Ep. 199 - Reducing cardiovascular risk & improving body composition, body fat, & BMI | Targeting visceral fat using diet, exercise, & DEXA | Stress, belly fat, & insulin resistance | Do you need fasting supplements? | Fasting Challenge | Nutrisense CGM

Uncategorized Oct 17, 2023

 

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In today’s episode, Dr. Scott and Tommy focus on visceral adiposity and its impact on health. They discuss various factors affecting the change in visceral versus subcutaneous fat during weight loss, citing studies comparing exercise training to low-calorie diets, emphasizing that exercise, even without significant weight loss, can lead to a decrease in visceral fat. They also stress the importance of managing stress, which can contribute to visceral fat accumulation. The episode highlights the need for a holistic approach, including exercise, dietary choices, and stress management, to address visceral adiposity and improve metabolic health.

 

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Article Links

VAI - calculator - https://healthy-ojas.com/calculator/visceral-adiposity-index-vai.html

 

https://pubmed.ncbi.nlm.nih.gov/18180786/#:~:text=Conclusions%3A%20Visceral%20adipose%20tissue%20is,benefits%20of%20modest%20weight%20loss

https://pubmed.ncbi.nlm.nih.gov/27213481/

https://pubmed.ncbi.nlm.nih.gov/34040197/

https://healthy-ojas.com/calculator/visceral-adiposity-index-vai.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490301/

 

Fasting For Life Ep. 199 Transcript


Hello. I'm Dr. Scott Watier.

And I'm Tommy Welling.

And you're
listening to the Fasting for Life podcast.

This podcast is about using fasting
as a tool to regain

your health, achieve ultimate wellness,
and live the life you truly deserve.

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.

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, want to hop

on real quick before we get into today's
episode and want to let you know that

the next seven day master your fasting
challenge starts November 1st.

That is right.

Right after Halloween, we get going

with our next master fasting challenge.

If you want to lose weight

before the holiday season ramps up
while enjoying food guilt free.

If you want to get the scale moving

and master your habits
before the end of the year

so you can start 2024
with more momentum than ever before.

Or if you're new to fasting,

or you just need to get back on track
or break that plateau

that you've been experiencing
with your fasting lifestyle,

then leverage the impending holiday season
that is upon us

and join us on the next master
fasting challenge.

It comes out November 1st.

We're going to go live seven days
inside of our private group.

We're going to teach you everything
you need to know to level up your skills

so you can have absolute control
through this holiday season

and create the fasting lifestyle
that you've been looking for.

So it's not just about the scale, it's
about creating a life

that you feel good and confident
in your skin day in and day out.

And our favorite time of year is
to overdeliver during the holiday season.

So come join us, click
the link in the show notes

for more details, dates and information,
and we'll see you on the inside.

Now, today's episode,

everyone.

Back to the Fasting for Life podcast.

My name's Dr.

Scott Water and I'm here as always, my
good friend and colleague, Tommy Welling.

Good afternoon to you, sir. Hey, Scott,
how are you doing?

Fantastic, My friend.

Today is going to be a fun conversation.

We're gonna talk fasting where you talk
fat loss, We're going to talk fat,

We're going to talk. How many more f words
can I put it in here?

We're going to put them all together
every time exercise.

I'm fit. It's going to work out, fun
doing it.

We're going to

land the plane with some actionable things
that you can do to continue

to put fasting into your day to day
life and adopt fasting as a lifestyle.

So if you are new to the podcast,
welcome in.

Thank you for giving us a shot.

If you want to hear more
about why we do this each and every week,

you can head back
and listen to our story in episode one,

give you a little bit of perspective
on Tommy's journey with fasting.

My journey with fasting, and
we're gonna talk about visceral adiposity

in visceral fat today,

which is still part of my journey,
but getting better and better as we go.

If you are a long term listener,
we want to welcome you in as well.

And we are so grateful

for each and every listen, each
and every download the five star reviews.

Yes, somebody said, I'm not giving you a
five star review because you asked for it.

Well, we asked for the reviews,
of course, that tell us

the podcast gods and goddesses
and the people in charge that run

this vast podcast world that we are
delivering value each and every week.

And we just had a huge milestone, Tommy,
that I just remembered

in real time, that sense
because we batch out our podcast, right?

Well, we passed 3 million download loads
and don't worry,

this won't be a self-aggrandizing moment,
but 3 million downloads.

Tommy, just from you and I, struggling for
decades with our health and our weight.

Right. And here we are.

and our goal and our impact

and our mission is to continue
to see those numbers climb.

Because if those numbers
continue to climb,

then we are making an impact and teaching
and helping others to do the same,

to reverse insulin resistance, to prevent
diabetes, to decrease heart disease, etc.

all of those things.

So we are incredibly grateful for each
and every one of you, new

or old or anywhere in between.

Welcome into the fast things like podcast.
Tommy. Just incredible.

Yeah, I absolutely love it.
Thank you guys. So much.

Just never thought

we'd be here a couple hundred episodes
later and 3 million downloads later.

So, so cool
and still somehow stuff to talk about.

I know, right? Yeah.

I mean, the battle continues,
right, with obesity and the the waistlines

and the food supply and, you know,
all of these things that matter.

And so giving the perspective that we wish
we would have understood decades ago

so that we could have gotten there,
gotten there faster and with less struggle

and less frustration and things like that.
So absolutely love this.

And thank you again to everybody
listening.

All right.
Let's dive into today's episode.

So we're going to talk
about visceral adiposity.

So I'm going to do big picture here
in just a second.

We're going to dive

into a couple of interesting articles,
some factors that are associated

with the percent change

in visceral versus subcutaneous fat
during weight loss from a systemic review.

And we've got another article

that we really found interesting,
another systemic review and meta analysis

on the effects of exercise
training versus a low calorie diet.

A.K.A if you fast

you're going to be putting yourself
into a lower calorie consumption.

If you do time restricted eating, time
restricted feeding.

However, we want to look at it.

We have an article
we're going to reference on that as well.

We're going to look at the distinct
effects on body weight

in visceral adipose tissue
with those relationships to exercise.

And we're going to bring back a throwback
to we've talked about visceral adiposity

multiple times on the podcast
in terms of a couple of previous episodes.

Episode 38, we're going to look
at very low carb versus low fat diets.

And it's a fact.

We're going to mention that again,
that episodes

episode 38, where we just dive
deep into that,

we're going to talk big picture
about visceral adiposity on episode 128,

and then we're going to mention
the episode 155

where we talked about time restricted
eating with or without low carb,

because big picture
here, Tommy, is if you go out

and then we'll get into the definitions
and kind of unpack it.

But the articles we're going to look at
today are going to be those focused

on exercise component, the low calorie
component, the overall effect.

We're going to talk about stress

in the HPA axis and how that can drive
insulin resistance and visceral adiposity

and then kind of have
some of those old touch points

just to paint a full picture of it
as we move forward.

But the difficult difficulty in
this is there's

so many conflicting moving factors, right?

So you can get articles
that say one thing versus another

and then you're sitting there at home
going, okay, well, what do I do?

What is the actual doing that
I need to do now that gets me a result

that I know that I'm on the right path
to health and weight loss and longevity

and not the past two diabetes, insulin
resistance, disease, cardiometabolic

issues and ultimately higher mortality
risk in the later decades of life.

Yeah, and well, step one,
what do we need to do?

Step one would be to understand
how important visceral adiposity is,

because that's something
I certainly didn't have on my radar

whenever I was going back and forth
low and slow diet, diet,

yo yos and things like that.

I mean, I was looking at the
never get rid of the belly, right?

And, you know, and in fact,
the visceral adiposity and the belly fat

actually was continuing to accumulate,
as it oftentimes does,

even through these weight
loss and weight gain fluctuation cycles.

If you do imaging or, you know, do like a
like a DEXA scan or something else

where you actually know

what your visceral adiposity
is, you might see that over time.

And so like understanding the fact
that it's

so highly correlated with cardiovascular
risk events and metabolic risk

and just decreasing health span
over time and everything that's that's

so important there, it's not necessarily
the number on the scale that matters

so much, but how much actual fat
we have around our internal organs.

So if we can move the needle on that
and understand

what the factors are,
then we've taken a big step forward

so that we can be aimed
in the right direction

regardless of what the scale says
and a host of other factors

that we typically go
to for making a determination

if we're like headed in the right
direction.

Like is this diet working for me?

Yes or no
might just be based on the scale. Yeah.

And when we do our challenges,
do we get a ton of very tactical questions

about this?
How much protein should I work out?

What's the best facet to get?

What about my hormone,
like all of these different things.

And the reality is, is that there are
some big levers that we should be pulling,

regardless of all of those sub questions
or subcategories of questions that we get.

Yeah.

So universal offer.

So I heard Peter Attia was on a Dr.

Peter Deal was on a podcast recently
and I heard him mention he's like,

if you've got 20 or £30 to lose, I don't
even want you asking me about supplements.

That's a great idea.

And I was like, okay.

And it was a cool I can't remember
who's whose podcast he was on

because he's blown up recently,
but I was like, Oh, interesting, right?

Because the effect of those
is not going to be a needle mover

nearly as much as his five pillars. Right?

And one of his pillars is exercise.

So we're going to start there
with the conversation today is exercise.

Well, what do you do?

What what's the point?

And with exercise, we want to be focusing
on this this visceral adiposity.

This is we know that this is a driving
factor of metabolic dysfunction,

of disease, of blood sugar issues,
cardiometabolic issues

in that
if you go from the insulin connection

to eight out of the top
ten highest mortality risks

that we have here in the States
in terms of why people lose their life,

you know, we've done an episode
solely just on that, you know,

getting insulin under control,
getting our blood

you're going to control
and getting the weight loss.

Specifically, the visceral fat is
what we're going to be talking about.

And this is so near and dear to my heart
because this is what I'm working

on currently.

And people say, what's your goal?

Like, what's your weight loss goal?
What's your forever number?

We teach us in our challenge
and it's like while

I don't really have a frozen number,
I have a visceral fat number.

Yeah,
I have a triglyceride to HDL ratio number.

I have an APOB number.

I have a fasting insulin number.

It's not so much, Oh, what's my BMI?
What's the scale say? Right.

So this visceral fat is the fat
that lives.

There's two main types
visceral and subcutaneous, right?

So visceral is stored, like you said, in

between your abdominal cavity
can build up in arteries.

It's located near several vital organs,
liver, stomach and intestines.

And subcutaneous fat is the fat stored
just beneath the skin.

It can be pinched with your fingers

considered much, much, much,
much less harmful.

So we talk about visceral adiposity
or visceral adiposity index,

and there's a cool calculator.

You can go and click
the link in the show notes

and it's going to be based on your waist
circumference,

your body mass index, your triglycerides
and your HDL cholesterol levels.

Right.

And this is going to indirectly express
your visceral adipose function

dysfunction
and insulin sensitivity slash resistance,

because you can't go to find out
your visceral fat.

You can't go.

And Doctor Sean O'Mara,

he does these on his Instagram where
he'll show before and afters of MRI's.

Right.

But you get an MRI scan done.

It's not typically looking
for visceral fat.

It's looking for tumors and fractures,
disks and all this other stuff.

Sure.

So there is even no application
of the tests,

the proper application of the results
from the tests that we can get.

So if you do go get a scan, great.
Now you have it.

But how do we know where
we're at on the scale?

Well, this equation, this is a much better
because when we did the episode

back in the day, episode 128, we
actually gave you the long form equation.

And now there's this one calculator
that can do it for you.

So we're going to be focusing
on that number.

You can put in your numbers
and then it gives you

the chart on kind of where you're at.

Ultimately,

this is something you can measure
as you start to implement

some of the things
we're going to talk about.

When we start to talk about exercise,
stress and food and how it affects

your visceral adiposity.

Yeah, and just understanding
that we want to be focus on this because

if it's disproportionately more important
than just the number on the scale

or even like any given metric
that we normally hear talked about.

So if we can understand
that there are multiple factors

that kind of lead into it
and just the fact that as it comes down,

it has a preferential reduction in risk
for so many of these important factors.

And so the exercise matters, the fasting
matters, the food choices matter.

Yeah, the stress response
and other lifestyle components that we may

or may not be able to control on a day
to day basis, they're going to matter.

We'll talk more about that, too.

But these all kind of factor in,
but without a conversation like this

that I haven't heard before and I
certainly didn't hear ten or 15 years ago,

it can be tough to like to have the right
focus whenever I'm in a fat loss phase

because just looking at the BMI charts
or just doing like this,

like a skin caliper for body
fat percentage test, even that you're

you're looking at subcutaneous
fat at that point.

And so maybe my subcutaneous
fat is decreasing.

Maybe I'm able to see
a little more muscle definition

than I'm working for
or something like that.

But I might not be moving the needle
my visceral fat in fact, it might be.

It might be increasing.

Yeah, well,
while other things are getting better.

And so, you know, just understanding

where we should be
focus is is really important.

And so at the bottom of this calculator,
it even says so we talked about,

you know, waist circumference, body
mass index, triglycerides, HDL,

these are all you know,
if you get into the AP,

I'm having some some blood work done
and I'm going to be doing a 30 day

kind of challenge to myself
and changing some some parameters.

And I'll share that in the future
after I get my my post numbers done.

But because I really want to be moving

the needle with visceral adiposity,
because to your point, back in the day,

my, you know, when I would do the macros
and the calorie counting and eat less,

move more in the CrossFit workouts,
my stomach never really changed.

I would lean out a little bit,

but I always had and I still have
a few remaining pounds of visceral fat.

It's as as I'm chunking down, you know,
slowly chunking down the BMI category.

I would always have the belly right.

And my dad, who's reverses
diabetes and lost, you know,

it is, come off all the 40 medications.

He still has the belly.

Well,
that belly has been there all along time.

That was from back
when he was in the Navy.

He had them. Right.

So my point of bringing those up
is because at the bottom of this chart

of this calculator, it actually says ways
to lower visceral adiposity,

a poor diet with high intake of carbs
and sugars and inactive lifestyle stress

related to the fight
or flight response of cortisol.

So these are all the articles we're going
to go through here in just a minute.

And high fructose
corn sirup or fructose in general.

So when we're looking
at visceral adiposity, you know,

that accumulates and induces
metabolic derangement.

So you have increased free fatty acids,
pro-inflammatory cytokines,

ultimately insulin resistance
and poor blood sugar control.

Yeah, right.

So this is

why we'll talk about having real time
data in just a minute is so important

and having this equation
and then moving these needles

that we're going to go into now
can really get you some

some really incredible results
and there's some really cool stuff

in regards
to putting the scale in its place

and talking about stress
and talking about exercise,

because everybody wants to know
what's the best way to do it right?

What's the latest and greatest?

What's the fastest way?

Well, when we look at the systemic review
and meta analysis

on the effects of exercise
training versus hypochlorite diet,

So we're going to look at exercise versus
decreasing your caloric intake

and look at those distinct effects
on body weight in visceral adipose tissue.

And there's a couple of cool takeaways
for me.

Yeah, we're actually looking
at the takeaways from these studies.

We want to be focused
on a couple of things.

One would be how did the actual groups
compare with what were they doing

and then how can we make some real life
application assumptions?

And so like if we're talking about food
intake, let's say, then are we looking at

just calories

or are we looking

at the types of carbohydrates
when we're looking at exercise is multiple

different kinds of exercise.

So there were a few of them

that the comparisons were a little bit
like some more mixed bags right

where we had we had groups
that were kind of like a mixed group.

Yeah.

And it's you know, since they're
systemic reviews and they're meta now,

like gold standard, like this is the stuff
we want to look at.

It's an aggregation of data, right?

So when we're looking at the effects

of hypochlorite diet versus exercise
training, the exercise that's included

is running or swimming or walking
or therapy or motion therapy or sports

athletic performance
or biking or physical exertion

or running or bicycling or training or

so there's a whole host of real life
applications here.

But the reality is, is that
when you look at it,

they confirm that
through radiographic imaging.

And they went through all these databases

and they found that both exercise and diet
caused that loss rate.

When comparing diet versus training, diet
caused a larger weight loss.

Okay, cool.

Eat less, right?

You're going to lose some weight.

Right?

In contrast, a trend was observed towards
a larger that decrease in exercise.

So changes in weight
and that showed a strong correlation

after diet
and a modest correlation after exercise.

But here's the thing.

So when you look at the actual
like in the absence of weight

loss, exercise is related to a 6.1%
decrease in that, while diet showed

virtually no change and that is where
the scale would not be moving.

So if weight was coming down,
then we would see

a decrease in visceral adiposity.

So that's a good thing.

But yeah,

we don't have to be losing weight in order
to be moving the needle on this.

And that's the

part that I really like
because you could be at a healthy weight.

You could even be at your forever weight.

Like, like, hey, this feels like I'm
not a maintenance phase, right?

But then when I look in the mirror
or I kind of grab my midsection and like,

this doesn't feel like
I want to maintain this,

it feels like there's still
some improvement that I could be making.

Or maybe the blood work still off a bit
and you're just like, Well, why?

I'm at a good weight, right?

Like,
so I can't really lose any more weight.

But just the fact that,

okay, we get asked this question
all the time, like what about exercise?

Or it seems like if you're fasting,
either you don't need to exercise

or that we're not advocates
for exercise as well.

Yeah,

but but just the fact that
even if I'm at a healthy weight or a quote

unquote maintenance weight or what
I thought was going to be my maintenance

weight, adding in exercise means
I can move that visceral adiposity needle.

And so the reasons for that
might be related to insulin sensitization,

mitochondrial boost and activity
that come about with consistent exercise.

But either way,
I have more levers than just my fasting

and just what's on my plate

or being scared of food,
which is which can be a real problem,

especially after you've used
fasting to actually or dietary.

Yeah, yeah.

Just the old diet dieting paradigm.

Right.

So, so couple more numbers
to round out this conversation

and then a couple of takeaways for this
study when it comes to exercise, right?

So the World Health Organization
and the ACSM guidelines

recommend a minimum of 5%
loss of body weight.

And in clinical practice,
it's usually a combination of training

and a decrease in calories. Right?

We're not even talking
about all the additional benefits

which will mentioned here in a few minutes
that we went over on episode 38.

When we talk about very low carb
versus low fat diets, we're not

going to talk about the
how to reduce your calories.

You're just talking
about a caloric hypochlorite diet.

There's a big discrepancy here
where I don't think that

and they mentioned this in the article,
the obesity reviews article,

that a 5% reduction
should be across the board.

And here's why.

So a 5% loss in body weight is associated

with 21.3% reduction
in that after exercise training,

but only only 13.4%
with caloric restriction.

Hmm. Well, that's a 50% improve

when you add exercise into the equation
right there.

Right.

So and you would just you wouldn't know
that just by looking at the scale.

Right. And here's the thing.
What exercise?

Well, what do you like to do now?

We can get into the whole heart rate zone
training, HIIT, all that stuff.

Right. But you're splitting hairs, right?

In the absence of weight loss
after exercise training,

you get a 6.1% reduction in that.

So we got to move. Yeah.

So this review and meta analysis
showed clear evidence

that exercise training, despite smaller
effects on reducing body weight,

tends to have superior effects
on reducing visceral adipose tissue

and getting that metabolically active,

destructive fat off of our skeletons.

Yeah. Wow.

So like anything with muscle attached to
it, like, we got to get some limbs moving

even if we have,
you know, reduced mobility or an injury,

you know, like,
something needs to move here,

then we, we get to activate muscle cells
and mitochondria all around that,

then reduce the insulin resistance
and increase insulin sensitivity.

And you have just
this preferential effect.

It's, you know, I almost feel like there's
a group of folks

that have like eaten less
and moved more for so long

that it's kind of like,
I don't need the exercise, you know, like,

like almost like frustrated with it
like did high end exercise for so long.

Yeah. Yeah.

But that's why because we tried to move
a very small lever,

which is exercise for weight loss
during exercise.

To lose weight is not the application
of exercise that we want to have,

but that's
what diet culture tells us. Mhm.

So you get frustrated.

You used to do it, used to stay up later
putting more stress on your.

We're talking about later.

Just you could burn some more calories

but that's such a small percent
of our total daily caloric burn.

Five, six 7% maybe.

So I'm not surprised
that we're seeing more

metabolic improvement and change
with exercise than we are in the scale.

And if anyone has ever started a new diet
or a 21 day fix or started fasting

and the scale starts going up
because you're also adding in exercise,

you're still making change.

It's important
we don't exercise for the scale.

We exercise for long term health metrics.

That's why when my wife's like,

Oh yeah, you're in the Peloton challenge,
great segue.

You really seem excited
that you have to do this.

I was like,
No exercise to me is not self-care, okay?

It's not like, Oh, I love it.

No exercise to me is something that I do
because I want to be around longer for you

and the kids.

Like, yeah, it's
part of my long term health strategy.

It's not like when I talk about self-care,

like I'm sitting watching football
all day, I'm out on the golf course.

That's my self-care.
Not going to sit on the freakin peloton.

Okay. Yeah. Brushing your teeth is
also not self-care, you know?

I mean, you know, it's self-care,
but it's not like

it's not like I'm meditating or it's it's
not, it's not cathartic.

I go to the float spa. Okay. Yeah. So.

All right, So the second thing here
we want to talk about is so get moving.

The second thing is factors
from the study, factors associated

with percent change

in visceral versus subcutaneous
abdominal fat during weight loss.

So this is another study

where we get the question
a lot like, well, how fast is too fast?

How fast, what is good?

Because with fasting
we see this consistency issue

where people will want to do extended fast
to get the needle to move and they have

unrealistic expectations of what healthy
fat loss and weight loss should be.

Yeah, so experiences that initial like,
Oh hey, I'm down £5,

I got the rule three days or something,
you know.

Yeah.

And then and then want or expect
that to continue which can be frustrating.

So this study is looking at the evidence

that visceral adipose tissue or VAT
is more pathogenic than subcutaneous.

Right? So we know that.

And what we want to see what they were

studying is the percent decrease

in visceral adiposity
with different percentages of body body

weight loss excuse me, percent body loss,
percent body.

What am I trying to say?

Percent Body weight loss. Yeah.

Thank you.

That's what I was trying to say,
but it sounded weirdos.

Okay.

Anyway, so when we look at the conclusions
of the study, preferential loss of VAT

compared with SAT
is greatest with modest weight loss.

Mm hmm.

And the effect is attenuated
and possibly lost completely

when you increase the weight
loss post that modest category.

So very low carb diets inducing rapid
weight loss in a short period of time

produce the greatest preferential loss
to visceral fat.

But the effect is transient,
so preferential loss of that is reduced.

And perhaps to get it all together
with greater weight loss

and is not related to the method of weight
loss, that's a mind bleep, right?

Right.

So what does it mean?

Rapid VAT loss
for the Q caloric restriction?

A very low carb diet suggests
that that has a physiological role

to provide energy at times of acute
negative energy balance and the sustained

preferential
loss of that with modest weight

loss may add to our understanding
of how modest weight loss

appears to provide significant metabolic
and long term clinical aspects.

So what I'm hearing here is
we want to lose some weight and then guess

what's going to happen? The dreaded pause,

the plateau.

Oh, don't say it.

Oh, you said it a few words cringe.

Don't say the word. Yeah.

So 3 to 4 weeks is that
is that rapid weight loss time? Hmm.

Just what we see when people
start fasting, they lose weight.

And then guess what happens usually
in the first, you know, 4 to 6 weeks.

Sure. Yeah.

They hit the pause.

Sugar can get a little tougher.

You know,

you don't have this direct feedback,

especially
if you're looking for the scale, you know?

So, you know,
I definitely feel like understanding

that is is really good perspective,
you know, on this.

This had to do with this particular
application.

Also looked at very low calorie diets
which we see being mimicked

in our fasting too.

And so the cool thing here was that,
you know, applying it, applying,

fasting, applying
better plates over those first few weeks

will move the needle
as far as visceral adiposity.

And that's a really cool thing.

But also understanding when and where
the plateau can kind of kick in

is good to know too,
because I feel like being aware

before you get smacked by something
that's going to be a motivator, can be

can be very helpful, can give you like
a little bit more resilience

in those moments of toughness
and the time frame we're looking at here,

you know, is when we're looking
at the very low calorie diet

that you mentioned
was exceptional in the short term.

For that, it was like,
you know, less than four weeks.

But as we got out to the 12
and 14 week timeline,

it was pretty much lost with the effect
on visceral adiposity.

So when we just talked about the exercise
example and Right, and you're exercising,

you're seeing visceral capacity come down,
but you're not seeing the scale change.

This is why we say often
with this same concept that you're going

to have visceral and possibly decreased
quickly for four weeks, right?

But then if you continue on that
same thing,

the guts using the same fasting schedules
in the same food choices

that got you there,

then by the time you get to three or four
months out, you're probably losing.

You've lost the effect
according to the study.

So this is why we say that you should vary
your fasting windows and making sure

that you are not over fasting and under
consuming for too long periods of time.

Yeah, good point.

I like this one line in here too.

It's a free fatty acid excretion
from excess visceral adipose

tissue is insensitive to insulin
and highly

sensitive
to stress signals in obese people.

Look at you
connecting the dots to the third.

The third article here. Right. Right.

But you don't like we hear about that
sometimes, too.

Hey, I've been fasting and some things
are kind of off on my bloodwork.

That can happen.

Well, you know, as

we start burning through some of the fat,
especially some of the visceral fat,

we're releasing fatty acids
so there can be some disturbances

that happen right there.

But understanding that that those free
fatty acids that are coming out

are insensitive to insulin and they're
part of the driver of insulin resistance.

And then the fact that now
we're also dulling our stress signals

or creating like a hyper stress response
to get

the same cortisol response
that the body needs during times of stress

because of the excess weight
means stress is a component here.

And oftentimes we we hear stress talked
about like we need to decrease stress.

We're in a stressful time during,
you know, during life and technology and,

you know, all these signals
and notifications and things like that.

But understanding that the fat can mess
with our stress response

means it's another big reason
why we got to get some of the fat off,

like we have to bring this down.

Even if I thought it was at my maintenance

weight, well,
if my fat percentage is too high,

especially
if my visceral fat percentage is too high,

then I still have some work to do.

I have some body composition work to do,
even if the scale, you know, tricked me

into thinking that I was kind of done
here.

I'm at a good maintenance point,
and that's where one of the things so

very low carb, very low calorie
diets versus the low fat diet.

Episode 38, you know, we saw,

you know, low carb, higher fat diet, keto
type diet versus a low fat diet

in older adults, five times more fat loss,
including three X,

more visceral fat loss,
all while maintaining greater muscle mass.

So we're talking about food choices,
right?

Driving this.

We're talking about stress driving it.

So we we want to go through these periods
of ebbs and flows.

So if you've hit a point where you know

you're exercising, you're doing
the fasting, the scale is not moving well,

maybe your visceral adiposity is changing.

And by what we see here
that we've talked about today, it is.

But then that effect is lost
by the three month mark.

So it's time to reassess and restrategize.

Right?

So this is where the time restricted
eating without low carb

because we say fasting can apply to
any lifestyle, can reduce visceral fat

and improves metabolic syndrome.

This is the study that we talked about
in episode 155.

Well, we haven't talked about before.

Timing is what you were just mentioning.

Is this the fact that your stress response

feeds the visceral adiposity machine and
or if you weren't stressed

and you put some weight on
and you've got some visceral fat, let's

say, due to fructose and poor food choices
and doing what I did and doing what

you did, trying to hack the equation
to write shop, to lose the grams

per day, pounds per week
and lose that metabolic flexibility.

This or sleeping over under,
sleeping over exercising.

Right. Yeah.

So the visceral adiposity mimics
your stress response and vice versa.

So now you're going to have more cravings,
right?

You're going to be more tired,

you're going to be putting more stress
on that HP access.

And the HP axis is the hypothalamic
pituitary adrenal access.

And this is really just think of it
as your stress response system.

Sure. Right.

So this one article shows
that visceral adipocytes the potential

to increase the cortisol clearance and may
facilitate to help stress management.

On the other hand, visceral fat
is also a contributor of the stress

which indicates that visceral

fat accumulation represents a non optimal
physiological adaptation to stress.

So it's like, which came first chicken
or the egg, right?

Well, how do we get off the crazy
roller coaster?

We got to manage middle somewhere.

You start moving the needle, right?

So we get we should be exercising,
choose the exercise of your choice.

We should be fasting.

Choose your favorite fasting window
goes in episode 155.

Right? Goes in episode 38.

If you want to do the keto thing,
we recommend doing ketones cycles.

We recommend
changing your fasting windows.

We recommend managing your stress.

And it's not, you know, tell me,
how did you how did you explain this?

When we were prepping
for, for the episode,

you said if we look at stress
in a certain way,

it can be kind of damning
and kind of paint us the corner, right?

Yeah, yeah, yeah.

The advice,

the recommendation that I hear oftentimes
is find ways to control your stress.

You know, first of all,
what does that really mean?

Most of us are victims, quote unquote,
of like a chronic stress response.

I got three kids, men under seven.

How many dogs?

Three. A horse. Yeah, right.

You got all kinds of all kinds of stuff.

That's just kind of like ping
in your stress response all day long.

Traffic just in Houston, right?

It was 100, you know, 100 and something
degrees for like 60 straight days.

I know all first world problems.

We got a dining room floor is bubbling
up, got to submit an insurance claim

because apparently we have a leak
somewhere.

Oh, man, I don't know.

We had a $400 water bill
because the pool apparently had a leak.

You know, I know all first world
problems are still problems, right?

They still induce a stress response,
especially when you're not sleeping.

The tiger stress

that we've, you know, all
but kind of overcome or compartmentalize,

you know, adapted to write doesn't exist
on like a moment to moment

basis for most of us who are podcasting
or listening to a podcast, right.

Like I don't see tigers in the wild
right now,

but if that notification on my phone
that just dinged, yeah,

that one doesn't go away.

You know, it's not like I outran the tiger
or I died from the tiger either.

I asked you to
I asked you to unpack this point.

I keep I'm just like over here
telling too many personal stories.

All right, land the plane.

So, okay, so if we're just told, like

he control your stress response,
that's not it's kind of an impossibility.

And then and it feels like
I'm chasing my tail around, like,

how am I going to move the needle
by controlling my stress response?

I can't really just change
all these factors in my life.

Current situation.

Yeah. Yeah.
And a little bit of meditation.

It might go a long way,
but it doesn't feel like it's

really going to move the needle or,
you know, burn some extra visceral fat.

Although it might.

But if I think about it
more like the fact that I'm carrying,

especially around my midsection
and especially around my internal organs,

is producing a worse stress response
because it's mimicking

the access, the cortisol response
from my body that I need

and that I'm going to produce anyway.

It's pushing that. It's it's elevating it.

It's escalating it to a point
to where a lot of the signals are muted

or even blocked.

And so if I can move the needle on

some of the fat,
especially the visceral fat,

I'm going to make improvements
on my stress response.

I'm going to feel
less of the stress response.

I'm going to feel less of the cravings
that are caused by that stress response.

And then I'm going to get better
sleep and I have a better balance going

on, which is part of why you have these
better health outcomes as well.

So the reason to move the needle for
the fat is for a better stress response

rather than just feeling like,
Oh, I got to fix my stress.

Yeah, yeah.
I mean, download an app, right? Right.

I got a timer, I got another medication.

Like those things are good.

Yeah, but yeah,
but for me, it's cold plunges.

Oh, yeah, I love it.

I'm just.

I'm a better human being when I call

you to, like,
my wife's, like you've been punched again.

I'm like, Yeah, how can you tell?

She's like,
because you're just a better husband

and father, and you're just better.
Michael Thanks, honey.

That's your self-care. Yeah, right.
That's the part of my self-care.

Yeah.

It's kind of an aggressive self-care, but,

you know, doing really hard
things that are never get easier.

Yes. So that's a really so not just, oh,
go fix your stress,

but let's get the weight off.

Let's decrease the visceral adiposity

and and then we move the needle
so you're not painted into a corner.

You will have a better stress response.

That reminds me of these
two conflicting articles that we have

in terms of access leading to the stress
response, leading to visceral adiposity.

The study that we just cited actually
looked at blood cortisol levels, right.

To see the relationship,
even though it is cyclical.

Right.

And then they talked about leptin
and subcu and all this other stuff.

This other article that we found was
chronic stress burden, visceral

adiposity, tissue, visceral adipose
tissue and adiposity related inflammation

related to heart disease as well.

But they looked at stress levels
and said, yeah, visceral adipose

tissue doesn't really seem to come from
or be driven by a chronic stress burden.

But they used a survey. Yeah.

I'm like, okay, how stressed?

You know, I'm good, man. I'm great.

You know, if you ask me versus,
you know, in a clinical setting versus

like we're prone to be like, I'm good.

How are you? Right. That whole like,
oh, have a nice. Hey, thank you, sir.

Have a nice flight. Oh, you too. Oh, wait.

That's the lady behind the counter

or the guy behind the counter
who checked my bag like. Right.

Why did I do that?

I was even thinking so I just
Because that juxtaposition exists, right?

Yeah, It's out there, like, okay, well,
where's the conflicting information?

Okay, well, in my head it's like,
all right, I'm stressed.

The need to fix the stress.

Well, let's get to the underlying cause.

Let's put some time restricted windows in.

Let's leverage the time restricted
eating data that's out there.

Right.

That shows

that if we just shrink our window,
if we go all the way back to January 17th,

we did an episode where we talked
about the ten hour versus the six hour.

Right?

If you just shrink your window

and you vary that window,
then you're going to be able to move

the needle in the underlying
visceral adiposity category.

Yeah, right.
So There's a few things you can do.

We talked about moving the exercise.

You talked about going to get
your VHI number using the calculator.

We're going to want to move the needle
and anticipate that we're going

to see body composition changes
and know what the scale is going to do.

We're going to want to decrease
our OCD intake,

our fructose specifically intake, right?

Because that hijacks our system

and causes and forces us
into storing more visceral adiposity.

And we're going to want to get
to the underlying cause of our stress,

not necessarily
be able to change the season we're in,

but change the physiology
that underlines our response to it.

Well, it reminds me
that if you ask 100 people like,

you know, rate your stress response,
but you see this like bell curve, but

the majority of people will just say, like
on a scale of 1 to 5, just say a three.

You know, it's like,
oh, it's just a normal day.

It's just a three, you know?

So when you try to it's like scale of

Oh crap.

Six or closer to a ten or no,
you can't say seven.

Yeah, yeah, yeah.

So we kind of tend to just like
put it in the middle, you know?

So it's

very difficult to correlate visceral fat
with your actual stress

without, without measuring, you know,
what's going on in the body.

So, you know, when we talk about shrinking
windows, what we get to start doing

is we start to get to tap
into the physiology of fasting,

which
so what we do is we're actually going

to keep the blood sugar
a bit lower than what

then where it's been, and then insulin
actually has time to drop down as well.

So not only are we tapping into fat stores
because of this hypo caloric,

this calorie deficit, and then we can add
in some consistent exercise with it, too.

But what we get to see is
like is an actual flattening of that area

under the curve for our blood sugar,

which is going to have a beneficial effect
on basically everything.

And like you just mentioned, cold plunges.

I remember when when I was actually
taking my glucose, my my ketones

and at one point wearing a CGM continuous
glucose monitor and actually doing

the cold plunge, I got to see the acute
like the tiger spike,

you know, in the blood sugar
and actually see what that look

and then how it came down
like very, very quickly.

And that was very different
from the rest of the day.

And so that just reminded me of it because
every time I jump in there, it's like,

Oh man, yeah, you feel the stress,
although you feel like this

alleviation of it too,
which is in direct contrast

to like the phone notifications
that you mentioned.

You know, that's a huge part
and I forgot to mention the CGM earlier,

but is specifically with cold plunging,
I've been able to see

the immediate response.

So we talk about not being able to see
or get a DEXA.

We don't have a DEXA scan in our house.

Yeah, like over time, let's get real
tired of you right now.

Yeah. You're not going to get a scan
every month, right?

Three months, six months, maybe.
Maybe you can't even get your bloodwork.

You're not going to run your bloodwork
every 30 days, right?

First of all, a lot of doctors
aren't going to order that

or know how to interpret
the tests that we recommend anyway.

So that's a huge part

that I had completely forgotten about,
but that the CGM and I just came off

wearing it for six months
and we've partnered with nutrition.

So what you were just talking about,
nutrition combines cutting edge tech

with human expertise so we can see
how our body responds to stress

or induced stress by doing a cold plunge
or sleep or exercise or different foods.

So then you compare, you pair the CGM,
which is their continuous glucose monitor.

It's the biosensor that you wear
in the back of your arm, and it's only

for diabetics or people
that are pre-diabetic,

or it is for folks
that want the real time health guidance.

And then you combine
the CGM with the dietician guidance

inside of the app
and you get visuals and you can set goals.

And it's absolutely incredible.

The visual immediate feedback
that you get.

So you get the app, you get the dietician
guidance, you see it in real time.

You can absolutely tell, you know,
like when I have a poor night of sleep

or a higher stress day, my route tells me
I'm in the higher stress zone, right?

I will see that my numbers are elevated.

Yeah, right.
When I look at my CGM and I scan it.

So absolutely want to encourage you
if you're looking for that real time data

on that real time feedback,

the lasting sustainable change comes
from taking consistent action over time.

So I'm going to encourage you
to choose the six or 12 month

subscription I'm just taking a break
because I got kind of obsessive about it

because that's what I do.

I'm like, Oh, what can I do now? Well,
what more is like, What are you doing now?

I'm like, I'm testing the steak.

If I could get this reversed,
She's like, Okay, you're losing your mind.

So the cool thing
is, it's been very impactful in

keeping my blood sugar numbers
between the field goal post, so to speak.

And it's really helping me dial
in how I feel on a day

to day basis and ultimately the actions
that I take based off of that.

So you can add to nutrition.

Scott i o forward slash fasting for life
nutrition start IO forward

slash fasting for life.

You get $30 off in one month free
dietitian support.

So Tommy, as we wrap up
another conversation on visceral Fat,

we've got some takeaways
you can head to the show notes.

You can go to the Task for Life
Community Group here on Facebook.

You can click the link for the nutrients,
you can click the link for the VEI

calculator to find out your visceral
adiposity is a mental take away

because we just gave a few action
steps, right, in terms of physical action.

But a mental takeaway
to wrap up today's episode.

Yeah.

Mental take away

would do a couple of things that increase
your consistency starting today.

Okay.

So what I mean by that is I know it's it's
easy to kind of get in the feeling of

I need a longer fast
to move the needle like,

oh man, I got a few more pounds or
maybe I'm trying to get my best for those.

A rough weekend. I'll do a 48.

Sure. Yeah.

Or a 72, you know, and it's like that
doesn't lead to consistency.

You know what leads to consistency
is, you know, making one or two better

food choices, you know, today
and tomorrow and next weekend

and and then also having having some sort
of default where I go, you know, what

what does my fasting lifestyle look like?

Well, maybe it looks like a 20 hour fast
every day or almost every day.

Right.

Or at least like maybe an 18 hour fast
every day with with a six hour

or maybe a four hour nutrition window.

And maybe I can
I can make that a little bit earlier

so I don't get tempted
into some of those late night temptations.

And then maybe if you're a late night
exerciser like I used to be,

that could be tempting to where the later
I stayed up.

And the more calories I took in later in
the day, I'd be tempted to do some cardio

at nine or 10:00 at night like that was
that was leading to.

It's funny, I was never attempted to
do that, but I used to go to the gym late.

Yeah, and I would do that too,

especially if like the goal was, okay,
I'm going to get up a little early and go,

but if that doesn't work out,
then I'll go,

you know, in the evening time,
after the day or get away from it.

Yeah, Yeah. And the date typically does.

But you know, progress
over perfection for sure.

So just increasing your ability to
to be a little bit more consistent show up

so a little bit more consistently,
even if the scales not just flying down,

you got a few more pounds
or maybe it's a bunch more pounds,

but getting a few steps right
and being able to apply

those consistently is going to move
the needle much, much better.

And like we talked about with CGM
and the calculator and all these things,

we're looking for decreases
in some of the peaks, the peak cortisol,

the peak insulin, the peak blood sugar
looking at decreases

in some of those peaks
so that we can have a long term increase

in health span
longevity and quality of life as well as

decrease the visceral adiposity
and insulin resistance.

Yeah, and adapt that fasting lifestyle.

We want to be intuitive about this.

We don't always
want to have to be stressed

and make a decision like we want
this to be an intuitive thing, right?

And that just creates
long term sustainability.

So what I just heard there in terms
of a mental takeaway is make a short term

decision with the long term
strategic goal in mind

to make a short term decision
taken action.

That's not based on the emotion
in the moment or the feeling.

Right.

But that's going to move you
towards your long term goal or your long

term destination.

So think strategic and strategic
for long term rather than that short term

gain of pleasure that you might get

or that happy hormone head
that you might get that just the dopamine.

So staying consistent
and that is literally what has made

keeping the weight off once
and for all, being able to

finally move the needle and move the labs
and feel better and sleep better

and just be more healthy
than I've ever been, where I was

definitely trending, just like
you were in the opposite direction

as we were entering our mid thirties
to early forties.

We want to encourage you
that you can do it too.

So head to the show notes, click the link
the via calculators in there.

All the links for the reference articles
are there.

You can also grab the blueprint
to fasting for fat loss.

You get the nutrition code,
the fasting for life community.

Come join us, stick with us.

Appreciate your conversation
as always, Tommy. We'll talk soon.

Yeah, thank you. Bye.

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