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

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was wrong?

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(Laughter)

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

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

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is now outdated,

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like snacking all day long
and eating many meals.

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

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

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as it pertains to health and aging.

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Over the last 20 years,

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as a nurse practitioner
and a functional nutritionist,

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I've seen tremendous shifts,

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tremendous shifts in health and wellness:

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escalating rates of obesity, diabetes
and cardiovascular disease -

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many of which are preventable.

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

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more than most of us realize.

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During my training as a nurse practitioner

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many years ago,

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the dominant nutritional paradigm
was exercise more, eat less.

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I've found this
to be profoundly ineffective

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

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

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

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really focus on the connection
between our lifestyle choices

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and how that impacts healthy aging

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and weight gain.

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

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

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The National Health
and Nutrition Exam Survey,

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which looks at data
with regard to children and adults

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in terms of their nutrition
and escalating obesity rates,

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compares what went on in the 1970s,

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where most Americans
consumed three meals a day

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and no snacks;

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fast forward to today,

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

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and snacking all day long.

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Really.

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And so one of the things
that starts to happen

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when healthcare providers
are telling our patients

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that we need to eat all day long -

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it's wrong.

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

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It overtaxes it so much
that it cannot work properly.

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

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or the nutrients in that food.

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Another really important distinction
when it comes to meal frequency,

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or how frequently we're eating,

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is the debate over sugar burners
versus fat burners.

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And when we're talking about that,

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a sugar burner is someone
that consumes lots of carbohydrates

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and taps into glucose
as their primary fuel source,

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which is incredibly inefficient.

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If you recognize these individuals:

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They are frequently hungry.

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They often get hangry.

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

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

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because insulin levels are high.

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Insulin is that fat-storing hormone.

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

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we have more inflammation;

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and we struggle more with weight gain.

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In sharp contrast to this are fat burners.

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They tap into fat stores for energy;

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they have sustained energy;

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they are much more clear cognitively;

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they don't get hangry;

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it's easier for them to lose weight

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because they tap into those fat stores;

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they sleep better;
and they age more slowly.

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

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Absolutely crucial.

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

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and healthy aging.

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

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and more than half are obese.

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How do we proactively
address this statistic

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without quick fixes?

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It makes me want to cry

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when my female patients
would prefer I write them a prescription

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than work on changing their diet,

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more exercise,

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other lifestyle changes.

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

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Per year. That's average.

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

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women having less lean muscle mass
than their male counterparts,

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sleep disturbances and mood disorders.

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

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So folks, I want you to save your money

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

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I've got a better idea.

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And I'm going to tell you about it.

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I've got a better idea.

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

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but none more powerful
than intermittent fasting.

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Intermittent fasting
can help fuel fat loss

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

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But it also can improve
interpersonal relationships

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and self-esteem.

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And for many women, this permits them -

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

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Really powerful.

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And the really cool thing
about intermittent fasting

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is it's free,

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it's flexible and it's simple.

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You take nothing else away.

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Free. Flexible. Simple.

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So let's talk about intermittent fasting.

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

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You exist either in a fed
or a fasted state.

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

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So when you eat, insulin
is secreted by the pancreas

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to move sugar into the cells.

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

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But when we exceed those storage sites,

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we store it as fat.

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When we're fasted, insulin levels are low

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and we can tap into fat stores for energy.

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Free. Flexible. Simple.

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

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If you skip breakfast -

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If you skip breakfast in the morning,

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

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

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is a 16:8.

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

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I know that seems
a little overwhelming at first,

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

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So, the 20-40 percent
reduction in calories

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means that you can fuel fat loss.

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

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fat loss and especially visceral fat
around our abdomens,

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around our major organs?

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

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We know that it spikes
human growth hormone,

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which helps us with lean muscle mass.

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We know that it induces
something called autophagy -

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I will speak more about this in a second.

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But this is spring cleaning for the cells.

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It is only evoked when we are fasted.

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Autophagy.

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We know that it lowers insulin levels,

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blood pressure,

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improves our cholesterol profile.

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

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

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

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

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I'm going to talk briefly

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about the individuals
that want to avoid this strategy.

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First and foremost,
if you are a brittle diabetic,

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or you have difficult-to-control diabetes;

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

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might not be the best strategy;

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if you are pregnant;

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

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not the best strategy.

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

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whether it is anorexia,
bulimia or binge eating -

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

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

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you're frail

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

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I'm not currently intermittent fasting.

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Now, everyone always asks,

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

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

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They will not break your fast.

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

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

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that are going to be more
advantageous for you to consume

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when you're ready to break your fast.

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So I want you to focus
on real whole foods.

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

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

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

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Healthy fats - so crucial -

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helpful for building healthy hormones

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

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make us happy.

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

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Really, really important.

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

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but now we know better.

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So I want you to focus
on things like avocados,

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

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Unprocessed carbohydrates.

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Ladies, absolutely crucial,

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

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or you're in menopause,

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quality and quantity are crucial.

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

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green leafy vegetables, squash,
quinoa, sweet potatoes

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as opposed to bread and pasta.

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

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

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

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And lastly, keep yourself well hydrated.

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Now, I want to make sure

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that I briefly touch on
some of the practical implications

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for how you would go about
starting intermittent fasting.

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

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

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until they've reached that 16 hour mark.

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Again, you want to keep yourself
really well hydrated.

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You can also have plain coffee or tea.

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

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

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And if you have chronic health conditions,

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

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Really important.

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And recognize it may take
six to eight weeks

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

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

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I have a fantastic strategy
to help with this,

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

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

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

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that you can try at home,

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discuss with your healthcare
provider if necessary.

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I really feel so passionately about this

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

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Thank you.

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(Applause)