Translator: Rhonda Jacobs Reviewer: Tanya Cushman

What if I told you that breakfast being the most important meal of the day

was wrong?

(Laughter)

What if I told you it is more important when you eat than what you eat?

Perhaps much of the nutritional dogma that we've been raised with

is now outdated,

like snacking all day long and eating many meals.

Over the next few minutes, I plan to discuss with you

what I believe to be the most profoundly transformational concept and strategy

as it pertains to health and aging.

Over the last 20 years,

as a nurse practitioner and a functional nutritionist,

I've seen tremendous shifts,

tremendous shifts in health and wellness:

escalating rates of obesity, diabetes and cardiovascular disease -

many of which are preventable.

The choices we make in terms of nutrition are profoundly impactful on our health,

more than most of us realize.

During my training as a nurse practitioner

many years ago,

the dominant nutritional paradigm was exercise more, eat less.

I've found this to be profoundly ineffective

for most, if not all, of my female patients.

The concept of "calories-in, calories-out" alone is just not effective.

Many of the things that I work with, with my female patients

really focus on the connection between our lifestyle choices

and how that impacts healthy aging

and weight gain.

I do not believe, nor do I support, the limiting belief

that women have to accept weight gain as a normal function of aging.

The National Health and Nutrition Exam Survey,

which looks at data with regard to children and adults

in terms of their nutrition and escalating obesity rates,

compares what went on in the 1970s,

where most Americans consumed three meals a day

and no snacks;

fast forward to today,

most of what we are doing as Americans is eating three meals a day

and snacking all day long.

Really.

And so one of the things that starts to happen

when healthcare providers are telling our patients

that we need to eat all day long -

it's wrong.

Eating all day long overtaxes our pancreas and our digestive system.

It overtaxes it so much that it cannot work properly.

And if it cannot work properly, we cannot absorb our food

or the nutrients in that food.

Another really important distinction when it comes to meal frequency,

or how frequently we're eating,

is the debate over sugar burners versus fat burners.

And when we're talking about that,

a sugar burner is someone that consumes lots of carbohydrates

and taps into glucose as their primary fuel source,

which is incredibly inefficient.

If you recognize these individuals:

They are frequently hungry.

They often get hangry.

They have - yes - significant dips in their energy level.

They struggle more with fat loss, and they struggle more with their weight

because insulin levels are high.

Insulin is that fat-storing hormone.

So if levels remain high, we have more oxidative stress;

we have more inflammation;

and we struggle more with weight gain.

In sharp contrast to this are fat burners.

They tap into fat stores for energy;

they have sustained energy;

they are much more clear cognitively;

they don't get hangry;

it's easier for them to lose weight

because they tap into those fat stores;

they sleep better; and they age more slowly.

So meal timing and how frequently we are eating - it's absolutely crucial.

Absolutely crucial.

Let's talk about some statistics as they pertain to women

and healthy aging.

So we know two-thirds of women 40-50 years of age are overweight,

and more than half are obese.

How do we proactively address this statistic

without quick fixes?

It makes me want to cry

when my female patients would prefer I write them a prescription

than work on changing their diet,

more exercise,

other lifestyle changes.

Women in their 50s and 60s gain an average of 1.5 pounds per year.

Per year. That's average.

And some of this is attributable to things like hormonal fluctuations,

women having less lean muscle mass than their male counterparts,

sleep disturbances and mood disorders.

However, there are strategies we can use to help offset this.

So folks, I want you to save your money

on potions and powders and supplements that are not long-term solutions.

I've got a better idea.

And I'm going to tell you about it.

I've got a better idea.

There are lots of strategies that I use with my female patients,

but none more powerful than intermittent fasting.

Intermittent fasting can help fuel fat loss

as well as many other benefits that I'll talk more about in a second.

But it also can improve interpersonal relationships

and self-esteem.

And for many women, this permits them -

it's the magic bullet that allows them to gain back their former selves.

Really powerful.

And the really cool thing about intermittent fasting

is it's free,

it's flexible and it's simple.

You take nothing else away.

Free. Flexible. Simple.

So let's talk about intermittent fasting.

It is the absence of food during a prescribed time period.

You exist either in a fed or a fasted state.

I'm sure for many of you, you had breakfast this morning.

So when you eat, insulin is secreted by the pancreas

to move sugar into the cells.

We store the bulk of our sugar in our liver and our skeletal muscle.

But when we exceed those storage sites,

we store it as fat.

When we're fasted, insulin levels are low

and we can tap into fat stores for energy.

Free. Flexible. Simple.

And so, when we're talking about intermittent fasting, it's fairly simple.

If you skip breakfast -

If you skip breakfast in the morning,

you can reduce your caloric intake by 20 to 40 percent.

And the typical time frame that I recommend to my female patients

is a 16:8.

Sixteen hours a day fasted with an eight-hour feeding window.

I know that seems a little overwhelming at first,

but I'll give you some strategies for how you go about doing that.

So, the 20-40 percent reduction in calories

means that you can fuel fat loss.

So what are some of the benefits other than fat loss -

fat loss and especially visceral fat around our abdomens,

around our major organs?

We know that it improves mental clarity because insulin levels are low.

We know that it spikes human growth hormone,

which helps us with lean muscle mass.

We know that it induces something called autophagy -

I will speak more about this in a second.

But this is spring cleaning for the cells.

It is only evoked when we are fasted.

Autophagy.

We know that it lowers insulin levels,

blood pressure,

improves our cholesterol profile.

And we know that it can reduce your risk for developing cancer

and Alzheimer's disease, which I like to call type 3 diabetes.

If, for no other reason, we want to protect our brains.

As wonderful a strategy as this is, it is not for everyone.

I'm going to talk briefly

about the individuals that want to avoid this strategy.

First and foremost, if you are a brittle diabetic,

or you have difficult-to-control diabetes;

if you are a child, an adolescent or age greater than 70 -

might not be the best strategy;

if you are pregnant;

if you have chronic heart issues, kidney or renal issues -

not the best strategy.

If you have a history of a disordered relationship with food,

whether it is anorexia, bulimia or binge eating -

might not be the best strategy because it can invoke those tendencies.

And last but not least, if you have a low body mass index,

you're frail

or you've recently been in the hospital like I was for 13 days.

I'm not currently intermittent fasting.

Now, everyone always asks,

Well, when you're fasting, we know we're not eating food,

but you can absolutely consume things like filtered water, plain coffee or tea.

They will not break your fast.

But when you're ready to eat, what do you eat?

Now, I would be remiss if I did not mention that there are foods

that are going to be more advantageous for you to consume

when you're ready to break your fast.

So I want you to focus on real whole foods.

That's what your body needs, wants and deserves.

So I want you to purchase the best quality protein that your budget permits.

Ideally, organic or pastured meat, wild-caught fish.

Healthy fats - so crucial -

helpful for building healthy hormones

and also really important for satiety - making sure our taste buds light up,

make us happy.

I'm not part of the anti-fat brigade.

Really, really important.

Twenty years ago, I might have told you not to eat fat,

but now we know better.

So I want you to focus on things like avocados,

coconut oil, grass-fed butter and nuts - really great, healthy fats.

Unprocessed carbohydrates.

Ladies, absolutely crucial,

if you're in perimenopause, the five to seven years before menopause,

or you're in menopause,

quality and quantity are crucial.

So I want you to consume things like low-glycemic berries,

green leafy vegetables, squash, quinoa, sweet potatoes

as opposed to bread and pasta.

Cautionary tale: I want you to limit sugar and alcohol.

By that I mean, I want you to not consume those things

because they can offset all the good that you're doing.

And lastly, keep yourself well hydrated.

Now, I want to make sure

that I briefly touch on some of the practical implications

for how you would go about starting intermittent fasting.

Generally, I have my ladies start with 12-13 hours of fasted period.

And they can slowly increase by an hour or so every day

until they've reached that 16 hour mark.

Again, you want to keep yourself really well hydrated.

You can also have plain coffee or tea.

In addition to that, you want to ensure that you give it a solid 30 days

before you determine if it's the right strategy for you.

And if you have chronic health conditions,

I want to make sure you discuss it with your healthcare provider.

Really important.

And recognize it may take six to eight weeks

to really see the full benefits of what you're doing.

The biggest pain point for my female patients is weight gain.

I have a fantastic strategy to help with this,

but I don't want you to buy into the next $50 container of protein powder

or the hottest weight loss supplement that's out there.

I want you to think about the fact this is a simple, flexible and free option

that you can try at home,

discuss with your healthcare provider if necessary.

I really feel so passionately about this

because it's something that all of us should be discussing with our patients.

Thank you.

(Applause)