This week we are talking about the benefits of intermittent fasting and how we can start to apply this eating technique to our diets. My guest Cynthia Thurlow is going to explain it all. Cynthia can be quoted saying, “I do not believe nor do I support the limiting belief that women have to accept weight gain as a normal function of aging.” She is going to help us learn how to find wellness through the healing power of nutrition and fasting.

As we age our weight can become a concern for our health and a nuisance in everyday living. One of the best things we can do for our overall health is to start to be conscientious about what we are fueling our bodies with. We all deserve the best quality of life we can get and it all starts with us. It starts by understanding how our bodies work when we eat certain foods and at what times we eat. We also need to focus more on our sleep needs and stress levels. That combined with intermittent fasting techniques we will be losing weight and feeling a whole lot better in no time.

On this podcast, we are going to talk about…

  • How intermittent fasting helped Cynthia.

  • How Cynthia got started teaching intermittent fasting.

  • How we can clean up our diet.

  • How to avoid health concerns.

  • The gut microbiome and intermittent fasting connection.

  • How intermittent fasting works.

  • How sleep affects your weight.

  • The correlation between alcohol and our overall health.

  • What is Lifestyle Medicine?

  • How women are different from men when it comes to fasting.

About Cynthia Thurlow

Cynthia Thurlow is a sought-after successful entrepreneur, nurse practitioner, intermittent fasting & nutrition expert, founder of Cynthia Thurlow, LLC, co-author of Primal Eating, and host of Everyday Wellness podcast. Cynthia brings over 20 years of medical experience, combined with current and progressive nutritional perspectives/approaches to truly serve those in need. She provides hope and customized programs that work. To add to her credibility, Cynthia has been a TEDx speaker twice. Her second talk has more than 5.3 million views on intermittent fasting, a guest on numerous podcasts including JJ Virgin’s Reignite Wellness, Natalie Jill’s Leveling Up, 365 Driven with Tony Whatley, Low Carb MD podcast with Drs. Tro and Lenzkes, University of Adversity to name a few. She has been featured on ABC, Fox5, KTLA, PIX11, Medium & Entrepreneur magazine and speaks on intermittent fasting, hormonal health, fat loss, self-care, the power of whole food nutrition, carb cycling, adaptogenic herbs, digestive health, and more. She has worked with thousands of individuals with a commitment to live their lives not just holistically, but wholly balanced and genuinely fulfilled.

Welcome, Cynthia to the Gutsy Gynecologist Podcast!

Cynthia: Thank you. I’m so excited to connect with you and your listeners.

Dr. Tabatha: Yeah, I loved the conversation we had last year. You have taken intermittent fasting to a whole other level. So now you’re back. Right?

Cynthia: Yeah, you know, it’s the ironic thing is that the decision to do a talk about a subject I knew a lot about, I had no idea that was going to catapult everything forward. Literally, the thought was, what do I know a lot about? I thought about fasting, and I didn’t realize that would turn into so much more. So I’m very grateful.

Dr. Tabatha: You are just changing millions of women’s lives. I’m really excited that you’re finally getting your book out, Intermittent Fasting Transformation.

I know my listeners have heard your story before, but I really want them to understand, why intermittent fasting was the key to your shift in your health.

How Did Intermittent Fasting Make a Difference In Your Health?

Cynthia: As a traditionally trained allopathic nurse practitioner, I went to a top-notch research hospital, trained there, and I don’t recall ever having any discussions about perimenopause. Most of the stuff about menopause was scary. We are talking about your grandmother and your mother and you are thinking that will never be you. I blissfully naively went through my 20s, 30s, and into my early 40s. I worked for a very large and busy cardiology practice. I did inpatient and outpatient management and had a lot of autonomy. It was a very stressful job, as you can imagine. I worked in ICUs, ERs, and managed patients throughout the hospital course.

On top of that, my husband did a lot of international travel. I also had two young boys, I probably wasn’t getting enough sleep, and I was probably doing the wrong types of exercise given where I was in time and space. But again, I had never heard the term perimenopause. I think about this now and it just makes me feel naive. It wasn’t until I hit a wall. I literally got to a point where I woke up one morning and I said, “Why am I so tired? What am I doing wrong?” I went down a rabbit hole and realized this is perimenopause. The reason this is happening is because of the physiological changes caused by lowered progesterone, relative estrogen dominance, the ability to not be able to manage and mitigate stress as well, the wrong types of exercise, and too low carb. Having a stressful job, two little kids and a husband who traveled probably was the perfect storm.

I think for me, initially, it was the recognition that a lot of things had to change in my lifestyle. I’d always been a healthy eater and been active, but I started putting on weight. When you’re 5’3”, 5 or 10 pounds makes a big difference in how you look and how you feel in your clothes. From my perspective, I think fasting, in many ways, was one strategy of many that I embraced. And I felt comfortable and confident doing it. I read Jason Fung’s book, he’s another allopathic trained healthcare provider who’s using this method successfully. I started feeling so much better quickly and that was the recognition I need to see that this was a strategy that would be helpful for others.

How Did You Get Started Teaching Intermittent Fasting?

Cynthia: I left clinical medicine in 2016, which is hard to believe that’s almost five years ago. In my traditional, I’m going to leap and then worry about it later fashion, I almost immediately started attracting women that were at the same stage of life. People who felt ignored, and felt that traditional medical establishments were suggesting things like synthetic hormones, antidepressants, an IUD, an ablation, or a hysterectomy to control symptoms when so much of what they were experiencing could be mitigated in other ways. I fell down another rabbit hole of nutrition, lifestyle medicine, and eating less often. I was having a lot of success with the women that were coming to me in my outpatient practice. I focused on lifestyle medicine. I wasn’t prescribing medications much anymore and it occurred to me that there was a lot of value in what I was teaching.

That is how I initially got started. I wanted to challenge myself, but as an introvert, which a lot of people are surprised to hear, I decided I was going to do a TED talk. The first talk I did was on perimenopause, which I can retrospectively say now, I was really embarrassed to do a talk on that because, in my head, I didn’t feel 47. How could I possibly be talking about being close to menopause? So at the same time, I accepted that talk within a month, and then I was offered a second one.

They told me I couldn’t do it on the same topic. So, I looked at my husband and asked what do I know a lot about? He said fasting. So, I decided that was what I was going to talk about. They asked me to slant it towards women and I said absolutely. I had agreed to two talks. I did one in December of 2018 and the second one in March 2019. And the rest is history.

I never realized that that second talk would change my life in so many profound ways. Now I can share with women sustainable strategies and ways to do fasting. It’s amazing how a talk that becomes very popular, suddenly, you now have to scramble as a business owner to create programs and resources, because people want to learn more and they want to be able to do it successfully.

On the fly, IF45 was created. It is a program for women which has evolved, shifted, and changed. I figured out that if you do something in your business and something works well, you’re like great, do more of that. Do something else in your business, it doesn’t work well you’re like, Okay, don’t want to do that. So this has been three and a half years of really figuring out what are the granular ways that fasting needs to be identified, shifted, and changed for women so that they can be successful?

Unfortunately, I think there are two schools of thought. There are researchers out there who fearmonger and tell you that fasting is bad for women. Then you have those who are applying the same principles that they use with men to women, and we’re just a bit more complicated in a wonderful way. It’s what makes us unique. So I like to take a middle ground and say, “Yes, fasting can be successful.”

There are different ways that we fast and that’s a lot of what the book talks about, which is what makes us unique. Why do we need to fast differently and I don’t address the fear mongers. I just mention to people that there are others out there that are anti-fasting and that’s okay. They’re entitled to their opinion.

Dr. Tabatha: I couldn’t agree more with fasting as just a healthy way of life. That is how our genetics and our body’s chemistry were designed to function. That’s how our bodies are created. We didn’t have grocery stores on every corner 1000 years ago.

You hit on so many pain points, like the fact that we don’t talk about perimenopause. Women don’t realize they’re going through this multi, many years of transitions in hormonal shifts. It’s very much ingrained in us that menopause is like a light switch, but that’s not true. One of the biggest things to happen is our metabolism, kidney function, and digestive enzyme production slows down. I mean, you name it, everything just starts to slow down. Then we compound the issue with eating too much and eating the standard American diet.

How Can We Clean Up Our Diet?

Cynthia: Oh, absolutely. You alluded to this ancestral health perspective that we would not have survived as a species if we weren’t designed to eat less frequently. We had food scarcity. There wasn’t a grocery store, convenience store, or Amazon groceries delivered to your house, it didn’t work that way. We are eating too frequently. I think it really diminishes the strategy, mindset, and philosophy that this isn’t something that is aligned with the way our bodies are designed to thrive.

I want to speak about a study Satchin Panda did earlier last year. The average American is eating six to 10 times a day. Every time you eat a meal, your body has to process what you’ve consumed. 88.2% of us are metabolically unhealthy. That’s a statistic from 2018. So we can assume that’s even worse now given the pandemic.

Frequent feedings are overtaxing our digestive system. It takes four to five hours between meals for our body to fully process what we ate. We have a migrating motor complex and our digestive system acts like a street sweeper. It’s pushing bacteria forward. If you’re habitually eating every two to three hours, not only does your blood sugar not come back down to normal, your insulin levels are not at the optimal level where they should be. It makes our bodies much less efficient.

It’s kind of like topping off the gas tank. My dad always liked to top off the gas. It’s the same kind of concept. We never get through the whole gas tank to actually work on what’s at the bottom. We’re just constantly burning what’s at the top. So we don’t get efficient at utilizing both carbohydrates and fats for fuel. We want to be metabolically flexible. Unfortunately, most people are just burning carbs, which is why they are frequently hangry. You know, that stage where you are hungry and angry.  They have energy slumps, a lack of mental clarity, they struggle with weight loss resistance, and they may struggle to stay awake after eating a meal versus people that are tapping into this fat fuel source. They have sustained energy, they can go four or five hours between meals and easily lose weight when they want to. That’s the way our bodies were designed. They weren’t designed to have a chronic carbohydrate issue.

If you look at the standard American diet, it’s highly processed, hyper-palatable, full of ingredients that more often than not, are just regulating our hormones. Things like high fructose corn syrup and seed oils have a profound negative impact on our bodies down to the cellular level. They can damage cells and the mitochondria making them less efficient. These highly processed hyper-palatable foods, along with eating frequently are dysregulating the normal way that our bodies are designed to thrive.

I encourage anyone that’s listening, to try to do at least 12 hours. You’re still giving your body digestive res. Say, you eat at 7:00 at night, and that’s your dinner, then you don’t eat again until  7:00 am. That’s 12 hours that you’re giving your body an opportunity to break down the food that you’ve consumed, package it up, and get it ready for excretion or to utilize it in the cell at a cellular level.

Watch the whole video interview here.

How to Avoid Health Concerns

Cynthia: I have come to find that since we have this increasingly, metabolically, inflexible, unhealthy population, people are prone to more health issues. They are more prone to polycystic ovarian syndrome, infertility, insulin resistance, leptin resistance, high blood pressure, high uric acid, cardiovascular disease, and cancer risks are all associated with these higher levels of insulin. And insulin is not all bad. I think, unfortunately, people think of it as a bad hormone. But it’s a great hormone when it’s working effectively. 

If our hormone levels are never properly balanced, we’re chronically eating, and our insulin levels go down, we put ourselves at greater risk for these types of metabolic disorders. I would be remiss if I didn’t really emphasize that. That’s why I feel so passionately, that this is a strategy that women, irrespective of life stage should really be considering. I want my children, and I’m sure your children as well, we want them to grow up in a healthier environment than what we’re currently in. The most recent statistics I’ve read suggest that this population of young people is going to be less healthy than we are, for like the first time in history. This is a trend that will continue unless we do something to change it. 

Unfortunately, I think that in traditional allopathic medicine, we focus on symptoms. So if someone comes to you, and they’re tired, you’re not going to talk to him about his diet or not getting enough sleep. You are going to see what you can give him for more energy. It’s those kinds of non-root causes of purchase that I think are at the forefront for why we’re not proactive. 

A good example of this is a lovely former nurse, who was a patient of my practice. She’s in menopause. She has all the signs of someone who has not been on bioidenticals or hormone replacement therapy. Which is almost a crime because she has everything that you can imagine when you’re not on hormonal replacement therapy. She has bone issues, insulin and leptin resistance, all the types of GYN-related symptoms, which is just a travesty. We did fasting insulin and it was 30. There’s no way this poor woman is going to be able to lose weight as it should be between 2 – 5. So we start with baby steps and walk through the things that we can do to help you so that you can be empowered and make good decisions. She’s now hooked in with a great functional gynecologist. Thankfully, her sleep is improving and she is feeling better.

I think we’re missing the mark with women. This discussion isn’t just for those in perimenopause or menopause, but women north of 35 – 40 as well. In many ways, and I’m using their terminology, they feel forgotten, silenced, and marginalized. I want them to have the ability to take their power back and to be able to make good decisions so that they will have a high quality of life in perimenopause, menopause, and beyond and not feel like they have to just accept things as they are. That’s one of those limiting beliefs that really is a source of irritation for me because, on so many levels, I feel I don’t want women to think that they just have to accept everything that happens with age. I mean, we all will get older, right? I look different now than I did 15 years ago, but I have so many wonderful things that are in my life. I worry less about some of the vanity metrics and look to the future. I want to be able to keep up with my very active boys, I want to be able to travel, and I want to be sharp as a tack just like my grandmother was until she passed away in her 90s. You want to have a high quality of life and find strategies that can help you embrace that.

Dr. Tabatha: Oh my gosh, without a doubt and that’s why I support you so much. I hear the same thing from my patients. They just get dismissed. The doctors tell them they’re fine, that this is part of aging, and to just deal with it. I had someone yesterday reach out to me and say, “My doctor told me that I can’t lose weight. So why should I try?” That is a travesty! We are giving the wrong advice. So I’m glad that you’re out there fighting the fight with me because women need us. They need to hear that that is a bunch of crap. Some of these doctors are not educated about health and wellness and they don’t understand. They’re so stuck in the world of disease, they don’t even know what health looks like anymore. 

Cynthia: The thing that’s funny slash not funny, was that when I was 44 and hit that wall and felt like crap I had to re-do everything I was doing. I had to exercise and eat differently. I had an appointment with my GYN, just coincidentally, on the day my period started. I had been telling her my periods are really heavy. And so honest to god, she grabs a speculum and takes a look at me. She goes, “Oh, my God, your periods are really heavy.” And that started the conversation of synthetic hormones, an IUD, an ablation, and a hysterectomy. I told her no, I’m not going to do that. 

I hope women know that if you’re working with someone that tells you you just have to accept things as they are, that weight gain is a normal function of aging and you should just suck it up, you need to find a new gynecologist, midwife, or NP. There are so many people out there that want to help women., I think that’s really what it comes down to, you have to really genuinely love the work that you do and genuinely want to help people. 

I want people to have hope. I don’t want them to feel that once you get north of 35, things all fall apart and you just have to accept whatever happens. 

Dr. Tabatha: Yeah, I call bullshit on that. 

What is The Gut Microbiome in Connection to Intermittent Fasting?

Cynthia: I talk about digestive rest. So for people who are new to intermittent fasting, they freak out like I’m going to starve to death after not eating for 12 hours. Even at the 12-hour mark, we know there are benefits of not consuming food with greater frequency. When we’re giving our body time to break down food to be able to absorb nutrients, create healthy neurotransmitters, and utilization of the migrating motor complex. It’s almost like a street sweeper. We’re eating less frequently, so if you’re eating with, you know, four to five hours in between a meal, it’s giving your body time to push food forward, get rid of bacteria or other potential pathogens that you’ve ingested or been exposed to. There’s definitely a variety of profound benefits including hormonal benefits. We hope that we’re able to break down and detoxify hormones like estrogen. There are two phases of detoxification in the liver and the third phase is in the gut. So if your gut health is not optimized, you can recirculate these estrogens. 

People say, “Well, I poop every day, this is really not a big deal.” And I remind them, well, you have to test and not guess. The onslaught of chemicals we’re exposed to in our environment, personal care products, and in our food can really dysregulate that process. There are certain things that we look for in a DUTCH test that can let us know how well we are getting rid of these waste products.

When I think about intermittent fasting, one of my favorite benefits is really on the gut microbiome. The gut microbiome impacts immunity, blood sugar regulation, and our ability to fight off pathogens. The unfortunate thing is there are some changes with aging that are a byproduct of being north of 40. You make less hydrochloric acid, which is that first line of defense in the stomach. We may not make as many digestive enzymes and become a little more prone to insulin resistance. So being knowledgeable about the net impact of food choices, along with food frequency, can be hugely impactful. It can be as simple as starting fasting and eating less often and sometimes people don’t even change their nutritional patterns. They can see huge net benefits. I know a lot of people come to it for the body composition changes, but I always say they stay for so much more.

Dr. Tabatha: Exactly, they stay because they have energy and less brain fog. Not only was the weight finally falling off without any exercise for me, but I could think again. I had memory again, whereas before I was relying on my assistant to remind me of everything the patient had said to me in the plan. That’s how bad things were. Tightening up that eating window, giving my gut a break, and burning ketones for fuel, shifted how my brain functions. 

How Does Intermittent Fasting Work?

Cynthia: Jason Fung has a fantastic example. We look at carbs as the refrigerator and the freezer, which are the fats. And so we want to burn through our carb source so that we can get to the fats and burn fatty acids as a primary fuel source. We want to keep our fasting insulin low and in this non-fed state. This allows our body to utilize specific types of ketones, these fatty acids called beta-hydroxybutyrate. It’s diffused right across the blood-brain barrier, which is what oftentimes we believe is what is the primary precipitant for all that mental clarity because our brains love fat. It’s such an efficient utilization of energy. Mental clarity comes from lowered insulin levels and keeping your blood sugar stabilized lowers other inflammatory markers. It lowers our likelihood of developing high blood pressure, diabetes, and certain types of lipid disorders. 

One thing that I certainly wasn’t taught in my training was that more often than not a lot of the chronic disease states we see in the United States are a byproduct of high insulin levels. High blood pressure is a good representation of this, as opposed to just being related to salt. Actually, it might be that their diet is is too low in proper types of salt or sodium.

We were just on vacation and I have teenage boys. So every morning we got up and we had to eat breakfast before we did anything because their metabolisms are like hummingbirds. When I’m on vacation, I will switch things up. The night before I had a salad for dinner so I decided I was going to have a big omelet, potatoes, and a little bit of fruit. We had a very active day, but I got sleepy. It wasn’t the wrong choice of food, but my body is not accustomed to eating that early in the day. I felt like my entire day was off. I decided that the next day I was going to have an egg-white omelet to see if something less heavy would make me feel better.  

For people who are insulin resistant or leptin resistant, it may take a little bit longer. It may take you 3-6 weeks to feel like you’re fully fat-adapted, meaning your body is able to switch in between using carbs and fats as a fuel source. Most Americans are cruising along with carbohydrates and they’ll struggle with weight loss resistance, that hangry sensation. It’s important for people to understand it may take time and may not be instantaneous. It may not be in a week or two. 

You have to think about the things that will not break a fast such as black coffee, bitter teas, and water. Unfortunately, there’s this misnomer that you can have bulletproof coffee until the day you die. I remind people if you’ve got weight to lose, I would rather you use your body stores of healthy fat as opposed to adding more fat. If you want to fast clean, you want to be mindful of what you are consuming, so that you’re not inadvertently breaking your fast.

There are a bunch of fit pros that I’m sure mean well, but they’ll say things like, “If you have five grapes, then you’re not breaking your fast.” However, if you eat fruit, you’re going to evoke an insulin response. We can get very granular about things based on research that we know technically don’t break a fast, but I always remind people, I want them to learn how to clean fast, so they’ll get the best results.

Dr. Tabatha: Yeah, exactly, especially if they’re trying to lose weight, because you can burn the fat that you’re intaking and still be in ketosis like you mentioned with Bulletproof Coffee, but you’re not tapping into your fat stores and burning your fat for fuel. So you’re not going to lose weight. 

I think that this is the way of living for women all north of 40. This is how your body best functions. I mean, the evidence is clear. I see time and time again, as soon as that estrogen starts to drop, everything shifts, and it might take three to six months to really reverse insulin resistance, pre-diabetes, and those cardiovascular changes you were talking about. But it can be done. I see it every day. We like to do follow-up labs with my patients. You have to follow up to see your trends and what you’re looking like.

How Sleep Affects Your Weight 

Cynthia: It’s also empowering when people learn a sustainable strategy that they can adjust and be flexible with if they go on vacation or to a party. Again, we just got back from vacation and I definitely had some dessert. I wear a continuous glucose monitor so I can see exactly how my body responds. We were also so active. One day I looked at my Apple Watch and we had done 22,000 steps in one day. So, I had zero guilt about having this teeny tiny dessert, especially after being so incredibly active. 

Unfortunately, we’ve got a culture that wants instantaneous gratification. They want a pill, a potion, or a powder that’s going to give them the results. However,  they need to invest in a strategy that may take 2 – 6 months to be fully actualized. 

I think the more weight loss-resistant someone is, the more metabolically deranged they are. You may have to do more testing and dig deeper. I have women that will come into this program and they’re frustrated because it’s week three, their best friend has lost 10 pounds, and they’ve lost none. I just remind them that you may have to dig deeper. It may be that you have to clean up your personal care products or question if you have been exposed to mold. I also check in on their sleep. Is your sleep terrible? That’s one of the first things I tell people, if you can’t sleep through the night, I can’t get you to lose weight. So that flips the switch and we deal with the sleep piece first. 

Sleep is foundational. But again, it goes back to the fact that a lot of women stopped sleeping well as they get closer to those perimenopause years. Loss of progesterone and if they’re stressed, they tend to wake up and have racing thoughts. So being mindful of the fact that the lifestyle medicine piece is so critically important.

I always say, “what’s your tell?” For me, if I wake up in the middle of the night, I know that my stress is not managed as well as I think it is. So, that’s an instantaneous need for me. It may be being more diligent about my meditation or connecting with nature. A good example of this is it snowed here. In the part of the country that I’m in when we get a whiff of snow, everything shuts down. We had sleet and snow this morning. So it was very appropriate for the school to close. It’s now sunny, but going to freeze tonight. So my kids will probably be off again tomorrow. But it’s one of those things where I know that my brain was thinking about this. I know I woke up because I was thinking I could hear the sleet on the window. They’re old enough that it’s not as if my whole day gets kerfuffle if they’re home because they’re pretty independent. But it’s also one of those things it’s reassuring to recognize, “Okay, tonight, when I go to bed, I need to do more restorative stuff before I fall asleep.”

I think on so many levels, we’ve really conditioned our patients to ask for a pill to help with sleep, when really what they need is oral or transdermal progesterone. I’m by no means suggesting that’s not helpful, but it may mean that they really have to work diligently at wind-down time. I’ve actually started to write a prescription that you will read for 30 minutes. A physical book not on a device. You are going to do all the things that are telling your body it’s time to go to sleep and gear down. 

Have you read the book Breath? 

Dr. Tabatha: No I haven’t.

Cynthia: It’s by James Nesta and I’m actually interviewing him in a couple of weeks. He does this really deep dive into all these things that impact the parasympathetic versus sympathetic and breath. He talks about alternate nostril breathing. I think if you suppress your right nostril, it’ll upregulate the parasympathetic. So there are all sorts of things that you can do to support your body that doesn’t involve more prescriptions. Although again, I want to be really clear, most women in perimenopause and menopause need some progesterone on board because that will help with sleep for sure.

Dr. Tabatha: Yeah. You don’t need addictive sleeping pills that don’t actually give you restorative REM sleep. It’s this false fake sleep. I know for me, if I’ve drank alcohol or had a snack before bed, that blood sugar drop wakes me up every time. I’m hot, sweaty, and miserable. As a gynecologist, we’re trained to think that it must be your estrogen and it couldn’t possibly be anything else when really it’s so often related to our blood sugar.

The Correlation Between Alcohol and Our Overall Health 

Cynthia: Alcohol is definitely a problem. There’s this incredible wine drinking culture and there’s no judgment. I mean, I grew up with a parent that was an alcoholic, so I’ve never been a big drinker. But the one thing I found in perimenopause is anytime I had alcohol, it didn’t matter if it was a martini or a glass of wine, the hot flashes started. We know that it suppresses melatonin, increases cortisol, dysregulates your blood sugar, and we don’t make good decisions. 

My sleep is so important to me, that it’s not worth it in my opinion. It’s what works for me, but other people may not have that problem. However, the fact that I don’t have any hot flashes in the absence of not drinking alcohol is reinforcement for not drinking it because I just hot flashes are so unpleasant.

Dr. Tabatha: Yeah, exactly. I think a lot of women don’t realize that alcohol is literally just metabolized into sugar. I hear over and over from patients, “I don’t eat a lot of bread, cake, or candy.” Carbohydrates are in so many more things than that and alcohol is a huge one. It doesn’t have to be wine or beer. It can be vodka or gin. It all gets metabolized into sugar and affects you. 

Cynthia: Our body will metabolize the alcohol first at the expense of storing all the other food we’ve consumed in fat. So, I remind people that our body processes alcohol as a toxin. It’s going to get the highest priority. I’m not saying you can’t drink, but acknowledge that that’s part of the process. Maybe at 20,30 and 35, it wasn’t a problem and now all of a sudden at 40 your sleep is off. You don’t think it’s a big deal, but then as you start getting older it becomes problematic. I think for most women, north of 35 and 40 alcohol can be a huge problem. 

I’m from a family that really likes wine. I just got to a point now I carry around a bottle of sparkling water and some kombucha. It takes the pressure off of me because most of the time they think I’m drinking something alcoholic and I’m not. Add a lime wedge and it looks like something completely else. But the point I’m trying to make is to really empower women to make the decisions that are best suited for them and their goals. I think the pandemic has really done us a disservice. A lot of people have struggled to cope with a lot of things we have no control over. 

I met a lovely couple when we were away on vacation. The wife was talking about this menopause belly that she was frustrated with. She’s said, “I couldn’t eat the way that you do.” I said, “Well, that’s okay because I don’t feel like the way I eat I’m at all deprived.” She was telling me how she really loved wine. I told her that’s great and to just recognize that wine can be the reason you might be feeling all of this weight loss resistance and to maybe investigate that with your provider at home. She came up to me later and said, “You know, you’re the first person that’s ever said that to me and I’m really going to consider reducing my alcohol intake to see if that helps.”

We know that alcohol can also be pro-inflammatory. So if you’re already inflamed, it’s like adding gasoline onto a fire. It’s going to burn a little brighter and magnify the degree of inflammation that you see in your body. It goes back to the same metabolic flexibility, we want to reduce the amount of inflammation in our bodies to be healthy.

Dr. Tabatha: I couldn’t agree more. That’s so awesome that you had an impact on somebody on vacation!

Cynthia: Sometimes when I’m on vacation my kid’s eyes will glaze over like she’s going to talk about metabolic flexibility and they are so embarrassed. But it’s just part of what I talk about. People don’t even realize because they go into their doctor and they recognize you’ve gained 20 pounds and now you’re menopausal. They give you this estrogen patch and maybe some progesterone. Then you’re going to gain 10 – 15 more pounds because all the foundational work is not done. You haven’t dealt with the sleep or stress. 

Lifestyle Medicine…What Is It? 

Cynthia: I think we really do our patients a disservice by not really focusing on Lifestyle Medicine first and then adding in these other modalities. And I’m pro hormone replacement therapy and bioidenticals. In fact, the more I learn about them, the more I kind of feel like the Women’s Health Initiative is a tangential discussion. Women’s Health Initiative really kind of shifted the trajectory of a lot of people’s lives. More people need to hear this information. 

Dr. Tabatha: We’ve just created diseases where there didn’t need to be. I came out of residency right as that study came out. I saw the impact it had. Women were happy one day, and the next day, their medications were taken away from them, and they went downhill. It’s an important conversation that we need to keep having. 

Cynthia: Before I finished my nurse practitioner program in 2001, my graduate-level thesis was talking about endometrial cancer. And so imagine, Women’s Health Initiative comes out and boom. There was no way I was going into women’s health at that point. So I safely went over to cardiology. Life comes full circle, but I saw so many family members come off of hormone replacement therapy and saw the side effects, cognitive impact, bone health, heart health, etc. 

Dr. Tabatha: You talk a lot about bio-individuality in your book and learn how to do intermittent fasting in your season of life. You mentioned earlier that we’re not like men. We are cyclical and we have major hormone shifts that we need to flow with and really embrace.

Women Are Different From Men…Plain and Simple

Cynthia: When we’re talking about women, cycling women, perimenopausal women menopausal women, all these stages of life, women can benefit from fasting. If the bulk of the population is metabolically unhealthy, there are very few people who shouldn’t be fasting. When a woman is still in her peak fertility or is very lean, that’s not someone I would recommend fast every single day. They might be somebody who fasts once a week or she has 12 hours of digestive rest because our brains are very sensitive to this feast famine cycle.

I remind people that whether we choose to or not our bodies as women are designed to be fertile. And so what impacts fertility can be a lack of nutrients and a lot of people struggle to get enough food in during their feeding window. So cycling and lean women are in a different category, but the average woman even while still cycling, can fast differently in your follicular phase, the first predominant phase of the menstrual cycle when estrogen is at its highest and differently than you do in the luteal phase, the last two weeks and progesterone predominates, versus women who are perimenopausal 5 to 10 years preceding menopause. If you’re north of 35, you are there, whether you are willing to admit it or not.

I have had pleasant arguments with people where I’m like, “Listen, your ovaries and eggs are as old as you are.” Whether you realize it or not, you’re not ovulating every month. Menopause is kind of cool because this is a time when there’s not as much fluctuation month to month or day-to-day. I always say women that are menopausal if their sleep, stress, and nutrition are all dialed in, you have the best of all worlds. You’re not getting a menstrual cycle anymore and you can probably fast as easily as most men provided that the lifestyle medicine stuff is dialed in. I have found for some women who are in their 50s realize that they have been able to get rid of 30 pounds that they have been trying to lose for 10 years with just fasting. 

I feel like women in menopause, provided all the other things are dialed in, get a little bit of a free pass. I worry the most about perimenopause women because it is such a seasonal fluctuation. There’s research that’s out there that I allude to in the book, but there’s so much fluctuation because some of these changes are so subtle. Maybe at 35, your progesterone is starting to decrease and your testosterone is not as great. Then you combine it with when you are in your early 40s, you are more prone to losing muscle mass and it starts to accelerate. The less muscle mass you have on your body, the more insulin resistant you become. The more insulin resistant you become you’re not going to have the same hunger cues. Maybe you’re trying to eat like you were at 25 and it doesn’t work for you in your early 40s and your sleep becomes evasive. I feel like perimenopause is this potentially vulnerable time for women. But again, if they dial in the lifestyle piece and they understand what’s happening to their bodies, they can navigate this beautifully. 

In fact, I use perimenopause as a barometer, as well as the menstrual cycle, as a barometer of whether or not fasting is working for them. I dive more deeply into this in the book, but I use the menstrual cycle, really as a barometer to get a sense of how much stress their body can manage. When we talk about beneficial stress, I’m talking about hormetic stressors. Certain types of exercise, foods, cryotherapy, infrared, sauna, etc. Those are all examples of hormetic stressors, it’s beneficial stress in the right environment makes the organism stronger and more resilient. We want our bodies to be stronger and more resilient. That’s why another reason why fasting and taxing our body in the right way can be hugely impactful.

However, you can’t fast as a woman at 32 the way that the husband can. I sometimes feel there’s this misnomer. If we look at the research over eight weeks, men will almost always lose more weight upfront because they generally have lower body fat percentages. Depending on where a woman is in her cycle or whatever else is going on, we’re just more sensitive. It’s taking in information around us in our environment. I remind people, even if you have no desire to get pregnant, that’s your body’s physiologically focus, is sustaining life. If there’s a possibility of someone ovulating,  the egg gets fertilized, and you go on to have a fetus and a baby. But it’s one of those things where I just remind people that our bodies are so complex as women. But fertile, younger women that are lean have to fast very differently than women who are still in their fertile years versus perimenopause versus menopause. All of this is talked about in the book and in greater detail. 

When Should You Fast?

Cynthia: But again, I don’t like the fear-mongering that goes on. I think it does such a disservice. You know, there are times in our lives when we can fast and times that we shouldn’t. A good example and a relevant example is when I spent 13 days in the hospital in 2019. You better believe I didn’t fast when I came out. I had lost 15 pounds and it took months to gain back healthy weight. I didn’t have the blood sugar control as I remember, I was symptomatic and hypoglycemic. It took time for my body to get back to a point where it was healthy enough to be able to fast. So there are times in our lives we may not be able to fast and there are times in our life when it’s completely appropriate. But it’s the acknowledgment that we have to be tuned in and aware of what information our body is providing us with.

So I  like to encourage women to lean into what their body is telling them. Which completely goes against what we’re taught as providers. We’re taught to be the expert telling the patient what needs to happen. Whereas, I encourage them to lean in and give me input on what is and isn’t working for them. 

Dr. Tabatha: That’s what my next book is about. We teach our children, our daughters, to ignore their bodies and to mask the symptoms, suppress them, get on the birth control pill, or do whatever you got to do to not be in tune with your body. We need to get back to listening to our bodies. 

So thank you so much for talking about all of these different stages in your book. I think it’s so important for women to realize that it’s not a one-size-fits-all. And it’s not even a one-size-fits-all, for you for your whole life. You have to do things differently in different seasons of your life that work for you. 

You address that so beautifully and I’m really excited about your book because I just know that it’s going to touch so many women’s lives.

Cynthia: No, thank you. It’s definitely a labor of love. My intent and my hope are that this book will be a resource and will help not only women but also clinicians as well. 

When I connect with people on social media, whether it’s an MD, a nurse practitioner, or a nurse, just say like, I want to learn more about this, because I want to be able to teach my patients. There are so many providers out there that need resources and opportunities to be able to share resources with their patients that are written from the perspective of a clinician. But also understanding what it’s like to be a patient and how they can feel lost. 

It’s so important that we as clinicians are transparent about the fact that I didn’t know anything about this. I thought I was, you know, fairly woke and informed. I certainly went to a good university and yet I didn’t until I hit that wall. That was what changed everything for me and got me to where I am today.

Tell Me How My Audience Can Connect With You

Cynthia: You can find me by going to my website. There you can read all about my story and my new book. You will also find ways that you can work with me on the website. I also have the podcast and YouTube channel you can check out. And of course, I’m on Instagram as well. 

Dr. Tabatha: Awesome. Go check out everything that Cynthia has to offer. 

Thank you so much for paying it forward and creating this. I think it’s going to change women’s lives. I want all gynecologists to read the book, take it in and think about doing things differently with their patients because that is what we need to change this system. 

Cynthia: Thank you for your time. I’m grateful to connect again with your listeners. I am grateful that the work that we do together allows us to inspire women to live healthier, happier lives, irrespective of where they are in their life stage.

To Wrap It Up

I hope that was helpful and that you have gained some clarity around what intermittent fasting is and how it can be beneficial to our overall health. If you are struggling with your weight, disease, or just overall not feeling well check out more of Cynthia’s information and see if intermittent fasting could work for you. It’s so important that we take care of our weight and we watch the types of foods that we consume. We need to clean up our diets, focus on getting rest, and try to avoid all the stressors that everyday life can throw our way.