Ep. 138 – Our Authentic Intuition: What It Can Teach Us About Fasting with Dr. Will Cole

We are excited to have Dr. Will Cole joining us as our guest for today. He is a leading functional-medicine expert who consults people around the world. Named one of the top 50 functional medicine and integrative doctors in the nation, Dr. Cole specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is very well-known as the bestselling author of Ketotarian, The Inflammation Spectrum, and his newly-released book, Intuitive Fasting, where he explains how to use the powerful benefits of flexible intermittent fasting to gain metabolic flexibility and find food peace. He is also hosting the new podcast, The Art of Being Well.

Dr. Cole has always been interested in health and wellness, even as a young kid. His parents were ahead of their time in terms of their approach to health and wellness. In the sixth or seventh grade, he was inspired by the book Patient Heal Thyself, where the author, Jordan Rubin, spoke about reversing his autoimmune condition with food. Dr. Cole’s interest in health eventually evolved into a desire to be formally trained. Be sure to listen in today to hear about his new book, Intuitive Fasting, and learn about how fasting will benefit your health beyond just losing weight.

“I really think that wellness should come from authentic intuition.”

Dr. Will Cole

IN THIS EPISODE YOU WILL LEARN:

• Dr. Cole discusses his background and how he created his powerful platform for his patients.
• Dr. Cole discusses what the impetus was for writing his book about intermittent fasting.
• Dr. Cole believes that wellness should come from our authentic intuition.
• Dr. Cole unpacks what metabolic flexibility means, and he explains why we should be concerned about it.
• Dr. Cole explains how much the mentality of fasting differs from that of counting calories.
• Dr. Cole explains why it is critical to eat for satiety and to align yourself with the intuitive eating approach.
• Ways to avoid eating too much fat when following the ketogenic diet.
• Dr. Cole talks about the anti-aging benefits of fasting.
• Why you need to find a sustainable way of eating where you can leverage all the benefits without doing too much too soon.
• How effective fasting differs for men and women.
• Dr. Cole discusses his personal dietary preferences.
• Dr. Cole shares his take on using bio-hacking tools.

Connect with Will Cole

On his Instagram

On his website

Connect with Cynthia Thurlow

• Follow on Twitter, Instagram & LinkedIn
• Check out Cynthia’s website 
• Check Out Dry Farm Wines: www.dryfarmwines.com/cynthiathurlow

About Everyday Wellness Podcast

Welcome to the Everyday Wellness podcast with Cynthia Thurlow! Cynthia is a mom of 2 boys, wife, nurse practitioner, and intermittent fasting and nutrition expert. She has over 20 years experience in emergency medicine and cardiology, but pivoted to focus on food as medicine. She loves to share science-backed practical information to improve your overall well being and is grateful to be interviewing leaders in the health and wellness field.  Her goal with Everyday Wellness is to help her listeners make simple changes to their everyday lives that will result in improved overall wellness and long term health.   

TRANSCRIPT

Presenter: This is Everyday Wellness, a podcast dedicated to helping you achieve your health and wellness goals, and provide practical strategies that you can use in your real life. And now, here’s your host, nurse practitioner, Cynthia Thurlow.

Cynthia: Well, today, I am really excited to have Dr. Will Cole. He’s a leading functional medicine expert who consults people around the world. He’s also been named one of the top 50 functional medicine and integrative doctors in the nation. He specializes in clinically investigating underlying factors of chronic disease, and customizing a functional medicine approach for thyroid issues, autoimmune issues, hormonal imbalances, digestive disorders, and brain problems. He’s very well known for his bestselling book, Ketotarian, and The Inflammation Spectrum, and the upcoming book Intuitive Fasting, which I’ve had the pleasure of reading myself, in which he shows how to use the powerful benefits of flexible intermittent fasting, to gain metabolic flexibility, and find food peace. He’s also hosting the new podcast, The Art of Being Well. Welcome, Dr. Cole. Such a pleasure to have you today.

Dr. Will: Thank you. Thank you so much for having me. I appreciate it.

Cynthia: Yeah. So, I would love for listeners to gain a better understanding. Did you go into medicine with the intention of really focusing on the nutrition piece or was that just a natural evolution of your practice? I find for myself, I was completely steeped in allopathic medicine for a long time, and then when I had a child with significant life-threatening food allergies that really caused me to pivot significantly, and to look at nutrition from a different lens, because that’s not how we are taught to think about food first. But I would love to get a little bit more about your background and how you’ve created this very powerful platform and voice for your patients.

Dr. Will: Thank you. Yeah, for me, I was always interested in health and wellness even as a young kid. I’ve realized in retrospect I was a strange kid.

Cynthia: [laughs]

Dr. Will: I liked going to the health food store. I was fascinated by it. I read a book, probably, I was maybe in seventh grade or something like that, maybe sixth grade. I read a book called Patient Heal Thyself from Jordan Rubin, and he reversed his autoimmune conditions with food. Then that evolved. My parents are interested in health and wellness, too. So, we’re talking about the 1980s and 1990s in the country, in Pennsylvania, like not Abbot Kinney in Venice, not New York City. My parents, in many ways were ahead of their time in that way. So, that was formative years for me, and then that evolved to wanting to be formally trained.

My schools have been California University of Health Science is more of an integrative medicine school. It has that bent, and we’re trained by all different modalities, MDs and DOs, and DCs, and acupuncturist, and Oriental Medicine doctors, and nurse practitioners, all teaching their craft. So, I was intentional with being trained with that vantage point. Then I had heard of a guy who had gone to my school, he was older than I was, but he was a graduate there. His name was Datis Kharrazian, and even today, he’s one of the early leaders in the space, and he was talking about this field of health care called functional medicine. So, that honed in even more targeted wise to really live and breathe functional medicine and resonated with me on a deep level.

Yeah, this make sense, and this is how I’m going to help people. I graduated. I was in Los Angeles, I went back to Pittsburgh, where I’m from, and then I’d be writing and speaking about this a long time ago, decades ago. Then there weren’t a lot of people talking about this field of healthcare. So, the whole telehealth thing happened just out of necessity. There’ll be people in different states and countries talking about that needed access to this because they heard me talking about it. So, we started one of the first functional medicine telehealth centers in the world. My day job remains the same from 8 AM to 6 PM. My focus is consulting people, like we’re talking right now. I just drop ship labs to them and provide that guidance. But yeah, it’s been born out of a passion of mine, and I have a family history of autoimmune conditions, and it’s interesting how things work together when you just are so focused, laser focused on something you’re passionate about.

Cynthia: Absolutely, and I think that there is this missing piece for traditional allopathic medicine. That’s how I was originally trained, and I wanted to do functional training, and I tell people all the time that we have to look at health and wellness from a different lens. We don’t wait for people to get disease. We want to be proactive about it, and from that, obviously, you’ve created several books, and so, what was the impetus for creating this intermittent fasting book. I know that obviously fasting is something that’s near and dear to my heart as well as many of the listeners. But for you, is this something you’ve been practicing over the last 10 years or is this something that you naturally came to fairly recently?

Dr. Will: Yeah. I’ve fasted in my own life since that I was saying in seventh or eighth grade. I was a young kid that would experiment with fasting definitely in high school more so. I learned about it younger, but I implemented more in high school. Yes, so for the past 20 some years, I’ve done fasting. It’s clinically, my entire clinical practice as well. This is really nothing new in functional medicine is something new, and it’s nothing new, really, in health and wellness world either. If anything, it’s just bringing it to the 21st century and a way that’s born completely Intuitive Fasting is 100% born out of my clinical practice. I’ve just seeing thousands and thousands of people over the years, and how to use intermittent fasting that makes sense sustainably, and also, the ethos behind. Hence, its name Intuitive Fasting, it’s this paradox on one level of how could fasting ever be intuitive?

The reality is this conversation that I’m having is, I really think that wellness should come off place from authentic intuition, not the nice sounding but an appealing intuitive eating that you’re in social media, because intuitive eating or doing anything with wellness intuitively, it sounds nice. But what’s the practical side of things? Because as I mentioned throughout the book, what’s really nice to say it, but what if you’re going through hormonal imbalances or chronic inflammatory problems, or you mentioned food reactivities, or blood sugar problems with their hungry, and struggling with insatiable cravings? Is it hungriness or is it intuition? Is it insatiable cravings or intuition? So, I want people to get to a place of true knowingness, a discernment on what your body loves and needs.

But let’s show up for our body and our health to get there. Because you have to create balance in the body or metabolic flexibility, which is a specific type of balance to actually have proper signaling pathways, to have proper satiety signals, to have lower inflammation. So, your body’s actually working synergistically to hear that resolute still small voice of your intuition. That’s what I wanted to bring about it. But to answer your– I guess, I went on a tangent there, but fasting itself was something that I’ve always integrated in both personally and professionally.

Cynthia: Well, I love that you’re way ahead of the curve on that as well, and I think sometimes, there’s this misnomer that fasting is new and novel, and I have to remind people all the time, this dates back to biblical times, and even before that, because if our bodies weren’t able to use fat as a fuel source, we would not have survived. There was a lot of food scarcity, there weren’t refrigerators and grocery stores that people could go to, or pantries that were plentiful, or food that could sit out without rotting for days and years on end. So, knowing that we’re getting back to as you state a more intuitive type of eating, when we largely as a culture have gotten to a point where we eat for comfort, we eat for lot of the wrong reasons, and so, I think of fasting intuitively for myself personally, but I know for many people, they’re really not familiarized with that concept.

But let’s unpack what metabolic flexibility is? Because we have a culture that is largely not metabolically flexible, and this is really a key concept for people to understand. When people make fun of intermittent fasting and I hear it all the time, people in starvation, you should just be counting calories, and we’ll unpack the calorie thing shortly. But what is metabolic flexibility and why should we be concerned about this and ensure that we’re on the right path?

Dr. Will: We have two main forms of fueling our body. We have sugar for fuel and fat for fuel. Most people are metabolically inflexible. They’re only sugar burning. They are not fat adapted, they’re hungry, their blood sugar’s all over the place, they have reactive hypoglycemia, but lay low blood sugar or super high blood sugar or volatility of both, and they have different various forms of inflammation, chronic inflammation levels and hormonal balance. I could go on and on. All of these are signs of metabolic inflexibility or metabolic rigidity.

Look, there’s various forms of them and varying forms of them. There’s the cleaner– theanalogy that he used in the book is kindling. Being a sugar burner only is like kindling on the fire. You’re going to get light, you’re going to get some flames and energy, but it’s going to be short lived. You have to keep putting kindling on, it’s going to burn out, the lights going to go out, your energy’s going to go out. So, there’s cleaner kindling. You’re talking about whole grains, and fruits, and starches, and lagoons. Those are all from Whole Foods. They’re cleaner kindling. But they’re kindling, nonetheless. They’re a better alternative than the refined carbohydrates in the junk food and the processed sugar, all that stuff. But there’s still both types of kindling.

The alternative is being keto adapted or fat adapted, and burning like a log on the fire. That’s burning fat for fuel. But as it’s to go further with that analogy, it’s more slow burning, it’s more sustainable, you’re going to feel better longer, you’re going to be able to go longer without eating food because your energy’s going longer. As its term implies, metabolic flexibility, it’s the ability to burn both. There’s a time and place to burn that clean kindling, and use the benefits of gift kindling. There’s a time and place for fat for fuel. I want the option for both and most people are stuck only in sugar burning mode. I want them to have the grace and the ability to burn both for energy. So, intermittent fasting is a great way to train the body.

The analogy that I use in the book is like a proverbial yoga class for your metabolism. If you’re metabolically inflexible, just like if you’re inflexible on a musculoskeletal standpoint, you show up to that yoga class, and you’re going to feel like, “Wow, I really suck at yoga. I can’t do anything for long, it’s really difficult, I didn’t know bodies could move in that way.” That’s the same way for many people’s metabolism. They show up to, even slight, in time restricted feeding slight intermittent fasting, like this is a natural, this is the antithesis of intuitive. Because you’re training your metabolism, you’re training your mitochondria, you’re training your blood sugar, you’re training everything to fuel your body in a different way. Just like with yoga, you just show up for that practice and be consistent.

Same way, with gentle, flexible, intermittent fasting, you have to show up. But when you start putting the log on the fire, and you’re past that metabolic purgatory of like, “Oh, my gosh, I’m in no man’s land. I don’t have all the sugar to depend on for the kindling, and I’m not fully fat adapted.” You keep the rhythm of consistency, then you’ll have metabolic flexibility. Metabolic flexibility is fertile ground for authentic intuitive eating. You actually will have proper signaling pathways. You’ll have proper gut brain access communication, you’ll have proper brain hormonal access, you’ll have proper cellular receptor site signaling, you’ll have proper insulin sensitivity, and leptin sensitivity, and ghrelin, and all of these hormones will be brought working appropriately.

That is where I want people to get to, because that will actually truly be intuitive eating, and it will truly be intuitive fasting, because you’ll be able to go longer without meals, not because you’re willing it or some arduous, punitive starvation or people like to judge intermittent fasting and say, call it disordered eating. It’s not that at all. It’s that you have a log on the fire. You’re eating when you’re hungry, and you can go longer without eating. So, it’s just normal human physiology if you allow your body to get there.

Cynthia: Well, I think we’ve gotten to a place in our culture where we are truly uncomfortable with the concept of being hungry. We have conditioned our bodies to be eating frequently. Snacks, mini meals, stoking our metabolism, I know, my gosh, that’s what I was taught in graduate school and undergrad that that’s what we should be telling our patients, and yet, it couldn’t be farther from the truth. In so many ways, we really have done such an enormous disservice, because hunger is a normal part of being a human being. I tell my kids, if you ignore it long enough, it’ll go away like it’s cyclical. So, that isn’t necessarily a negative thing to be connected to your hunger, to experience what that really feels like, because many of us don’t allow our bodies to ever burn off the fuel that we’ve consumed. So, we never connect with intuitive eating, intuitive fasting, intuitive hunger.

Let’s unpack one of the common misconceptions that I hear about fasting. The Broscience that’s out there, and sorry for anyone who gets offended by that term. But across social media, people tell me all the time, “Well, you just need to count your calories. Fasting isn’t any different than that.” So, let’s unpack, how fasting is very different than counting calories or that mentality that which is counting calories is just a unit of measurement. It’s not something that our bodies intuitively actually acknowledge. Our bodies actually interact with protein, and fat, and carbohydrates, and that’s what our body knows how to interact with. It’s not the calorie piece, which is this terribly common misconception that is propagated by a lot of individuals out there on social media and many health care providers.

Dr. Will: Yeah, absolutely. Side note, too. I do love your dog. It’s so cute. Is it a Goldendoodle?

Cynthia: I have two. I have a Labradoodle and a Goldendoodle. The Labradoodle’s behind me, he’s actually being quiet, but the Goldendoodle just got shuttled out of my room, because he tends to be naughty.

Dr. Will: [laughs] I have two Goldendoodles. They’re dog twins. It’s a sweet dog.

Cynthia: Yeah, there great dog.

Dr. Will: Great kind dogs. Anyway, so, it’s very easy to be overly reductionist when it comes to food, and reduce our body to this being a calculator. Our body is less of a calculator, more of a chemistry lab. The foods we eat or times of pause is the regulator of this beautiful biochemistry lab. It shifts everything of your biochemistry lab. Food is medicine and fasting is medicine. It is calories are a part of the puzzle, but it’s just one part of it. But when you hang your hat on that as being the end all be all as calories is king, well, that’s going to be missing out on lots of other components in other contexts to human health and weight loss or weight gain, or just health, and feeling great, and having optimal energy levels.

The foods we eat are actually raw materials to instruct our biochemistry, to instruct our gut microbiome, to instruct our blood sugar, instruct insulin, all the rest of our endocrine system, everything. So, a thousand calories of one thing versus thousand calories of another thing depending on its macronutrient structure is going to interplay instructor biochemistry in myriad of different ways, even though, those calorie amounts as units are the same. It’s part of the puzzle, but not the entire puzzle.

Chronic caloric restriction, meaning, chronically lowering your calories. Even it’s like a slight deficit of restricting calories in some way, is the antithesis of what research is really exploring with specific types of intermittent fasting, and more specifically, the type of intermittent fasting that I explore in Intuitive Fasting is time restricted feeding.

Actually, studies had to be done to see, “Okay, if you have the same amount of calories, and one group ate all day long that those amount of calories they spread it out, and the other group ate in specific eating windows, or time restricted feeding, or TRF, what’s the difference?” What researchers have sown in different journals, time and time again is that, you had positive markers, you had less inflammation, you had better blood sugar control, you had better insulin, cardio metabolic markers. I could go on and on. There’s so many health benefits to this.

There’s many other types of intermittent fasting as well beyond time restricted feeding, and then also have explored that, that there might be for the deeper time restricted feeding windows, a slight caloric deficit, because have you have less time to eat, you could be eating slightly less calories. But that’s not where the benefits lie, the main benefits. You might have some fringe benefits of slight caloric deficit, which has its own set of benefit, but we’re not talking about severely restricting calories. We’re talking about basically eating until satiety in a specific window. That’s really where researchers are exploring these benefits, because it’s the yin and the yang. It’s a time to eat and at time to break from eating. But we’re constantly as we’ve been talking about constantly eating, constantly snacking, eating late, and on top of that the quality of the food is largely inflammatory and disruptive to the gut microbiome, disruptive to insulin, our blood sugar, all the other stuff.

It is, yes, we have to look at food as medicine, but we also to use fine, what’s a break from eating food for our body? Can we leverage and amplify the benefits of that? Because eating requires a lot of energy, digesting requires a lot of energy. So, giving our body just flexible windows of a break from the eating does immense benefit to restore a lot of health benefits and restore proper pathways that are lying dormant for many people. I explore all these benefits in the book because it’s completely free to people can just lean into this, and it’s wonders what the body can do if we give it the time to do so.

Cynthia: I think it’s really important, and you touched on the concept of satiety. I think for so many people that are listening or have family members that really struggle in this area, they don’t eat for satiety. So, they’re never satisfied and it’s this endless desire for more food, more food, more food, and so, when I’m working with patients and talking to them about specific macronutrients largely protein and healthy fats first, and then deciding if they’re in a position to have non-starchy carbohydrates. I think that’s a concept that a lot of people are not familiarized with, and they don’t even make the association that certain types of foods use some of the inflammatory foods.

You’ve talked about the ones that dysregulate hormones in very negative ways that drive cravings are exactly these non-satiating foods that so many people are drawn to. I know, it’s always like the wet blanket when I’m teaching an intermittent fasting class, and I talk about, I really would like you to have whole food sources of carbohydrates, and so when we talk about examples. Squash, sweet potato, etc., versus breads and pastas, and my kids, I have teenage boys. Their metabolisms are like hummingbirds, and so, they can’t imagine that anyone out there can’t just eat these things, and trying to explain that, we really have to shift our perspective on eating foods for satiety because that is where the beauty lies.

I’ll give an example to the listeners that my biggest meal of the day is, typically, when I break my fast before this podcast and for me, it was I had essentially breakfast for lunch. It was bacon, and eggs, and I had some salad, and some other things like olives, and plenty of fats, plenty of protein, feel great. I am super full. There’s no way I could put one more morsel of food in my body, but if I just sat down and ate pizza or ate a big bowl of pasta, I am confident that I would still be craving more food, because you get this insulin response. So, let’s touch on satiety and this hormone piece, so that people really are very clear on why that is so critical, why we really want to eat for satiety, and align ourselves with this intuitive eating approach.

Dr. Will: Yeah, so, a lot of the research that has been done on different types of intermittent fasting and more specifically time restricted feeding, actually, showed you don’t have to change your diet much to see benefits. So, researchers had to look at that, because we need to know different types of fasting cannot stand on its own is, where does the benefit come from? From a research standpoint, it needs to be done that way, and it should be done that way to have the variables controlled as much as possible. But from a real-life standpoint, and this is my day job as you do, your day job, too, and we see this. It’s one thing to have intermittent fasting. And yes, is it going to move the needle in a positive direction? Yeah, because you’re going to give your body a break, and you’re going to get all the benefits that research shows. We know that. For most people, it’s going to move the needle.

There’s other studies that show, I should say this, and this comes up like, “Well, did you see that one study that showed, if you don’t change your fit and just did the fasting, it’s not going to change much?” Yeah, I think that’s the point of what I would really advocate for that for some people, you can’t fast your way out of a poor diet. Absolutely, you can get away with it, and some people are going to see benefits of it by just doing some time restricted feeding and not changing their diet. Studies have shown that, people– so, I’ve seen that clinically, too. But you can exponentially amplify the benefits of different types of intermittent fasting when you eat in a way that is congruent and symbiotic with the vast.

Eating healthy fats is really amazing way to leverage the benefits of the fast even when you’re not fasting. That’s why in many ways, if you look at the different pathways and how things are working in the body, a clean ketogenic diet, or even a clean low carb diet mimics in many ways fasting, because of its regulating effect on blood sugar and insulin, and if you’re talking about specifically the ketogenic diet, moderating protein, which modulates something called mTOR, which is a pathway that is one of some of the benefits of fasting. It elicits a very similar effect on the body as fasting. So, it mimics fasting. That’s why Intuitive Fasting, I paired a flexible intermittent fasting window with a clean keto diet or Ketotarian, which is the name of my first book. But in many ways, Intuitive Fasting is a continuing of the conversation.

You don’t need Ketotarian to read Intuitive Fasting, but it’s the two sides of the same coin, because the more fat adapted somebody is, the more keto adapted somebody is. The more they’re randomly just going to intermittent fast, and they may have never intermittent fasting in their life. But they start eating a clean keto diet like a mostly plant based clean ketogenic diet like Ketotarian, you’ll go longer without eating food because you have that log in the fire. But on the flip side, the more somebody intermittent fasts, the more fat adapted they’re going to be. But if you fuse them together, they’re so symbiotic because they’re both increasing fat adaptation, they’re both improving a lot of the same pathways, they’re both increasing nutritional ketosis, beta-hydroxybutyrate is that signaling molecule that works in both a ketogenic diet and intermittent fasting, that acts as researchers refer to it as a fourth macronutrient.

We have proteins, fats, carbs, and ketones. It’s not just a way to burn fat, which for people that have to lose weight. It will do that. But let’s just say you don’t have to lose weight. Beta-hydroxybutyrate is so much more than that. It actually is a great way to preserve lean muscle mass. You’ll actually hold on to muscle, you’ll gain good weight, if you’re don’t have enough good muscle, but it also is a signaling molecule, lowering inflammation, and increasing mitochondrial biogenesis, improving BDNF, brain derived neurotrophic factor actually making new neurons. I could go on and on. Both the ketogenic diet and intermittent fasting both do that.

Like you mentioned, when you break your fast having things like olives or people drizzling extra virgin olive oil, or having wild caught fish, or having coconut cream, or having avocados and avocado oil, having soaked nuts and seeds, all of these clean Ketotarian foods are very satiating. They’re very satiating, they’re very filling, but they also don’t have a negative effect on blood sugar and insulin either. They’re a great blood sugar stabilizing macronutrient and good group of foods as well beyond the fats, too, just from a phytonutrients standpoint, polyphenol standpoint, fibers standpoint, there’s a lot of benefits there.

Cynthia: I think, it’s really important for people to understand that you may align yourself with one nutritional philosophy at some point in your life. Two years ago, I had a prolonged hospitalization, rah-rah to the ruptured appendix. 13 days in the hospital came out and the only thing I tolerated was meat. So, I did largely carnivore for about nine months. I’m just finally getting back to being able to enjoy eating vegetables, and I’ve been wearing a CGM, a continuous glucose monitor for the last two months. Boy, has that been enlightening?

For me, my blood sugar loves for me to be more ketogenic. I’ve been low carb for a long time, but when I eat large portions of meat, which is what I was drawn to for a while, it’s amazing to see the net impact on my blood sugar, which it’s very, very humbling. It could also have something to do with the fact I’ve been intermittent fasting for a long time. I’m very metabolically flexible. It’s interesting to see that, if you’re eating lower carb or ketogenic for a period of time, when you reintroduce certain foods, you’re pushing yourself out of ketosis. So, really very interesting, and for full transparency, I think, it’s important for me to share with the listeners that I’m not rigid. I acknowledge the now my body is enjoying this ketogenic diet and doing it right. I think a lot of people and I’m sure, you could probably speak to this thing ketogenic diets mean, you can eat all the butter, and all the creamy one in the world, and it doesn’t matter.

I just remind people on like, it’s not copious amounts of fats. You’re going to eat more fats relative to protein, you’re going to be very low in carbohydrates. But if you do it wrong, I have clients who’ve gone overboard with nut butters, and cheese, and unlike all those things are delicious that keeping your portion sizes reasonable. Do you find that to be the case that sometimes people really get the portions of their ketogenic foods really off base and that can undermine their results?

Dr. Will: Totally. Yeah, there’s many potential pitfalls with doing it. I think going for Whole Foods as your base as much as you can, and these calorically dense foods like if you’re talking about, especially, if you have like your melting butter, or melting coconut oil, and having it in lots of coffees and teas, or if you’re drinking your calories in many ways. Yeah, and there’s other examples, too, within the ketogenic, even if you’re putting these fats that are needed. It’s very easy to especially at the beginning, where you probably, people don’t have the proper satiety signaling, either. The body’s still adjusting, and its many people can get into ketosis is this fourth macronutrient state without actually having copious amounts of healthy fats. It’s really the carb limitation.

While technically, it’s a high fat, moderate protein, low carbohydrate diet. Sometimes, people have to moderate their fat down a little bit and bring their protein up a little bit. Technically speaking, you could talk about gluconeogenesis and how it could impact ketone levels. But I find that most people don’t have to be super specific about that. If you want to talk about longevity, and protein moderation, and there’s a lot of benefits to that. But at the beginning, you’re right. It’s especially with these liquid fats and lots of calorically dense fats, they’re good, but until your body gets fully intuitive, sometimes people can overdo it. If you give people a reason to be like, you can have lots of cheese and butter, and it’s like all the things they were told they could ever have. I understand the psychology behind it of getting excited. But not everybody does well with a lot of these fats anyways.

That’s why Ketotarian is large. It’s dairy free. Other than ghee, there’s no dairy in it. Some people don’t do well with lots and lots of saturated fat. So, I think diversifying fat with a lot of these more plant based or wild caught fish, and grass-fed beef, too. Grass fed beef is not entirely– has taught lots of fats that aren’t saturated fat. So, let’s not reduce red meat to just saturated fats either. This intuitive fascinating has a lot more than just keto dairy and had because I wanted to open it up. If someone wants some grass-fed beef, have some organic pasture raised chicken and have that, I can open it up to make it easier for food choices that people don’t have to be entirely plant based or mostly plant based if they want to, because even as a functional medicine practitioner, I use carnivore and carnivore Jason protocols for people who do have food reactions or aren’t digesting foods properly. So, there’s context and space for all of these different protocols.

Cynthia: I know we’ve touched on some of the benefits of intermittent fasting, but I’d love for you to touch on some of the things related to anti-aging. There’s a lot of technical terms that I think would be beneficial for the listeners to understand a little bit more about. Just from the perspective of its beyond just yes, you can have some fat oxidation, you can have some fat loss, you’re satiated, you’re using ketones for fuel. But let’s pivot and talk a little bit about the anti-aging benefits, because I think for a lot of people, this is the sweet spot. This is what will continue them being focused and dedicated to the practice of fasting.

Dr. Will: Yeah, so an Intuitive Fasting, it’s a four-week flexible fasting plan. We go through these vacillating, ebbing, and flowing fasting windows, fasting and eating windows. So, each week is different. I highlight the benefits from the research in that specific week are based around those type of fast more or less. Week one, it’s a 12-12. It’s very easy, but I wanted a starting point, and were pairing that with a Ketotarian way of eating to work with metabolic flexibility, even when we’re eating. Week two is about a 14-18 week, 18 hour fast. So, 12 to 6 PM. Maybe what you’re doing today, it sounds like so around there. Then week three is an almost OMAD week, which is an acronym stands for one meal a day. That’s actually what I’m doing today, too. It’s about a 22-2 fasting to eating window, and then week four, we open it back up.

Again, we’re expanding and contracting, that’s fascinating windows. Again, that yoga class for your metabolism, and we’re playing around with macronutrients too, to either mimic fasting or not mimic fasting to have that flexibility and balance to the kindling on the fire and the log on the fire. You will have both. So, the longevity benefits, I really highlight in that week three and there are a new week. That’s what I’m doing actually today of fasting. So it’s an almost OMAD week. So, those deeper fasts, and then anything beyond on OMAD, too. So, I would say OMAD and beyond which we don’t expand like, we’re not talking about multiple day water fast and Intuitive Fasting, but I would say anywhere from OMAD on to multiple day fasts, you really can get into the longevity benefits, and there are other ways to do it as well.

If you look about the Ketotarian diet, the way that Ketotarian is, it does mimic fasting, and you can get some of the longevity benefits of that as well. But talking about more specifically the upregulation the deeper ketosis, the increase of autophagy, or cellular recycling, cellular renewal, our body’s own anti-aging, cellular renewal pathway, and all our healthy cells are gobbling up all the dysfunctional cell, that is one of the longevity benefits, anti-aging benefits to support that in these deeper fasts, and also increasing stem cells or tissue regeneration, we’re increasing deeper mitochondrial biogenesis actually making new mitochondria, and we’re increasing anti-inflammatory pathways too, which is really, inflammation is anathema to longevity.

In lowering things like NF-kappaB and the COX-2 pathway, and something called the NLRP3 Inflammasome, all these pro-inflammatory cytokines that you don’t want super high for longevity, they will shorten your lifespan. So, that lowers that and up regulates these deeper fasting, and moderate fast increase something these pro-antioxidant pathways which we need for health and longevity, like the AMPK pathway, and the NRF-2 pathway. But the reason why in week three, I call it an almost OMAD versus a more traditional OMAD of 24-1 fasting the eating window is, there’s some studies that show that eating in such a condensed window doesn’t work for everybody. It works probably for some people, and that’s fine. But some people with a lot of calories to get in such a short period of time that it can create, it activates and up regulates something called the PKR pathway, which increases something called metaflammation is what the researchers referred to it, which is just another way of saying systemic inflammation, which you don’t want.

I want that when the eating window to be congruent and work with the fast, so by opening it up to an almost OMAD fast to 20 to 22, you’ve fast and then whatever corresponding eating window that allows for more time to eat food. But you’re still getting the benefits of those deeper fasts. So, I recommend in the book to break the fast with gentle foods and not having tons of raw foods as soon as you are breaking your fast. The break the fast meal section includes a lot of soups and stews, things that are really good for the gut because the villi of the gut are going to be slightly blunted, cortisol is going to be slightly elevated coming out of your fast, that’s a good thing. That’s a hormetic effect that good stress, just like working out raises cortisol too.

Again, that yoga class, it’s a good thing to be there, but you want to meet your body where it’s at then, and have something gentle, almost like pre-digested with lots of cook soups and stews, or at least something cooked in soft to lean and transition your body out of the fast into that eating window. Then after about an hour or so, an hour and a half, after that break the fast meal, you can have your regular meal. That’s what I want people to do every other day. So, there’s a non-consecutive almost OMAD fasts. You go almost OMAD then you have a normal 12-12 eating within 12-hour period, and then almost OMAD 12-12. So, it’s those deeper fasts that I’m really exploring the longevity benefits and the anti-aging benefits. It’s really exciting.

But people need to be consistent with it. I want people to cycle through these as much as they can like once a month, take a week and do those almost OMAD weeks. That’s a great way to support these longevity benefits.

Cynthia: I think, it’s really important I remind my own patients and clients all the time that much like we don’t eat the same foods every day, we don’t do the same exercise every single day, it’s really important to get some variety. We know we’re flexing those fasting muscles, if you will, and I love that you touched on the fact that, bio individuality rules that for so many of us, I don’t do well with trying to eat all my days macros in an hour, and I end up feeling like miserably stuffed. So, I love that there are some flexibility surrounding how you define that, and I love on social media, when I see these huge weightlifters, they are doing OMAD, and they only like 3,000 calories in a sitting and I’m looking at their meals going, how is that possible? Obviously, they’re probably two or three times my size, and they’re obviously men. Very, very different, but I do find that women can sometimes struggle a bit in terms of trying to consume all their days macros in one sitting.

Dr. Will: Yeah, I agree with that. Opening up a bit, you still can leverage the benefits then. It’s not all or nothing. I think you can get these amazing benefits without feeling like you have to do it this one way, because really, the best way for these principles are, is the way that it’s sustainable for you. What’s it going to be if it’s a miserable source of dread or it’s unsustainable? That’s not going to serve you in the long run. So, let’s find a way that’s sustainable, where you can leverage these benefits without doing too much too soon in a way that doesn’t work for your body.

Cynthia: Do you see a lot of gender differences between your male and female patients in terms of how you tackle the concept of intermittent fasting? Are you someone that encourages women to change their fasting habits around their menstrual cycle or women that are in menopause?

Dr. Will: This is a big conversation in the book as you know. It’s just because we get that question a lot. We, in the health world, anybody that talks about fasting is, I heard that fasting isn’t good for women. [laughs] It’s very going back to that reductionist concept. Not all women are the same. I know that’s like earth shattering news to some people, but to produce women is like, this is good for women, and this is bad for women and that make these blanket statements. Well, who are we talking about? Who is she? Is she struggling with PCOS, that is polycystic ovarian syndrome? Is she struggling with metabolic syndrome, insulin resistance, weight loss resistance, inflammation, neurological issues? She’s going to respond to deeper fasts in moderate interment fast completely different than somebody with that’s thinner or lean, that maybe has sluggish thyroid, maybe she’s going through a chronic stress time of season of her life, and she’s not sleeping well.

But all women, are going to produce a completely different outcome. Then, of course, is that, is she cycling or not cycling, too, that’s plays a part of it as well. Absolutely, women tend to have higher levels of kisspeptin, which is a signaling molecule that makes most women, not all women, more sensitive to times of fasting and the ketogenic diet, which is mimicking fasting. So, it doesn’t mean that you throw the baby out with the bathwater and just say, “Well, it’s fasting is bad for women.” But no, it’s how are you using it? It’s just like working out. You’re doing the wrong workout for your body. If you’ve never worked out a day in your life, you show up to the gym and do tons of workout, and you feel horrible, it doesn’t mean workout’s bad, and you can’t say, “Well, gym is not for me,” but that’s what people say about the fasting. Fasting is not for me. How did you do it?

In both fasting and workout, going with that analogy, they’re both hormetic effects. They’re both types of hormesis, good stress. A lot of the same pathways there.

Let’s not be all or nothing about something, but context matters here as with lots of different things in life. I think it’s a matter of how you’re doing it and meet your body where it’s at. That’s where the magic happens. It’s not saying all or nothing and being super tribal about it. But women do better, especially, if they’re cycling, if they have a menstrual cycle to be lighter around their period like you mentioned, or around ovulation, they’re not really fasting that day, or they’re doing a 12-12, which is very easy. It’s basically eating your calories between 8 AM to 8 PM. Basically, all day, or 7 AM to 7 PM. You’re fasting through the night when you’re sleeping until you break the fast at breakfast.

I find that a lot of women do better with that. But still the rest of the month, they’re leveraging the amazing benefits of fasting on the other days. So, they’re just being strategic, or they’ll do it around heavy workout, or they’ll do it whenever they want to. They’ll do it weekly. They’ll do like three to five days in deeper fasts, moderate fast, and then the other days, they’re loosening up. That’s that grace and the lightness and the flexibility, that’s the intuition that I want people to find for themselves, because and let me just say this. What worked for you today in this season of your life isn’t necessarily what you’re going to be have to do forever and ever, depending on all the other variables that there’s so many variables externally what you’re going through stress wise, or preference, or your work schedule of so many things. Let there be an art to this, and don’t be so strict on one thing for or against.

Cynthia: Oh, you’re so incredibly aligned with my whole mindset and philosophy about fasting. It’s delightful as opposed to being really rigid. I think there’s so much rigidity, and a lot of the women that will crash and burn that end up on my doorstep and are desperate to do fasting, it’s because they’re so rigid. They’ll say to themselves, “I’m supposed to fast 18 hours today, and I’m going to fast for those 18 hours whether or not it kills me, I’m dizzy, I’m weak, I feel miserable.” So, trying to force an outcome is never beneficial for our bodies. So, I’m curious at this point in time, where is your and these are some of the questions I got on social media. I knew that your background is plant-based keto, or is that more aligned with where you are right now, or are you just like, what you advocate for your patients? Are you flexible with yourself depending on what your body is drawn to?

Dr. Will: There’s two different levels to– Ketotarian was my personal journey, really. Then clinically, for my patients, it’s whatever makes the most sense clinically, I have no agenda other than getting them healthy. I don’t have any dogma when it comes to this. So, it’s like, what clinically gets them better? What’s their preference? What do they enjoy? Because if you have the same food protocol, same similar labs with a one person loves what they’re doing, the other person hates what they’re doing, it’s going to produce a completely different outcome. They’re stressed around food produce completely different outcome. So, it’s about clinically what’s relevant, and then it’s understanding where they’re at headspace wise, what they’re up for, and then what’s their personal preference for these things. Because that’s the science and the art of what we do.

So, I don’t like, clinically I have patients doing all different types of things based on all those factors. So, that’s how I feel as a functional medicine practitioner with my patients. Personally, I prefer being more plant based most. Like the cover of the book says, ‘mostly plant based.’ It’s not entirely plant based. I have grass-fed beef, I have wild caught fish, I have lots of plant based and non-plant-based foods. But still my center I prefer like fresh avocado with avocado fries or a piece of bacon. That’s just my preference. But there’s a place for grass-fed bacon, too. If you want to go there, but there’s a flexibility there. Some days are different than others, too. I want people to have that same rhythm with their body where they don’t feel so tribal. They can’t even hear that voice of their intuition, because their egos in the way or because they’re shamed in the way, or because their obsessions in the way. All these things that can distract ourselves from what our body actually needs at this time.

Cynthia: Do you use any biohacking tools in your practice like a continuous glucose monitor or Lumen? There’s so many of these devices that are out there that I have been tinkering with myself that I find really– Because on many levels, it’s very reaffirming. Because in many ways, it’s showing me that for my N of 1, me, as an individual has been very validating, and for many clients, they like having the data. Is that part of what you do with your clients, or you solely focused on just the intuition piece of really validating how they feel in terms of what they’re doing with physical activity, and lifestyle, and nutrition, and other parameters?

Dr. Will: It depends on the person and depends on the case. So, back to that science and the art side of things. Sometimes, it makes sense clinically to be specific on tracking macros, or tracking sleep, tracking an Oura Ring, or something like this, or the Lumen, or using these amazing technologies, or even testing ketones, for example. Testing a ketone strip or getting a breath meter. Sometimes, that’s needed, sometimes, it’s not. But it’s not only what’s clinically relevant. Sometimes, it’s like, is this going to stress this person out more than they’re like stressing about not stressing, [laughs] or they’re like stressing about not sleeping, and this stress of brown sleep is keeping up at night? So, the science is great, and we need to use it, but we need to use it to our benefit.

If the science is messing up the art, you have to pull back on the science and say, “Okay, this isn’t serving you as is like the opposite of what we want out of this. So, let’s just keep it simple. We’ll give you some general guidelines,” because sometimes, you have all this amazing information. We in healthcare and these conversations in labs and technology, and we have amazing information. But it’s too big for the vessel to contain it, too. Meaning, it’s just too much for this person where they’re ad space wise. So, you have to meet them where they’re at and say, “Okay, let’s drip these things in where they’re at to better their life, to enhance the quality of life, where they enjoy these things, and not stress about it.” Because stressing about it, you can’t stress your way into health. It’s not going to work.

That’s really my thought on it. But if patients are that type of personality where they really love the biohacking, it stuff encourages them, and they could see their own N of 1 experiment over the course of the weeks. Obviously, we’re running bigger labs every couple of months. But the small day to day, is this working for me beyond how I’m feeling subjectively? It works for some people. I feel like there’s different types of people and they can use these in a way that serves them. We’ve used continuous glucose monitor, CGM. We’ve used Oura Ring data for many patients. We still do for all these for certain people. Lumen, I haven’t tried it yet. They sent me one recently. They’ve sent to me actually last week, but I haven’t tried it yet. Have you used Lumen?

Cynthia: I have. I guess the reason why I’m asking and I’ve been open about this with listeners. In September, my thyroid medication was pulled off the market. So, there were thousands and thousands of patients out there, myself included that we’re left in abyss and my functional medicine doc put me on compounded T4, T3, which made me [crosstalk] thyroid, and then I got put on Armour Thyroid, which didn’t agree with me. So, now, I’m on my third variation. The one I think is working, but all the way along, I was trending my Lumen data, and my CGM, and that really was very helpful in the context of the conversations that I was having with my functional medicine group saying, “Listen, I’m normally fat burning, I’m not burning fat at all. Here’s all this data,” and they’re like, “Oh, my gosh. You’re becoming a little bit insulin resistant.” All the things that should not be happening.

This all was because of a medication switched in September. It’s taken four months to get back to where it was. But the reason why I was even mentioning it. First of all, people ask questions. They were curious if you use those devices. But particularly relevant to Lumen for me, it’s completely aligned with my CGM data, my fasting schedule, my stress management, and so I’m actually interviewing the co-inventor of Lumen this week, and I’m excited to talk to him about what N of 1, which has really been surprising. I went into it with skepticism, which is my normal mindset. Show me the data, maybe look at it, let me see if I can really get it. This is really useful for someone like myself that’s already metabolically flexible. So, my N of 1 experience has been pretty phenomenal because it allowed my functional medicine group to take what I was saying pretty seriously. I was like, I know sounds crazy. [giggles]

Dr. Will: Yeah, well tell them thank you for sending me the kit. I haven’t tried it yet, but I’ll try it soon.

Cynthia: Oh, good. So, what’s next? You’ve got this book, you’ve got a new podcast, what else is new for you that’s going on? I know, we’re still in pandemic, hopefully [crosstalk] At some point in 2021, that will shift and change. What else are you going to be doing?

Dr. Will: For me, it’s just my focus calling is really my patients. I really enjoy. I’m so thankful, we were always done telehealth. So, for us, it was like there was no transition for COVID. It was this complete– Sometimes, people would drive in or fly in for their first consult because they wanted that face-to-face in person experience. It’s the only thing that’s changed. That was just an option for some people, and I was like, “We’re not doing that.” But I’m excited for the year to really focus on that. Having conversations about Intuitive Fasting, the podcast is really exciting. Having conversations through a functional medicine lens on different health and wellness topics, that’s The Art of Being Well. That’s really basically it.

I have two kids. I have a 14- and 11-year-old. I have two Goldendoodles I told you about, lovely wife. So, I don’t know. I want this year to be more normal like this better than 2020 for many people. Not so much for me. I know I live in my weird little bubble where I just to talk to people online, and I live a pretty simple life in the middle of nowhere. But a lot of people’s lives are turned upside down. So, my hope for everybody is just it goes a little bit more normal. But maybe a better normal because I think that the silver linings that many people have learned over the past year, over last year, hopefully, we can keep that in a better stronger way of appreciating things and not taking things for granted, and slowing down, and being more efficient with many things, too. So, that’s same stuff for me and not much is going to change this next year. Hopefully, it’s going to more what I love to do but that’s it. Yeah.

Cynthia: Well, great. So, let the listeners know how they can connect with you, how they can purchase your book, what is the best way or on social media, your website?

Dr. Will: Yeah.

Cynthia: You’ve very active Instagram channel I’ve been following you there.

Dr. Will: Thanks. Yeah, everything’s at drwillcole.com. That’s D-R-W-I-L-L-C-O-L-E. But yeah on Instagram @drwillcole, and they can get this tons of free resources on drwillcole.com. I write articles all the time, and you can order the book, Intuitive Fasting, all the other books, too. We offer a free webcam or phone health evaluation if people want to get a functional medicine perspective on their case and see if a consult with me is right for them. That’s everything’s at drwillcole.com.

Cynthia: Awesome. Well, thank you so much for your time today. It’s really been a pleasure connecting with you and I look forward to continuing to follow what you’re doing.

Dr. Will: Yes, likewise. Thank you.

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