Ep. 110 - Can I fast with gout? How to lose the weight & control flare-ups | Fasting and blood pressure, diuretics, & kidneys | Can fasting & keto make gout worse? | Free OMAD Intermittent Fasting Plan

Uncategorized Feb 01, 2022

In this episode, Dr. Scott and Tommy discuss the key points to understanding how fasting can be optimized to coexist with gout and high uric acid levels. Many physiological processes govern metabolism, weight loss, and gout, so navigating these waters requires a basic understanding and strategy to ensure long-term success.


Gout Summary

Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies

Uric acid, impaired fasting glucose and impaired glucose tolerance in youth with overweight and obesity

Beware: Fasting Causes Gout

Regulation of uric acid metabolism and excretion


Show Transcript: www.thefastingforlife.com/blog  

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Fasting For Life Ep. 110

Dr. Scott Watier: [00:00:04] Hello. I'm Dr. Scott Watier

Tommy Welling: [00:00:06] And I'm Tommy Welling, and you're listening to the Fasting for Life podcast.

Dr. Scott Watier: [00:00:10] 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: [00:00:18] 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: [00:00:27] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned along the way. Hey, everyone, welcome to the Fasting for Life podcast. My name is Dr. Scott Watier and I'm here, as always, am a good friend and colleague, Tomi Welling. Good afternoon to you, sir.

Tommy Welling: [00:00:50] Hey, Scott, how are you doing?

Dr. Scott Watier: [00:00:51] Fantastic. As always, my friend, we are in the throes of consistently having conversations around fasting, and the fasting lifestyle just came out of a most recent challenge. Just an incredible group, tons of new energy in the continuity group and just really starting to unpack how we're going to start to level up our fasting knowledge and our fasting application. And we joke that you and I spend most of our days and most of our time talking about fasting, and that breaks our first two rules. So if you're new to fasting and the fasting for life method, then your first two bits of homework are Don't talk about fasting and don't talk about fasting. If you're more experienced and you've been with us for a while, then yes, you've seen the results you've made. It started to implement this into your lifestyle and then you can go and share with others, of course. But this is a conversation today, Tommy, that you and I have received multiple questions on and it's been on the docket to dive into and talk about for how long would you say? Since we started. Yeah, forever, yeah, yeah, and this was a question that my dad asked me originally when he was starting the fasting journey and lost over sixty five pounds and reversed his diabetes was like, Well, my doc's worried about my gout.

Dr. Scott Watier: [00:02:12] And I'm like, Right? And you should be. But what we're going to do should be OK, and you're going to see the results. So just do you trust me? Yeah, and luckily, he trusted us probably more you than me, but in that moment, and then the transformation took place, so it's been on the docket for a while. So I love the conversation and we're going to try to keep it reined in to being succinct and give you some action steps of how fasting can hurt and or help the production of gout flare ups and the uric acid levels. So we're going to zoom out like we typically do 30000 foot, then we're going to zoom in some of the specifics. And if you're sitting there going well, I know God affects men more than women, usually a three to four to one ratio. I've never had gout. Don't think I have gout. I'm not a man. This really doesn't apply to me. There's still going to be some really cool talking points about insulin insulin resistance medications, so on and so forth that give us a shot here. I think I think we're going to it's going to be a good one, even if you don't fit into the specific category of a gout sufferer.

Tommy Welling: [00:03:27] Yeah, absolutely. Because just like you alluded to, a lot of things are happening under the surface, under the hood, if you will, which is similar to how insulin resistance builds over time and oftentimes get, you know, kind of stays under the radar for a long period of time while certain things are kind of getting worse in the background. So that's similar in that with with uric acid because you may not ever notice a gout flare up or even be considered that you have gout until it reaches a certain tipping point, which is which is something that's building over time. And we'll get into that.

Dr. Scott Watier: [00:04:02] Yeah, and so that's let's let's start there with what is GAO so GAO can be called. You know, sometimes described as an arthritic condition, it's an inflammatory condition. It is the buildup of uric acid, which then gets deposited in the joints. There's an inflammatory cascade that takes place and then boom, you have your acute gout attack, which can be anywhere from six to 12 hours, and then it can last probably typically resolves itself within seven to 10 days. And the the main concern is that this comes from a natural physiological process and this is the formation of purines. Now this is from the Journal of International Journal of Cardiology. In 2016, it's the regulation of uric acid metabolism and excretion. So I want you to envision, just like Tommy, you said, talking about insulin resistance and how it builds over time, uric acid levels will build for 10 to 20 years, they estimate, before you actually have your first attack.

Tommy Welling: [00:05:01] Yeah, yeah. So there is a normal physiological range that they're normally sitting there in a normal, normal, healthy individual, a young individual, someone had a normal healthy weight. And then over time as usually well, we see a high correlation with with weight and other portions of metabolic syndrome. As those things get higher and higher as weight grows, then uric acid levels are rising even before they reach that. That tipping point where you experience an actual flare up.

Dr. Scott Watier: [00:05:32] Yeah, we'll talk about how fasting can stimulate some of those flare ups. And then we're going to give you the exact plan on how to, which is the main point of this, which is getting the weight off and decreasing the insulin resistance, which is going to remove the uric acid in those buildups. So we're going to unpack all that as we go just for clarity in terms of the purine formation and how that leads to to uric acid periods are important. They're important for DNA formation, RNA formation that contribute to modulate energy metabolism and signal transduction, their structural components of enzymes. They play an important role in the physiology and the makeup of your platelets, which is part of your blood and your muscles and neurotransmission, right? So there's periods are a very important thing in your body has a natural balance of these. So a creation of and then a synthesis of and then a degradation or a breakdown of and this takes place in the liver and there's a relationship here to glycogen and insulin and all of those different types of things. And we'll go over that here in just a second. But the overproduction is generated from the metabolism of those purines. So it's the last step when they're being broken down. And then what the body will typically do then, is it will excrete them. One third of them will be excreted in the intestine. And then the majority here, which is a key component, is going to be excreted in the kidneys. And that's going to be a big unpacking or talking point when we come to the the plan. If you are trying to lose weight and you've done the keto diet and you can't seem to get it to stick and it causes your gout to flare up. If you've been doing the intermittent fasting lifestyle and you're like, Well, I can't lose weight the other way, I thought this was going to be the answer. What the heck's going on, right?

Tommy Welling: [00:07:19] It's important to understand that that that kidney component that you just mentioned is a is a huge part of this whole thing because as as anything stresses the kidney or stresses the the filtration rate that's happening, which has to do with our blood pressure, our actual urine excretion, anything that's affecting those those systems will affect the uric acid production, the uric acid levels and overall, the actual severity or frequency of gout flare ups to. And so that's that's important to to remember that that whole two thirds is excreted within the kidneys.

Dr. Scott Watier: [00:07:58] So the study that really connects some of these dots is the uric acid, impaired fasting glucose and impaired glucose tolerance in youth with overweight and obesity. So one of the overarching things here is or one of the risk factors I should say for gout and the fact that it's. Predominantly in men, right, and there's another category of menopausal women that have a higher risk, and they're related to the fact that there's a big correlation between the obesity levels or the overweight category, right, but also alcohol consumption, high fructose corn syrup, the the effect of kidney diseases, right? And not just like a full blown diagnosed kidney disease, but as your weight increases the effect, excuse me, the effectiveness of your kidneys goes down. So getting the weight off is really important. Now how fast you do it and how sensitive and how long and how high are uric acid levels are and how glycogen stuffed you are? How much glycogen and short term energy supply you have is going to be a part of whether or not you're going to see these gout flare ups. And the cool thing is in the study was there's a direct linear correlation between uric acid levels in the blood and metabolic abnormalities. So if you have metabolic syndrome, over 50 percent of gout sufferers have some category of metabolic syndrome. So triglycerides that are out of whack HDL, that's low

Tommy Welling: [00:09:40] High blood pressure, high

Dr. Scott Watier: [00:09:41] Cholesterol, you know, and then from there you get the increased chance of forming diabetes, right? Right. So I'm going to land the plane here. Impaired fasting, glucose and insulin resistance, so the underlying cause of weight loss resistance, the underlying reason why you develop blood sugar related issues in the long term. You know, over the over decades, those are directly related with higher levels of uric acid and then the impaired glucose tolerance and insulin sensitivity. The insulin sensitivity, which is a good thing, are reduced when you have high levels of uric acid. So the take-home message here is that insulin in itself stimulates your liberal liver to produce uric acid by the breakdown of purines while reducing so it increases the formation and decreases the excretion. So it's a perfect storm.

Tommy Welling: [00:10:40] Yeah. So, so both things are going in the wrong direction as we increase our our insulin resistance and decrease our insulin sensitivity, which which makes absolute sense why this could be developing for years and years and years and decades before ever actually having a gout flare up and why we see such high correlation with being overweight and being obese and then suffering from gout and other related things. Because those those levels are rising, those concentrations are not being allowed to fall as they should. And again, any additional stressors on the kidneys is going to make that that problem that much worse. And that's part of the reason why as we get into longer fasts or as we see more ketones, some of the data out there says, please be cautious or don't fast if you have gout, things like that. Because as ketones level, as ketone levels rise, those start to act on the kidneys as well and start to get competitive with excretion of the uric acid. So they're kind of battling each other, right?

Dr. Scott Watier: [00:11:45] Yeah. And that's that's that whole juxtaposition of that. Just imagine the little chemistry scale, right? So we have the problem on the initial creation side and then the problem on the excretion side, we've got the increased weight, we've got the insulin acting on it, we've got the blood sugar levels and that's you had said something from that study to kind of connect the dots there, which was looking in that study with the overweight youth is that the. Highest levels. So when you're uric acid was higher, right, which is a marker of impaired glucose metabolism, so your body's inability to process food that you're digesting, right? Mainly in post challenge rather than in a fasting state.

Tommy Welling: [00:12:30] Yeah. So what that means is that if if you take two individuals, one's a normal healthy individual, one's a high level gout sufferer. If you just looked at uric acid levels while they're both fasting 12 hours, 20 hours fasted, you're going to see very similar uric acid levels. But as soon as you bring in the food or bring in the glucose, bring in a sugar test and put sugar in both of those individuals, then you're going to see the normal healthy individual stay within the normal range of uric acid levels. You're going to see the gout sufferer, the person who has a uric acid excretion problem. Those uric acid levels are going to immediately start to go through the roof, and that's where you're going to see the difference in those two.

Dr. Scott Watier: [00:13:14] Yeah. So you're literally by your stoking the fire, right? And so when we talk about action steps from this, you know, there's there's popularity out there and you had mentioned that Tommy and the ketosis in the keto diet, right? Right. You know, if you look, just go Dr. Google gout and uric acid, right? You're going to see, well, you know, foods that are high in vitamin C, remove the alcohol, remove the high purine foods, the organ meats, those types of things, right? So that's an exogenous that's an outside source of increasing the potential production. Then you have the insulin component that increases the production, which is an endogenous or internal source, right? And then people are like, Well, I need to lose the weight, and then my doctor put me on, you know, diabetic. Mm hmm. Which has a direct increase. It's it's one of the causes of gout flare ups. So then you're doing the keto diet or you're you're doing you have to watch your protein intake. So then what are you substituting that with where you're adding in carbohydrates? Yeah. Carbohydrates stimulate glucose, and now you've got this extra energy supply. So you just said you're no longer in the fasted state. You're now have this this energy that needs to be burned, which then increases the production and you've got your kidneys that can't excrete it and you're sitting here in a perfect storm of, well, what do I do? How do I navigate this? And if fasting is a lifestyle that I enjoy, but I can't fast because of the flare up and when? Just to be clear, when your body reaches ketosis, the ketones restrict the ability of the kidneys to filter out uric acid.

Dr. Scott Watier: [00:15:08] So that's where you get that increased kind of rising kind of levels over time. But you also have like we talk about the diet, the diet component and then the one that really surprised me when we started looking in this. And we're going to hammer hydration here in a minute. But it's when you release the weight your fatty tissue actually produces. Excuse me, when you keep the weight on your fat, your adipose tissue increases the production of uric acid. Mm-hmm. It literally releases uric acid into the body, so you've got the food component, you've got the insulin producing component, you've got the excuse me, the internal component, you got the external component. You've got this dichotomy of of opposing, like you said, push pull opposing forces. And it's like, All right, well, how do I navigate that right? Well, I thought I could just change my diet. Ok, great. You could. But that could also be just part of the issue and only get you part of the way there.

Tommy Welling: [00:16:13] Yeah, it's it's really there's a complex set of arrows here, and it's no wonder why a lot of folks suffering with gout feel like they can't figure out how to, you know, how to control it or what to do to get the weight off and how to navigate this. Because what I didn't even hear you mentioned was was blood pressure related issues. Because if you are if if you have been recommended to go to reduce sodium in your diet, then that's going to push more water out. You're holding on to less water, which means all of a sudden uric acid levels, those concentrations in the blood rise immediately. And then you mentioned your fat cells actually increasing the purine levels or the uric acid levels. But as you metabolize those, as you drop the weight, then those can also release those same compounds, thus increasing the uric acid levels. So it's like it's

Dr. Scott Watier: [00:17:06] Like a catch. Twenty two.

Tommy Welling: [00:17:07] Yeah, if I move backwards, I get worse. If I move forward, it kind of gets worse. So how do we how do we kind of navigate it? Well, you have to understand that there's there's several moving parts at play, obviously, but if we can, if we can navigate this, get the weight off and keep the the the scales tipped in our favor and know that there are a few things. There's probably going to be a few roadblocks along the way a few times where you go, OK, well, maybe I should. Maybe I should do something a little bit differently. Here you can. You can make tweaks over time with the hydration, with the ketones, with the length of your actual fast, with what you're putting on your plate. Right?

Dr. Scott Watier: [00:17:46] Right. For clarity, when I said fatty tissue, what I was referring specifically to was visceral fat. Right. So abdominal obesity. And even if you're not obese or overweight, you can still have visceral fat the fat in between organs, right? The stuff that increases your risk of a lot of those co-morbidities that come with blood sugar related issues. But metabolic syndrome is the high blood pressure, the high blood sugar, the high serum triglycerides, low low serum HDL. So the good cholesterol being low, which increases your risk of cardiovascular disease and type two diabetes. So if you look at most people in the 50s to 70s, there's going to be a blood pressure concern, a cholesterol concern and a weight concern. And that's just eighty six percent of the population by 2030 is going to be obese or overweight. So we're not talking about like the minute we're talking about the the we're not talking about the small subset. We're talking about the majority right now. Does gout affect everybody? No. But you know, having the excess weight, which is where we started this conversation can lead to these increased things. So what are you going to do if you're a gout sufferer and you really love fasting, but you've hit a couple of those roadblocks, Tommy? Yeah, and you can't. You've had a flare up or you hit a certain I think you had a conversation with someone recently where they hit a certain hour and it was the first time they'd hit that hour and they had a flare up.

Tommy Welling: [00:19:00] Yeah. So my my dad in particular, when he reached the thirty six hour mark, he's been a long term gout sufferer, probably, you know, 10 or 15 or more years. So when he I think it was the 36 hour mark and then he noticed a flare up. And so we started, you know, kind of digging in from there like, hey, why would that be? Well, so as ketones, as ketone levels start to rise, which they tend to do as we get, you know, thirty thirty six hours plus we tend to see a rise in ketones, then we're we're tipping the scales back in the higher uric acid, in the higher potential for a gout flare up kind of range. So the sweet spot there is is. Is burning through some of those long term fat stores at a at a steady pace while keeping ketones from getting too high so that they're pushing back against you on the on the gout side. So, you know, somewhere in the like 20 to 30 hour fast kind of range would be a really good point to get enough time to get insulin levels low, tap into long term fat stores and break the fast before ketone levels get too high. And then on the back end of that, when you are breaking the fast, that's going to be 20 to 30 hour fast. You don't have a whole lot of room for error for to maintain consistent fat burning because you it's not like you just burn fat for four to three days, right? Like an extended period of time. So being very intentional when you do break your fast, putting some some intentionality, some planning into that lower purine foods like you, you mentioned before and just making sure those are, you know, fresh, good, healthy, nutritious foods when you do break your fast means that you can consistently see those those those fat burns.

Dr. Scott Watier: [00:20:44] Yeah, and there's some other triggers here we want to mention, too, so keto diet is going to increase your chance like you just said the the dietary component overall. You know, when we're looking at breaking the fast of the research that we were looking at is anywhere from the 48 hour plus mark. Right. So you're still going to get a great fat burning weight loss effect from the from the 20 to 30 hour range, right? Yeah, right. You're still going to see a considerable decrease in insulin, which is going to be one of those internal or endogenous type forms of of purine production, which can lead to the lack of excretion or the buildup of uric acid. So and then there was some studies at like thirty eight hours, fifty four hours, right? So we're talking about longer, faster some studies that look at Ramadan fasting and seven day fast and those types of things, but we don't want to lose the weight too quickly, right? We have a whole podcast episode on that, but we want to do in a way that's sustainable and what you just said there about the intentionality of breaking your fast. So a couple of things you can do is really focus on alkaline rich foods, vitamin C, rich foods and removing those purines right, the liver, the game anchovies, sardines. Our alcohol is a big one as well. And then we mentioned just for clarity, the diuretics, which can also cause the dehydration, which is what I want to talk about now, which is something that can also be proliferated in a fasting state. So when you fast insulin comes down and then you're it tells your kidneys to actually excrete water because and this is why we see people drop their blood pressure right when they start fast saying, Oh, my blood pressure dropped down.

Dr. Scott Watier: [00:22:27] Yeah, right, exactly. So diuretics do the same thing. So diuresis right with fasting and diuretics, which is the medication due to high blood pressure. It's a double edged sword. It's kind of like that catch twenty two again, so you're like, All right, well, what do you do to in these 20 to 30 hour fasting window as well? You're going to have to supplement. And this is going to be counterintuitive to a lot of you because one of the recommendations of high blood pressure is to cut out the salt, right, which is actually making the problem worse. So you're going to have to use either Himalayan salt, a good form of a Celtic sea salt like a Redman's, or you can use any type of those those elements, electrolyte products or a trace mineral. Or there's a product that they're called Relight that also has the ability to help balance that electrolyte so you don't have to be drinking two gallons of water a day to rehydrate. Really, what some of the gout or arthritis cyborg and the straight health care about what gout is kind of like a a higher level. What's that one? Medscape, right? So don't go to Medscape, but the straight straight health Care.com Arthritis dot org says you want to do one point five liters. We would love to see you doing 90 ounces of water plus adding in that salt supplement or trace mineral supplement.

Tommy Welling: [00:23:52] Yeah, because the key here is is remembering that uric acid concentrations are directly related to your hydration level. So if hydration is coming down like you're transitioning into the ketosis process, you're going through that diuretic effect, you know, dropping the water weight, especially if you're just starting off fasting, that's going to lead to some shorter term dehydration. Well, that can immediately rise uric acid levels in the blood. So to combat that, you're going to want to be very intentional with the hydration portion. So, so consistent water intake. If you know if nighttime nighttime bathroom issues are a problem, you know, maybe stopping four or five o'clock in the afternoon, not not getting too late into the evening with it if you're not used to drinking that much water. But this can be a big game changer for feeling like you have a level of control or whether you have a frustration level, because we've seen a lot of gout gout sufferers going into longer, fast and having those those like frustration, getting some pushback from it and then and then feeling like, Oh, well, I guess fasting is not for me, right? But but it doesn't have to be like that.

Dr. Scott Watier: [00:25:00] Yeah. And if you're, you know, if you've been doing fasting longer and say you're tracking your blood sugar numbers and your ketone numbers, you really want to stay in a low level nutritional ketosis. So like 0.5 to maybe one point five, you don't want to be pushing those ketones higher because you're just going to be fueling that fire. So from a dietary standpoint, on the positive side of things that you can add into your breaking of your fast, right, the intentionality behind that because you know, you can't do too much keto because that'll produce, you know, a problem with the excretion of uric acid. You can't do too many carbs because then that produces the insulin, which then produces the purines, right? And then it's like, you can't do much too much protein because a lot of the periods come from the metabolism of the proteins, right? So what do you do? Ok, well, the good news is, is that you can add in alkaline forming foods, and fasting really limits the amount of those purine inducing those Hyperion based foods, right? Yeah, because you're going to be limiting your ability to have those meals, right? So alkaline foods would be like Kiwi's cherries, you guys.

Dr. Scott Watier: [00:26:07] If you ever just googled gout, one of the things you're going to see is cherries, right? Tart cherry juice. Yeah, yeah. Blueberries, pineapples, papaya, lemons, apples and then vegetables as well. So cucumbers, asparagus, bell peppers, celery is a good one. Leafy greens, right? So adding in a giant and I know this is. Standard dieting mentality, one on one. Have a big salad, right? Yes. Have a big salad, but have a lean protein with it as well. And really, you know, just being intentional about breaking that window with with a with a balanced plate, right? Another cliché, right in the nutritional world balance of a balance plate, right? So not too much of this. Not too much of that. Not too much. So just a balanced plate of the fats, some some unrefined processed carbohydrates, even a little bit sad. Something on your plate for some satiety. And then, you know, a healthy protein source, but not too much. Adding in those leafy greens and those alkaline foods can really help you feel fuller. And then also not be kind of stoking the fire from your dietary choices.

Tommy Welling: [00:27:11] I think what you said, there is a great point I want to underline, which is the fact that when you're fasting, you're not going to have the opportunity to be eating all of these foods and all these pureeing rich foods all day long. So don't be afraid of of a of a steak, right or of a of a of a piece of meat right on your on your plate, even though it is on the on the purine food. But when you're you're fasting, you're doing 20 to 30 hour fast. I mean, make it a make it a good, balanced, healthy plate, and that's OK to have some meat on there. But you know, these are all of the tools to kind of have in your tool belt to keep the scales tipped in your favor as you're you're navigating dropping the weight consistently over time. This is going to be about slow and steady wins. The race is going to be about consistency over time, dropping the weight and taking those those three main action steps the fasting, the hydration and what you're breaking your fast with and then just consistently applying that so that you can you can get there and see the success without getting frustrated or thrown off course.

Dr. Scott Watier: [00:28:16] And there's just a couple of other triggers that I want to mention would be like wearing two tight shoes, right? You can stop stubbing your toe can cause that short term inflammation menopause based on the hormonal changes. So the estrogen allows the kidneys to release that uric acid that drops off when you're in menopause. So that's another potential trigger, you know, losing the way too quickly already unpack that to unpack the diet, the point of getting the weight off over all the hydration and then the medication side, the diuretics and the aspirin as well. So aspirin can also boost uric acid, right? So yeah, it's it's. It's something that's taken very commonly in the demographic that we're talking about, that suffers from gout, right? So these are things to take into account when you are putting these action steps into your day to day. And I know we mentioned like tracking your ketone levels. That's not something you do. Then you don't have to run out and get a ketone monitor and be like, Oh, now that's like taking all of these different talking points, which I know there's been a lot and putting them into. All right, I'm going to push my window a little bit. I'm going to change my plate a little bit. I'm going to increase my hydration a little bit. I'm going to know these other triggers and understand that if I'm in a fasting window, I probably shouldn't be popping a couple of extra aspirin now. This is not medical advice, right? I'm not saying if you're taking it for a reason and talk to your doctor or whatever, but right, just have knowing that these are all other causes that can lead to it. And we don't, as a takeaway message, tell me we don't have to be afraid of using fasting or the fasting lifestyle because the cool thing is, is a couple of the stats and you found this one. Three time increased chance of normal uric acid levels when you have a 10 kilogram or approximately twenty two pound weight loss, and there was a really cool timing component to that stat.

Tommy Welling: [00:30:11] Yeah, that's that was tracked over a seven year period. So whether you lost the weight in three months or if or you lost it over a period of seven years, dropping that 10 kg, that approximately twenty two pound weight loss was associated with a three times higher likelihood of being able to effectively control those uric acid levels. Whether or not you had gout, which is the great part, it didn't have to be at the tipping point to see the the overall reduction in the uric acid levels. And that's that's huge. That's incredibly empowering perspective right there for anybody on a fasting journey or not.

Dr. Scott Watier: [00:30:52] And there's a whole nother rabbit hole. We can go down here with uric acid in its relationship to overall health markers, and we're not going to. So Doctor Dr David Perlmutter, you can go find him and go down his research rabbit hole. But I want to make it known that it's not in this case. Yes, it's a fascinating podcast. Fasting for life. We've gotten this question dozens of times. It's been something that's touched you in our both of our lives, personally with our dads and their health journeys. So really just hopefully the encouraging thing throughout this entire conversation today is that it's doable. You can do it and hopefully today give you some of those tools. So if you're new to fasting, hopefully you got some nuggets out of today. You can go to the website. Download the fast start guide. If you've been intermittent fasting and you haven't been able to get it to stick or you've lost five, gained five, et cetera, the fast start guide is really how to take you from an intermittent window and bring you to a one meal a day window, which is really, really where we see the needle move for a lot of the people that have gotten frustrated or stuck with their weight loss journey, not necessarily just their passenger, but the weight loss journey.

Dr. Scott Watier: [00:31:57] You can go to the website download that. If you're wondering about insulin resistance, you're like, What the heck is that? I'm new. What am I talking about? You can go back and listen to episode one hundred, which is kind of a reset and a starting point of some of the episodes that will explain more of the basics of what it is that we do and why. And the insulin assessment is also on the website. This is to a subjective look at do you potentially have insulin resistance? And is that the underlying cause of some of your issues? And that was the underlying theme of today's conversation. Tell me, too, which is we always try to relate it back to the physiology of why fasting was so powerful for us. So I'm really excited that we finally ripped the Band-Aid off on this one.

Tommy Welling: [00:32:41] You got me too. There was so much to unpack here, so many different interconnection points, but I'm I'm glad we started the conversation because I think it's going to be helpful for a lot of folks out there with so many question marks and not sure which direction ahead.

Dr. Scott Watier: [00:32:54] Yeah. And just, you know, one day it flares up. The next day it doesn't, right? So let us know we love to hear from you. Drop us a review. We prefer the five star kind, but we also like honesty and transparency as well. Absolutely. Head to the website. Download one of the guides. Download the insulin assessment. As always, tell me. Appreciate the time and the conversation, and we'll talk soon.

Tommy Welling: [00:33:14] Thank you, bye. So you've heard today's episode, and you may be wondering, where do I start? Head on over to the fasting for life 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: [00:33:30] 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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