How To Be WellnStrong

70: How to Use Intermittent Fasting to Boost Energy, Improve Cognitive Functioning, and Promote Metabolic Health | Cynthia Thurlow, NP

• Jacqueline Genova • Episode 70

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Food plays a remarkable role in healing, but the timing of when we eat or abstain can significantly affect our health as well. Fasting serves as a powerful tool to support longevity. It not only triggers the activation of anti-aging genes but also strengthens the immune system by repairing damaged DNA and eliminating compromised cells. Fasting has also been shown to enhance metabolic flexibility, sharpen mental focus, and support consistent energy levels.

Today I'm joined by Cynthia Thurlow, NP, the CEO and founder of the Everyday Wellness Project, and international speaker, with over 10 million views for her second TEDx talk (Intermittent Fasting: Transformational Technique). With over 20 years of experience in health and wellness, Cynthia is a globally recognized expert in intermittent fasting and nutritional health, and has been featured on ABC, FOX5, and Entrepreneur among others. Cynthia hosts the Everyday Wellness podcast, considered one of "21 Podcasts To Expand Your Mind in 2021” by Business Insider. Her mission is to educate women on the benefits of intermittent fasting and overall holistic health and wellness, so they feel empowered to live their most optimal lives. In this episode, Cynthia and I discuss the benefits of intermittent fasting – from longevity to metabolic health to cognitive functioning, how to fast correctly, who should & shouldn’t be fasting, the optimal meal to break a fast, and so much more.

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*Unedited Transcript*
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Jacqueline: [00:00:00] Well, just to kick things off, Cynthia. So I'm really excited to connect with you. I saw your Ted talk and then just dove into all of your work. You are the intermittent fasting expert. This is a topic I write a lot about. I share a lot about it, but I haven't actually yet had a podcast episode dedicated to it.

So really excited to have you on and thank you so much for your time.

Cynthia: Absolutely. It's my honor.

Jacqueline: So, let's just start off with the basics. I feel like intermittent fasting is, is thrown around a lot. For folks who've never heard of this term before, what is it and how does it differ from like time restricted eating, if so?

Cynthia: Yeah. So when I think about when I talk to patients or talk to clients about intermittent fasting, it's as simple as saying eating less often. There's tremendous flexibility when we speak about intermittent fasting. And really when I think about how that differentiates from time restricted eating, I think of them as being like kissing cousins.

They're very similar. There's a time in which you eat. And there's a time in which you do not eat. It is that simple. [00:01:00] And you know, the average American consumes a sugar sweetened beverage or food 10 to 15 times a day. So that is the average person. And what we are recommending when someone is either eating less often intermittent fasting or using time restricted eating as a strategy, and that's really as simply as what it is, it's helping them understand, like you are going to decide for yourself.

when you start eating and when you end eating. So I'll give you an example. When someone has gotten into a rhythm with intermittent fasting, they may do a 16, eight, which means 16 hours fast within an eight hour feeding window. And in that feeding window, you should be able to consume two to three meals.

Now for younger women like yourself, I am of the belief system. There's a time in your menstrual cycle when you should fast. And there's a time in which you should not women at my stage of life and perimenopause and menopause. Things get a little bit more complicated, but it doesn't mean that it's in your incapable of doing it.

And then looking at gender differences, men seem to have the [00:02:00] easiest time with intermittent fasting because they're not dealing with the cyclic rhythms of sex hormones. So again, kind of getting back to that distinction that we were initially talking about, intermittent fasting is simply eating less often and then deciding for yourself and your lifestyle, what makes the most sense.

Intermittent fasting is not about rigidity. It is not about restriction. It is not this negative perspective as it pertains to nutrition because we never want the, uh, the kind of implied philosophy around intermittent fasting to be, don't nourish your body. But we know that most Americans, about 93 percent of Americans are not metabolically healthy.

And so most people listening to this podcast could benefit from eating less often and that eating less often might just be 12 hours of digestive rest versus 16, 18, 20 hours fasted. So I think so many things depend on what strategy utilize and when. And I think when it comes to women, as I always say, [00:03:00] we are not many men.

It is a little bit more complicated, but not in a bad way. We have to lean into our physiology. Not apologize for it and just be aware of the cues and signs our body are giving us to help us understand What is or is not working?

Jacqueline: Yeah, that was a very helpful breakdown. And you mentioned metabolic health. So when it comes to the actual physiology, what are the benefits of intermittent fasting? Why would someone want to do this?

Cynthia: Well, I think a lot of women in particular come to intermittent fasting because they want to lose weight, right? We have this very kind of toxic prevailing diet culture Um, I certainly grew up in the days where Weight Watchers and Jenny Craig were huge and we would, you know, eat these processed foods and, you know, undernourish our bodies and be starving all the time and we had bastardized fats.

But when I think about the true intrinsic benefits, I think many people want to focus on changes in body composition and I get it, like that can be a primary focus for a lot of individuals. But I also think about [00:04:00] changes in biophysical markers, so improvement in. Blood sugar, blood pressure, lipids. I think about the whole concept of digestive rest.

You know, a lot of people deal with a tremendous amount of bloating, constipation, diarrhea, giving them opportunities to get a hold of digestion in their bodies. Um, I also think about things as simple as just having a reduction in inflammation. You're not eating as often reduction in inflammation, oxidative stress.

I think a tremendously about, you know, just the basic, when we talk about metabolic flexibility, we're really speaking to. allowing our bodies to utilize different types of fuel to fuel our bodies. So when we talk about the 93 percent of Americans that are not metabolically healthy, it is largely because they never, it's almost like the analogy I like to use is, um, topping off a gas tank.

So my dad was famous for this. He would get a quarter, you know, get a quarter tank down and he would want to fill up the tank again. Well, in many instances, when we are eating 10, 12, [00:05:00] 14 times a day, we're never allowing our bodies to get to a point where we're going in and using stored fat as a fuel source.

So for those 93 percent of Americans who can't lose weight, who deal with energy crashes, who are grumpy when they get hungry, those are individuals that are very likely only using one fuel source to fuel their bodies. And that is stored glycogen. Now we want to be able to also use stored fat. And so intermittent fasting can be a vehicle.

For allowing us to become much more efficient and utilizing different types of energy. And let me be clear. We want to be efficient. We don't want to be just burning carbs. We want to be able to burn fats. And if we are able to effectively burn enough fatty acids, you know, the important thing is. the piece about benefits includes mental clarity.

So if we are utilizing stored fats as a fuel source, we can diffuse some of these fatty acids and stimulate beta hydroxybutyrate, which is this, um, ketone in the brain that gives us a lot of mental clarity. Uh, can [00:06:00] make us feel like, you know, our brains get turned on. And that oftentimes turns into being the most powerful benefit of intermittent fasting is people feel like their brain is laser focused.

They don't have brain fog. They aren't getting sleepy. So I would tie that in neurocognitive improvement. So reducing our likelihood of developing Alzheimer's, dementia, Parkinson's, um, a lot of these things that are entirely preventable if we are healthy from a metabolic health perspective. The other thing that I think about is how many women deal with fertility issues.

They deal with PCOS, polycystic ovarian syndrome, which is the number one endocrine disorder in the United States. It is not just a rarity and PCOS. So maybe clear is not something that we just see in obese or overweight women. I think they'll understand like you can literally improve your metrics around fertility, um, and that includes PCOS, which as I mentioned, is this number one endocrine disorder [00:07:00] that we see in young women and can carry through into middle age as well.

It is not just a young woman's disorder. It can be. A disorder that women deal with for many, many years. So those are some of the things that I think are the real high points, and it goes beyond that as well. You know, neuroinflammation, you know, we talk about if you have leaky gut, you've got a leaky brain.

Jacqueline: Mm hmm.

Cynthia: this is the 

Jacqueline: I see a tail. 

Cynthia: yes. This, this is, this is the puppy. I was like, he just came over. He's been licking my feet, i's like trying not to laugh. Um, but those are the things I think most people. A lot of people really focus in on, but mental clarity and changes in body composition seem to be the ones that people really are most interested in.

Jacqueline: Yeah, so interesting. I personally try to schedule all of my podcast interviews in the morning when I'm in a fasted state because I find that that like You said is when I feel them as sharp and clear and also to in terms of longevity I've also read a lot of research about intermittent fasting and longevity because we hear this term autophagy, right?

That kind of kicks in when we're in a fasted [00:08:00] state What is the research around that? You

Cynthia: Yeah, so autophagy, just to kind of define the term, autophagy is this waste and recycling process that goes on in the body. So in an unfed state, and I think it's a common misconception that when you don't eat for you have evoked autophagy. Um, it really, it's the longer, the fast, the more autophagy and really the research shows 18, 20, 24 hours is when you get that uptick in autophagy and why this is important is that we have mitochondria and other types of organelles in our body that, Over time, and especially for people north of 40, uh, mitochondrial dysfunction is at the basis of nearly every chronic disease state you can imagine.

And so, just by virtue of the aging process, we are, you know, we get to a point where there's more and more diseased, disordered organelles that have the potential to go on and create disease, cancer, etc. So, What does the research show about autophagy? Um, number one, we think that a lot [00:09:00] of the wayward, the wayward expansiveness of cancer diagnoses that we're seeing here in the United States can be explained in a number of different ways.

Some of it's epigenetics. Some of it is the way we live a lifestyle, you know, just not being metabolically healthy because cancer cells don't use autophagy. oxygen, they are able to reproduce with this process of glycolysis. And if you understand that cancer cells proliferate in different ways, it helps you understand why it is so important to just be as optimally attuned.

So when I think about taking the, the current research that's done, and a lot of the research done on intermittent fasting is done on animal models. It's done in vivo in vitro. A lot of times, oftentimes on men and menopausal obese women. There's not a lot of research on younger women. There's not even a lot of research in general on women in, uh, I mean that's improving, but women's menstrual cycles make things complicated for researchers.

And so for that [00:10:00] reason, uh, they prefer to do. experiments on animal models where they can control a lot of variables and animals in the lab do not have lifespan of humans. So when we're extrapolating data, it gets a little bit complicated. You can't say that a mouse model is the same as, um, you know, the gestation of a human, which therefore everything that you see in an animal model is extrapolated to humans.

So kind of getting back to what you had originally asked about, we're looking at longevity. We know that eating less often has a lot of benefits. We know that individuals that are not overfeeding themselves and, and unfortunately we're in a culture where we eat too much, we eat too often. And so helping people understand that if you do a.

Uh, a two day fast, a three day fast, you know, five day fast, you are different benefits from these longer fasts. Sometimes it can be stem cell activation. Um, sometimes it can be things like, you know, uh, improvement in the intestinal lining of the gut, which is only one, say a layer thick, uh, in particular in the small intestine, helping people understand that you [00:11:00] can get this reduction in these inflammatory markers.

But I think like many things. We as a culture take good strategies and intermittent fasting is not new or novel. It dates back to biblical times. And then we go to extremes. So what do I see a lot of people doing in on social media is that you take a 22 year old, thin lean athletic woman and she starts fasting and she loses her menstrual cycle.

And it's because her body's perception of that hormetic stress, which is beneficial stress in the right amount at the right time, um, Is too much stress for her, but a 22 year old female who has 50 pounds of looseness PCOS may benefit from some targeted intermittent fasting. So I think that there's many things to extrapolate to.

And I think when we're really looking at the research, it's understanding a lot of the research that's been done has not been done on young women and certainly not done on a lot of women. And then understanding that. Animal model research, although compelling and leads [00:12:00] to, you know, human trials, you may not get as much information from those that will be as directly applicable to human beings.

And so I think that we're still at a point where there's ongoing research. I think that I look at intermittent fasting as a strategy to be used conservatively. And I think in my concerns as a, as an individual, not only as a clinician is that a lot of people are not doing it correctly, meaning they're, they're overdoing it.

They're adding too much stress to their bodies. And that can in and of itself be detrimental.

Jacqueline: Yeah. No, that makes sense. What are your thoughts on longer extended fasts for, let's say, someone who is otherwise healthy? Let's say a woman's in her either menstrual or follicular phase where, you know, your body's more resilient. That's probably the best time to fast. What are your thoughts on like a two or three day fast?

Cynthia: I think it depends on the individual. I don't like long fast for women. Um, I think it's different when you have someone who's obese. not metabolically [00:13:00] healthy, needs to get a grasp on a significant degree of inflammation, but a thin, healthy, athletic woman doing a lot of long day fast, you're at risk for losing muscle mass.

And I always say like muscle is this metabolic currency and women's peak bone and muscle mass is in their twenties and thirties. That is not the time. If you are a thin and lean and athletic to be doing this over fasting phenomenon. And, and I think we've really, we've kind of gotten off the rails, like fasting.

Yes, is good to a point. And then I've started to watch not just myself, but others in this space. Starting to back off on the intensity of exercise at the risk or concern for muscle loss. So I, I think that if someone were to come to me and said, you know, Cynthia, I, I had this, I, I, I went through a cancer diagnosis, um, where we know that intermittent fasting can be a very targeted strategy for upregulating, autophagy and can be very beneficial.

Um, I still have 10 or 20 pounds to lose. I, I think it could be a jumpstart if [00:14:00] you are someone who, you know, just went through, um. You know, maybe you went on vacation and you overindulge, you come home and you're like, I feel terrible. I'm inflamed. My jam. My joints hurt. I feel puffy. I feel bloated. I want to give myself a 48 hour reset.

I think targeted that is reasonable, but thin, healthy people over fasting. I don't like at the expense of muscle. And I think that distinction is not discussed enough.

Jacqueline: Yeah. No, I, I couldn't agree more. Um, and also too. So my mom, Cynthia, I don't know if you read a bit about my background on well and strong, but she was diagnosed at stage four breast cancer back in 2018. Um, she's the reason why I started this blog and we've been dealing with that for the past six years.

But through that, I learned a lot. about fasting when it came to, you know, specifically the benefits of fasting for cancer patients. I mean, there are centers in California that do these like very intensive extended long fast for cancer patients. And it's, it's really, really fascinating the [00:15:00] research that I've read on it.

But my mom really utilizes intermittent fasting around. high dose IVC treatments. Um, so we couple that. And again, when you can kind of stack therapies, um, it makes both more effective. Um, so yeah, very cool research around that as well.

Cynthia: Yeah, and I think that I would echo, because I have a team member who's a breast cancer thriver. She just hit that five year mark, so she's doing really well. And I'm always sharing things that kind of fall across my lap with regards specifically to breast cancer, um, and survivors. It's relevant to intermittent fasting as a strategy, but when women are in perimenopause and menopause, which I know is, is you're not, you're not that yet there, sarcopenia is a real issue.

Muscle loss with aging, unless you were actively working against it, you are losing muscle every single year. And I just see a lot of women that do these, I call it the over fasting phenomenon. And it's usually coupled with a lot of [00:16:00] exercise. And you know, they want to eat in a four hour feeding window and they're just under chronically under nourishing their bodies.

They don't hit their protein macros. They're not lifting weights. And then they're over fasting and it just sets them up for metabolic disaster because what gets tied into sarcopenia is frailty and you know, frailty then leads to falls and whether you break a hip or you hit your head, um, it is all a real issue.

And so I think that, I think that it goes without saying, you know, if you're dealing with a cancer diagnosis, that's a very specific. diagnosis. And that is different than an obese 52 year old who wants to lose like 30 pounds. And so figuring out ways to build muscle and, you know, eat less, do less snacking, really eat some targeted nutrition.

I think that's very, very different.

Jacqueline: Yeah, absolutely. So in terms of, you know, doing intermittent fasting, quote unquote, correctly, I've read that. [00:17:00] Eating with your circadian rhythm appears to be like the most effective method of that type of time restricted eating, and just from a personal note, I used to intermittent fast again. I think I did go a bit extreme at times back in college.

So what I would do is I would start eating at like 1130, 12 o'clock, and I personally found that my energy was very low, um, and I would be more likely to binge eat later on. So I've shifted that now and I eat breakfast within the first hour of waking up and then I'll stop eating around maybe like 530, six o'clock and call it a day.

And that's been most effective for me. So what are your thoughts? on proper timing. Like, is it good to eat breakfast and then stop eating earlier? Does that depend on the person? 

Cynthia: Oh, that's a great question. I think bio individuality rules. So ultimately it has to be what's sustainable for you. If you look at the research, Most individuals, and I'm getting ready to interview Dr. Stacey Sims, who's an exercise physiologist, [00:18:00] acclaimed researcher and really talks about how women are not many men and why research, there needs to be more research on women.

And she's a fan of having protein before exercise. So I used to always work out in a fasted state. I would get up. I would go to the gym. I would do my thing. I then wouldn't eat till 10 or 11. And now I've completely turned everything around. I do some zone two training in the morning. And then I usually eat by nine o'clock and then my feeding window closes by five or six and I usually do an afternoon workout and an afternoon workout after two meals.

totally different. I feel completely different exercising. I've started speaking about this publicly. So it's not like I'm sharing something with you or people are going to be surprised to hear me say this, but yes, the research. And if you look at Sachin Ponda's work, um, he's this acclaimed circadian biologist.

He talks a lot about you eat when it's light outside and you don't eat when it's dark outside. It's easy to say that in summer. It's harder to say that in winter. Especially as [00:19:00] someone who used to work shift work and I woke up and it was dark and went home when it was dark. I never saw a light outside.

It's no wonder my, my circadian clocks were totally off, but other people understand that, you know, your circadian biology is so along, be more insulin sensitive in the morning and early afternoon. Um, we know that women, depending on where they are in their menstrual cycles. So you're more insulin sensitive in the follicular phase when estrogen tends to predominate.

Um, Less insulin sensitive in the luteal phase when progesterone predominates. Again, that's an oversimplification. And then you look at women that are in their forties, fifties and beyond. And we just start losing insulin sensitivity because we are losing muscle mass unless we are not actively working against it.

So yes, I do think that I personally feel best when I start eating when it is earlier in the day, and I don't like to eat at night. In fact, it's funny. I wear an aura like so many people do. And, uh, if I eat a later meal, it wrecks my HRV. It wrecks my deep sleep. And this is even like, I [00:20:00] don't even drink alcohol.

Like we're not even talking about eating crazy meal. This is eating a steak and some vegetables. I will notice a difference. So there's also differences in physiology for me at that life stage. I'm at then it for you. But I think when we're speaking to this, it's helping people understand. Yes, there's a little bit of trial and error.

My night owl teenage son would tell you that he doesn't want to eat it yet. Well, I have two of them now. They're both like so primed. Jack is my, my college student and he, he just got up. He's home for fall break. He just got up. He's eating his first meal. Um, he'll eat his last meal at 10 o'clock at night.

So, so much of it depends on our lifestyle and what makes us feel good. But I know the gift of the pandemic for me was realizing I felt a whole lot better if I closed my feeding window by four or five o'clock. Now that's not always realistic if I want to eat with my family, but on days where I'm traveling and I don't care, it's just me.

It's not a big deal. Um, I do best when I eat earlier. So I think for anyone that's listening, [00:21:00] it's really helping people understand that A little bit of change for us can be really helpful. Like for me, I just know that my workouts I can really put, and I have a trainer and like now I have a trainer. I pay to kick my butt several times a week.

And so she'll say to me, what did you eat before you came to see me? And I'm like, all right, I need to eat three hours before I see you, which means I need to have that second meal by like one or 1230 so that I'm not focused on digesting my food. But helping people understand like what works best for you, and then kind of widgeting in when your meals will be at point.

Jacqueline: Yeah, no, I couldn't agree more. I also used to work out in a fasted state and I had JJ Virgin on the 

show also not too long ago and

she, friend of mine.

we, yeah, I mean, she too just also opened my eyes and she was like, it's not, not a, not a solid strategy right there. But yeah, I always have to, to eat now prior to working out and to the aura ring point as well, I also have noticed eating late does also impact my HRV.

And it increases my body temperature as well because your [00:22:00] body is focused on digesting while you're sleeping, right? Which certainly takes away the amount of energy it could use for other things. Um, processes that, you know, we need to restore ourselves at night while we sleep.

Cynthia: Well, and the other, the one thing I forgot to mention that I think is, is relevant. We have clocks throughout our body. They're not just ~penile~ glands secreting melatonin in our brains. And so we have this circadian clocks throughout our digestive system. So as you can imagine, when you eat a large bowl of food before bed.

Your circadian clocks are like timeout. We should not be secreting melatonin. We need to process this bowl as a food. We're going to increase cortisol. We increased cortisol up goes glucose as does insulin. And so for a lot of people, it's, it's just helping them understand, like putting these pieces of a puzzle together.

And understanding like we have clocks everywhere in our body, including our ovaries. It's so cool. Like I'm in the midst of writing my second book right now. And so the circadian clocks throughout our body is so interesting. It's not just in your digestive system. They are literally, we even have them on our skin, which is why [00:23:00] if someone sleeps with a light on in their bathroom and they think, Oh, there's just a little bit of light coming underneath the door, your body knows there's little light receptors on your skin that will tell your body like.

We can't go totally to sleep because there's light out. We're confused. We think we're supposed to be awake, but when we think we're supposed to be in bed. And so the body is far smarter than we give it credit.

Jacqueline: How long did it take you to become adjusted to normal life after your late night, uh, shifts during residency?

Cynthia: Uh, um, so it's interesting. So obviously, um, during my medical training, there was a lot of flip flopping back and forth. I think the last night shift I worked was when I was pregnant with my oldest is 19 years ago. There are many of my colleagues that could be up all night long and they would manage. I was never one of those people.

I was, I was not an eater when I was working overnight. I was someone that felt nauseous. I was sick to my stomach. I am not a coffee drinker, so I [00:24:00] drink Diet Pepsi, which is disgusting. I mean, I had to find something that had some caffeine in it. So I think for so many of us, and I also think that's why in your 20s, that kind of lifestyle, you can buffer it better than now.

There's a lot of research that shows that shift workers are at greater risk for developing cancer and having metabolic disease. And I cannot tell you how many of my colleagues that I see even now, you know, and especially people that work in the ER, OBGYN friends of mine, people that are on trauma call.

They get to a point where they, they just, you know, they just don't feel good. They just can't bounce back as easily and as readily. And so whether it's, you know, an EMS police officer, all these people that work shift work, in your twenties, you can weather, it just gets so much harder. And I, I made a conscientious decision that I no longer wanted to do call.

And so that was a big decision, um, for me. And then I just got to a point where I was like, this does not serve my best interests. My, my best health, [00:25:00] it's not good for my family. You know, I would wake up in the morning and I literally felt the only way I can describe it, although I had not been drinking, I felt drunk.

Like it was that lack of like mental clarity. And I just never, ever, ever did well flip flopping back and forth. And that's what we ask our healthcare professionals to do. And so you wonder why. Um, there's so many healthcare providers that get diagnosed with cancer and I, over the, the course of working with, you know, hundreds of thousands of patients and colleagues, um, seeing those consistent, those consistencies and looking at the research where that disruption of circadian biology has profound impact on our health.

Like, So profound that I think if you do it long enough, if you work shifts long enough, you will end up developing either significant metabolic disease. vis a vis, um, you know, poor metabolic health or a cancer diagnosis. And that to me is incredibly sad.

Jacqueline: Yeah. No, And even, I mean, beyond shift [00:26:00] workers, just lack of, of sleep, right? Like, less than seven hours of sleep. sleep. I mean, my mom, for example, she was a high school French teacher and also managing a household with, with two children. And I mean, she would get less than like six hours of sleep every night.

And this was, this was years, um, and her body just adapted and she just went off of that. But I think that was a contributor to her recurrence, um, in 2018, but you know, people take sleep, you know, as if it's not really a big deal, but it's probably one of the most fundamental ways to, to keep our bodies and our immune systems robust.

Cynthia: I agree. I mean, in fact, I tell women, um, if I can't get you to sleep through the night, I can't get you to lose weight. Like it is so foundational to our health. And I guard my sleep. I guard my sleep, like viciously, like I'm at a state right now, you know, I have a 17 year old, I have a 19 year old in college.

And And I said to my husband for the last two weeks, I've slept eight hours every single night. Like I go to bed at 10 and I get up at seven. Well, that's like eight to nine hours. Maybe I'm not asleep the entire [00:27:00] time, but you know, I'm sleeping consistently eight hours every night. And it's like, I have no problems like powering through a workday.

I have no problems getting through a workout. I have no problems, you know, just being, having, you know, addressing the busy things. But I can tell you when I was still seeing patients in a traditional allopathic model, uh, I would get before 30 in the morning. To go to the gym, then I would come home, then I would shower, then I'd get my kids to school.

Then I would go and see patients all day long. Then I'd be racing home to get the kids off the bus, and I would take 'em to, I mean, when I think about lovingly, like I wouldn't, I wouldn't change a thing because I'm exactly where I need to be. But I think about those years and years and years. As you mentioned, your mom, oh my God.

I mean, you just ne,

you 

just 

Jacqueline: 24 7.

Cynthia: right, you're sympathetic dominant and almost always occurs in like, you're in perimenopause, you're not sleeping well anyway, 

and it just kind of compounds over time.

Jacqueline: Yeah. Same point. But I mean, you know, as a mom, you know, you put your children

first and 

Cynthia: which is what you're supposed to do. yeah, 

Jacqueline: yeah, sometimes, but I, I mean, I tell my mom now, I'm like, if you [00:28:00] want to help take care of my, you know, Juliana and myself, you got to take care of yourself first. So she's slowly starting to shift that mentality. Um, anyway, Cynthia, so that was a, I love going down rabbit holes like that, but yeah. Circadian rhythm, optimal sleep pattern. So important. But going back to fasting, what is, um, the best way to break a fast to avoid blood sugar spikes, um, digestive issues? What's, what's the optimal meal?

Cynthia: so I think, so the answer is, is always the longer the fast, the lighter the meal. So that's kind of a, if you've done a 24 hour fast, don't sit down and have like a bolognese and a steak. You're going to have some serious digestive upset. By the same token, if you fasted 15, 16 hours, the answer is always protein, whether the protein is starting with bone broth, because maybe you're not ready to sit down and eat a meal.

Um, I'm a fan of lean protein and veggies. So some type of protein, no less than 30 to 40 grams of protein as a bolus and [00:29:00] some type of, uh, non starchy carbohydrate, I think is a great way to do that. Uh, I, I find that lean proteins plus some starchy or non starchy vegetables is a good way. It's usually a little lighter.

Uh, I do have patients that prefer to do bone broth. They prefer to do Uh, let's say they tolerate dairy. So they're doing organic, uh, unflavored, uh, yogurt. Maybe they add some whey protein to it. Uh, maybe they're adding some berries, maybe some nuts and that's light enough for them. And so a degree of experimentation, but understanding that first meal should really be.

That first bowl is a protein. It's so important because we know if you look at the research that that first meal of the day sets a blood sugar regulation for the entire day. So if I sit down, not that I would, if I sit down and eat like, uh, pancakes and syrup, or if I sat down and had a bowl of like cereal, it's not going to have the same blood sugar regulate, especially for me, I'm a middle aged person, [00:30:00] um, I have to work a little harder at my blood sugar regulation just by virtue of the stage I'm out.

I don't think you'll understand. Like if I sat down and had. Uh, leftovers from the night before, leftover steak, leftover chicken, leftover piece of fish with some salad, very different blood sugar regulation, much more blunted blood sugar response. Uh, and I can even say that what we don't want is we don't want to see a lot of spikes.

If we're looking at a glucometer, we're looking at a continuous glucose monitor and I do believe in using those tools. Uh, but from my perspective, protein, protein, protein depends on the individual. If you do a five day fast, you're probably going to start with a very, very, very, very, very light. meal because your body is, has been like on total digestive rest for a period of time.

Sometimes you'll see people get diarrhea when they start eating again. And I just say, okay, let's MacGyver, let's go back and re engineer that first meal. Generally tends to be lighter. Might just be that you start with a very small portion of food. And then maybe 30 minutes later, you can tolerate something larger, but that's usually a good rule of thumb.

Jacqueline: [00:31:00] Yeah. No, that makes sense. Speaking of five day fast, I'm sure you've heard of Walter Longo and this fasting mimicking diet. What are your, what are your thoughts on that? And I mean, we were talking about, you know, the importance of ensuring that you're not losing muscle while you're fasting. And I know that One of the big draws to this five day program is that they say that you don't actually lose muscle mass.

What are your thoughts on that program?

Cynthia: I have great respect for, for Walter's work. Number one. Uh, there's no question that he is heavily influenced, uh, the way many of us practice or many of the considerations that we go through. It's interesting, for full disclosure, Prolon was a podcast sponsor. In last year. So I'm pretty familiarized with his research.

I think that if you look at the longevity experts that are out there and I'm when I'm thinking about I'm thinking about Walter, I'm thinking about David Sinclair versus, uh, you know, Gabrielle Lyon, Sean Baker. Uh, there's this differentiator, correct, there's this differentiator [00:32:00] about protein intake. I am not a fan of low protein intake because it accelerates that sarcopenic obesity pace that so many people are dealing with.

So I, I, I'm, I'm not sold on five day fast, not allowing you to lose muscle. I think if metabolically healthy. And a five day fast is going to allow you to like jumpstart your metabolic health. That's different. But because I am so much in alignment with the Uh, the, the community of metabolic health experts of which Sean and Gabrielle are personal friends, that is very different.

I do think that muscle loss is catastrophic. I speak from personal experience in 2019, I was hospitalized for 13 days, lost 15 pounds, most of which was muscle. I'm still to this day, working to build it back up as a middle aged woman, catastrophic impact on your health. [00:33:00] Do I think that doing a prolon type fasting to making diet has some benefits?

I do I think that I think for people who are really trying to do a longer fast But the thought of not eating for five days is terrifying I think it's reasonable. Um, I do within some of my programs do prolonged 24 hour fast, which to me is manageable and I'm less worried about muscle loss there. And the reason why I say this is that most of my female patients do not eat enough protein and most of them do not properly strength train.

So those are two separate issues. Obviously, if you're a younger person, if you're 25 or 30, do I think you can do an occasional fast and mimicking diet and probably be okay? Yeah, because you're still at peak muscle mass building ages. Your hormones are working with you and not against you. At this stage of life I'm in, Um, those decline in sex hormones, even with hormone replacement therapy, you have to work a lot harder.

Like those myocytes and those myokines, you have to work much harder to stimulate them to do their [00:34:00] work. So,

Jacqueline: What age does that start to?

Cynthia: um, so if you look at like perimenopause, I usually say like when I'm thinking about women and aging. 35 and under is peak fertile years. And I say peak, like that's average. So by the time you're in your mid thirties, you're correct. You're creeping close to perimenopause. And that is 10 to 15 years preceding menopause.

Average age in the United States is 51. So you can look at the trajectory. If it's. tenure. So you're really looking at late thirties, early forties. That's when perimenopause starts. And that starts in our ovaries. It's called ovarian senescence. The ovarian clots drive the aging process in women. So when I start to think about when I'm most cautious with women, and I really, really proactively have these conversations about Make sure you're eating enough protein, make sure you're, you know, lifting weights.

I'm really starting that at 40. 40 is when sarcopenic obesity, and you can be skinny fat, how many people do you

know are thin, but like they literally have a pancake butt, [00:35:00] they have no muscle tone, um, you know, there's, there's three kind of main body types, physiques. I'm an ectomorph. I will be thin, but I have to work much harder at building muscle than a mesomorph who builds muscle easily. And so that's an important distinction. So I, I think from my perspective, it's helping women understand, like, you have to lift heavy enough. to tell your body to tell your muscles like, okay, we need to grow. That's number one. And then number two, you got in enough protein. So if you're chronically under nourishing your body, like many, many women are, and have been conditioned to believe that their entire lives, then you throw on fasting, it's adding gasoline to a fire.

There's a strategy for fasting if it's used properly. But more often than not, what I find is people over fasting at the expense of muscle health. And muscles are far more than They're far more than our physiques. You know, we can tell when people train, uh, or train diligently because they tend to, I always call it like your internal [00:36:00] Spanx.

I think actually that's one of JJ's terms, your internal Spanx. It like holds everything in, but it's also like understanding that. We're setting ourselves up for disaster if we're not properly feeling like I keep going back to the, let's not undernourish our bodies. And I think for a lot of women, that's what they've heard from their parents.

That's what they've heard from their loved ones, from their friends, well meaning people in their lives, that that's the message they've gotten for so long. Like we want to be tiny. We want to be little. We want to be less than. No, we actually want to be able to lift heavy things. We want to be able to enjoy our lives.

We want to be able to vacation and do things with our loved ones. We don't want to be in a position where we're in, you know, how many patients I took care of that at 50 couldn't get off a bedside toilet in the hospital. And I used to say to myself, I don't ever want to be that person. So to getting back to what you'd originally asked, um, 40 is usually the benchmark, but that doesn't mean that people under the age of 40 get it passed.

We all need to be lifting. We all need to be [00:37:00] conscientious about protein. I will give you this one example. So when you're younger, you don't need quite as much protein to stimulate muscle protein synthesis. So like my teenagers. One plays lacrosse in college. I mean, one's a competitive martial arts guy and swims.

They could probably sneeze with 10 grams of protein and stimulate muscle protein synthesis. I need at least 40 grams. Dr. Gabrielle Wine would say 30, but I would actually say 40 grams. I think we need to aim for 40 because my body needs a larger stimulus. And so I think that's an important distinction to make that.

It is not enough to eat a whiff of chicken on your salad. It is not enough to eat half of a burger. It is not enough to go to a restaurant. Like I'm not the least bit embarrassed in some restaurants. I'll say, can I have two portions of protein? Like true food kitchen. It's kind of my go food, go to when I'm traveling.

Cause I know I'm not going to get seed oils. It's generally going to cook pretty healthy. And I've [00:38:00] had nights where I've ordered like takeout because I'm in a hotel room and I don't feel like going out. And I'll just say, can I get a side of chicken or can I get a side of shrimp? Or can I get a, so it's like, I'll have protein on my meal in my meal.

And then I will ask for an issue because I want to make sure I'm hitting those protein macros. So it isn't impossible. It just means that we have to be more diligent about it.

Jacqueline: Yeah. Yeah, that makes complete sense. Do you mostly strength train right now? Do you do any cardio in your workout? ha 

Cynthia: so it's funny that you, that you asked me that. So, um, my trainer, Linda, who likes to kick my butt, um, Linda likes me to end my strength training workouts with a little bit of sprints on the assault bike. That's been our new thing. And I'm gassed. Like when I've done, you know, 30 seconds of sprints three times, like, you know, she lets me recover two minutes in between.

And it's like, my heart rate goes to 150 and then I recover enough. So I'm like, okay, I don't feel like I'm going to vomit. And then she starts me up again. So I do some hits. I do quite a bit of zone two training. Yeah, because I'm, [00:39:00] I put a weighted vest on and I'll either depending, I live in a very humid part of the country.

So I just, as do you. Um, so you understand when I say in the peak of summer, sometimes it's just too humid to go walk two or three miles outside. So I will sometimes put my, and we have not a flat piece of land in our entire neighborhood. So walking up and down Hills is good, but I'll put my weighted vest on and I'll do zone two.

Um, but like in terms of like cardio, like traditional cardio now, because my time is better served doing the strength training, really focused on that. I do, I do love a solid core and I do like Pilates. Um, I took a break from Pilates, but it's more so, Because I like to challenge my proprioception, like where is my body in time and space?

And it was something that my husband and I started doing solid core classes together, like during the pandemic, just to do something together. And so we try to episodically throughout the year, do some, maybe one class a week, but that's very different. That's not like, I would not consider [00:40:00] that cardio. Um, Yeah, the, the days of like cycling classes and, you know, jump or like, 

no, I don't want to do any of that.

Jacqueline: I love that. I think that's a great program. And your trainer sounds like she's wonderful. 

Um, I'll have to join you in one of your, your

sessions where we're coming up on time. Um, there is two, there are two other questions, Cynthia, that I wanted to ask you with fasting. So when someone's intermittent fasting, obviously they can't have any food.

I know that you obviously can drink water. You can have tea. What are your thoughts on coffee? I know that black coffee won't break a fast, But in the same vein, I also know that caffeine on an empty stomach can cause cortisol spikes and glucose spikes. So, what are your, what are your thoughts on that?

Cynthia: Very bio individual. Um, I, I can tell you that if I took a hundred people and I said them, okay, you can have Yeah. Uh, all the unflavored electrolytes and water you could ever want. And in addition to that, you can have bitter tea, like green tea, black tea, or plain coffee. 50 [00:41:00] percent of them easily would say, I get GI upset if I consume a polyphenol bitter compound, like coffee or tea.

Uh, black or green tea. So there's that. And I respect that. I am one of those people. I cannot like drink a full cup of green tea on an empty stomach. It will make me nauseous. So what I do, I've learned, what I do is I probably have half of it. I then ice it and then I drink it during the rest of the morning, um, after I've broken my fast.

When it comes to caffeine in general, I'm a fast metabolizer. So caffeine does not make me feel bad, but there are people that are slow metabolizers Oops. They're slow metabolizers and their adrenals are shot. You know, they're not sleeping. They're not managing their stress proactively. Yes. Caffeine can make that worse.

I can, you know, increase their cortisol. And I'm not talking about, I'm not talking about like the exposure to caffeine, increasing cortisol. Like it's like adding gasoline to a fire. This is someone who slept for hours. Um, is super [00:42:00] stressed out. You know, they're sympathetic dominant. They take that coffee because they're exhausted.

Like if someone says to you, because I'll ask patients, how many cups of coffee do you drink a day? If someone says to me five or six, I'm like, okay, that's a clue. There's a problem because really the answer should be, I manage 12 ounces or eight ounces of coffee in the morning. And that's all I need. A lot of people are dependent on caffeine to keep them awake.

So generally the people that are consuming way too much caffeine that are slow metabolizers that have shot adrenals that are not sleeping are the ones that will have that provoked response in cortisol. And we know in cortical cortisol goes up, their glucose goes up. And so more often than not, it's a lifestyle mediated issue.

It does not mean per se that they cannot tolerate caffeine or coffee. The other thing that I think about with coffee, when people don't feel good with it is. Coffee tends to be a fairly contaminated food substance. So whether it's mycotoxins in mold, um, whether it's the filtration process, that's why I think it's [00:43:00] important.

I'm not a coffee drinker. But, um, let me just throw a disclosure. I know a lot about coffee because I'm oftentimes counseling people. It is important to buy good quality coffee because it could very well be that you are consuming an inferior product. And that's why you feel crummy. Like I just, uh, was talking to Dr.

Vincent Pedro at an event and he was saying how he's Cuban. And he was saying like, I'm Cuban. Like I should be able to drink all the coffee. He said, but I'm actually a slow metabolizer. And he said, when I would drink coffee, he's like, I took a break for two or three years because every time I drank coffee, I would feel awful.

And he said, I finally realized it was not the coffee. It was that my gut needed to be supported and I wasn't drinking good quality coffee. And he's like, I'm almost embarrassed to admit that as a Cuban American, I'm telling you, like, I should know everything about coffee. So I think that there's multiple variables that impact that.

Um, one thing that I would just say is, uh, like a pearl, if you are struggling to consume plain coffee, cause it's so bitter. Cause we, as Americans like things [00:44:00] that are sweet, you can add, um, high quality salt, like Redmond's. Or you could add cinnamon, neither of which will break a clean fast. They will change the flavor profile.

And for some people, that's how they learn to drink black coffee without breaking a fast. I'm not a fan of people dumping in like half a stick of butter and a, you know, two tablespoons of MCT oil. And I'm like, well, now you've turned something that should otherwise be a fairly low calorie item into something that is a fatty coffee.

And for some people may make a big difference in body composition just by consuming that much fat in a concentrated amount.

Jacqueline: Yeah. No, I'm so glad you mentioned that the only coffee I drink is purity coffee I'm sure you've heard of it before they have a great decaf blend I don't know if you just don't drink coffee because you're opposed to the taste or the caffeine But they have a really good decaf blend if you want to try it

Cynthia: yeah, it's funny, uh, you know, I would say probably seven or eight years ago I started drinking green tea because of the benefits. Like I was like, okay, I don't love coffee. I never have. I've tried it a hundred different ways. Um, and so I will drink [00:45:00] green coffee, green, green coffee, green tea a couple of days a week.

Not because I love the taste. But because I know those polyphenols, that bitter, those bitter compounds are important signaling molecules in our bodies. And so I just remind myself, um, of the fact that sometimes we have to do things we don't love for the betterment of our bodies.

Jacqueline: So true. Amen to that. Well, Cynthia, this has been such a wonderful interview. There's so much to still touch on with you. So I do hope to have you on again at some point soon. But I do want to be conscious of your time. With that, where can listeners find you?

Cynthia: Thank you. This has been a great conversation. So probably easiest to start with my website, www. cynthiatherlo. com. You can get access to everyday wellness, which is my podcast. That's really my passion project. It's one of my favorite things I do in my business. Um, we have a growing YouTube channel slowly, but surely, um, the full length podcasts are also up there.

I'm active on Instagram. Um, uh, before Warren, I'm a little snarky on Twitter and then I have a free Facebook group. I have to [00:46:00] tell people that I have a free Facebook group called the midlife pause backslash my name. There are men and women in that group. Um, and my team is attempting to grow tick tock because I'm told that I need to, but that, that is not like, if you go to tick tock, it's like recycled content to be fully transparent.

I have a book called intermittent fasting transformation. Um, I have a couple of Ted talks and I have a book that will be published in 2026. It's really speaking to women in perimenopause and menopause specific to the gut microbiome, which although that does not sound sexy, it impacts everything. Like 

everything you can 

Jacqueline: true. 

Cynthia: health, 

immunity, et cetera.

Jacqueline: Yeah, that's a topic in itself for another episode. Well, I will be linking all of those in the show notes. I'm in the same boat as you as TikTok. I really try not to be on there, but nature of everyone's attention spans today. I feel like that's kind of the main platform to go to, but, uh, I'll be including links to all of that.

And my last question for you, and this is my favorite one to ask, and that is, what does being well and strong mean to you?

Cynthia: Hmm. That's a great question. Um, well and strong to me [00:47:00] means that I wake up without effort. It hurts. That I'm able to go about my day and not feel like I need stimulants to get through it. It means I'm able to work out and not have any pain or discomfort. It means I can engage just, you know, with my, within my business, my personal life, and to be able to do so without thinking about my health.

I think that so many people, once they hit a certain age, Whether it's 40, 45, 50 or beyond, they just assume that being overweight, metabolically unhealthy aches and pains are the norm. And I just turned 53 and I feel like I have more energy now than I did 10 years ago. And

so, yeah, to me, I think that, um, I think so much of its mindset.

I think that I, I think for all of us, we have to work on our mindset because it's constantly finding that reframe. Like each year is better and better, but it's the acknowledgement that, you know, true health and wellness starts right here.

Jacqueline: I love that. [00:48:00] And with two teenage boys, you got to have that high energy level.

So glad 

Cynthia: you're not kidding. you're not kidding. 

Jacqueline: Awesome. Well, thank you so much, Cynthia. Um, this was so fun and yeah, I hope to have you on again soon.

Cynthia: Sounds good.


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Jacqueline Genova

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