In terms of losing visceral fat, I mean,

the good news is is that you can lose it

quite easily and quite rapidly.

>> I was going to say parents have a hard

time because you're naming those things

about like sleep and stress and and I

was thinking gosh, parents have like a

have it coming from them from all sides.

They do. Um the but see this is where

the good news comes in because, you

know, part of the reason why sleep is

causing you to gain more visceral sleep

loss is causing you to gain visceral fat

is because it's causing your body to

become insulin resistant. It's like this

vicious cycle. Visceral fat causes

insulin resistance insulin insulin

resistance causes more visceral fat,

right? And becomes this and that's why

once you get into that cycle, it just

spirals out of control, right? And you

start to gain more and more and more. So

wait, insulin resistance, what is that?

That is when your body no longer

produces insulin or

>> No. No, insulin resistance is when your

body is no longer responding to insulin.

So it's like it's like you're waiting

for the phone to ring and it's ringing,

but you can't hear it, right? Like you

you're not getting the signal. And so

your your cells are not responding to

the insulin that's made. Insulin is

really helping your body bring move the

glucose out, right? Move it move it out

of your bloodstream where it can cause a

lot of damage if it sits around.

>> And if you put too much pressure

pressure on the insulin system, then it

kind of shuts down. Eventually shuts

down.

>> And the thing that puts too much

pressure is consuming too much glucose

or too much activity?

Too much glucose refined glucose can do

that. Visceral fat is one of the I would

say bigger causes of insulin it's

actually one of the major major causes

of insulin resistance because

if you are physically active and eating

a lot of glucose, that glucose is going

to your muscles. Physical activity makes

your muscles very responsive to glucose

without needing insulin. Your the

transporters that transport glucose are

super super responsive when you

exercise. That's why physical activity

and this is what I was getting at with

parents is so important. The visceral

fat is the really big like concern with

insulin resistance. This is and this is

the thing that again it's like people

don't even know about it. A lot of

people are thinking about glucose and

oh, I got to watch my glucose and that's

all fine. I mean, yes, to some degree

that's also playing a role,

but it's it's it's the visceral fat

that's the real underlying problem

that's that's causing you to become

insulin resistant. You mentioned parents

have it like bad because they're

stressed out and they don't get sleep. I

was wearing a continuous glucose monitor

when I became a new mother.

I was appalled by my fasting blood

glucose and by my postprandial blood

glucose levels. Postprandial?

Postprandial means after a meal. Okay.

So your levels go obviously much higher

after you eat a meal versus in the

morning when you haven't had anything to

eat.

>> Mhm. And my levels were were so high I

was pre-diabetic and and I was just I

couldn't believe it. It's not like I'm

eating, you know, drinking Cokes and

eating terrible, right? But there was a

period of time when I'm not as

physically active particularly in the

first couple of months. It's really, you

know, that's the time when you're kind

of just in this cave. I immediately was

looking into the scientific literature

and found that high intensity interval

training and exercise can help almost

negate most of the those poor effects of

causing insulin resistance and causing

your glucose regulation to not be

normal. That's the good news for parents

is that you should prioritize new

parents should prioritize exercise. And

exercise does

cause you to lose visceral fat. It's not

just any type of exercise really has to

be aerobic and the more vigorous the

better. So for people that don't know

what that means, aerobic and vigorous.

>> Yeah. So what I mean is resistance

training and lifting weights don't

really move the needle in terms of

helping you lose visceral fat. It does

help you

improve your metabolism. It does help

with like glucose, you know, sensitivity

and all that like cuz your muscles are

going to be more sensitive to take the

glucose in, but if you want to lose

visceral fat, you're going to have to do

running, jogging, cycling, swimming when

it like get your heart rate up a little

more. Why? It's energy expenditure. It

plays a role in getting you to that

caloric more caloric deficit and that's

better. So that's one way and the other

thing is weight any any weight loss

program. So intermittent fasting,

caloric restriction, you know, even

GLP-1 receptor agonist and all the

classes of GLP-1 anything that is going

to make you lose weight, lose fat

visceral fat's one of the first to go.

And in fact, people on on these these

weight loss programs or even on exercise

training program, visceral fat's the

first fat to go and and so you can lose

it quite quite quickly. So on this point

of fasting,

are you a fan of fasting to combat

visceral fat? And also, could you give

me your thoughts on being in a ketogenic

state as it relates to visceral fat?

Yeah. People when they think about

intermittent fasting,

they kind of think about,

you know, one thing and they think about

weight loss, right? But there's a lot

going on here and I like I like that you

mentioned being in a ketogenic state

because there's also a metabolic switch

that happens. This metabolic switch from

burning carbohydrates and glucose to

burning fatty acids and getting in

ketosis, right? That's a metabolic

switch and it's very important. There

are two different things happening here.

But intermittent fasting is essentially

a good tool that people can use to

reduce their calorie intake without

having to count their calories. That's

why I like it. You can you can lose

weight by counting your calories and

reducing your calorie intake. I

personally think that's a lot of work.

Some people love doing it and that's

great. I think whatever works for a

person, but

way in which intermittent fasting helps

people lose visceral fat is by reducing

calorie intake. That's what I'm getting

at. It's like a tool that some people

like to use because I like it for one

because I can not think I just I'll skip

one meal making sure I get enough

nutrients in the in the meals that I eat

and protein in the meals I eat, but I'll

skip a meal and it gets me in a caloric

deficit without having to think about

and count everything. So it's easier on

me. To fast? To fast versus counting

calories.

>> And how how do you do that? What's your

>> So I like to fast in the morning and the

reason I like to fast in the morning is

for the exact reason you mentioned and

that is the ketosis which I like to call

the metabolic switch. You're not eating

while you're sleeping obviously. So if

you're sleeping for eight if you're in

bed for 9 hour 10 hours, you're not

eating during that time. And it takes

about 10 to 12 hours for your liver to

deplete glycogen. Glucose that's been

taken up by the liver is stored as

glycogen so that you can then use it for

energy later if you don't have energy

coming in, right?

>> So the glycogen is like the the petrol

station. Yes.

>> So it runs out of petrol.

>> that's right.

And and so um it takes

>> to diesel.

>> And then it switches to diesel. And so

after that switch, that metabolic switch

when you deplete that glycogen while

you're sleeping or while you're not you

know, not eating after about 12 hours.

And by the way, this is all relative

because it depends on the kind of foods

you eat and how physically active you

are. So if you eat a lot of high

carbohydrate refined sugar stuff, you

might take even longer to deplete your

glycogen because you're you're putting a

lot of input in there. You keep filling

up the the fuel tank, right? But if

you're eating things that are more low

carb, you might deplete your glycogen

sooner. So when you deplete your

glycogen, you get into this metabolic

switch because your body still needs

energy, but there's no nothing no

glucose around, right? So you start to

switch to, you know, your fatty acids

are mobilized. They come out of your

adipose tissue. This is why people lose

fat. They come out of the visceral fat.

You you start to use those fatty acids

and burn them as energy and as a product

of that energy you're making ketones,

ketosis.

And the reason I like to do this in the

morning is because then I can really get

into that ketotic state where if I'm

fasting, I do it typically I fast for

about 16 hours a day and then I eat my

meals within 8 hours of a day. Typically

that's my what I do. The reason I like

to be in that metabolic switch state is

many reasons actually. One,

the ketones themselves are

providing my brain with energy very

easily utilizable energy, but they're

also acting as a signaling molecule to

my brain going, "Hey, this is a

stressful time. There's no food. You

better be cognitively sharp. You got to

find that food. You got to like know

what you're doing, right?" It's an

evolutionary adaptation. You know,

humans for thousands of years were going

through this metabolic switch because we

didn't have Instacart. We didn't have

Postmates. We didn't have all Uber Eats,

right? We had to find our food. We had

to hunt our food and we always didn't

always do that, right? And so when I get

into that metabolic switch state, I feel

it. I feel more cognitively sharp and I

feel less anxious which is part of it

because those ketones also help increase

something called GABA. That's an

inhibitory neurotransmitter. It's

essentially you can just think of it as

like it helps you feel calmer. When I

feel calmer,

I'm more cognitively focused because

it's like the background anxiety is

down, right? It it's like you can focus.

And so I love being in that state in the

morning because that's when I get my

work done. I also like to be in that

metabolic switch state and this is why I

like fasting in addition to you know,

the calorie the fewer calories I'm

consuming, right? Your body has to be in

that fasted state to repair. If you're

constantly in a fed state, fed states

are important for anabolic growth. We

need it to grow, right? But the repair

state is also very important because

with the growth comes damage. Damage

comes along with that and you want to

repair that damage because damage will

accelerate aging. And so I like to be

and give my body enough time. I don't

want to just wake up and eat where it's

like, "Oh, I've only barely depleted my

liver glycogen. I'm not even in that

repair state very long, right?" I want

to extend it a little bit. And so I like

to have that repair process active. And

that it is active during it's fasting

activates it, but also you have some

amount of active repair going on even

when you're in a fed state. It's just

heightened when you're fasted. So those

are the reasons I like to be

I like intermittent fasting. I feel good

when I do it. I also do a lot of

training, not all of it, I do a lot of

training fasted.

Cardiovascular, aerobic, endurance

exercise, so running, biking, that stuff

I like to do fasted. I'm not going for a

10-mi run, I'm going for a 3-mi run,

right? I mean, this is So, if I was

going for a 10-mi run, I wouldn't be

fasted. I would need some fuel.

But, there are studies

multiple studies showing that if you do

aerobic endurance training, this kind of

running, cycling, swimming type of

training,

you actually have better adaptations if

you're fasted versus fed. What does that

mean?

So, much of the benefit from exercise,

right? Aerobic exercise, when you're

breathing in, you're you're you're

you're Yeah, right? You're working hard,

is from the working hard, but your body

responds to that, right? Because the

working hard is causing inflammation,

it's causing oxidative damage, and your

body is responding to that by going,

"Oh, we got to get better at this

stuff." So, you have anti-inflammatory

pathways activated, you have antioxidant

pathways activated. Your body needs to

burn fat, you need fuel. And so, if

you're fasted, you get better at burning

the fat and oxidizing the fat, and you

continue to do that throughout the day

better as well. So, you have what are

called mitochondrial adaptations that

are better. You make more mitochondria.

Mitochondria are very important little

tiny organelles inside of most of our

cells that make energy, and they, you

know, they're very important for

everything. I mean, they're running our

brains right now so we can talk, our

heart, you know, so we can breathe, our

lungs, everything, right? And so,

exercise does make you increase the

amount of those new mitochondria that

you make that are young and healthy. If

you're fasted? Both, even if you're not,

but if you're fasted, it's even better.

This has been a big debate around

whether this applies to both men and

women. Should both men and women

exercise fasted? This is my read of the

literature and my thoughts on this from

also having experts that have studied

male versus female

responses to exercise. First and

foremost, how do you feel when you

exercise fasted? If you feel terrible,

that's a sign. I think listening into

your body

is the most important thing that you can

do. There are times when I have to eat

before I exercise, and I listen to my

body. I That's it. I'm I'm going to eat.

When it comes to women versus men and

doing exercise fasted, it also depends

on are you again, are you doing a 30-mi

run? Are you doing a 2-hour run? If

you're doing a 2-hour run, you need to

fuel. That's a lot. That's a big stress.

When it comes to a 30-mi run,

you don't really necessarily need to.

Now, the problem with women is that

they're often if you're in too much of a

caloric deficit and you don't eat enough

food within, you know, like afterwards,

you're not refueling enough, and you're

doing very, very long, high volume types

of exercise, then you can basically

disrupt your, you know, some of your

hormones, your your follicle-stimulating

hormone, luteinizing hormone, these

things will make you become amenorrheic.

So, you basically stop ovulating and you

stop getting your menstrual period. And

what's the evolutionary reason for that?

What's going on there? Because your

body's like, "There's not enough food

and energy around to sustain

a baby, you know, a growing fetus, like

there's a growing baby."

>> down. So, it's So, it's basically like,

"Hey, we're not going to allow you to

have a baby, basically." So, you stop

you stop ovulating, right? So, you can't

you're not making you're not making

those eggs. Is this often the case with

women who exercise a lot and and no

longer have their menstrual cycle? First

of all, it's not a common thing. This is

like This is something that happens in,

you know, like athletes, elite athlete

women that are not eating enough food.

Like, I I did this to myself when I was

in my early 20s and I was running I was

racing marathons and I was running 10 mi

a day, you know, 8 to 10 mi a day, 5

days a week, and then I was eating

carrots and hummus, and you know, I just

I wasn't fueling myself, and I did I did

this to myself, too. So, how do you feel

if you train fasted? Do you feel

terrible? Don't do it. If you want to

train somewhat fasted, go for the

protein, you know, protein shake with a

little bit of almond milk or something

like that, where you're not eating a

full meal, but you're getting something.

So,

I do a lot of my training fasted, and

that has helped me, you know, I'm 47

years old and perimenopausal.

>> You're in phenomenal shape. Thank you.

Thank you. Um, but I did notice, of

course, as as I started to reach that

perimenopause part of my life, that I

had to be a little bit more aggressive

and put a little bit more effort in to

not get

this fat right here on my belly cuz it

started coming up, and I didn't want it.

I didn't It wasn't It wasn't an option

for me. Speaking of uh studies done for

women, I used I heard you talk in the

past about the SWAN study, which kind of

relates to what you just said there.

Um, when uh relating to women and

visceral fat, and they found that women

experience an accelerated increase in

visceral fat starting 2 years before

their final menstrual period. Yeah, cuz

that's when their estrogen is about It's

plummeting, right? You're just going off

a cliff because you're you're about to

go into menopause. Again, what age would

that be? Average age of menopause is

between 50 about 50, 52 for women.

A lot of that There's a lot of things

that can affect your reproductive

lifespan, your ovarian aging, I guess we

can call it. And

unfortunately, one of them is when you

the age you were when you got your

menstrual period. So, if the younger you

were,

the younger you're going to be when you

experience menopause. So, also when your

mother experienced menopause is very

very indicative of when you're going to

experience it, but lifestyle and diet

play a role, too. Obesity accelerates

ovarian aging, so you're more likely to

go into menopause earlier with obesity.

Also, these chemicals that we're exposed

to, and we can talk about those as well.

A lot of these endocrine-disrupting

chemicals affect the age of menopause as

well and and accelerate that. So, some

In some cases, women go into menopause 2

years earlier than they would have

otherwise.

And you're say you're 47. Mhm, and a

half. And a half. And the the data that

I'm looking at here says

when we think about perimenopause, it

usually starts in mid-40s, which is the

age range you're in. This is where the 8

to 10% annual visceral fat increase

begins. It is. And and I know

>> Annual? Yeah. I can tell you from people

in my life that I've seen going through

this, it's pretty sudden

that you'll see someone in your life

that's a woman that's going through

peri- perimenopause,

and maybe hasn't had any other symptoms

yet, so they haven't really sought out

any treatment. Now, you can You can try

to do some hormone replacement therapy,

as well, to help with that, but they

start to gain visceral fat, and it shows

up around the belly quite rapidly. And I

noticed this in myself. It almost feels

overnight, seriously. This is the only

symptom that I noticed in myself where

it was like all of a sudden

my belly was like growing, and um

you know, not super, super large, but

enough where I was like, "There's

something wrong." It's not even

necessarily reflected if you get hormone

tests cuz mine all seem normal. The

thing is is that the estrogen, when it

drops, that estrogen is so important for

telling your body to store energy

differently, not around the organs, but

to make it around, you know, other parts

of your body, like your your thighs and

your butt, right? Like, your adipose

tissue. And so, when that estrogen goes

down and declines, it's like, boom, it

starts to go right to the belly.

So, that is why for me, intermittent

fasting has been really important. Like

with any

weight loss or calorie restriction

protocol, you do need to make sure

you're getting enough protein because

that's important for muscle, right?

Muscle growth and preventing atrophy of

your muscle, and you need to also do

resistance training. That also is a very

important signal for muscle because the

problem is some people

calorie restrict and eat fewer meals,

and then they're not getting enough

protein, and they're not training, and

they start to lose muscle in addition to

fat, and you don't want to do that. You

want to kind of just lose the visceral

fat and keep the muscle, ideally keep

gaining muscle. And for men, I was

reading that testosterone and growth

hormone typically peak in their late

20s, so I guess mine's peaked already.

Um, and starting at age 30, testosterone

drop drops roughly 1% a year. So,

between the age of 25 and 65, men

typically see a 200% increase in their

visceral fat, even if their total weight

stays the same.

So,

>> [clears throat]

>> is that linked to the testosterone

decline? Is that what's going on there?

What's causing it? Yeah, I mean, it's it

testosterone does you burn even if

you're gaining visceral fat, it helps

you burn it. It's It's also why some

women that are in perimenopause want to

do testosterone because it helps them

burn the visceral fat. Mhm. Um, so, it

is it is linked to testosterone decline,

as well. But, also, as men are aging,

they're becoming more sedentary. They

send they tend to eat a little bit

They're consuming more calorie. Like,

all these things are hand in hand, so

it's like a It's not just like a one

punch, right? It's like multiple angles

are kind of all compounding and coming

together. Whereas, you could get away

with it a little bit easier when you're

younger cuz the testosterone was helping

you burn it more. Mhm. [clears throat]

When you're declining, it doesn't it

doesn't work that same way. So, even

though you're gaining it, you're not

burning it as quickly. So, you start to

have a net gain in it, uh if that makes

sense. So, going back up to the top

then, we were talking about things you

can do to lower your visceral fat, and

we talked a little bit about exercise,

sleep, diet. Is there anything else in

that category?

Yeah, I think those are the main ones.

Obviously, avoiding excess alcohol

consumption. Yep. And also Stress. Yeah,

we talked Yeah. The stress, like, you

know, trying to to

relaxation techniques, buffer that

stress. That's a big one. It's an

amplifier.

Yeah, people don't talk enough about

visceral fat. You know,

they look at other markers. No, well,

most people just want to lose weight and

look good. Yeah. Or

Yeah, they look at, you know, HbA1c,

your long-term glucose, or they're

looking at lipids, and visceral fat is

just it's it's insidious, right? It just

starts

increasing, increasing, increasing, and

you can't see it. You can't see it until

all of a sudden, belly, right? I mean,

it's it's it's bad. And it affects the

way you feel

daily.