Ep. 109 - Psoriatic Arthritis (PsA), Auto-Immune Conditions, Insulin & Fasting - Connecting the Dots | Psoriasis, Inflammation, C-Reactive Protein (CRP) | Free Intermittent Fasting Plan for OMAD

Uncategorized Jan 25, 2022

In this episode, Dr. Scott and Tommy discuss Psoriatic Arthritis and a host of related inflammatory and auto-immune conditions. These ailments are being increasingly acknowledged to have metabolic commonalities, and studies show improvements through fasting and other insulin-lowering methods. 

Rheum Doctor - What is a high CRP? Measuring inflammation

The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study

Psoriatic Arthritis and Diabetes Mellitus: A Narrative Review

Effect of fasting with two meals on BMI and inflammatory markers of metabolic syndrome

Relationship between C-reactive protein and visceral adipose tissue in healthy Japanese subjects


Show Transcript: www.thefastingforlife.com/blog


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Fasting For Life Ep. 109.mp3

Dr. Scott Watier: [00:00:01] Hello. I'm Dr. Scott Watier

Tommy Welling: [00:00:03] And I'm Tommy Welling, and you're listening to the Fasting for Life podcast.

Dr. Scott Watier: [00:00:08] This podcast is about using fasting as a tool to regain your health. Achieve ultimate wellness and live the life you truly deserve.

Tommy Welling: [00:00:15] Each episode is a short conversation on a single topic with immediate, actionable steps. We cover everything from fat loss and health and wellness to the science of lifestyle design.

Dr. Scott Watier: [00:00:25] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned

[00:00:30] Along the way.

Dr. Scott Watier: [00:00:40] Hey, everyone, welcome to the Fasting for Life podcast. My name's Dr. Scott Watier and I'm here, as always, am a good friend and colleague, Tommy Welling. Good afternoon to you, sir.

Tommy Welling: [00:00:47] Hey, Scott, how are you doing?

Dr. Scott Watier: [00:00:49] Fantastic, my friend. We're going to be having a research, science based conversation today. We're going to be tackling a question that we've received over the last few months and it's been on our radar and it's it's finally come to light. We've been able to put some connection points in there and really dive into dozens of research articles. So don't worry if you're new to the podcast, this is kind of what we do. This is in our wheelhouse. We like to go and take real life situations, real life questions, things that have come in from you guys to listeners and digest them and figure out, does fasting benefit this insert x, y or Z situation? And today we're going to be talking about psoriatic arthritis, which is a condition of inflammatory arthritis that occurs in people that are affected by the autoimmune disease of psoriasis. So a lot of there is a a a Charlotte's Web woven right, a spider web woven of connection points between the things we're going to talk about today. But don't worry, like I said, if you're new to the podcast, we're going to be guys a couple of very direct action steps so that you can have a plan moving forward coming out of today's conversation. And if you do not have an autoimmune condition, there are going to be a lot of touchpoints today in terms of blood sugar, diabetes, prediabetes, metabolic syndrome, heart disease, cardiovascular disease, all of the stuff that we are inundating our health care systems and our medical doctors with and the health care industry that we have, that is literally what the majority of people are suffering with. So there's a lot of overlap today, and I think it's going to be a great conversation.

Tommy Welling: [00:02:42] Yeah, so do I, because the connection points are just they're so vast when you start looking at these things and you start seeing the overlap between the treatments and the symptoms and the the etiologies of these various conditions and then how people are actually finding or not finding relief. There's just so many overlapping points and so many parallels that it starts to become like, let's let's look to see if we can start connecting some of these dots so we can we can make our way forward towards towards a better outcome.

Dr. Scott Watier: [00:03:17] Yeah. And one of the things we talk a lot about with the fasting for life, lifestyle or the insulin friendly lifestyle or the fasting lifestyle is most people come to fasting for weight loss. And Tommy, you and I had, you know, been dealing with not being able to get the weight off by doing the standard operating procedure of move, more exercise, more calories tracking. So the eat less move more type method. And we had we had built up some insulin resistance and the underlying cause of that weight loss resistance over time. And, you know, after thousands of dollars of testing, being a clinician, being in clinics, teaching patients how to get better. But I was I wasn't getting better myself. Do you have any issues that you've alluded to and talked about on the episodes? And if you're new, go back and listen to the first couple of episodes where we tell you about our story and how we ended up here and why we started the podcast and do the challenges and everything. So the point is that we want not just to lose the weight, but what does losing the weight mean? Does that have an effect on the quality of life? Our decreased health care costs, our increase overall health longevity and living the life that we truly deserve.

Dr. Scott Watier: [00:04:27] And when we're talking today's conversation, it's really about building that health, and it's going to come down to a couple of key players in today's convo, which is going to be inflammation, right? And then what those markers are, how to track them have a basic understanding of what it is and then how is that related to blood sugar? Is it related to blood sugar? Is it related to BMI? Is it related to our waist circumference? And then what are those treatments that are being done? And I will say, mostly ineffective at reversing the disease, more of just that management of the disease process or the what we like to call the the the management. If we go to the Diabetes Association websites, they don't really talk about reversing type two diabetes. They talk about managing it, right? So we're going to talk a little bit about more of the correction model, which is let's get to the underlying cause of the problem, address it, put a plan together. And the cool thing is is we don't need to move mountains here. We just need to do simple, actionable things, which is what we're going to give you at the end.

Tommy Welling: [00:05:37] Yeah, that's a that's a great point, because when we start looking at these things and every everything points towards management, it's just like with the diabetes or the prediabetes and blood sugar related issues. You have the same thing for things like autoimmune disorders and other things that are just like, there's a lot of question marks. There's not great outcomes, even with these highly expensive crazy amounts of research and development. I mean, these are millions and tens of million dollar, you know, campaigns and hundreds of millions of dollars even to to come up with some of these drugs that are the main, you know, the main ammunition being used, you know, to to fight these these diseases or to control them to give patients a better outcome. But when we when we start looking at what's actually effective, like you said, you don't necessarily have to move mountains and you can see some extremely beneficial effects.

Dr. Scott Watier: [00:06:29] Yeah, let's hop into it. So here's the disclaimer. We are not in a, you know, client, Tommy Masters in physiology. You know, I have my doctorate, you know, undergrad in biology, whatever, like, we're not in a client, you know, a patient doctor relationship here, right? So these are conversations and things you want to get a baseline understanding of and then go have the conversation about, Hey, Doc, I know this is what we've been treating it with, or I know this has been the plan. But what I'd like to do is is do this and this is what I'm doing and I'm seeing these results. So we want to give you that actionable thing that you can see changes in in the first study within 30 days. Let's just hop into it. Good, Tommy. Okay. Yeah. All right. So we're going to navigate this the best way we can. So psoriatic arthritis, painful joints, inflamed joints, high levels of inflammation. You've got that signature large round hot joint in the fingers. You've got the the the fingers that will then start to shift and move kind of into the hand, right? You've got.

Dr. Scott Watier: [00:07:32] So just picture, you know, we've had some of it in my family. You can just picture my grandma's hands, right? Right. They look frail, brittle, painful, those type of things. So weird angles. Yeah, yeah. Yeah, the the you know, the doc, the lightest and the lightest type thing, so the changes in those joints. But the point is is that that is an autoimmune condition. The underlying issue is the autoimmune condition of psoriasis. So when we're looking at this, we're going to look at a first study, which is the study of the impact of intermittent fasting because this is a fasting podcast or Ramadan fasting on psoriatic arthritis. Disease activity emphasizes that colitis. And this is a multicenter study, and this came out of the Journal of Nutrients in March of 2019. So the biggest takeaway is we'll just begin with. The end in mind is that there was a direct correlation of psoriatic arthritis in, excuse me, an improvement, a major improvement in psoriatic arthritis after basic kind of. I don't want to say beginner level, I guess I'll just say it beginner level type fasting windows, right?

Tommy Welling: [00:08:47] Yeah, so, you know, go ahead. You've got to you've got to start somewhere. And when we when we talk about bridging the gap between kind of our standard operating procedure as a country and most of the world just kind of just kind of no real boundaries around our eating schedule, particularly, it's just kind of like, OK, let's start with three meals a day breakfast, lunch, dinner. And, you know, typically just kind of add in whatever snacks you kind of feel like or are comfortable with or whatever. You have an opportunity and you feel a little bit hungry, right? So but when we when we bridge the gap between that kind of standard operating procedure and then getting more to a Ramadan type boundary, we're talking about probably getting to a 16, 17, maybe even an 18 hour window here, like a dawn to sunset kind of intentional month or, you know, a set set period of time and you've implemented some boundaries here that can start to change the physiology on what's happening within our body.

Dr. Scott Watier: [00:09:48] Yeah. So just amazing outcomes here, right? So after this Ramadan study, so we looked at 30 days of 17 hour fasting windows, right? So you are just an hour after the basic intermittent fasting protocol, 16 eight. So 16 hours of fasting and eight hour eating window. So most commonly, people would just skip breakfast. They'll do a 12 to eight p.m. eating window, have a couple of meals, get all their nutrient dense calories, et cetera, put their workout in there. But in this study, so 17 hours, there was a 14 percent decrease in CERP. Now this is where we're going to introduce one of the key players in today's conversation, right? So we've got psoriasis and psoriatic arthritis. We've got the autoimmune connection. We want to see if the fasting has an outcome on the these patients quality of life, right? So 30 days of 17 hour fast, right? So you can do anything for 30 days and the 14 percent decrease in CRP. So what is CRP? Crp is C-reactive protein, and it is an inflammatory marker that is pretty much connected to the majority of inflammatory conditions that we have. So we're talking, you know, atherosclerosis, cardiovascular disease, metabolic syndrome, anti-aging. You know, you can look at things like joint arthritis, like osteoarthritis, degenerative disease, you know, you've got CRP is connected to a lot of different things. It reminds me of insulin and its connection points, right? Right.

Dr. Scott Watier: [00:11:26] Absolutely. So when we're looking at CRP, the fact that this came down 14 percent is huge and CRP can be both anti-inflammatory and pro-inflammatory. So therapy can be a good thing, but not chronic long term, low levels of it, right? So it can recognize pathogens, right? So it can actually be a boost to your immune function. It it clears out old dead tissue. It really it, which is all good things, right? But then on the negative side, it releases cytokines, which are these little chemical messengers that increase inflammation. So there are three categories. They're not like set boundaries like high cholesterol, low cholesterol. If you're over this number, you have high cholesterol, right? Right. That's a whole nother conversation for a different podcast. But when we are looking at these, this levels of inflammation, we have low, moderate and high levels and over 50 percent of ppi little s big ppi little as big a right. So not PSA like the prostate issue or the prostate metric, but capital p little ass capital a in psoriatic arthritis. Over 50 percent of the cases have high, not low or moderate, but high levels of CRP, and then another 30 percent have the moderate level of inflammation. So CRP, the fact that it came down 14 percent in the study is incredible.

Tommy Welling: [00:12:53] It really is in CRP is one of those things where a lot of times you'll you'll go have your blood work checked. You have elevated CRP. A lot of times you might have elevated LDL, you might have decreased HDL triglycerides might be off like there are there are you might have your A1C. That's high. You may have had, you know, you know, high resting blood glucose.

Dr. Scott Watier: [00:13:15] A lot pressure is up when you go to the office. Yeah, all of these different moving parts,

Tommy Welling: [00:13:19] It's a lot of times associated with just like a laundry list of other things going on to where you just kind of leave going, OK, well, my CRP is elevated, not really sure what to do. It's hard to get a direct action step on what to do, and you might just kind of track it over time, like broadly. But at the same time, we know one of its its main things that it does is, is it it promotes building up of of plaque inside the arterial walls, which leads to a host of. Of other issues, so it's like it's really it's really bad to have elevated levels, I want to get them down, but hard to get a direct action step to actually do that.

Dr. Scott Watier: [00:13:56] Yeah, and this is where metabolic syndrome comes into play. So metabolic syndrome is and we've mentioned this to the comorbidities, right? Or. And you've heard a lot about this cytokine storm and comorbidities and the people that you know with with the pandemic and everything that's been happening. And you know, there's there's a lot of talk about this stuff. The people that are at most risk have these type of things in these conditions. Metabolic syndrome is three of the five following, and it's obesity, high blood pressure, high blood sugar, high serum triglycerides, so high triglycerides and low serum HDL. So the good, the good and the bad, which I don't like the nomenclature, but the HDL low HDL, right? So middle metabolic syndrome is directly related to developing cardiovascular disease, like you mentioned, Tommy. Yeah. And type two diabetes. So when we're looking at this, there's a connection point when we start talking about CRP inflammation, autoimmune conditions like psoriatic arthritis, and then we're looking at increased BMI, increased obesity. We've got all of these other comorbidities of metabolic syndrome, right? And we're like, Well, wait a minute, where do we even start? So the last thing that I want you to share, Tommy, is some of those statistics that come out of that Ramadan study in terms of the weight changes, right? Yeah. Because we're going to we really want to. You know, use fasting as a health building strategy, right, not just a weight loss strategy. And then there's some PSA severity numbers that are just incredibly powerful.

Tommy Welling: [00:15:25] Yeah, I love this study because, you know, when when we go into it, the average BMI for participants in the study was twenty six. So just a little bit on the overweight side. One point, right? Yeah, but probably right in line with average or maybe even a little bit healthier or better BMI than than the average American, you know, at this point. So just slightly overweight and an overall no net change in the actual weight of the participants. So they're using these 17 hour fast, but they're not seeing big drops on the scale at all. But then they still are benefiting from that decreased that 14 percent decrease in the CRP, as well as multiple PSA severity numbers dropping anywhere from twenty one up to twenty seven percent in severity of their symptoms in just that 30 day period, again without any weight loss

Dr. Scott Watier: [00:16:20] In 30 days. They dropped by twenty one to twenty seven percent, right? So like, let's just say, 25 percent, so like like incredible improvement. Seven Eighty almost 80 percent of those people had no weight change. A couple of people had a two pound gain in. A couple of people had a two pound loss, right? So like, we're talking, no really net change in weight, so no really decrease in BMI, but a massive improvement in the quality of life and those inflammatory markers. So as we start to look at some of these, you know, markers and nitty gritty kind of details here. One of the things that we've noticed is there is a direct relationship between the increased probability of having a blood sugar related condition when you have psoriatic arthritis, a 20 percent increased chance. Yeah, not with having increased other markers like BMI and other relatable related metrics, but just solely that there is a relationship here. Yeah, one of the can overlap. Yeah, there's a huge overlap in one of these. These these markers that we're going to look at is something called TNF alpha right or tumor necrosis factor, and this is highly elevated in PSA. And interestingly enough, here's the connection point that TNF alpha also increases and is known to increase insulin resistance. And this conversation, or this alignment, came out of the study that was done on the Rheumatology of Therapeutics Journal, and it was psoriatic arthritis and diabetes mellitus a narrative review, and this was out of June of 2020.

Dr. Scott Watier: [00:18:02] So again, more recent. Connection points on things like we talk about metabolic syndrome, how is CRP related to all of these things? Why does 17 hour fasting windows decrease the PSA markers by up to 27 percent just in 30 days, right? So TNF alpha direct relationship to increase insulin resistance. It also suppresses glucose transporter four, which is insulin sensitivity increasing. So we're we're having opposing things here. You're increasing the resistance, you're decreasing the things in our body that actually increase the effectiveness of our insulin, which is what takes the energy that we that we have and shuttles it to be either stored or burned, right? So, you know, the insulin switch, the hormone switch, a fat burning versus fat storing. Then you have adiponectin, which is markedly lower in psoriatic arthritis, which also has insulin sensitivity properties, which is a good thing. But in this case, in PSA, it's lower and it also has anti atherogenic properties. So we're talking about again, a connection point to one of the metabolic syndrome conditions of arteriosclerosis or blocking of your arteries. So, so

Tommy Welling: [00:19:11] Also doing the reverse of what the CRP elevation was doing. On the on the negative side, they're from from where we talked about earlier in the CRP conversation and the TNF alpha getting back to that, that's been been found to be acutely increased just in hypoglycemia alone. So as blood sugar goes up, TNF alpha is going up way before diabetes even hits the radar. So it's I mean, you start to see what's happening under the hood, developing years and years and years in advance.

Dr. Scott Watier: [00:19:44] Yeah. So it was it was crazy to just think about, you know, I didn't know this until we started looking at some of these articles that that, you know, that 20 percent increase of type two diabetes when you have PSA. Well, now that we're looking at some of the connection points. I mean, it makes sense. And here's a real life example we'll bring up a professional golfer. Last time we mentioned his name, we got some interesting feedback, so we'll keep it really light today. But Phil Mickelson is very is known to promote fasting, and it's actually extended his career. And he was diagnosed with psoriatic arthritis, and he was taking one of the medications called Enbrel, which actually decreases the TNF. So it's a blocker, right? So you're decreasing the insulin resistance. He ended up losing a bunch of weight. Go, figure. And he's extended his career. He actually was the oldest golfer to ever win a major just recently, so I want to just read the quote. From him and then we can move on, but just a real life example of putting some of this stuff in place. So what he does from a fasting perspective and he says this, it gives my body a chance to reset, right? So the quote that he says is is pretty basic to and it's nothing really drastic, but he's figured out a way to make this work into his his golfing like he plays golf Thursday, Thursday through Sunday. So his his eating is around periodic fast. He goes on longer fast and he does three day fast every few months as a way of resetting his immune system. He does shorter, fast more often and saying after his final round. So if he plays in a tournament, then he fast for 36 hours straight once a week. Hmm. And that's what Dr. Fong says, too. He's like that thirty six hour mark is a huge reset for insulin resistance. And he's he's had a complete turnaround using, you know, obviously some medical intervention as well, but also changing those lifestyle components.

Tommy Welling: [00:21:39] Yeah, I used to see him in those

Dr. Scott Watier: [00:21:40] Commercials

Tommy Welling: [00:21:42] For those drugs because here in the states. Oh yeah, yeah, we can have those those advertisements for those drugs. And and it's it's incredible to see like how much better he looks and he looks like he feels like you look at him now and it looks like he feels just completely different from from several years back. And like, that's it's incredible. And I love the fact that he knows exactly how he's going to use those control points on an ongoing basis. And and just like leaning into that, that feeling of additional control and having just like knowing that that he has power to to like, affect some of those

Dr. Scott Watier: [00:22:17] Important health workers. Yeah, I love it. And two more studies we're going to share with you, right? Tell me then we're going to land the plane with two really simple action steps, right? Yeah. So the next study is the effect of fasting with two meals on body mass index and inflammatory markers of metabolic syndrome. So again, overlap, overlap, overlap, right? If we did a Venn diagram, my head would be spinning. I don't even know if that's the right term, but I think it is one of the circles, right? Yeah. So everything would just be in the circle, in the middle, right? So everything is overlapping. Yeah, in this study, they were looked at. They were looking at the diagnosing metabolic syndrome with some ATP criteria, which is the most accurate way to do it. And they were using simple linear regression that demonstrated that after fasting, CRP was a directly related to waist circumference and increased BMI. Mm hmm. So higher levels of CRP, higher levels of inflammatory cytokines, higher levels of things like leptin and IL six, and some of the, you know, the words we used earlier and all those markers right is a direct relationship to having a larger waist, higher BMI. And then we're going to have another connection point here to visceral fat in just a second.

Tommy Welling: [00:23:25] Well, and this is probably why I felt like it. It felt the same when you go in. And if you hear that your CRP levels are elevated, but you don't really have direct action steps to get them lower, like, well, you're in an inflammatory state, that's bad. We should look at getting this down, but no real concrete things to do about it. But that's the same way that that many people. Feel leaving with with a weight loss recommendation as well, like, well, you're going to need to get some weight off, right, but then how do you do it and then

Dr. Scott Watier: [00:24:00] Lose 20 pounds? Yeah. Ok, well, what do you mean? Ok. All right. Well, I guess I'll go, you know, get on the treadmill and and, you know, start eating salads.

Tommy Welling: [00:24:10] Yeah, eat a little less. Move a little more, right? Maybe I'll join a gym. But then usually nine times out of 10, or maybe even more than that, maybe nine and a half times out of 10, you come back and in three months or six months, is the 20 pounds gone? No, it's it's probably not. There's probably some oscillation going on, right?

Dr. Scott Watier: [00:24:25] And so when we look at BMI is not the best metric or most accurate way to determine health, right? But there are some correlations to things like metabolic syndrome and a lot of things we've been talking about, but in this study, directly related between CRP, C-reactive protein and visceral adipose tissue. So the fat tissue that is around in in between your organs and around your midsection. This was a study done out of the Diabetes, Obesity and Metabolism journal in 2004, and one of the main takeaways was CRP levels associated with visceral adipose tissue and is significantly associated with the components of insulin resistance syndrome. So call it whatever you want. Call it undiagnosed diabetes, right? But it is literally directly connected. And there's two other articles if you just keep going down. It's like visceral fat and exercise participation with C-reactive protein, insulin resistance, C-reactive protein to body fat distribution and its relationship to metabolic syndrome, right? So we're just layering on the reasons as to why fasting can be such a powerful tool because we know it immediately decreases the insulin, never mind a lot of the inflammatory markers as well.

Tommy Welling: [00:25:37] Yeah, and it's interesting. What I keep hearing is insulin resistance is an inflammatory process. It's like the body sending out signals to you that says, well, things aren't quite right. Things are out of balance. We have we have the inflammatory markers and we have the insulin sensitivity and they're going hand in hand. So what can we do about it? And you know, that brings us right back to the Ramadan study, where as soon as they started, you know, encapsulating that insulin response and controlling for those insulin levels and the blood glucose levels throughout the day, they started to give more time during the day to where it was like, no, no foods coming in right now. I got a 17 hour stretch, no foods coming in. Well, guess what gets to happen during that time? Insulin and blood sugar gets to start coming down and they get to stay at at much lower levels than they do between the typical three four five hour stretch that we might go between meals. And that's assuming that there's no snacks in between. So when we start encapsulating start putting some boundaries there, we start to see a difference even way before the weight comes off, or even if no weight's coming off like we're we're taking in a maintenance level of calories here, but we're still controlling for the blood sugar and the insulin response with a huge beneficial effect on the body.

Dr. Scott Watier: [00:26:51] Yeah. And that's why, you know, when we we, you know, we have these questions come in about very specific conditions like, Hey, Doc, what about my gout? We're going to do an episode on that. Hey, what about Insert X, Y and Z? Like we started just like circling back to the Ramadan studies where we started this conversation today was here's this condition does fasting benefit? And absolutely, with the amount of overlap that we've just gone through, this is why we then get the messages in the conversations Hey, I'm off my insert blank medication. Hey, I feel better than ever. Hey, my joints don't hurt. Hey, I was able to throw out my pain meds. Mm hmm. Hey, insert sorry

Tommy Welling: [00:27:30] All my life back.

Dr. Scott Watier: [00:27:31] Yeah, yeah. And we're really starting to make some change. So timing as you wrap up today's episode, we have a couple of really simple action steps. And I think, you know, obviously we just talked a lot of detail, went through five or six different studies. The main takeaway is fasting will have a benefit to a lot of these things, and we believe that it is an extremely long term, sustainable strategy to long term health.

Tommy Welling: [00:27:57] Yeah, it absolutely is. And there's different ways to do it. So two action steps are going to be one see what's going on under the hood. A really good quick two or three minute way to do that is through our insulin sensitivity assessment that you can go download at the fasting for life, go to the Resources tab, get the insulin sensitivity assessment, check it out. It's going to get you an idea of what's going on, you know, just based on some subjective questions that you can answer and it'll get your score and you can track that over time. It's a really cool tool. And the other one is especially if you're new and you're not really sure where to start or you haven't done a 17 hour fast in the past, but or you're not really sure what to do. Go download the fast start guide. It's going to help you put it into six simple steps so that it can kind of take the thinking out of it and give you a place to start and. And then you can go from there.

Dr. Scott Watier: [00:28:49] Yeah, we have decision fatigue today, right? Thousands and thousands of decisions we make every day. So go get some perspective. Download the insulin assessment. Check out the fast start guide. If you've been fasting, you can't seem to make it stick or you just looking for a restart. It will absolutely smooth out that process and get you started, and hopefully we'll see that you'll get you'll get on the right track and see those benefits a lot faster, pun intended. So I know, you know, as we plan coming into the out of the month of January, New Year's resolutions season is officially over, according to the statistics. We just came out of a challenge last week, just incredible results. I just wanted to let everybody know that the next fasting challenge is merely four weeks away in a day. So that is February 23rd market on your calendars, you'll start seeing some, some announcements about it coming out. But make sure you head over to the website. Grab one of those assessments. Get on our newsletter so you don't miss out, and we're going to continue to make 20 22 the best year yet. Tommy, thank you for the conversation today. Thank you for landing the plane with those action steps and just really hopeful that this this conversation will have a great impact. And yeah, a way we go. We'll talk soon.

Tommy Welling: [00:30:08] Absolutely. All right. Bye bye. So you've heard today's episode, and you may be wondering, where do I start? Head on over to the fasting for links and sign up for our newsletter, where you'll receive fasting tips and strategies to maximize results and fit fasting into your day to day life.

Dr. Scott Watier: [00:30:24] Why are you there? Download your free fast start guide to get started today. Don't forget to subscribe on iTunes, Spotify or wherever you get your podcasts. Make sure to leave us a five star review and we'll be back next week with another episode of Fasting for Life.


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