So the whole point is that people tend to eat a certain way so that they can still eat, which gives them the pleasure, right? There's a -

28:16Dr. Michael Gervais:Okay, so if I take GLP-1 or Ozempic as an example, and I feel full faster, is what you're saying, I'm likely not gonna eat food that helps me feel full in and of itself. So I'm starting to eat sugary foods. I'm starting to eat other stuff. Sugary, refined foods.

28:31Dr. Jason Fung:Yeah, that's the worry. And certainly what happens then is that if you're not having that, you could have the muscle loss. So there's actually a big concern that there's more muscle loss on people who lose weight with Ozempic than when you lose weight without Ozempic. There's a big concern about that. And obviously that's gonna be fleshed out. But the other thing is that the way that people eat, which is sometimes through this sort of constant snacking and stuff, What happens is that for some reason they lose that subcutaneous fat more than normal. So then because you're losing the subcutaneous fat, you get this really gaunt look.

29:03Dr. Jason Fung:It makes you look really, really old. If you look online, there's a ton of pictures of people and they really look terrible. I agree.

29:11Dr. Michael Gervais:Now, when it comes to weight loss for a certain profile, are you saying, yeah, this is a good choice? But for the majority of folks, are you saying buyer beware?

29:19Dr. Jason Fung:Yeah, it's a drug. So all drugs have side effects. So certain people are going to benefit. So everything is sort of risk versus benefit. So if you're very overweight and you have type 2 diabetes and you have all these health issues, then yes, the risk is probably worth the benefits. But if you're really just doing it to lose a few pounds to look good, then sometimes it's worth it and sometimes it's not worth it. And that's a choice you have to make for yourself because there are side effects too, right? There's gastric paralysis, there's like anything. Gozempic stimulates the GLP-1 system, but at a very high level.

29:53Dr. Jason Fung:You can't get that naturally. It's a super physiologic dose.

29:57Dr. Michael Gervais:What are some foods that trigger or some, let's call it supplements, you know, that are not at the grade of medicine that also trigger GLP-1?

30:07Dr. Jason Fung:Yeah. If you talk about foods, I mean, protein. So protein is sort of becoming very popular. And one of the reasons is that it's great for satiety because it stimulates GLP-1 more than say carbohydrates. The other one that's really good is like fiber. So fiber, it's not digested. So there's no calories because your body can't actually digest it, but it gets to the colon and it gets fermented into these short chain fatty acids, which stimulate GLP-1. The other thing that really stimulates a lot of satiety, if you really want to feel full is sort of really bulky foods. So when you have really bulky foods, so if you're thinking like cauliflower, broccoli, like big leafy vegetables.

30:45Dr. Jason Fung:Yeah. It's like, if you ever look at a salad, right? It's huge. So when it goes into the stomach, your stomach's sitting there churning it. It's got to work it down, right? So it takes time. So it stays in the stomach longer and it's big. So there used to be this very popular way of eating called volumetrics, which is eat big volume food. And it's playing along that line. When you stretch the stomach and let the stomach stay stretched, it's going to signal your brain that you're full and you need to stop eating. Chill out. You pushed too far here. Yeah. Okay. Exactly. So eating things like, you know, big leafy greens, things that are full of fiber, full of water, those are going to be better for you in terms of staying full.

31:27Dr. Michael Gervais:You introduced cadence, like the grazing approach, and you're obviously well-studied on intermittent fasting, including one of the first docs to really talk about it many, many years ago. So I know you're learned here. Can you talk about grazing, but but more importantly, can you talk about intermittent fasting?

31:44Dr. Jason Fung:Yeah, so intermittent fasting was sort of one of these things that 10, 12 years ago was considered really, really bad for you. And again - Never skip breakfast. Yeah, you can't skip breakfast, never skip a meal. You got a snack all the time. And it became entrenched. So if you look at the schools, for example, it became entrenched that you had to have breakfast and you had to have a snack in the middle of the day. you had to have an afterschool snack, right? I remember, you know, when my kids were younger, they'd get a note. The note was like, we're going on a school trip. They'll be back at four, please pack two snacks.

32:19Dr. Jason Fung:I'm like, why? It's like, are you not giving them lunch or am I not giving them dinner, right? Because when I grew up in the 70s and you wanted an afterschool snack, it was, no, you're gonna ruin your dinner, right? And if you wanted an after dinner snack or bedtime snack, the answer was, no, you should have ate more at dinner, right? So somehow we went from that, which is that snacks are an indulgence. You're eating it because you want to, not because you have to, right? You need to have your three meals a day, but you don't have to have anything else. To, oh, we need to eat all the time. And it was really a huge shift that happened without anybody actually thinking about it.

33:01Dr. Jason Fung:And there was no science behind it. People just sort of, it was like fashion, right? It was just like, oh, you should eat all the time. But what happens when you eat all the time?

33:08Dr. Michael Gervais:You know what I remember about that time before you get to the problem here is that during that time, the reason I remember thinking that, oh, this kind of makes sense was that you want to keep your system burning calories on a regular basis. Do you remember this narrative? Yeah, yeah, that's right. Like a bunch of coal in on a frequent basis keeps the energy or the train running. Yeah, keeps stoking your metabolism. Yeah, right. And so you are saying that that is inaccurate.

33:30Dr. Jason Fung:Oh, yeah.

33:31Dr. Michael Gervais:There's no science behind it. It's not, it's totally not true at all. Yeah, okay. Eat when you're hungry though, before you get to the fasting piece. Eat when you're hungry or no? wait until a meal.

33:39Dr. Jason Fung:Well, again, you can. I mean, it was at the time in the seventies, of course, it was still pretty regimented meals, right? But there's actually no reason why you couldn't skip a meal, right? If you weren't hungry, you could skip a meal back then and people wouldn't start yelling at you that you can't skip, you know, dinner or whatever. Right. It was funny because it's like back then it was interesting because, you know, one of the sort of classic punishments for bad boys was, oh, go to bed without dinner, right? There is none of this. So people are going from lunch, which is like 12 o 'clock until the next day breakfast at like eight o 'clock, like you're going 16, 17 hours, right?

34:18Dr. Jason Fung:And there was no thought that, hey, this is harmful, right? It was uncomfortable. It was uncomfortable. You hoped you learned your lesson, right? But that was about it, right? And the truth is that if you have any kind of body fat on you, then you have enough to get by. Like that's the entire reason you carry body fat. It's a store of calories for when you don't eat. So use it. You're using it for what it's for. How can that be bad for you? Right. And this was the strange thing because it always bugs me because it's like, I look back at stuff and I think, where's the logic? Where's the science behind this entire way of thinking that gets entrenched and institutionalized in our entire society, right?

34:59Dr. Michael Gervais:So let's talk about the benefits of intermittent fasting and some of the risks and also the considerations across genders.

35:06Dr. Jason Fung:In terms of the benefits, the benefits is that it gives you an alternative way to deal with weight loss, right? So when you're trying to lose weight, it's not about the calories, right? It's really about the hormones, right? You're trying to drive your insulin levels down. And the whole thing about calories is that it doesn't work because that's only one piece of the puzzle, right? So if you think about calories, when you eat, food has energy. So for every calorie you eat, your body could either store it as fat or can burn it as energy, right? But which one does it do? Because that's the crucial question, right?

35:43Dr. Jason Fung:In one case, you're going to get fat. In the other case, you're going to have lots of energy and you're going to feel full because you've got energy, right? So the question isn't the number of calories. The question is, what is your body doing with those calories, right? And that's because when you eat, your body produces hormones and different foods produce different hormones. So say you eat cookies, for example, lots of sugar, lots of refined carbohydrates, insulin spikes way up. What does the insulin do? Insulin tells your body to push all these calories into storage, right? So you push, say you eat 500 calories of cookies, you push it into storage, Your body has nothing left for the rest of you.

36:25Dr. Jason Fung:So it's like, okay, 10 minutes later, you're like, let's go find something else to eat because I actually have no energy because it's all stored away. So you flip it and you say, okay, let's eat 500 calories of, you know, grilled salmon or something like that, right? Insulin doesn't really go up. So you don't really store much of those 500 calories, plenty of energy to sit around. It stimulates GLP-1, it stimulates peptide YY called the cystokinin. So you feel full and you have plenty of energy. So why would you pretend those two things are the same just because they have the same number of calories?

36:55Dr. Jason Fung:Completely different effects on eating behavior. So why pretend they're the same? But that's what people do. So insulin is your sort of main switch, right? So when you eat, insulin goes up, tells your body, store those calories. But different foods stimulate insulin to different levels.

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38:25Dr. Michael Gervais:That's always in my control. That's always in your control too. This is the same morning mindset routine that some of the world's top performers across sport, business, and the arts are using. The best part? It only takes about 90 seconds to do. So just head over to findingmastery.com slash morning to download the audio guide for free. Again, head to findingmastery.com slash morning to get your morning mindset routine. There's a food scientist that I've done a lot of work with in professional sport. It was almost like a throwaway conversation, but it stuck with me a long time ago, which was if you sit down at a meal and bread comes out and then maybe a salad comes out or your main meal comes out.

39:09Dr. Michael Gervais:whatever you do, eat protein first.

39:11Dr. Jason Fung:Oh, absolutely.

39:12Dr. Michael Gervais:Yeah. Right. He's like, whatever you do, Mike, don't eat the bread first. I know you're hungry, whatever. You might not even want bread, period. It was a, it's a different conversation, but eat the protein first. Can you talk about, it's an interface on insulin is what I think is happening. Exactly.

39:26Dr. Jason Fung:So, so insulin is this sort of main switch that you want to know because that's its normal job. It's not an evil hormone. It's just that if you're stimulating it too much, you're going to store more fat, but that's what you told it to do. So not just the carbohydrates. So if you eat less carbohydrates, you generally stimulate less insulin, but there's actually a lot more to it than that. So the food order makes a big difference. So if you, and they've done this study where they had somebody and they had the carbs, which was milk and orange juice. And I covered this in the hunger code and there's proteins and veggies, which was vegetables and chicken.

40:02Dr. Jason Fung:And they took a person and they gave them the carbs first, then the meat and veggies. And then they took the same person a few days later, they flipped it, right? So then you had the meat and veggies first, and then 10 minutes later, you had the bread and orange juice. And the difference in insulin response to the same foods was shocking. It was like 30 % higher when you ate the carbs first. So your food order makes a huge difference. And it makes sense because what happens, of course, is that when you're eating the bread and orange juice first, it goes into the stomach. Remember, the stomach is a reservoir.

40:31Dr. Jason Fung:holds the food and then slowly parses it out into the intestines where it gets absorbed into the bloodstream. So if you just have pure carbs going down the pipe, then what's coming out is pure carbs and your insulin is going to shoot way up. Same ideas like when you drink alcohol on an empty stomach, right? It's not so good because you get drunk very fast because there's nothing to slow it down. When you eat the meat and veggies first, the meat and veggies are sitting in your stomach, Then you're putting in the bread and the orange juice. Everything's mixed in. What comes out of the stomach to the intestines is a bit of meat, a bit of veggies, a bit of carbs and a bit of orange juice, right?

41:09Dr. Jason Fung:So your absorption is not like boom, it's like just slowly going up, right? And that makes a huge difference to the insulin effect. And it turns out there's a lot of things that affect the insulin response other than the total number of carbohydrates. So that's one example, food order, how late in the day you eat affects it. If you take a walk after a meal, that'll affect it. If you eat vinegar, for example, with carbohydrates, that can make a huge difference to your insulin levels, which I actually thought was fascinating. How do you do that? Well, what happens is that the vinegar and all organic acids, so vinegar is acetic acid.

41:44Dr. Jason Fung:This is not apple cider vinegar, you're just - Any vinegar. So red wine vinegar, white vinegar, any vinegar. It actually inhibits the enzyme amylase, which breaks down the carbohydrates. So carbohydrates are chains of glucose. When you eat it, your body starts to digest it with amylase and chops the glucose into small pieces so that it can be absorbed. The organic acid, so that's vinegar or fermented foods like kimchi and sauerkraut, which is lactic acid, or lemon juice, which is citric acid, any of those organic acids will inhibit the salivary amylase. And when you inhibit the amylase, then the absorption is much slower because it's not getting chopped up.

42:23Dr. Jason Fung:So therefore your insulin effect is actually like 20, 30 % more. There's another interesting one called resistant starch, which is that if you cook and then cool your rice and then reheat it, you get less absorption of the carbohydrate. So cook, cool, and then reheat. Cook, cool, reheat.

42:41Dr. Michael Gervais:And how cool do you get it down?

42:43Dr. Jason Fung:Like to refrigerator. So if you cook it and then put it in the fridge overnight, for example, or you can freeze it.

42:48Dr. Michael Gervais:And there's no risk, there's no bacterial risk in, I don't know where I'm reading this or learning this, that stored rice is potentially problematic. If you leave it in the fridge too long, yeah. You can freeze it too. That'll do the same. Okay. So I cook my rice. First, I rinse my rice.

43:03Dr. Jason Fung:Yeah.

43:04Dr. Michael Gervais:Right. How long do you rinse your rice? I usually do like two, three times.

43:08Dr. Jason Fung:Two, three times. Right.

43:09Dr. Michael Gervais:This is just to get some of the pesticides, I think.

43:11Dr. Jason Fung:Yeah. Yeah.

43:12Dr. Michael Gervais:Is that right? No, no, no.

43:14Dr. Jason Fung:There's also a little bit of that powdery stuff on it.

43:16Dr. Michael Gervais:Okay, good. So you rinse the rice, heat it up, boom. 10 minutes later, you pull it out, you cool it down and then put it in their fridge. And then when you're ready to eat it for dinner.

43:25Dr. Jason Fung:Yeah. What happens is that the crystals in the rice actually crystallizes. That's why when you eat, you can't eat cold rice because it's actually quite brittle because it crystallizes. When you reheat it, not all those crystals sort of go back into the liquid state. So therefore you've got this resistant starch because it's a starch, which is a chain of glucose, but it's resistant. so your body can't absorb it anymore. So even though it tastes exactly the same, because I do this all the time now because it's sort of the simple way to do it. I cook it, I put it in the freezer and then when I want to eat rice, I reheat it, but I'm getting way less of the starch because your body simply can't absorb it.

44:04Dr. Michael Gervais:Good to know. That's a great little process there. Okay, let's go back to intermittent fasting and hit some of the benefits of it, you know, concretely and then the gender differences between.

44:14Dr. Jason Fung:Yeah, so the intermittent fasting has a huge number of benefits actually. So weight is one of the big things, right? So it gives you an alternative way to manage your meals, manage your weights, because if you're not constantly being, you know, eating, then you're allowing your body to use the calories it's stored, right? So that's the whole point of fasting is that you're switching. When your insulin's high, your body wants to store energy or calories. When it's low, it wants to release calories, right? That's why you don't die in your sleep every single night because your body is releasing calories for you to use.

44:47Dr. Jason Fung:So the whole point is that you want to drive the insulin low and fasting is the most efficient and effective way to do it. So it gives you sort of an alternative method to control your calories, but it gives you an alternative method to drive your insulin down as well. So it can be very effective in weight loss, can be very effective in type 2 diabetes. So type 2 diabetes, there's a bunch of trials now that show that if you get people to stick to it, you can reverse about 50 % of type 2 diabetes. Through intermittent fasting. Just through an intermittent fasting.

45:18Dr. Michael Gervais:It's crazy. And so to be concrete, are we talking about 12 to 14 hours?

45:24Dr. Jason Fung:Most of them are sort of like 16 to 24 hours. 16 to 24. Three times a week sort of thing. There's different regimens. Okay.

45:31Dr. Michael Gervais:So let's talk about the different regimens and the recommendations and also include the gender piece as well.

45:36Dr. Jason Fung:Yeah. So the different regimens would be, so a normal fasting period should be around 12 to 14 hours, right? So if you eat dinner at seven, you eat breakfast at seven, it's 12 hours, right? That's what you should be fasting. It doesn't actually happen most of the time in these days for different reasons, like the conditioned hunger. But if you want to push it, you can go up to 16 hours. And again, it's better to do it early. So again, eating late tends to be a problem because again, if you eat late, then you're getting, you get more of an insulin response to the same food. Like you eat the same food in the morning and at night, you get bigger response at night.

46:11Dr. Jason Fung:If you're going to do a 16 hour fast, it's good not to push it too late. So you want to try and keep your meals relatively early. Then you can go up to the 24 hour fast, which is sort of a one meal a day schedule. So a lot of people like that. And it doesn't have to be every day.

46:24Dr. Michael Gervais:Yeah. How do you get enough protein? How do you get enough calories to, if I'm interested in being athletic and having the right composition of weight, as opposed to just losing weight?

46:35Dr. Jason Fung:Yeah, it all depends, right? So if you're a competitive athlete and you need that, then yes, that may not work for you. On the other hand, you have all these people who are like, you know, Terry Crews has talked about how he does sort of one meal a day. It doesn't have to be every day too, right? You could do it a couple of times a week. So obviously there's a couple of bodybuilders that use intermittent fasting. It's quite popular these days. That's 24 hours. And then if you're not a competitive athlete, then you don't need to worry about the calories because your body is carrying so much body fat.

47:06Dr. Jason Fung:you're trying to use it up, right? And that's the whole point. You're just not eating so that your body can use it up. The whole idea of protein, I mean, protein is important, but you don't have to have it all the time because your body does break down some of the protein and it will rebuild it. The interesting part about fasting is that it also really raises your growth hormone quite a lot, which sounds like it's really bad because people are like, why would your growth hormone be up if you're fasting? It's like, it's because your body starts by this process of autophagy, which is another, you know, very interesting topic where when you fast, your body actually starts to break down some of the old sort of senescent cells.

47:48Dr. Jason Fung:The zombie cells. Yeah. The stuff you don't need. The dirty stuff. Yeah. And then the stuff that's just not necessary, right?

47:56Dr. Michael Gervais:But that doesn't happen after one 16 hour cycle.

47:58Dr. Jason Fung:It probably starts around 20 to 30 hours. Yeah. Right.

48:01Dr. Michael Gervais:You need to get past, I thought that 24, but you're saying between 20 and 30, you begin the autophageal process, which is a cleansing and a cleaning of the senescent cells.

48:11Dr. Jason Fung:Yeah, the old cells, the stuff that just not needed anymore. At the same time, you're pumping up growth hormones so that when you do eat again, you will replace the cells that you need. So, you know, it's basically a rejuvenation process, but it always starts with breaking down cells. Just like when you renovate your kitchen, the first thing you got to do is throw out all the old stuff, right? Okay. So it's a huge benefit. And that's why a lot of people think it's very beneficial from a longevity standpoint, a health standpoint.

48:41Dr. Michael Gervais:So maybe one way to account for the difference, the biological differences for people is, could you walk through like a cadence that you might consider and maybe a cadence that you would consider for your sister? Yeah.

48:52Dr. Jason Fung:So for sure, the 16 hours and the 24 hours, anybody can do, right? And there's no reason other than you don't like it. Physiologically, there's really no reason why you can't do it because the number of calories that you have in body fat is more than enough. You only need about like 2000 calories roughly. That's like a half a pound of fat. And most people are sitting at around 25 % body fat. So you're talking about 30, 40, 50 pounds of body fat on an average person. So a half a pound is sort of nothing. So anybody could do those. And then the other thing you can do is you can push it longer if you want to.

49:30Dr. Jason Fung:So there are longer strategies. And then the other sort of metric where people differ on is what's allowed during that fast. So you can be a purist and you can say water only. But I think you can actually preserve a lot of the benefits by using some of these other things like teas and coffees and a little bit of cream and bone broth and that kind of thing. How clean the fast is and how long you do it for is different. because certain fasting protocols, there's two others that have been fairly well studied, which is the five to two regimen, which is five days of normal eating with two days of 500 calories.

50:05Dr. Jason Fung:So that's not actually a true fasting because there's no defined period when you're not eating. You're just eating 500 calories in that day. So even when you drop it down, you're actually gonna preserve a lot of the benefits. And then there's another protocol called the fasting mimicking, which is five days of somewhere around five to 800 calories. They have a proprietary sort of blend of stuff, but it's around 500 to 800 calories. So five days of the month, that's their protocol. Five days a month, five to 800 calories a day. Yeah. So again, not a true fasting period.

50:38Dr. Michael Gervais:I would rather do the intermittent fasting. So tell me if I'm wrong. The way I do this is that on a regular basis, probably four days a week, I am, I'm on 16 hour of fasting. And so the remaining is my window to eat the eight hours remaining to eat. And then I am working to get about a gram or less of protein per body pound. I'm active. I'm working out that composition between muscle and fat is something I'm trying to optimize for. And then the two, three other days, you know, I'm just kind of doing my good choices, if you will. I'm not fasting, but I can't remember the last time that was inside of a 12 hour window.

51:17Dr. Michael Gervais:That's a normal thing for me. Yeah.

51:19Dr. Jason Fung:And see, that's the key, right? If you do the 12 to 14 hours, like if you think about the seventies, you're getting this 12 to 14 hours of fasting every single day without even thinking about it, right? Because it was just life, right? You didn't think about it, right? Your mom would be like, no, you should eat more at dinner and there was nothing in the pantry anyway, right? So, and that's probably enough to keep you pretty good because people just were not watching their diets that closely, right? They weren't obsessing over the way that people do now. But that's enough to keep you there. If you wanna lose weight, the 16 pushes you up into it.

51:53Dr. Jason Fung:And you don't have to fast to lose weight. There's lots of different ways to lose weight. But like the quality of the food, the processing of the food, like there's so many other variables that you can attack. What about menstrual cycle? How does that show up? Yeah, the menstrual cycle is really interesting because it really gets to the fact that women, women can fast, first of all, right? So when you're talking about fasting, if you have body fat, as long as you're not in the very, very, very low sort of, if you're like sort of malnourished, then no, you shouldn't be fasting, right? That's obvious.

52:25Dr. Jason Fung:But for most people who are fasting, you want to time it within the cycle because there are certain sort of better times than others. So if you think about the first half of the cycle, so from menstruation to ovulation, that's probably your best time because estrogen is going up and estrogen is actually an appetite suppressant. So it's easier to fast. After ovulation, which is the midpoint of the cycle, then progesterone starts to go up and progesterone is an appetite stimulant. So if you track how women eat over the cycle, you'll see that there's a very distinct pattern. They actually eat less and less as they approach ovulation and then more and more.

53:06Dr. Jason Fung:So the thing is that if you're trying to fast during the latter half of the, like the second half of the cycle, you're going to be hungry. It's just going to be harder to do, right? So why do that? You want to fast, not the beginning, but sort of just before that ovulation period when you're going to be the least hungry, right? Well, I love science.

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56:13Dr. Jason Fung:What about somebody who is perimenopausal or menopausal? Yeah, perimenopausal is the biggest problem because estrogen, which is that sort of, you know, suppresses appetite, starts to go down. So the appetite starts to go up. And that's why perimenopause is actually the highest risk period for weight gain in women. Like you see this and perimenopausal women will tell you straight up, right? It's like, I used to be able to do this, but I haven't changed my diet. I haven't changed my exercise and I'm gaining weight. Yes, because of your hormones. It's not because you don't have willpower. Like, do you really think every woman that goes through this just loses willpower?

56:50Dr. Jason Fung:No, obviously not, right? So this whole idea of calories and willpower is clearly misguided. Because everybody has the same problem at the same time. Therefore, it must be a hormonal issue, right? The hormone in this case is the estrogen. So it's actually a problem anyway, because that's where you can say, okay, well, if that's the case, then maybe you have to fight it with some of these other things, right? Whether it's fasting or changing up some of the eating schedule or cutting out ultra-processed foods or that kind of thing.

57:19Dr. Michael Gervais:So let's say somebody that is menopausal or shouldering it and they're eating leafy vegetables, they're doing kind of the grilled salmon, they're doing their thing. Would you suggest intermittent fasting during this phase?

57:31Dr. Jason Fung:It can help. But again, because the estrogen is down, it's a little harder, right? And here is where the conditioned hunger is really, really important because it puts those sort of guardrails on. Because what happens with conditioned hunger, so this is that sort of social hunger, right? There's the physical hunger, which is homeostatic. There's the emotional hunger, which is the hedonic. And then this sort of social hunger, which is conditioned, right? If the environment around you doesn't allow you to eat, then you won't eat, even if you're hungry. And this was the experience of, you know, the seventies, right?

58:06Dr. Jason Fung:Because it was really frowned upon to do a lot of the stuff that we do today, right? You ate in the cafeteria at lunch, right? Nobody's like eating in their car. It's not takeout, right? You don't eat at your desk. You don't eat in front of the TV. Like that whole thing was like, no. And snacking's just not allowed. Like say you have a meeting, right? Or something in the middle of the afternoon. In the seventies, that's it. You're bored. Too bad. Get a little hungry, whatever, right? Too bad. You're stuck. Now what happens? You're in a meeting. Somebody orders a plate of cookies. You're not even hungry, but you're super bored.

58:41Dr. Jason Fung:So what do you do? You eat that cookie because you're not feeling very good about yourself because you're so bored. You want a little pick-me-ups. There's that hedonic hunger. The conditioned hunger is the social condition that allows you to eat in that meeting. So what do you do in that environment?

58:56Dr. Michael Gervais:Do you - Well, you have to change the environment. Yeah, do you ask people to not bring in cookies? I totally would.

59:01Dr. Jason Fung:If it was up to me, I'd be like, you know, we shouldn't be having food at the desk. We shouldn't be having candy bowls and thing. There's all meetings that are in the boardroom. There's no food in the boardrooms ever, right? Because this is the way it is. Because it's not fair to somebody who's trying to lose weight, right? Everybody thinks, oh, you're so mean, right? But it's like, no, I'm actually trying to be nice here. Because it's like, look, it's so unfair for you to put cookies in front of somebody who's trying to watch their weight or is perimenopausal, right? You're perimenopausal. You're in the boardroom.

59:36Dr. Jason Fung:You have nothing else to do. Your estrogen's down. So you're actually a little bit hungry too. You're hungry and you're bored and there's a plate of cookies. you've hit the homeostatic hunger, the hedonic hunger, the condition hunger. Guess what? You're eating that cookie. You can't stop eating that cookies, right? That's so unfair. Because I know that if I simply take those cookies away and said, this is not allowed, they would be so much healthier. They would appreciate it. What if it was a different snack? Oranges, apples, if it was mixed nuts or something like that. Yeah, you could do that.

1:00:05Dr. Jason Fung:But that only fixes one of the problems, right? That fixes your homeostatic hunger because it's obviously a much healthier snack, right? But it doesn't fix the conditioned hunger. You're still conditioning yourself to associate being in that meeting, being bored with eating. You don't want that. So the classic example of conditioning is like Pavlov's dog. So you take dogs, you give them food, they get hungry. You ring a bell and give them food. Soon they learn that when you ring a bell, they should get hungry. But now you're conditioning them, people, to be like boardroom, eat, boardroom, eat, boardroom, eat.

1:00:40Dr. Jason Fung:So you're not taking care of that. And you haven't taken care of the hedonic hunger because it's like, even if it's relatively healthy snack, right? There's no reason to eat it.

1:00:49Dr. Michael Gervais:What happens in the processing? We are talking about processing the way that you process calories. What happens between standing up and eating, eating at your desk or eating at the dinner table?

1:01:00Dr. Jason Fung:Really, it's the way you perceive it, right? It's the conditioning that's happening, right? So the dinner table is always a place that you associate with eating, but nowhere else, right? So if you simply stop eating at your desk or in the boardroom, then what you'll get is extinction, which is that by pairing the boardroom with not having food, you're going to be able to extinguish that sort of conditioned response. And so really you have to think sort of broadly in these terms of hunger because it's like there's a huge difference. So now the only place that you're stimulating that hunger is going to be in this very narrow condition of the kitchen table at dinnertime or lunchtime, right?

1:01:43Dr. Jason Fung:Or the cafeteria at lunchtime, right? Rather than hunger everywhere, in the car, at the table, everywhere, right? Got it. Okay.

1:01:50Dr. Michael Gervais:So you're more interested in the pairing, not the actual processing.

1:01:53Dr. Jason Fung:The processing makes a huge difference, actually, for different reasons.

1:01:57Dr. Michael Gervais:When you're standing, do you process the meal?

1:02:00Dr. Jason Fung:Not a huge amount. The only thing that makes a difference is walking after a meal really helps that insulin response.

1:02:06Dr. Michael Gervais:20 minutes, relatively vigorously.

1:02:08Dr. Jason Fung:You get up to about 30 minutes. So the effect almost disappears at about 30 minutes. So it's best if you... Prior to 30 minutes. Yeah, after the meal. So they've done these super interesting studies where they took people, and they give them sort of a meal and they make them walk, right? So it's like a 15 minute walk or something. So they have them walk before dinner and then give them dinner or they do dinner and then they walk. And what you find is that if you get people to walk immediately after dinner, you can again reduce the insulin response by a good 20, 30%, right? And then that slowly wanes.

1:02:43Dr. Jason Fung:So the longer you wait between eating and walking, the less and less you get. Then after about 30 minutes, you don't get any benefit in terms of the glucose insulin response. And I think it's because, again, it's one of these things that makes a lot of sense when you think about it, because it's like your body's essentially saying, hey, you're doing exercise. Let me leave some of this energy for you to use and not store it, right? Because normally you're going to store it. The insulin is telling you to store it. But by walking, what happens is that you're going to increase some of these counter-regulatory hormones, the ones that counter the insulin, which tells your body, hey, leave a little bit out here for us, right?

1:03:24Dr. Jason Fung:It's like, that makes a lot of sense. So when you think about it, it's like, oh, that's easy to do, especially here in California, because then it's like, make it a habit every day after dinner.

1:03:34Dr. Michael Gervais:Do you know if there's a difference in gender in those two, especially if somebody is paramenopausal or menopausal about eating afterwards?

1:03:40Dr. Jason Fung:I don't think there's a big difference from that for activity. For the insulin, it's the same? Yeah, that's about the same.

1:03:45Dr. Michael Gervais:And let's stay on the menopause one more turn here. Are GLPs and paramenopausal, is there an interesting, more interesting combination between those two at that phase, or do we not know yet?

1:03:58Dr. Jason Fung:I don't think we know yet. They're effective in both males and females because they work on the GLP-1 system, which is separate from the estrogen system, right? So even though your estrogen is going down, which is going to increase your hunger, the GLP, you can activate the GLP-1 system and still try and counteract that. Great.

1:04:14Dr. Michael Gervais:Good call out. And then what about diabetes and other diseases, type 2 diabetes, I should be more specific, and heart health and maybe cancer? And can you talk about some of the other reasons to get this to work at the insulin slash diabetes interaction via weight loss is kind of your premise. But are there other kind of alarming factors that you can point to?

1:04:36Dr. Jason Fung:Oh, completely. So if you think about the disease of too much insulin, you start with weight gain. So if you measure people who are overweight compared to normal weight, their insulin levels are much higher, which again makes sense, right? If you have more insulin, then you're getting the message to store more calories. And the way you store calories is body fat. So therefore, there's a clear distinction there. When it keeps going and going, then as insulin keeps going up and up, then a lot of people will get type two diabetes, which is sort of, that's why there's a link between the type two diabetes and obesity because they're really both diseases of too much insulin.

1:05:14Dr. Jason Fung:And then you get into this really interesting thing because insulin is not only a metabolic hormone, it's actually a very powerful growth hormone. And you can clearly link hyperinsulinemia, which is too much insulin, to a number of cancers. particularly colorectal cancer and breast cancer which are very important they're sort of the number two and three cancers that we deal with lung is number one but but falling so it was interesting because it wasn't until the year 2000 so relatively recently that most doctors accepted that hey obesity is actually associated with like 13 different types of cancer they're obesity associated cancers and really insulin plays a huge role in that because again if you think about it, you've got a disease where you've got all these cancer cells that are growing.

1:06:04Dr. Jason Fung:If you now sprinkleize and fertilize them with all this insulin, guess what's going to happen? It's going to grow because you've got all this insulin. And what does the insulin do to the cancer cells? Well, the cancer cells are going to use the insulin to suck in all this glucose so it can grow and grow and grow. So a lot of these diseases are related to hyperinsulinemia as well. If you look at a breast cancer cell, it has like six times the number of insulin receptors as a regular breast cell. So it loves the insulin. It loves the glucose. Oh my goodness. Yeah. So really important. And then diabetes itself increases your risk of heart disease, heart attacks, strokes, peripheral vascular disease, amputations, infections, you know, the whole gambit, right?

1:06:52Dr. Jason Fung:So it's like, it actually plays a huge role in almost every single one of these diseases that we face today.

1:06:58Dr. Michael Gervais:And are you putting more emphasis on getting the insulin dialed in or the downstream effect of the diabetic response?

1:07:06Dr. Jason Fung:They go hand in hand. Yeah. So it's a, it's a, it's the same thing. Yeah. They're, they're really, it's, it's the high insulin. That's the problem. And that's where say GLP-1s may be of benefit because they actually, because they work on the GLP-1 system to really cause, they cause nausea. They slow down your stomach so that you can't eat. When you can't eat, your insulin levels are going to fall. So it's one of the first drugs we have that really significantly drops insulin levels through a different pathway, right? Through the nausea, through GLP-1, through the hunger pathway, right? This is hunger and satiety pathway.

1:07:39Dr. Jason Fung:But the point is now we're seeing all these benefits, right? You hear that, oh, hey, it's preventing heart disease and it's preventing kidney disease. And we're finding all these benefits. And it's like, yeah, because finally you're using a drug that lowers your insulin

1:07:52Dr. Michael Gervais:But really what it's getting at, and that's what I was going to say, the insulin. So let's just round up a few things really quickly to be great with insulin. One, I'll work kind of backwards, but my memory is not going to serve me exactly properly here. And that's why I have you here to help me through this. One is if you want to be better with insulin after you eat, walk. Within 30 minutes, you know, I thought it was 20, but you said 30, but relatively vigorously. Like this is not just a casual walk. Like get out and walk a little bit. Yeah. Right. Okay. So that's one. Ultra-processed foods, reducing ultra-processed foods.

1:08:25Dr. Jason Fung:Full stop, that's the big one. That's actually my number one sort of golden rule of weight loss that I wrote about in The Hunger Code is get rid of the ultra-processed foods because they actually, again, they work on multiple levels, right? So they affect all three different types of hunger and they affect insulin in multiple ways. So one, they're very processed. So the absorption is very fast. You get this huge insulin spike. Give me a couple ultra-processed foods that are a little sneaky.

1:08:50Dr. Michael Gervais:I get that the, you know, Fruit Loops and like gummy bears. I get all those, right? Like, but what are some sneaky ones?

1:08:56Dr. Jason Fung:There's studies on what the most common ultra processed food and it's actually commercial white bread. So that's probably like, that's like 11 % of calories. Cereals is number two, but then the baked goods, but that's probably fairly well known, right? But commercial. Is sourdough the same? No. In fact, if you look at, this is interesting because if you look at bread, sourdough bread, for example, but it's made from a bakery or something. That's actually not considered an ultra processed food. I thought so, right. It's actually class three. So there's this NOVA classification where they have sort of unprocessed and then minimally processed and then ultra processed, right?

1:09:32Dr. Jason Fung:The ultra processed is very specific in that, you know, it's got all these chemical additives and stuff. So if you look at bread, it should have like three or four ingredients, right? Flour, sugar, water, maybe egg, right? And then you look at the commercial white bread. It's got like 15 ingredients, most of which you've never heard of, right? That's right. And it's like, well, think about the difference. Okay, if you get a commercial white bread, it stays soft for like a week. Like what happens to your sourdough loaf? Like that day after, it's like a raw because that's what it's supposed to do.

1:10:05Dr. Jason Fung:So you've got all these chemicals in the commercial white bread to keep it like that. But it's super soft, right? So there's no chewing. They've sort of created this sort of ultra process monster. but it's gonna cause way more insulin than you want. But it's also because you're getting these huge spikes, you're getting the extra dopamine, extra pleasure in eating it. So you're getting the hedonic hunger. And then because they're cheap and convenient and easily available, you can condition them everywhere, right? Everybody gets used to it. So it cuts across all three different types of hunger. That's great.

1:10:40Dr. Jason Fung:And not coincidentally, like American diet is like 70 % ultra processed foods. And if you look at other countries like Italy, I think Italy and Japan are fascinating comparisons because they're modern. They're very similar in terms of the technology and all that, right? But their obesity rates are like half of the Americans, right? But Italians love food, right? They're famous for it. They love food, but what don't they eat? Ultra processed foods, right? They're like 25, 30%, same as Japan, right? And the other interesting thing is that you take an Italian or a Japanese person and their risk of obesity in Italy or Japan is very low.

1:11:23Dr. Jason Fung:Now you plunk them down in like San Francisco or New York City, what happens? Their rate of obesity skyrockets, right? It just goes way up. Why? It's not the person, it's not the culture. It's the food environment you're surrounded with because the environment influences you in so many ways. What's acceptable, what, you know, the social sort of mores that you deal with. That's why social influencers are so important, right? And then the quality of the food, it's all ultra processed, right? And then it's like they get here, they go to Costco and they're like, oh wow, this stuff is so cheap, right?

1:12:01Dr. Jason Fung:Well, that's going to influence how much you eat, right? So the entire environment is sort of geared, all the ultra processed foods, but also all these sort of acceptable eating behaviors that we tolerate that they don't tolerate in a lot of other countries, right? Eating on the streets, for example, is not a big no-no in Japan, for example. But that means it's not an individual problem. It's a social problem. It's an environmental problem. So we need to acknowledge that and say, how are we going to change our environment or make our own food rules such that we're going to be able to counteract it?

1:12:36Dr. Jason Fung:It's so frustrating because obesity gets plugged into this sort of moral sort of lens because everybody thinks it's your fault, right? You didn't have any willpower, right? And it's like, that makes so little sense, right? And it's always there.

1:12:53Dr. Michael Gervais:But there is a choice that people do get to make. There is a choice. Unless you can't afford options. For the most part, there is choice. But I do think that many people are, I don't know, maybe uninterested. You know, I know our community is very interested in living a great life and that involves being really healthy and, you know, strong and mobile and all of the quote unquote amazing things that our human bodies can do and our minds can do. So our community is, but I do think that other people may not, are just not that interested.

1:13:23Dr. Jason Fung:I think it's that. I mean, you see it like, you know, if you go to, in California, there's all this emphasis on fresh local cuisine, right? It's true. I am contextually. Yeah, it's less, but in other places they don't. But, you know, even if you look at it from a, you know, a societal standpoint, like how much emphasis have we put on the processing, right? Almost none until this most recent like dietary guidelines, like, you know, a month ago. It was all about calories, all about lowering fat, lowering calories. So how much is it our fault?

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1:16:45Dr. Jason Fung:Well, I think you have to sort of take it all. You can't just say, no, this, right? Because that's obviously a strategy that doesn't work, right? If you say no to everything. But what you have to do is set the sort of scaffolding in place. So you can say, well, you have breakfast, lunch, and dinner and no snacks, for example. Snacks are an indulgence, right? And that's just taking you back to the 1970s, right? Eat normal foods, right? And that's the big push of this dietary guidelines. Like none of this stuff with a lot of chemicals. If it has all these chemicals, don't eat it. It's not good for you.

1:17:18Dr. Michael Gervais:I love it. What about things like, we're in Southern California, tortillas are in a lot of restaurants. Mexican food, tortillas, tortilla chips, flour, corn tortillas I'm asking about and chips. What

1:17:28Dr. Jason Fung:do you make of those? I mean, I think that depends. Stone ground is probably better. So again, it's the machine ground is very fine. So the processing is much higher. So therefore you absorb faster. So stone ground tortillas and stuff are probably a better choice. And it's not that you can't eat carbohydrates. There are ways to get around it, but don't eat them by itself. And this This was one of the big sort of things that got missed is that again, if you eat carbohydrates with other stuff, this is back to that sort of meat and veggie thing, right? So you're putting meat and veggies in it. You're not getting that super high rise.

1:18:02Dr. Jason Fung:In the sort of heyday of the low fat movement, I don't know if you remember, but it was all carbs, carbs, carbs. It was wild. All day long because -

1:18:11Dr. Michael Gervais:Protein, everything, low sugar or high sugar, low fat.

1:18:16Dr. Jason Fung:Low fat was the big, big, big thing, right? So you had the snack wells, you had all this stuff and it's all pure carbohydrate and pure refined carbohydrates. So you didn't have any fat, you didn't have any protein because there's those - Constantly hungry. Everybody was hungry all the time. And that's why people started to eat constantly. And this was the thing that was weird, right? So if you ate a breakfast of, you know, you have a three egg omelet, right? Lots of protein, fat and so on. You're full at least until lunch. You could have like a frappuccino and a muffin, same 800 calories. You're hungry like 10 minutes later.

1:18:52Dr. Jason Fung:Like I know I've had that before. You're hungry. Why? Because insulin spiked way up. You stored all those calories. Now your body's like, get me more.

1:19:00Dr. Michael Gervais:That's interesting. Ultra processed foods actually can come in the form of your coffee. I love tea.

1:19:06Dr. Jason Fung:Oh, me too.

1:19:06Dr. Michael Gervais:Hoolan greens, black teas. Like I'm super particular about my tea. The more exotic, the more interesting. And so I really appreciate tea. So I don't put anything in it. But I do see people that have plenty of like, is oat milk processed? It's quite processed.

1:19:19Dr. Jason Fung:I mean - So that's an ultra processed food? Yeah, because you're basically taking the oat, which is the whole food, and then changing it in a way that it's actually much easily absorbed. Is milk your got on their coffee?

1:19:31Dr. Michael Gervais:Would you say choose a milk versus an oat milk?

1:19:33Dr. Jason Fung:I'd go with the natural one. Because oat milk's not all that natural, right? Because it didn't really exist like more than a few, you know, 10 years ago. Same with almond milk? Like almond milk and nut milks are sort of half and half because some of them are more protein-y, right? Because of the nuts and stuff. So they're maybe not as bad, but they're still processed, right? So again, it's all sort of relative. I don't think you can ever go to 0 % ultra processed foods, but you're trying to come from 70, right? Yeah, that's really good. So if you can get to like 20, 25, 30, which is sort of what a lot of these other countries are at.

1:20:06Dr. Jason Fung:Like when I was in Italy, I was like surprised because everything's just different, right? It tastes different. Like the fruits are different, right?

1:20:14Dr. Michael Gervais:Three raviolis are actually quite satisfying as opposed to the 13 that we get here. Yeah, yeah. Listen, I've really appreciated the conversation. I loved your book. You're on it. You're speaking something that makes perfect sense from a logic and a science standpoint. And I thank you for introducing it to our community. Is there anything that you hope that we haven't covered that would be materially important that you would want people to understand to go live a little better in their own lives?

1:20:39Dr. Jason Fung:I think if you're really struggling with the weight loss, the main thing I would say is that understand that it's not your fault, right? It's not your fault that you were told that it's calories, calories, calories, and forget everything else, right? You get all this stuff, which is a calories, a calorie. It's like, no, there's tons of complexity and nuance to those calories. There's good calories and there are bad calories, right? All that means is that some foods are more fattening than other foods. Like, isn't that pure common sense? But that's not what we're taught. I know because I was taught that in medical school.

1:21:13Dr. Jason Fung:It's all calories. Don't worry about the rest. You could have ice cream for dinner. It's like, that's a terrible idea. You are not going to lose weight by having ice cream for dinner because of this other hungers, hedonic hunger, conditioned hunger, the rest of it. So understand that if you're trying to lose weight, you really have to dig in to what the hormones are, but also the root of the problem, which is the upstream sort of hunger, right? Because that's why you're eating. So if you don't understand the hunger and the more you know, the better you're going to do. The whole problem with this weight loss, which is everybody says eat fewer calories.

1:21:46Dr. Jason Fung:That's the whole answer, right? It's like, okay, but that means for every single problem that causes weight gain, it's the same answer. That's like the man with the hammer. Every problem is a nail, right? So if you don't get enough sleep, the answer is eat fewer calories. No, the answer is get proper sleep. If the answer is you're stressed and you're eating emotionally, the answer is eat fewer calories. No, the answer is deal with your emotions, right? If your problem is you eat too much ultra processed foods, the answer is not eat a few less ultra processed foods so that you eat less calories.

1:22:21Dr. Jason Fung:The answer is deal with the ultra processed foods, right? So there's so many different problems. It gets lumped in. But nobody talks about this stuff like a few people do, right? But for the most part, the establishment doesn't talk about this stuff. And they don't talk about it enough. They don't talk about the hormonal problem. And they don't talk about the hunger problem. Because I think it's a real issue. I mean, you know, psychology is actually a hugely important part of what drives behavior.

1:22:47Dr. Michael Gervais:100%. You know, one we didn't get to is statins. And so one of my colleagues is on a statin right now for a heart condition. And he's now pre-diabetic. Yeah. And this is something that takes place, right? Right. And so I don't know. I mean, that's, that's not, that's a real concern. So what general

1:23:05Dr. Jason Fung:guidance from my friend, somebody that you don't know. Yeah. Then you have to sort of, you have to push on some other levers because one of the studies that it's actually been flagged a long time, like over 15 years, it's always been flagged as a cause of diabetes. Right. And it turns out that now that people are really measuring GLP-1 is that, so Ozempic raises GLP-1, which increases the satiety, statins decrease GLP-1. So it's basically the opposite of Ozempic, which is going to make you diabetic as opposed to not make you diabetic, right? So Ozempic is used to treat diabetes. If you do the opposite, you're sort of creating diabetes, which is exactly what the statins do, because they actually can crush the GLP-1 to zero.

1:23:45Dr. Michael Gervais:So you're becoming, you're just interested in eating more. Is that why? Yeah, because it's - So there's a behavioral component.

1:23:52Dr. Jason Fung:It's a behavioral component because you're turning off the satiety signaling, right? So normally when you eat, you should be signaling GLP-1 and it's gonna tell you stop eating. But with the statin, it's not doing that because you've turned that off. So now you're eating and then you're like, I'm gonna keep eating because I'm still hungry, right? You haven't turned on the satiety signaling. So it turns out that's what's happening with the statins and that may be why. So yes, it ultimately comes down to you're eating more, but that's not what we're interested in. We're interested in why are you eating more?

1:24:23Dr. Jason Fung:Right.

1:24:23Dr. Michael Gervais:That's the real problem. Love it. Great. That's clean. I did not know that. Look, this is great. I felt like I talked to you for a long time because it's so intricate and you've made the big rocks clear. And my big takeaway from this conversation is, again, reminder, reduce ultra processed foods. And it's the subtle ones that I'm more interested in that kind of slip by me. So those and then really work the insulin to my advantage. Those are two big takeaways. OK, Doc, thank you so much. You are awesome. You're a real gift to our community. And your social media is really fun. So can you give your Instagram handle as well?

1:25:00Dr. Jason Fung:Yeah. So you can follow me on YouTube. That's Jason Fung. Or you can follow me on Twitter, Instagram. That's at Dr. Jason Fung. Well done. Appreciate you. Thank you so much.

1:25:12Dr. Michael Gervais:Next time on Finding Mastery, we're joined by Dr. Laurie Santos, Yale professor and host of the Happiness Lab, who created the most popular course in the university's history on the science of well-being. In this conversation, she unpacks a growing mental health crisis among young people where anxiety, depression, and burnout are rising and what it reveals about how all of us are chasing happiness. She explains why our minds are wired to compare in ways that make us feel worse and the simple shifts that can actually help us feel better. Join us Wednesday, April 15th at 9 a.m. Pacific only on Finding Mastery.

1:25:47All right.

1:25:48Dr. Michael Gervais:Thank you so much for diving into another episode of Finding Mastery with us. Our team loves creating this podcast and sharing these conversations with you. We really appreciate you being part of this community. And if you're enjoying the show, the easiest no-cost way to support is to hit the subscribe or follow button wherever you're listening. Also, if you haven't already, please consider dropping us a review on Apple or Spotify. We are incredibly grateful for the support and feedback. If you're looking for even more insights, we have a newsletter we send out every Wednesday. punch over to finding mastery.com slash newsletter to sign up.

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1:27:00Dr. Michael Gervais:Lastly, as a quick reminder, information in this podcast and from any material on the Finding Mastery website and social channels is for information purposes only. If you're looking for meaningful support, which we all need, one of the best things you can do is to talk to a licensed professional. So seek assistance from your health care providers. Again, a sincere thank you for listening. Until next episode, be well, think well, keep exploring.