0:00:14.131,0:00:19.016
What if I told you that breakfast[br]being the most important meal of the day

0:00:19.016,0:00:20.708
was wrong?

0:00:22.628,0:00:25.043
(Laughter)

0:00:27.323,0:00:33.808
What if I told you it is more important[br]when you eat than what you eat?

0:00:34.901,0:00:38.777
Perhaps much of the nutritional dogma[br]that we've been raised with

0:00:38.777,0:00:40.552
is now outdated,

0:00:40.961,0:00:44.533
like snacking all day long[br]and eating many meals.

0:00:44.724,0:00:47.285
Over the next few minutes,[br]I plan to discuss with you

0:00:47.285,0:00:52.775
what I believe to be the most profoundly[br]transformational concept and strategy

0:00:52.775,0:00:55.539
as it pertains to health and aging.

0:00:55.685,0:00:57.004
Over the last 20 years,

0:00:57.004,0:01:00.043
as a nurse practitioner[br]and a functional nutritionist,

0:01:00.043,0:01:02.156
I've seen tremendous shifts,

0:01:02.156,0:01:04.762
tremendous shifts in health and wellness:

0:01:04.762,0:01:09.221
escalating rates of obesity, diabetes[br]and cardiovascular disease -

0:01:09.221,0:01:11.421
many of which are preventable.

0:01:12.060,0:01:16.860
The choices we make in terms of nutrition[br]are profoundly impactful on our health,

0:01:16.860,0:01:19.225
more than most of us realize.

0:01:21.600,0:01:23.673
During my training as a nurse practitioner

0:01:23.673,0:01:25.519
many years ago,

0:01:25.799,0:01:31.516
the dominant nutritional paradigm[br]was exercise more, eat less.

0:01:31.604,0:01:34.407
I've found this[br]to be profoundly ineffective

0:01:34.407,0:01:37.547
for most, if not all,[br]of my female patients.

0:01:37.547,0:01:43.355
The concept of "calories-in,[br]calories-out" alone is just not effective.

0:01:43.834,0:01:47.060
Many of the things that I work with,[br]with my female patients

0:01:47.060,0:01:51.608
really focus on the connection[br]between our lifestyle choices

0:01:51.608,0:01:53.942
and how that impacts healthy aging

0:01:53.942,0:01:55.440
and weight gain.

0:01:55.742,0:01:59.566
I do not believe, nor do I support,[br]the limiting belief

0:01:59.566,0:02:05.026
that women have to accept weight gain[br]as a normal function of aging.

0:02:06.214,0:02:08.763
The National Health[br]and Nutrition Exam Survey,

0:02:08.763,0:02:14.856
which looks at data[br]with regard to children and adults

0:02:14.856,0:02:19.321
in terms of their nutrition[br]and escalating obesity rates,

0:02:19.321,0:02:23.123
compares what went on in the 1970s,

0:02:23.318,0:02:26.223
where most Americans[br]consumed three meals a day

0:02:26.223,0:02:27.793
and no snacks;

0:02:27.961,0:02:29.745
fast forward to today,

0:02:29.745,0:02:33.763
most of what we are doing as Americans[br]is eating three meals a day

0:02:33.763,0:02:35.922
and snacking all day long.

0:02:37.116,0:02:38.303
Really.

0:02:39.338,0:02:42.331
And so one of the things[br]that starts to happen

0:02:42.331,0:02:46.157
when healthcare providers[br]are telling our patients

0:02:46.157,0:02:49.199
that we need to eat all day long -

0:02:49.199,0:02:50.821
it's wrong.

0:02:51.066,0:02:56.832
Eating all day long overtaxes[br]our pancreas and our digestive system.

0:02:57.299,0:03:01.161
It overtaxes it so much[br]that it cannot work properly.

0:03:01.653,0:03:04.963
And if it cannot work properly,[br]we cannot absorb our food

0:03:04.963,0:03:07.202
or the nutrients in that food.

0:03:07.392,0:03:10.664
Another really important distinction[br]when it comes to meal frequency,

0:03:10.664,0:03:12.592
or how frequently we're eating,

0:03:12.592,0:03:17.343
is the debate over sugar burners[br]versus fat burners.

0:03:17.343,0:03:19.006
And when we're talking about that,

0:03:19.006,0:03:24.891
a sugar burner is someone[br]that consumes lots of carbohydrates

0:03:25.075,0:03:28.499
and taps into glucose[br]as their primary fuel source,

0:03:28.499,0:03:30.621
which is incredibly inefficient.

0:03:30.621,0:03:32.571
If you recognize these individuals:

0:03:32.571,0:03:34.603
They are frequently hungry.

0:03:34.923,0:03:36.732
They often get hangry.

0:03:36.732,0:03:41.336
They have - yes - significant dips[br]in their energy level.

0:03:41.616,0:03:46.297
They struggle more with fat loss,[br]and they struggle more with their weight

0:03:46.297,0:03:48.425
because insulin levels are high.

0:03:48.425,0:03:52.278
Insulin is that fat-storing hormone.

0:03:52.278,0:03:55.905
So if levels remain high,[br]we have more oxidative stress;

0:03:55.905,0:03:58.675
we have more inflammation;

0:03:58.675,0:04:01.192
and we struggle more with weight gain.

0:04:01.565,0:04:04.595
In sharp contrast to this are fat burners.

0:04:04.595,0:04:07.028
They tap into fat stores for energy;

0:04:07.028,0:04:08.776
they have sustained energy;

0:04:08.776,0:04:10.951
they are much more clear cognitively;

0:04:10.951,0:04:13.555
they don't get hangry;

0:04:14.603,0:04:16.531
it's easier for them to lose weight

0:04:16.531,0:04:18.603
because they tap into those fat stores;

0:04:18.603,0:04:22.046
they sleep better;[br]and they age more slowly.

0:04:22.344,0:04:27.931
So meal timing and how frequently[br]we are eating - it's absolutely crucial.

0:04:28.181,0:04:30.015
Absolutely crucial.

0:04:30.761,0:04:34.241
Let's talk about some statistics[br]as they pertain to women

0:04:34.241,0:04:35.965
and healthy aging.

0:04:35.965,0:04:41.274
So we know two-thirds of women[br]40-50 years of age are overweight,

0:04:41.274,0:04:43.490
and more than half are obese.

0:04:43.711,0:04:46.827
How do we proactively[br]address this statistic

0:04:46.827,0:04:48.723
without quick fixes?

0:04:48.919,0:04:51.480
It makes me want to cry

0:04:51.482,0:04:55.342
when my female patients[br]would prefer I write them a prescription

0:04:55.523,0:04:58.471
than work on changing their diet,

0:04:59.011,0:05:00.503
more exercise,

0:05:00.503,0:05:02.504
other lifestyle changes.

0:05:03.272,0:05:09.201
Women in their 50s and 60s[br]gain an average of 1.5 pounds per year.

0:05:09.471,0:05:11.521
Per year. That's average.

0:05:12.158,0:05:15.716
And some of this is attributable[br]to things like hormonal fluctuations,

0:05:15.716,0:05:19.615
women having less lean muscle mass[br]than their male counterparts,

0:05:19.615,0:05:22.010
sleep disturbances and mood disorders.

0:05:22.010,0:05:26.631
However, there are strategies[br]we can use to help offset this.

0:05:27.903,0:05:30.755
So folks, I want you to save your money

0:05:30.755,0:05:35.753
on potions and powders and supplements[br]that are not long-term solutions.

0:05:35.753,0:05:37.664
I've got a better idea.

0:05:38.129,0:05:40.223
And I'm going to tell you about it.

0:05:40.582,0:05:42.526
I've got a better idea.

0:05:42.767,0:05:46.625
There are lots of strategies[br]that I use with my female patients,

0:05:46.625,0:05:50.543
but none more powerful[br]than intermittent fasting.

0:05:51.014,0:05:54.761
Intermittent fasting[br]can help fuel fat loss

0:05:54.761,0:05:58.007
as well as many other benefits[br]that I'll talk more about in a second.

0:05:58.007,0:06:00.430
But it also can improve[br]interpersonal relationships

0:06:00.430,0:06:02.211
and self-esteem.

0:06:02.211,0:06:04.688
And for many women, this permits them -

0:06:04.688,0:06:10.451
it's the magic bullet that allows them[br]to gain back their former selves.

0:06:10.599,0:06:12.181
Really powerful.

0:06:12.381,0:06:14.812
And the really cool thing[br]about intermittent fasting

0:06:14.812,0:06:15.903
is it's free,

0:06:15.903,0:06:18.298
it's flexible and it's simple.

0:06:18.298,0:06:19.697
You take nothing else away.

0:06:19.697,0:06:21.881
Free. Flexible. Simple.

0:06:22.191,0:06:24.551
So let's talk about intermittent fasting.

0:06:24.551,0:06:28.969
It is the absence of food[br]during a prescribed time period.

0:06:29.770,0:06:33.404
You exist either in a fed[br]or a fasted state.

0:06:33.404,0:06:36.108
I'm sure for many of you,[br]you had breakfast this morning.

0:06:36.108,0:06:39.524
So when you eat, insulin[br]is secreted by the pancreas

0:06:39.524,0:06:42.082
to move sugar into the cells.

0:06:42.082,0:06:47.942
We store the bulk of our sugar[br]in our liver and our skeletal muscle.

0:06:47.942,0:06:51.096
But when we exceed those storage sites,

0:06:51.096,0:06:53.143
we store it as fat.

0:06:53.465,0:06:58.308
When we're fasted, insulin levels are low

0:06:58.308,0:07:01.891
and we can tap into fat stores for energy.

0:07:02.858,0:07:05.138
Free. Flexible. Simple.

0:07:05.459,0:07:09.822
And so, when we're talking about[br]intermittent fasting, it's fairly simple.

0:07:09.822,0:07:11.713
If you skip breakfast -

0:07:11.913,0:07:13.739
If you skip breakfast in the morning,

0:07:13.739,0:07:17.320
you can reduce your caloric intake[br]by 20 to 40 percent.

0:07:17.529,0:07:21.103
And the typical time frame[br]that I recommend to my female patients

0:07:21.103,0:07:22.705
is a 16:8.

0:07:22.705,0:07:26.962
Sixteen hours a day fasted[br]with an eight-hour feeding window.

0:07:27.305,0:07:29.621
I know that seems[br]a little overwhelming at first,

0:07:29.621,0:07:32.735
but I'll give you some strategies[br]for how you go about doing that.

0:07:32.735,0:07:36.504
So, the 20-40 percent[br]reduction in calories

0:07:36.504,0:07:39.332
means that you can fuel fat loss.

0:07:39.707,0:07:43.403
So what are some of the benefits[br]other than fat loss -

0:07:43.742,0:07:46.593
fat loss and especially visceral fat[br]around our abdomens,

0:07:46.593,0:07:48.403
around our major organs?

0:07:48.403,0:07:52.847
We know that it improves mental clarity[br]because insulin levels are low.

0:07:52.849,0:07:55.515
We know that it spikes[br]human growth hormone,

0:07:55.515,0:07:58.140
which helps us with lean muscle mass.

0:07:58.530,0:08:01.725
We know that it induces[br]something called autophagy -

0:08:01.725,0:08:03.691
I will speak more about this in a second.

0:08:03.691,0:08:05.709
But this is spring cleaning for the cells.

0:08:05.709,0:08:09.212
It is only evoked when we are fasted.

0:08:09.212,0:08:11.095
Autophagy.

0:08:11.095,0:08:13.429
We know that it lowers insulin levels,

0:08:13.429,0:08:14.527
blood pressure,

0:08:14.527,0:08:16.942
improves our cholesterol profile.

0:08:18.184,0:08:22.258
And we know that it can reduce your risk[br]for developing cancer

0:08:22.258,0:08:25.932
and Alzheimer's disease,[br]which I like to call type 3 diabetes.

0:08:25.932,0:08:30.320
If, for no other reason,[br]we want to protect our brains.

0:08:31.757,0:08:36.709
As wonderful a strategy as this is,[br]it is not for everyone.

0:08:36.969,0:08:38.397
I'm going to talk briefly

0:08:38.397,0:08:42.027
about the individuals[br]that want to avoid this strategy.

0:08:42.423,0:08:46.140
First and foremost,[br]if you are a brittle diabetic,

0:08:46.140,0:08:49.223
or you have difficult-to-control diabetes;

0:08:49.716,0:08:53.747
if you are a child, an adolescent[br]or age greater than 70 -

0:08:53.747,0:08:55.993
might not be the best strategy;

0:08:56.165,0:08:57.496
if you are pregnant;

0:08:57.496,0:09:02.482
if you have chronic heart issues,[br]kidney or renal issues -

0:09:02.482,0:09:04.479
not the best strategy.

0:09:04.719,0:09:07.596
If you have a history[br]of a disordered relationship with food,

0:09:07.596,0:09:13.693
whether it is anorexia,[br]bulimia or binge eating -

0:09:13.693,0:09:16.973
might not be the best strategy[br]because it can invoke those tendencies.

0:09:16.973,0:09:20.493
And last but not least,[br]if you have a low body mass index,

0:09:20.493,0:09:21.622
you're frail

0:09:21.622,0:09:25.252
or you've recently been in the hospital[br]like I was for 13 days.

0:09:25.252,0:09:27.803
I'm not currently intermittent fasting.

0:09:28.911,0:09:32.071
Now, everyone always asks,

0:09:32.441,0:09:35.162
Well, when you're fasting,[br]we know we're not eating food,

0:09:35.162,0:09:40.620
but you can absolutely consume things[br]like filtered water, plain coffee or tea.

0:09:40.620,0:09:42.316
They will not break your fast.

0:09:42.316,0:09:45.186
But when you're ready to eat,[br]what do you eat?

0:09:45.186,0:09:50.384
Now, I would be remiss[br]if I did not mention that there are foods

0:09:50.384,0:09:53.361
that are going to be more[br]advantageous for you to consume

0:09:53.361,0:09:55.818
when you're ready to break your fast.

0:09:55.818,0:10:00.030
So I want you to focus[br]on real whole foods.

0:10:00.030,0:10:03.249
That's what your body needs,[br]wants and deserves.

0:10:03.249,0:10:07.487
So I want you to purchase the best quality[br]protein that your budget permits.

0:10:07.487,0:10:11.433
Ideally, organic or pastured meat,[br]wild-caught fish.

0:10:11.693,0:10:13.477
Healthy fats - so crucial -

0:10:13.477,0:10:15.797
helpful for building healthy hormones

0:10:15.797,0:10:20.042
and also really important for satiety -[br]making sure our taste buds light up,

0:10:20.042,0:10:21.345
make us happy.

0:10:21.345,0:10:24.015
I'm not part of the anti-fat brigade.

0:10:24.015,0:10:25.594
Really, really important.

0:10:25.594,0:10:28.163
Twenty years ago, I might[br]have told you not to eat fat,

0:10:28.163,0:10:29.282
but now we know better.

0:10:29.282,0:10:32.125
So I want you to focus[br]on things like avocados,

0:10:32.125,0:10:37.170
coconut oil, grass-fed butter and nuts -[br]really great, healthy fats.

0:10:37.556,0:10:39.172
Unprocessed carbohydrates.

0:10:39.172,0:10:40.923
Ladies, absolutely crucial,

0:10:40.923,0:10:44.605
if you're in perimenopause,[br]the five to seven years before menopause,

0:10:44.605,0:10:46.098
or you're in menopause,

0:10:46.098,0:10:48.863
quality and quantity are crucial.

0:10:49.123,0:10:53.933
So I want you to consume things[br]like low-glycemic berries,

0:10:53.933,0:10:58.241
green leafy vegetables, squash,[br]quinoa, sweet potatoes

0:10:58.241,0:11:00.664
as opposed to bread and pasta.

0:11:01.552,0:11:05.766
Cautionary tale: I want you[br]to limit sugar and alcohol.

0:11:06.075,0:11:08.817
By that I mean, I want you[br]to not consume those things

0:11:08.817,0:11:11.777
because they can offset[br]all the good that you're doing.

0:11:11.783,0:11:14.714
And lastly, keep yourself well hydrated.

0:11:15.374,0:11:16.531
Now, I want to make sure

0:11:16.531,0:11:19.242
that I briefly touch on[br]some of the practical implications

0:11:19.242,0:11:22.579
for how you would go about[br]starting intermittent fasting.

0:11:22.579,0:11:27.292
Generally, I have my ladies[br]start with 12-13 hours of fasted period.

0:11:27.292,0:11:30.296
And they can slowly increase[br]by an hour or so every day

0:11:30.296,0:11:33.161
until they've reached that 16 hour mark.

0:11:33.161,0:11:35.696
Again, you want to keep yourself[br]really well hydrated.

0:11:35.696,0:11:37.801
You can also have plain coffee or tea.

0:11:37.801,0:11:42.837
In addition to that, you want to ensure[br]that you give it a solid 30 days

0:11:42.837,0:11:45.609
before you determine[br]if it's the right strategy for you.

0:11:45.609,0:11:47.649
And if you have chronic health conditions,

0:11:47.649,0:11:50.735
I want to make sure you discuss it[br]with your healthcare provider.

0:11:50.735,0:11:51.795
Really important.

0:11:51.795,0:11:54.112
And recognize it may take[br]six to eight weeks

0:11:54.112,0:11:57.418
to really see the full benefits[br]of what you're doing.

0:11:57.618,0:12:02.282
The biggest pain point[br]for my female patients is weight gain.

0:12:02.530,0:12:06.165
I have a fantastic strategy[br]to help with this,

0:12:06.165,0:12:10.291
but I don't want you to buy into[br]the next $50 container of protein powder

0:12:10.531,0:12:14.117
or the hottest weight loss[br]supplement that's out there.

0:12:14.341,0:12:19.693
I want you to think about the fact[br]this is a simple, flexible and free option

0:12:19.693,0:12:22.381
that you can try at home,

0:12:22.381,0:12:25.184
discuss with your healthcare[br]provider if necessary.

0:12:25.394,0:12:27.691
I really feel so passionately about this

0:12:27.691,0:12:31.525
because it's something that all of us[br]should be discussing with our patients.

0:12:31.525,0:12:32.843
Thank you.

0:12:32.843,0:12:34.488
(Applause)